Tobias Lindholm on Directing ‘The Good Nurse’ As A Thriller Built On Compassion

Lindholm didn't want to make just another Netflix serial-killer true-life drama. "It's our responsibility as storytellers to find a reason to enter the darkness."

Eddie Redmayne (l) as Charlie Cullen and Jessica Chastain as Amy Loughren in ‘The Good Nurse.’ JoJo Whilden / Netflix

Danish filmmaker Tobias Lindholm has spent most of his career confronting the inner workings (and failings) of social systems. “I’m fascinated with the fact that we, as human beings, seem to build these systems that become so cynical that they turn against us, and that gives us as human beings an extreme responsibility to speak up,” Lindholm told Observer in a recent Zoom interview.

Best known for A War and Another Round, Lindholm’s latest outing is his first English-language feature. Directed by Lindholm and written by Krysty Wilson-Cairns, The Good Nurse—based on Charles Graeber’s book of the same title—tells the horrifying true story of Charles Cullen (played by Eddie Redmayne), a serial killer who confessed to murdering up to 40 patients as a nurse. But unlike the book, Lindholm’s narrative unfolds from the perspective of Amy Loughren (Jessica Chastain), the healthcare worker who was able to bring Cullen to justice. 

“I often find unsung heroes in these stories—people that didn’t do it to gain anything. They just did it to do something right and to show up and show life what they were made of, and I think that those are the stories we can learn from,” Lindholm said of Loughren. “I feel like I feed best not off of my own imagination, but of the reality of the world I’m in, looking at it and finding human traits in these inhumane circumstances.”

Below, Lindholm spoke about the experience of working with Chastain and Redmayne, the ethical responsibilities of telling a true-crime story, the old-fashioned thriller films that inspired the look of the film, and the new 9/11 responders drama that he is currently working on with Jeremy Strong.

[Note: This interview contains spoilers for The Good Nurse.]

At the Toronto Film Festival you said, “The Good Nurse became an unexpected journey into the most crucial human trait: compassion.” How did you all want to go about capturing the humanity and compassion in a genre that you describe as a kind of “hollow darkness”?

Tobias Lindholm: It’s a great question. I’m surprised that it is so revolutionary to actually make a thriller built on compassion. I don’t even know if true crime is a genre, but we are definitely obsessed with it as consumers these years, and I do see it as our responsibility as storytellers to find a reason to enter the darkness instead of just blindly being fascinated by it. The real-life Amy was the reason.

Reading the book, I realized the first 16 chapters maybe are almost just a biography of Charlie’s life, and then the last couple of chapters are about his time at the hospital where he met Amy. I realized that the story we had never seen before was the story of a woman who did what a whole system couldn’t do, and who stopped a serial killer from his cruelty by reminding him of his own humanity. I was like, “Okay, now I have to do this film,” but then also I had to reach out to the real Amy, because it seemed almost too good to be true that she had been leading this lifestyle where she was a nurse caring for other people, and yet she wasn’t allowed the care that she needed herself. She really needed a friend, and he offered that friendship, and then it turned out that he was a serial killer, and now she had to stop him. It almost felt like too perfect of a story structured out of real life that I definitely needed to confirm that it actually was true.

Director Tobias Lindholm Kenneth Pihl Nissen

In the hands of another filmmaker, The Good Nurse could have turned into a lurid tale about a serial killer who was able to skirt a broken system, as well as the nurse who was able to bring him to justice. How did you want to go about telling this story responsibly and in a way that honors Amy and the families of the victims?

I’m not fascinated with Charlie. I’ve seen Silence of the Lambs, and it feels like those things have been done. I don’t see Charlie that way. I see him as a product of a system that was broken, and I think that that’s much more interesting too, because we can’t really change individuals like Charlie. I don’t think that’s possible, but what we can do is change how our systems seem to protect themselves. So that is the whole reason to tell this story, right? It was definitely not his cruelty, but it was much more the inhumanity of the system and the humanity of Amy that were the main ingredients for me in building this film.

Have you heard from any of the victims’ families?

We haven’t heard directly from anybody. I suspect that Charles Graeber, who wrote the book, has been sharing knowledge with his sources. Deliberately, we have changed all names and all events in a way, so it’s built on the logic of what happened, but we do not mention or portray any real events that way. The only thing we do portray is how the system allowed this to keep on going and how they protected themselves; the rest is inspired by [real cases] and we never go into details on each individual case, what he actually did.

Now, Amy, Charlie and [detectives] Braun (Noah Emmerich) and Baldwin (Nnamdi Asomugha) are mentioned by name. The rest is all fictionalized, because I never wanted to point out an individual person responsible in these systems. I think that it’s much more a view of the system, not the individuals living in there [who are] also being caught in them, so hopefully nobody will recognize their own trauma. But hopefully, they really recognize the humanity of Amy and the responsibility that the system didn’t carry.

This film was shot in a very naturalistic and almost sterile way, with a lot of the action taking place at night in a hospital. How did you design the look of this film?

The whole logic of the film is that there’s something going on in the darkness that we don’t know of, so the nights in the ICU where they dimmed down the lights were kind of perfect. We didn’t want to make it bright just to entertain, and the color palette is given from hospitals around. We’ve all been to hospitals, so we kind of know, so I didn’t feel comfortable changing anything. Had we had the opportunity, I would have loved to shoot it in a real ICU. We shot during the pandemic, so clearly, there was a better use of hospitals at the time, which was the reason that we built our own.

I’m extremely inspired by and on the shoulders of some of the brilliant thrillers of the ‘70s, and I think that you are able to see [films such as] All the President’s Men in the way we shot it, in the way we work with not overdoing colors. In the location of the diner scene where [Amy] tries to get [Charlie] to confess, if you look at the lamp over the tables, you will find a lamp looking exactly the same as the one in the living room with Jane Fonda in Klute. And that’s the reason why we picked that location.

I’ve always shot my films with a handheld camera, and the logic of a handheld camera is that you give the illusion that things are happening while we’re filming, so [it’s like] we don’t really know and we come unprepared. And in this case, it was based on a true story, which meant that everybody would know that it wasn’t happening in front of us, that it wasn’t a documentary. So instead, we decided to treat the frame as the system. We made the frame a window into a world that already existed, and then we would treat the frame as the system itself so that we would use a lot of lines in the background, from door openings and shelves and tables.

We would shoot the first half, where Amy didn’t know that Charlie was the killer, and that would be a little more observant and not as close-up, and as soon as she knew, after the meeting where she’s realizing, “Oh, he’s done this before”—there’s a change. And then suddenly we started to move in in these small, brooding close-ups, where we move closer into the character and suddenly force the audience to lose their breath in the observation of Charlie. In the diner scene where she tries to get him to confess, you see that we’ve almost just separated Charlie’s face in a square and the rest is just black, and that’s just pushing him into as small a space as possible. He moves out of it when he’s confronted, and then moves back in and his eyes have changed, so that was the idea of making the frame represent the system where these human beings live.

Noah Emmerich as Tim Braun, Nnamdi Asomugha as Danny Baldwin, and Jessica Chastain as Amy Loughren (from left) in ‘The Good Nurse.’ JoJo Whilden / Netflix

I would like you to break down two scenes towards the end of the film: Amy confronting Charlie at the diner, and Amy using her empathy to break Charlie down. What did you guys want to convey in those quiet moments between the characters where they’re attempting to outsmart each other?

In the first one, Amy needs to confront Charlie to stop him. She, at this point, has forgotten his humanity, and she’s there as a secret agent. She’s speaking into a microphone to somebody who’s not there, so she’s not really present. She is not Charlie’s friend waiting for him—and he feels that right away. When he comes in, she stands up and she hugs him, but she kind of pats him on the back, like you do when you don’t really want to hug somebody and you want to get it over with.

In the rehearsal, it was interesting, they did have different points of view for that scene, and they wanted to try to solve that by a conversation, and I said, “Listen, guys, it’s not a democracy. You don’t have to agree. Just come in and bring the truth for your character, and I’m pretty sure it’ll work out.” The task was to just go in and listen to what the other person was saying and respond truthfully to that, and nobody in the world does that better than Eddie and Jessica. They both come from theater, they have tremendous respect for each other, and we luckily were able, with the way we built the production, to give a lot of time for those scenes, so we could actually keep going, keep searching for the truth. We had so much time that I allowed Eddie to drive into that scene every time, even though we were just doing his close-up. We would never see him drive in and walk all the way, but he kind of felt he needed it to get into the right space, so we did.

The scene where Amy tells Charlie about her secret behind the curtain when she is having a heart attack, and he is breathing with her, calming her down, putting a sweater over her shoulders, becoming her friend and promising her to help her through this. The mirror scene of that is the final scene when she gets into the interrogation room and offers him her sweater, comforts him, sits down, offers him friendship, reminds him of the possibility of confessing, reminds him of his own humanity, and then finally gets him to reveal his secret.

And as he does that, Eddie made a decision to breathe exactly like he did in the scene behind the curtain, so he would go [lets out a big exhale] because it felt for him to get it off his chest. And as much as I would love to take credit for this as a director, I have to admit that working with these two artists made my job pretty easy on those days. I was drinking a lot of coffee by the monitor and not trying to get it that way, because they were clearly on the right path.

Last November, it was announced that you were going to write, direct and executive produce The Best of Us, with Jeremy Strong attached to star and executive produce as well. What can you tell me about the status of that show?

I’m writing The Best of Us now, as we speak, and I’m talking a lot to Jeremy. He’s shooting Succession now, and I don’t think we will start to shoot within another year at least, so I’m still in the building of the whole thing.

The Best of Us is gonna be what you could call an American Chernobyl story. It’s about all the people who got sick from the toxic dust that was spread over the city of New York after 9/11. There was more than 400 tons of asbestos inside the towers as they fell, and now, more than 20 years later, people are still getting sick but not necessarily getting the help that they need. So it’s a celebration of all the best of us—all the people that actually did [make] a difference, went to the pile, started to clean up and now are being left behind. It will be a celebration of the bravery and strength of the city of New York, and it will be yet another confrontation of a system that doesn’t necessarily work.

This interview has been edited and condensed for length and clarity.

The Good Nurse is now playing in select theaters and begins streaming on Netflix starting October 26. Tobias Lindholm on Directing ‘The Good Nurse’ As A Thriller Built On Compassion