The acclaimed Geraldine Winters directs this terrifying horror movie with stunning imagination and refreshing creativity. Working from her own original screenplay, Winters fills her film with plenty of thrills and electrifying jolts of fear. A homicidal clown, Patient X, and a mental hospital are much more than the clichés they may first seem. These elements are energized here and given a new twist. The atmosphere is incredibly dark and frightening, the set design breathtaking, and the imagery extraordinarily haunting. At times the story becomes overwhelming in its intensity and unrelenting in its horror, almost more than one can endure. However, the violence and graphic slaughter never becomes gratuitous and always serves to advance the plot. The cast delivers some superb performances, with Thomas Daniel a particular standout. Overall, there is no denying that this is one of the better horror films to come to theaters in the last decade.