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A surgeon with no respect for his fellow physicians, much less the whiny patients under his care, Helmer faces two serious interrelated problems: His touchy-feely boss has instituted a policy called "Operation Morning Air," which is designed to improve transparency and communication in the hospital. (The campaign is promoted by stickers of the sun giving the "thumbs-up" sign.) This is bad news for a guy who prefers to dictate from his ivory tower, but it gets worse when Helmer is faced with a malpractice suit over a botched operation that left a young girl in a vegetative state. Taken out of context, the Helmer subplot could fit into any ER/House/St. Elsewhere hospital show, where in-house politics, doctor-patient relationships, and personal melodrama is par for the course.

But the context in The Kingdom is seriously nutso. Consider the following developments: a medical student who expresses his love for an older nurse by sending her the head of a cadaver that resembles him; a professor whose crazed ambition leads him to order an operation to replace his own healthy liver with a diseased liver that might advance his research; a bizarre Masons-like club of hospital power-brokers that holds secret bacchanals; a phantom ambulance that pulls up to the emergency-room doors every night, then disappears; and a pair of dishwashers with Down Syndrome who act as a kind of all-knowing Greek chorus. Central to the madness is the show's lone unambiguous hero, the elderly Mrs. Drusse (Kirsten Rolffes), who keeps checking herself into the hospital under made-up symptoms in order to crack an old mystery. It seems that a little girl who died in 1919 is still wandering the halls, and it's up to Mrs. Drusse to figure out how to bring peace to this restless soul. But in doing so, she risks prying open the doors to supernatural mayhem.

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As might be expected from a miniseries intended to run more than 13 hours, The Kingdom has to plant a lot of seeds at the beginning in order to reap a harvest of cascading subplots later on. And while it's certainly off-kilter from frame one, the first few hours are like a mock soap opera, albeit one with occasional shocks and a wicked strain of dark humor. Always one to be skeptical of institutions and the compromised men who run them, von Trier attacks the monumental elitism of doctors like Helmer who look down on patients and scoff at their basic human need for warmth and spiritual connection. To von Trier, science can be a bloodless pursuit that tramples on ethics and discounts the possibility of transcendence. At the same time, he's equally skeptical of naïve measures like "Operation Morning Air," which vow transparency even as the hospital's top doctors are actively covering up ethical lapses and gross malpractice. (Shades of Dogville and Manderlay, which are all about the horrible perversion of well-meaning, idealistic systems.)

All the patient build-up of the first three-quarters of The Kingdom leads to a magnificently twisted payoff in the finale, which amps up the horror and the farce until the two giddily collide. The action reaches fever pitch when "Operation Morning Air" prompts a visit from Danish health officials, who manage to stumble onto virtually every dirty little secret the hospital is harboring within its walls. I'm reminded of those episodes of Buffy The Vampire Slayer where a newbie comes into Buffy's inner circle, and she and the gang have to explain why, for example, the Slayer is dating a vampire, or why they're protecting a werewolf. What's totally explicable in the context of the show looks utterly insane to outsiders, and that's where the comedy comes in. Witness this great scene late in The Kingdom, where the inspectors come across Mrs. Drusse and friends mid-ritual:

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I won't spoil all the surprises of The Kingdom here, except to warn faint-hearted newcomers that they'll experience Udo Kier as they've never seen him before. As much as I admire von Trier's uptick in ambition over the last decade, it's a shame that his strict Dogme aesthetic has steered him away from zany genre indulgences like this one, which play to his considerable talent for rambunctious entertainment. (Perhaps his next effort, a cabin-in-the-woods horror film called Antichrist, will bring him back.) Before he was hamstrung by his own manifesto, von Trier had an arsenal of cinematic tricks at his disposal (see also: Zentropa) and he wasn't shy about using them. With The Kingdom, he gave his inner prankster full run of the asylum.

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Next week: American Movie: The Making Of Northwestern

Sept. 11: Hiatus (Toronto Film Festival)

Sept. 18: Fight Club

Sept. 25: Songs From The Second Floor