‘Little Woods’ Is a Devastating Modern Western Set Against Our Broken Health Care System

“Your choices are as good as your options are.”

These words, spoken by Ollie (Tessa Thompson) to her sister Deb (Lily James) in the kitchen of their late mother’s soon-to-be-foreclosed house in the far northern reaches of North Dakota, come about halfway through Little Woods. But they hang over every frame of filmmaker Nia DaCosta’s remarkable writing and directing debut, which premiered last year at the Tribeca Film Festival. 

For starters, this lack of options serves as the narrative driver of the film. Ollie, who is already on probation after getting busted for bringing back meds from Canada to help both her dying mother and the downtrodden men battered by the state’s booming fracking industry, is forced to get back into drug dealing to help her estranged sister and save the house. 

Meanwhile, Deb, who lives with her son in an illegally parked trailer, becomes pregnant by her alcoholic and abusive boyfriend (a mangy James Badge Dale). It’s a situation she cannot afford emotionally or literally: giving birth will cost her $8,000 ($12,000 if it’s a Caesarean) and Deb, a waitress at the town’s overpriced diner, doesn’t have health insurance.  

The paucity of choices—the nearest abortion clinic, and the only one in the state, is more than 300 miles away in Fargo—give Little Woods an urgency and a fiery political purpose uncommon in contemporary American narrative film. 

This is not simply one of the finest films to explore the unique challenges that beset women in rural parts of the country where men outnumber them two-to-one. It is also one of the only to illustrate the devastating social impact of the war against women and their reproductive rights that has been waged by statehouses across the nation. In the process, it depicts a health care system so badly broken that the only person effectively attending to the town’s sick and injured is the local drug smuggler.

But DaCosta is not here to make an argument, rather to tell a story. It’s a uniquely cinematic one at that, effectively blending elements of thriller, family drama, noir and western. It is not hard to see why Jordan Peele plucked DaCosta to direct the update of 1992’s politically-informed slasher film Candyman, which he is writing and producing and is due out next year. Both in her overall structure of the film and the way she builds individual scenes, the Brooklyn-born DaCosta manufactures tension and dread in ways that are simultaneously subtle and intense. A sequence where Deb tries to secure a fake Canadian health card from two men operating out of a secluded home by a roadhouse is both absolutely terrifying and utterly recognizable to anyone who has ever been forced to procure something on the black market.

As dire as their situation might be, Ollie and Deb are not as alone as they seem. A veritable underground railroad of women aid the sisters in their plight; these include a corporate recruiter, a bank manager, a stripper, a motel owner and a health care worker. The film shows how these largely invisible and ad hoc networks end up pushing back against the entrenched systems that seem designed to strip under-resourced women of their agency.

In this way, Little Woods shows Ollie and Deb as a kind of contemporary Butch and Sundance, battling against overwhelming enemies in a punishing Western landscape. And like any classic cinematic pair, the manner in which the two lead actors play off of each other is remarkable to behold.  

As they slowly restore their love for each other, we see them start to build each other up—Ollie repeatedly reminds Deb she is brave while Deb keeps telling Ollie that she’s good—to the point where the characters get stronger as their situation becomes increasingly untenable. As bad a hand as they have been dealt, due to the way that they are played by Thompson and James and written by DaCosta, no one will be calling these sisters victims.  

With its uncompromising commitment to showing the reality for women like Ollie and Deb, as well as its steady and deliberate pace, Little Woods can at times be difficult to handle. The characters in this movie aren’t having much fun; like affordable health care and consistent work, it’s not really an option for them. But those willing to endure the film’s discomforts will come away having witnessed as powerful and essential a depiction of familial love as they are likely to see this year.