Skinny as a whippet and fierce as a snapping turtle, Matthew McConaughey brings a jolt of unpredictable energy to "Dallas Buyers Club," an affecting if conventional real-life story of medical activism. The film, directed by Jean-Marc Vallie from a script by Craig Borten and Melisa Wallack, tells the story of Ron Woodroof, a Texas electrician and rodeo rider who, after receiving a diagnosis of HIV in 1985, took his treatment into his own hands and helped others with the disease obtain medication not legally available in the United States at the time.

When we first meet Ron, he is enjoying the company of two women and preparing to mount an enraged bull. Flamboyantly heterosexual and crudely homophobic, he runs on cigarettes, liquor and arrogance, with an occasional dose of speed or coke to boost his confidence. He is a proud good old boy, but not an especially nice person. In time, of course, his rougher edges will be smoothed away by suffering and compassion, though he will never entirely lose his wild, profane lust for life. He is redeemed, but not fully sanctified.

‘DALLAS BUYERS CLUB’ Rated: R Opens today at Kahala 8

Along the way, Ron tangles with a medical establishment partly blinded by its self-interest. Never an easy patient — he has a habit of unhooking IV drips and bolting from hospital beds — he becomes a thorn in the side of doctors at the hospital where his condition is first diagnosed. He flouts the rules of an experimental drug trial, buys stolen AZT from an orderly, and does a lot of angry shouting at Dr. Eve Saks (Jennifer Garner) and her boss (Denis O’Hare).

Eventually, Saks will become an ally, as she and Ron — he instinctively, she by more careful scientific means — conclude that high doses of AZT are likely to do more harm than good in fighting HIV. Ron, meanwhile, has found his way to Mexico, where a renegade American doctor (Griffin Dunne) convinces him that a combination of drugs and dietary supplements can help the immune system and stabilize the T-cells. Soon he is smuggling pills across the border, at one point disguised as a cancer-stricken priest. Back home, he circumvents the rules against selling unapproved medicines by starting the subscription service that gives the movie its name. Patrons pay a monthly fee and receive regular orders of Ron’s contraband.

The lines that stretch outside the door of the club’s headquarters — a few rooms in a shabby motel — suggest the extent of the AIDS epidemic, and other details in the film remind viewers of the often poisonous social climate of the times. Ron’s friends shun him, showering him with the same slurs he had been in the habit of using. The government (embodied by a doughy Food and Drug Administration bureaucrat) is more concerned with procedure than compassion. Doctors and pharmaceutical companies chase glory and profits at the expense of patients.

What is largely missing, though, is the sense that Ron’s efforts are part of a larger movement. The problem is not that "Dallas Buyers Club" focuses on a straight hero acting mainly on behalf of gay men. Ron’s bravery and determination are entirely credible, thanks to McConaughey’s disciplined, high-spirited performance and the film­makers’ interest in the complexity of the character. But his actions unfold in something of a vacuum. There is little sense of the militancy and passion chronicled, for example, in David France’s documentary, "How to Survive a Plague," which brilliantly illuminated how the response to AIDS — as a political as well as a medical emergency — helped to transform gay life in America.

Instead, "Dallas Buyers Club" presents the fable of a homophobe’s awakening, with supporting roles given to Garner’s kind doctor and to Rayon (Jared Leto), a troubled transgender person who becomes Ron’s business partner. Leto is always a subtle and intriguing actor, but Rayon essentially revives the ancient stereotype of the tragic, self-destructive queen, suffering operatically and depending, at last, on the kindness of strangers.

Rayon is meant, I suspect, to inject both a dash of camp and a surge of pathos into the movie, but the character helps instead to confine it to the realm of simple and sentimental melodrama. There is warmth and intelligence here, and undeniable sincerity, but also a determination, in the face of much painful and fascinating history, to play it safe.

———

Review by A.O. Scott, New York Times

© 2013 The New York Times Company