Steven Soderbergh’s best thriller you’ve probably never heard of is streaming now on Netflix

A depressed woman cycles through a series of medications that only seem to make her sick while failing to improve her mental health. Her somewhat arrogant doctor assures her the medicine will eventually help as he prescribes more pills to counteract the adverse effects of the previous pills. Her imposing husband, a former high-powered finance executive recently released from prison for securities fraud, is impatient for her to get better so they can resume their previous life. This is a story about a woman at the mercy of a system designed to minimize and silence her, right?

Well, not exactly. Steven Soderbergh’s 2013 film Side Effects does an excellent job of convincing the viewer it’s telling one kind of story — before revealing that it’s been telling a completely different kind of story all along. Soderbergh and screenwriter Scott Z. Burns (who previously collaborated on 2009’s The Informant! and 2011’s Contagion) never minimize the real dangers of big pharma or the insidiousness of institutional sexism. Those societal factors are what enable the characters to pull off such a daring conspiracy, playing on the inherent self-interest of everyone around them.

There’s no reason for people to think that Emily Taylor (Rooney Mara) is anything other than a victim, even after she commits a horrible crime under what she says is the influence of a new psychiatric pill called Ablixa. She’s spent the last four years waiting for her husband Martin (Channing Tatum) to be released from prison while working at a New York City ad agency so she can keep the couple’s finances afloat. Shortly after Martin returns home, Emily drives her car head-on into a parking garage’s concrete wall, suffering only minor injuries but ending up in the care of psychiatrist Dr. Jonathan Banks (Jude Law).

Dr. Banks prescribes a series of medications that don’t seem to help Emily, while she remains in constant low-level distress, breaking down at public events and reaching out to him for help during his personal time. Emily’s previous psychiatrist, Dr. Victoria Siebert (Catherina Zeta-Jones), offers minimal support, although she does steer Dr. Banks in the direction of Ablixa. For a little over half an hour, Side Effects is a movie about a woman having a slow-motion breakdown, surrounded by men who are incapable of helping her.

Then, things change dramatically. Emily does something violent and horrific, and Soderbergh’s camera hones in on her bottle of pills, making it clear where blame will be assigned. The picture fades to black, and when it comes back up, Side Effects is a whole new movie.

Except it’s really not. Soderbergh and Burns have been planting clues all along about what’s actually going on in Emily’s deliberate performative acts for the people around her. Dr. Banks gets drawn in, and mounts a passionate courtroom defense for Emily, who claims to have no memory of the crime she supposedly committed. He argues that, due to Ablixa, Emily had no awareness of her actions and can’t be held accountable for them. She agrees to a so-called NGRI (not guilty by reason of insanity) plea and avoids prison time.

The potential end of Emily’s ordeal is just the beginning for Dr. Banks, who’s hounded by the press, interrogated by professional organizations, and ostracized by his colleagues. Even his wife (Vinessa Shaw) isn’t willing to give him the benefit of the doubt, especially once he starts digging deeper into Emily’s case, challenging the assumptions that he and everyone else made about her situation.

As a seemingly meek victim of powerful men, Emily fits alongside Gone Girl protagonist Amy Dunne, and Side Effects was released in the time between Gillian Flynn’s novel and its screen adaptation by David Fincher. Most of the movie unfolds from Dr. Banks’ perspective, and it’s easy to root for his vindication, even if he’s a bit overconfident and insensitive at times.

But the female characters who engage in blatantly illegal, destructive acts are not just one-dimensional villains, either. Society has placed them in a position where crime is an attractive option, a way for them to seize power from men who ignore and belittle them. They’re bad, but Soderbergh and Burns never forget that they’re people, too.

Law and Mara capture all of those character nuances without the filmmakers having to blatantly spell everything out. Even a late-film flashback sequence that explains what really happened is more impressionistic than expository, and Soderbergh never belabors any of the key plot details. Side Effects is preposterous but also elegantly constructed, the kind of efficient small-scale thriller that Soderbergh has excelled at making in the later part of his career, in movies like Haywire, Unsane, and this year’s Kimi. Every plot twist and tonal swerve is purposeful and methodical, and unlike his characters, Soderbergh is in full command the entire time.

Side Effects is now streaming on Netflix.