Waking up during major surgery would be horrible. Waking up during surgery and being forced to watch Awake would be truly ghastly. To be precise, you wouldn't suddenly wake up. According to this preposterous thriller, patients that experience "Anesthesia Awareness" never actually go out. They appear to be under yet know what's happening and can feel pain. They are paralyzed -- unable to move or communicate and thus bring an end to their physical and psychological ordeal.

The scenario, which sounds like something Edgar Allan Poe or Stephen King might have dreamed up, is the brainchild of Joby Harold, an unknown British writer-director making his debut. Any doctor who advised him should probably have their license yanked, and hence lose the opportunity to harm people in medical settings (if not inside the Cineplex) ever again.

Nevertheless, despite all its improbabilities, Awake does work on a certain level. Combining medical malpractice, a forbidden romance, and a creepily possessive mother, the film startles with its slick disregard for verisimilitude and diverts with its attractive cast.

Few approach a thriller like this with an eye toward plausibility anyway, and going with the story does have its rewards. First off, there's no chance you'll fall asleep. Second, it will teach you to plan ahead. Next year at this time, when all the quality movies that opened over Thanksgiving are sold out, you won't let yourself succumb to the only new wide release, one that hasn't been screened in advance for critics.

Hayden Christensen plays Clay Beresford, a boyish New York billionaire who has hit an unpleasant trifecta. He has a weak heart and needs a transplant. He can't emerge from the shadow of his late father, a well-respected financier and founder of the family firm Clay now runs. And his mother Lilith (Lena Olin) -- with whom he has an icky, possibly incestuous bond -- doesn't know he's been secretly engaged to her personal secretary Sam (Jessica Alba) for months.

On the plus side, Clay has a knack for business and has become fast friends with the heart surgeon Dr. Jack Harper (Terrence Howard) who will perform the transplant as soon as a suitable organ, matching his rare blood type, becomes available. One does, on the very same night Clay decides to tell his mother about his relationship with Sam and after the lovebirds get hitched in an impromptu ceremony.

At the hospital, Lilith begs Clay to let a top surgeon in the field (Arliss Howard) perform the procedure. But Clay trusts his fishing buddy Jack. Unfortunately, thanks to a drunken anesthesiologist (Christopher McDonald), he finds himself "awake" on the table.

Those squeamish about watching a rib cage cut open or the live heart beating inside, let alone the idea of it being removed from a person who can feel it, will find the operating room sequences excruciating. Clay tries to focus on his love for the voluptuous Sam. Not even the image of Alba in her underwear is distracting enough however. As for what follows, to reveal even a snippet would spoil the fun. The twists are significant; and though they bear little relation to reality, they're not completely devoid of noble behavior.

Awake is taut and effective enough that Joby Harold will likely get another crack at making a movie. Here's hoping he stays out of the chest cavities of gullible protagonists like Clay and the oedipal boudoirs of cougar mommas like Lilith.

(Released by The Weinstein Company and rated "R" for language, an intense disturbing situation, and brief drug use.)