Rachel Weisz stars in Prime Video reboot

From an obstetric standpoint, twins aren’t really mysterious. An egg splits after fertilization, or multiple fertilized eggs implant successfully. Fertility treatments have even made multiple births more common. In art, though, from Shakespeare to The Silent Twins, identical twins are weird and magical, handy metaphors for split selves, our better angel and inner demon. David Cronenberg blurred that neat dichotomy to chilling effect in Dead Ringers (1988), in which mirrored yet emotionally divergent gynecologists descend into a drug-fueled existential crisis. Prime Video’s female-centered riff on the movie (which premieres April 21) keeps the madness, gore, and eerie scarlet scrubs, but pumps it full of hormones.

If you’re not automatically opposed to TV reboots (a Fatal Attraction series, really?), the best way to enjoy Dead Ringers is to put the film out of mind. Cronenberg’s flesh melancholy is there, filtered through multiple female perspectives and doled out (a bit leisurely) in six hours of elegant yet stomach-clenching narrative. (Alien gynecological instruments didn’t make the cut.) Flipping the body-horror scenario, we no longer have a bifurcated Jeremy Irons trying to revenge himself on female reproductive organs. It’s now a silken, ferocious Rachel Weisz as two damaged doctors chasing wholeness in a field that treats pregnancy like a disease and babies like fetishized commodities.

Beverly and Elliot Mantle are OB-GYN stars at New York’s fictional Westcott Memorial Hospital. Beverly is the tactful, sensitive one, desperate for a baby after numerous miscarriages. Her hair’s pulled back and parted in the middle. Elliot is the cruel, hedonistic one, hungry for sex, food, control. Hair down, parted on the side. The coifs are useful visual shorthand, but Weisz also does a masterful job shifting between the two, from a softer and kinder look in Beverly’s eyes to the hard, manic glee in Elliot’s. Beverly has a good bedside manner, while Elliot likes to noodle in the lab with jokey dude researcher Tom (Michael Chernus), seeing how long she can gestate an embryo outside a womb.

After a long day of traumatic births and managing terrified mothers, apathetic surrogates, and clueless partners, Elliot gives Bev an injection (hormones?), snorts a line of crushed oxy, and hits the nightclub for quick bathroom intercourse. Sex, drugs, and transvaginal probes: all within the first 10 minutes of episode one.

Created by Alice Birth (Normal People) running an all-women writers’ room, Dead Ringers is chic, potty-mouthed, and unafraid to wallow in bodily fluids. There will be afterbirth. Babies are yanked out of dilated vaginas, bulging bellies sliced open, white operating-room sneakers soaked in blood. Early on, after a pee, Beverly reaches into the toilet and fishes out an embryo that dropped from her, a bloody string of gelatinous DNA quivering in the palm of her hand. She strokes it with a finger and murmurs, “Hello.”

The spine of the season is built around Beverly’s quest to have it all: a baby, true love, and a revolutionary birthing clinic in the sisters’ name. The latter institution is funded by Rebecca and Susan Parker (Jennifer Ehle, Emily Meade), a super-wealthy couple interested in pushing the limits of science and bespoke reproductive services. For profit, naturally. Ehle is wicked fun, gazing through giant hexagonal eyeglasses, a reptilian alpha lesbian who salts her barbs with copious f-bombs. “You don’t tell me fuck off then fuck off yourself, sit the fuck back down,” she purrs at a bumpy business dinner. The line may look overdone, but Ehle delivers it with cool indignation. “Is capitalism very bad?” Elliot taunts Beverly, who is reluctant to jump into bed with a family clearly modeled after the Sacklers and responsible for a nationwide opioid crisis.

Beverly is the sympathetic, relatable one at first. But Elliot is a lark, sowing chaos with her cynicism and lust for sensation. Hoovering up yet more cocaine, she raves about the future of their field. “You want to stop menopause, you want men to lactate, you want female sperm? You want me to grow you a baby out of nothing? You want me to tighten your vagina whilst I pull a baby out of your belly button? Fine. Bring it on, let’s do the research!”

As for Beverly’s love life, that comes in the form of Genevieve (Britne Oldford), the beautiful star of a TV show who comes to the Mantles to have her fallopian status checked. The deeper in love Beverly falls with a wary Genevieve, the more alarmed and out of control Elliot grows. “It’s not fair to keep her all to yourself,” complains Elliot, chowing down on a sandwich. “You haven’t had her unless I’ve had her.” This symbiotic bond between the twins is both their superpower and their kryptonite.

Not all the side plots are as engaging or narratively satisfying as the agonized struggle between the sisters. Poppy Liu lurks on the periphery as Greta, the Mantles’ domestic assistant and factotum: cooking, cleaning, but also engaging in an obscure witchy side hustle. When the sisters are away courting Parker money, Greta collects a used tampon from the trash and pubic hair from panties in the hamper. By the end, though, Greta’s secret agenda turns out to be surprisingly tame and tangential to the main story. Another episode’s flashbacks to the Mantle sisters’ childhood sheds little light on their dysfunctional relationship, except to note they had a highly ambivalent mother.

Directed with exacting Kubrickian cool by Sean Durkin, Karyn Kusama, and others, the visual compositions abound in mirrors, reflections, and symmetrical framing of bodies and architecture. The dominant and obsessive palette is red. Cinematographer Jody Lee Lipes (on the first two episodes) includes washes and panels of red in a high proportion of shots, from pulsing hot lights in a nightclub to rectangular scarlet light panels in the sisters’ kitchen. Once you notice red-and-mirror vocabulary, it’s everywhere. The Mantle Birthing Center looks like the Guggenheim Museum decked out as the space station lobby from 2001: A Space Odyssey.

For all the lush production values, smart, cutting dialogue, and Weisz’s monstrously fine performance, Dead Ringers still feels a bit much. Do we need six episodes? Must they be a solid hour each? Weisz works herself to the bone and uses every tool in her kit, but there’s just so much manic, destructive Elliot and anguished, weepy Beverly one can take. Each episode could drop ten minutes—especially with subplots and supporting characters this sketchy.

Still, there’s enough craft and tension to hang on for the gruesome finale of this limited series. Will Beverly free herself from her evil twin? Will she carry the baby to term? Was Elliot the victim all along? Cronenberg’s movie ended, unforgettably, with one twin vivisecting the other before dying of a drug overdose. Birch and Weisz find a different path out of the Mantle maze, but it certainly isn’t family viewing.

Dead Ringers premieres April 21 on Prime Video.