Gary Oldman fan or not, the movie grabs you with its graphic portrayal of the horrors of such medieval institutions. The abuses were in no way exaggerated-- they were commonplace in that time, and if some viewers think Oldman's character was too intense, I say he was shaped that way, forced by an untenable situation to struggle to save himself and his fellow patients any way he could. The only part I found unrealistic was at the end when he was assured that things were about to change immediately and drastically after only a few questions from the investigating committee, especially while he was heavily medicated and not entirely cognizant of his surroundings. It couldn't be that easy, otherwise I'd have given it a 10. Think Cuckoo's Nest, minus the comedy, meets Deliverance. It gave me shivers.