“Well if it’s that simple, why don’t you put out an APB for someone riding a broom and wearing a tall black hat?” — Dana Scully

20th Century Fox via Chrisnu
The X-Files goes Nip/Tuck before there was a Nip/Tuck by mixing up plastic surgery and witchcraft all at once.
Radhika: The X-Files often used established writers to pen its episodes, but it was also a show that occasionally relied on a spec script, which allowed less experienced writers to write for programs they may not have been part of otherwise. In some cases, this worked out really well — Vince Gilligan, now a force to be reckoned with in the industry, wrote “Soft Light” back in season two as a spec project. His effort went on to land him a solid future on The X-Files, where he went on to write more episodes, while also serving as a co-executive producer on even more.
But that was the story of Vince Gilligan and “Soft Light.” I would say that “Sanguinarium” never quite showed that level of promise. And the writers, sisters Valerie and Vivian Mayhew, who did go on to do some more work in television at least until 2001 or so, never really went on to build the reputation that Gilligan did for himself.
“Sanguinarium” isn’t “The Field Where I Died” awful, but it’s not great either. It kind of starts out promising and has a dark enough tone to still feel a bit classic X-Files, despite the fact that something also feels a bit off. But that’s just it: Something still manages to feel off.
The episode starts with a doctor performing what seems to be a routine liposuction, before it goes horribly wrong (of course), resulting in the patient’s death. As Mulder and Scully investigate and find pentagrams on the floor of the operating theater, Mulder decides witchcraft is the culprit.
After another doctor kills a patient under similarly bizarre and gory circumstances, it seems medication could have influenced their actions. The agents eventually learn that a similar series of deaths had occurred at the hospital ten years earlier. They suspect a nurse, Rebecca Waite, who is the only person who has been at all the deaths. But Waite soon goes on to suffer a bizarre death by vomiting up pins after trying to attack one of the doctors, a certain Jack Franklin.
Mulder manages to figure out that all the victims who have died had birthdates that matched with dates of the Witches’ Sabbath. And thanks to a computer program that allows you to play with one’s appearance, he figures out Franklin is actually a Dr. Richard Cox, a doctor who was thought to have died during the first batch of murders. By the end of the episode, Cox literally peels his face off, takes on a new appearance and ends up applying to another hospital for a job.

20th Century Fox via Chrisnu
There’s just a lot of heavy-handedness, combined with some genuine plot holes to create an X-File in this episode. It’s a little entertaining and shocking, while being rather gory between faces melting off and faces being peeled off (I still shuddered watching that one), but it’s not particularly cohesive. Gratuitous gore without a solid plot do not a good episode make. And the ending is kind of weird — the climactic scenes before the final reveal just seem to end abruptly, and then that’s it. “Sanguinarium” is just one of those episodes that involves a lot of weird choices, and while far from being the worst episode, it’s not one for the ages either.
Max: Almost ten years ago, when I was rewatching the series with my friend/roommate Kenji (who I interviewed about his fandom last year) I recall my general reaction to this episode being a wonderfully gory excursion that was atypical for a show that preferred to terrify its viewers by letting them imagine horrors not shown on the television screen. Here, the spec script by the Mayhews puts everything on the table and then some.
While I don’t outright dismiss the episode today as a clunker, it seems to me that the best course of action that should’ve been taken was to play with the allegory more than the episode itself did. Radhika playfully compared this episode to the FX show Nip/Tuck, but by comparison Nip/Tuck got a lot more mileage out of the many thematic facets that one could explore about the booming practice of plastic surgery. Hell, they even had Joan Rivers come on a lament all the times she went under the knife to recapture something (her youth) that was gone forever.
In “Sanguinarium,” the more compelling material does get drowned out in a din of blood, guts, and screams. Predating the maligned “torture porn” genre by almost a decade, this entry in The X-Files has more in common with Saw and Hostel than our heroes poking around dimly lit environs with flashlights. If the writers wanted to show the lengths to which Dr. Cox has gone to be forever young, then I understand their intention. But, as the great Alfred Hitchcock once said, “There is no terror in the bang, only in the anticipation of it.”

20th Century Fox via Chrisnu
The best MOTW episodes are those that intimately involve Mulder and Scully in the case and reflect some part of either agent’s psychology, mindset, or worldview. When your lead actors get reduced to bit players playing off the more prominent guest stars, you know that there is a bit of a problem here. You do not want Mulder and Scully to go through the motions. The audience is enthralled when our agents are engaged and digging for answers, and “Sanguinarium” shows them constantly behind the curve. This episode had all the ingredients, but it ends up like a botched nose job.
YES, IT’S THOSE GUYS
O-Lan Jones – While she doesn’t seem to have done extensive front-of-the-camera work in recent years, O-Lan Jones may be pretty recognizable to most viewers as Esmeralda in Edward Scissorhands. Her other credits include guest work on Seinfeld, as well as roles in Natural Born Killers and The Truman Show.
Richard Beymer – Appearing as the insidious Dr. Franklin in this episode, Richard Beymer has had a lengthy career, playing everyone from Tony in West Side Story to Benjamin Horne in Twin Peaks.
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