Horror 101: What Scary Movies Teach Future Medical Professionals

A film scholar and professor, Dr. Mikal Gaines connects horror movies to real-world healthcare, from mental illness to systemic neglect.

In "The Substance," one of the film's most gut-wrenching moments shows Demi Moore's character primping for a date, sitting before a mirror, obsessively wiping off and reapplying makeup. As a taunting vision of her younger self lingers, she smears blood-red lipstick and black eyeliner across her face in frustration. The scene, steeped in body dysmorphia and self-destruction, captures the film's visceral horror—one that earned it five Oscar nominations, including Best Actress for Moore.

The film follows an actress fired from her fitness show for being “too old,” leading her to a black-market drug that promises youth at a terrible cost. Its themes connect deeply with Mikal Gaines, PhD, a horror film scholar and associate professor of English at Massachusetts College of Pharmacy and Health Sciences (MCPHS). Through his work, Gaines explores how horror films reflect medical and social issues, encouraging students to think critically about healthcare in the context of real-world challenges. By analyzing fear, vulnerability, and the human body in cinema, he helps students draw connections between storytelling and the ethical dilemmas they may face in healthcare professions.

"The body dysmorphia in that scene, where she agonizes over her self-image and can't even leave the house—that's what hits hardest," Gaines said. "It's the most relatable part of all the surreal events in the film." He often ties moments like these into his teaching, adding, "I'd be curious how some of our psychology students might diagnose her situation."

From the Silver Screen to the Syllabus

The shelves in Gaines's office are packed with books on film, literature, and history, including "Men, Women, and Chainsaws: Gender in the Modern Horror Film" and "African American Literary Theory." His courses extend far beyond horror. In Health and the Public Body, students examine how different communities' bodies are policed, medicalized, and discussed in public discourse. His film classes—Introduction to Film and Speculative Fiction and Film—dissect cultural fears and anxieties, whether it's the psychological manipulation in "The Silence of the Lambs" or the pandemic horrors of "Contagion."

Hanging on his office walls are shot sketches drawn by students—part of an assignment that breaks down the elements of a single scene, from lighting to dialogue to camera angles. Among them are frames from Alfred Hitchcock's "Shadow of a Doubt," "Ocean's 11," "Psycho," and Sidney Poitier's powerful slap from "In the Heat of the Night."

"Many of them make observations even I missed," Gaines said. "They'll notice, 'Oh, the lighting in this shot changes in this really interesting way compared to the previous shot, and what that means is this.'"

He also connects horror films to medical fears, as seen in "An American Werewolf in London." The film's protagonist, who transforms into a werewolf, is treated by a nurse who becomes romantically involved with him—a relationship that defies professional ethics.

"If we read his transformation as a metaphor for illness, particularly mental illness, then what is this woman's role?" Gaines asked. "She's supposed to be his caregiver, but she crosses boundaries that shouldn't be crossed. I was surprised by how willing students were to really think through those dynamics and unpack what that says about power and responsibility in healthcare."

A Lifelong Fascination with Fear

Gaines' love of horror began at his older sister's slumber parties, where he sat transfixed by Freddy Krueger's clawed menace in "A Nightmare on Elm Street" and the claustrophobic terror of "Alien," Ridley Scott's 1979 sci-fi horror classic. Absorbing the frights alongside teenagers who barely noticed their younger tagalong, he had no idea those early encounters would later play a starring role in his life's work.

"One of my earliest horror memories—actually, one of my earliest memories overall—is waking up in my living room just as the opening of 'A Nightmare on Elm Street' was coming on," Gaines said. He was just 7 years old when he saw "Aliens" and "Poltergeist," films that both “terrified and traumatized" him—but also kept pulling him back for more.

By graduate school, Gaines wanted to understand why horror resonated so deeply, particularly with Black audiences. His dissertation at William & Mary explored Black spectatorship in horror films from the 1960s to the 2000s, uncovering a long-standing but often overlooked connection between Black viewers and a genre that rarely placed them at the center.

“There’s a distinction between ‘Blacks in horror’ and ‘Black horror,’” Gaines said, citing writer-director Jordan Peele’s Oscar-winning “Get Out,” which became a critical and commercial hit in 2017 for using the horror genre to make an eviscerating allegory of racial relations in America.

“‘Get Out' was a Black horror film—it placed Black experiences at the center rather than just featuring Black characters in supporting roles,” Gaines said. “That shift opened doors for more films to explore racial identity through horror.”

Gaines continues his research on horror and representation in film, publishing articles and scholarly work, including "American Cinema of the 2010s," "Fight the Power: The Spike Lee Reader," "Jordan Peele's Get Out: Political Horror," "Merchants of Menace: The Business of Horror Cinema," and contributing pieces to the Journal of Cinema and Media Studies.

The 'Texas Chainsaw' Case Study

At MCPHS, Gaines brings the horror genre into the classroom, using it as a tool to help students analyze storytelling, media, and cultural perspectives—skills that prepare them to better understand the different communities they will serve as healthcare professionals.

“We are always going to need people who can closely read and interpret things, come to thoughtful conclusions, and present information in a way that makes sense to their audience,” he said. “Storytelling is how humans make sense of the world—and in healthcare, it’s how patients communicate their needs.”

If Gaines could turn any classic horror film into a case study for health science students, he said it would be "The Texas Chainsaw Massacre," the 1974 slasher flick about a family of cannibalistic serial killers.

"It's a study of family, particularly generational dysfunction, and what happens when there's no intervention," he said. He points to the Sawyer family as an extreme case of social determinants of health. "They are a product of economic collapse, isolation, and cycles of violence. It's an exaggerated, grotesque depiction, but at its core, it's about what happens when people are abandoned by the systems meant to support them,” Gaines said.

The film's brutal portrayal of survival and trauma, he argues, makes it an apt metaphor for healthcare discussions surrounding generational poverty, mental illness, and systemic neglect.

"Breaking the cycle of generational trauma is a real issue in public health," Gaines said. "'Texas Chainsaw' presents a worst-case scenario of what can happen when there's no intervention."

Gaines said he sees horror as more than just a genre—it's a lens for understanding the world.

"I grew up glued to a screen, absorbing these terrifying but captivating stories,” he said. “Now, I help students dissect those same kinds of narratives—not just for entertainment, but to understand how storytelling shapes our perceptions of health, identity, and society."

Horror & Humanities: Fun Outtakes with Dr. Mikal Gaines

• Worst Horror Trope? "Stop going to the isolated rich people's houses. No cell service? Creepy basement? Just … why?"
• Favorite Horror Moment? “'Barbarian's' dark hallway scene. I sat there thinking, 'I don't like this. I don't like what I'm feeling right now.'"
• The Power of 'Moonlight': "It's a film I return to repeatedly. It proves Black identity isn't a monolith—it's complex, multifaceted, and deeply personal."
• A Horror Movie for Future Healthcare Leaders: "Steven Soderbergh's ‘Contagion’ immediately comes to mind. I've always thought of him as a low-key horror director. The film is an unsettlingly realistic depiction of a global pandemic, making it essential viewing for anyone in healthcare."
• Dream Guest Speaker: "Jordan Peele is the obvious choice. But after watching ‘Blink Twice,’ I'd love to sit down with Zoë Kravitz. It's a tough film, not perfect, but incredibly well-crafted. I'd be curious to hear how she tackled the difficult subject matter."
• A Modern Horror Masterpiece: "'Jordan Peele's 'Nope' is probably my favorite horror film of the decade so far—absolutely brilliant from top to bottom."