According to one medical dictionary, anesthesia awareness "is a situation that occurs when a patient under general anesthesia becomes aware of some or all events during surgery or a procedure, and has direct recall of those events. Because of the routine use of neuromuscular blocking agents during general anesthesia, the patient is often unable to communicate with the surgical team if this occurs."

That's the plot fulcrum for first-time writer-director Joby Howard's new thriller, Awake, and it works well.

Clay Beresford (Hayden Christensen) is a young, wealthy businessman with the world at his doorstep and a beautiful new wife, Sam Lockwood (Jessica Alba). But everything is not so picture-perfect when he learns he has a weak heart. On the waiting list for a heart donor, Clay puts all his trust in his friend, Jack Harper (Terrence Howard), a cardiologist with a shaky record -- no fewer than four malpractice lawsuits against him. Meanwhile, Clay's overprotective mother, Lilith (Lena Olin), doesn't trust Dr. Harper -- or even Clay's new wife, for that matter. She wonders why, with all his money and power, he doesn't choose a first-rate heart surgeon.

Clay's nightmare begins when he receives a phone call from Jack: A new heart has arrived and they need to perform the transplant ASAP. During the preoperative phase, the anesthesiologist doesn't perform all his duties. What Clay goes through in the next hour and twenty minutes is a thoroughly terrifying out-of-body experience. Unable to move or communicate to the surgical team, he tries to think happy thoughts but fails to hold his concentration throughout the ordeal. Worse still, he learns his life is truly in jeopardy but can do nothing to help himself. It is up to Sam to save his life ... or does she have someone else on her mind?

Christensen (you'll remember him as Anakin Skywalker) is little more than a play-by-play commentator, but he keeps the tension going and shows the hidden conspiracies of his past. Alba finally gets to do more than serve as eye candy, using her allure convincingly as a femme fatale par excellence. Howard adds considerably to the plot twists, delivering another believable performance as the trustful doctor even until the end, when he rediscovers his conscience.

Awake is a taut psychological thriller that will have you clenching your fists and squirming in your seat -- not because of the graphic heart surgery scenes (if you can handle Grey's Anatomy, you can watch this), but because we're as helpless as Clay feels as his voiceover reveal his pain and what he hears around him. While predictable at times, Awake delivers enough surprises through its course of deception and ultimate sacrifice to hold one's attention throughout.

Ultimately, it's a fast-paced suspense ride with twists and turns aplenty, in the tradition of movies like Memento and The Usual Suspects. The revelations keep peeling back, layer by layer, until the very end. You'll have no problem staying awake throughout.
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