There is a tradition among mad scientists who exhibit creativity with their victims that comes down to three little words: some assembly required.

Meet Dr. Heiter (Dieter Laser), a specialist in separating conjoined twins who now has more creative aspirations in his private research. When a pair of American tourists (Ashley C. Williams and Ashlynn Yennie) find themselves lost in Germany with a flat tire, their misfortune grows when they find Dr. Heiter’s home and ask him for help. As both young women and a stranger later awaken in a private and sound-proof medical suite, Dr. Heiter explains how he intends to join the three together and bring his fantasy creation to life: a human centipede.

After seeing advertisements features the doctor’s scrawling of three human beings on hands and knees linked back end to front, first thoughts tend to go to, “Who’s the unlucky fool in the middle?” The key difference between this bit of medical horror and films such as Frankenstein or The Island of Dr. Morrow is the claim that the feature procedure is 100% medically accurate, making it all the more twisted and horrific. Even with a simple three act plot of gathering, creation, and the eventual fallout, the film is eerily watchable in spite of the subject matter.

Perhaps it is Dieter Laser’s performance as the “good” doctor that continually renews interest throughout the film. His confession of how he “hates human beings” speaks volumes in just a few words without providing further evidence of the fact. At the same time, he delights in his own creations whether he’s dolling out punishment or rewarding for accomplishment. It’s easy to hate the doctor for what he’s done, but is it wrong to feel that in some way he’s actually provided a better purpose for his victims than what they were previously doing with their lives?

The practical makeup effects serve the story well, suggesting more than they reveal. Outtakes from the DVD show the flip side of the demented story matter, including Dieter Laser assuring another actor that he’s not really going to do what it looks like he’s going to do. Director Tom Six is already hard at work on a sequel (in case you didn’t realize that “first sequence” meant he’s just getting started) with the claim that the next installment will be 100% medically IN-accurate. So, let’s just start with what we have. After all, if you haven’t got your health, then you haven’t got anything.

(a three skull recommendation out of four)