Malignant director James Wan reveals inspiration behind film's jaw-dropping twist

Warning: This article contains major spoilers for Malignant.

In director James Wan's just-released horror film Malignant, Annabelle Wallis plays a woman named Madison who starts seeing visions of grisly murders after her husband smashes her head against a wall. As the bodycount rises, it is ultimately, and shockingly, revealed that Emily is sharing her skull with a "teratoma," a type of tumor which can contain muscle and bone. In the world of Malignant, this teratoma is an evil, parasitic twin brother of Emily's named Gabriel who has been reactivated by the blow to Madison's skull after many years of dormancy and now periodically takes over their shared body to slaughter those who have displeased him.

While Wan takes wild liberties with medical facts for his film, the director reveals that real-life teratoma cases did inspire the movie, whose story is credited to Wan; his wife, Ingrid Bisu; and Malignant screenwriter Akela Cooper.

"My wife, Ingrid, she does a lot of research into medical anomalies," says Wan, recalling how he was introduced to the concept of teratomas. "She goes, 'There are people that are afflicted by this thing, that were born like this.' I just thought, wow. So obviously my horror movie-f---ed mind went immediately to the most messed-up story I could come up with. Her and I, we just started spitballing ideas and [it] eventually snowballed into a concept. The whole time I was thinking, how do I take this seed of an idea and actually turn it into a film and what I can do with it that can possibly allow me to have fun with all kinds of practical effects that I haven't played with in a while? You know, the blood and guts and all the cool animatronic stuff. It stemmed from all kinds of aspirations, but that really was the start of that idea."

Malignant is currently screening in cinemas and on HBO Max.

Watch the trailer for Malignant above.

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