No film encapsulates the plastic surgery panic that hit Hollywood in the early 1990s quite like Doc Hollywood, if only because no film tackles plastic surgery from such a preposterous premise – a young doctor, Benjamin Stone, played by Michael J. Fox, who crashes into a picket fence on his way from New York to Los Angeles in the small town of Grady, South Carolina, where he is forced to put in thirty-six hours of community service as the town doctor to atone for his crime. There, he meets and falls in love with Vialulu, a nurse played by Julie Walters, and finds himself more and more indispensable to the town as a whole, until he starts to question whether he even wants to continue travelling onto Los Angeles, with most of the second and third act following him as he compares the benefits of living in Grady with the benefits of living in the City of Angels. For all that this decision is entangled with his romance with Vialulu, the film presents it more conceptually as a choice between reconstructive and plastic surgery, since the major drawcard of Los Angeles for Stone was the prospect of working in the nation’s leading cosmetic clinic, a space in which surgical and cinematic intervention have become completely fused. What ensues is a meditation on the implications of plastic surgery for Hollywood naturalism, and Hollywood romance, in which the Deep South becomes both the caricatured logical conclusion of this new plasticity and a pastoral vision of an antebellum Hollywood universe founded on “real” bodies and visages.

At first, the plasticity wins out, with Doc Hollywood sitting fairly comfortably alongside a swathe of small-town caricatures that became popular as a source of dark comedy in the early 1990s (and especially Dan Akroyd’s Nothing But Trouble, released six months before). These films were prescient that the nostalgic small-town fantasies of the late 80s had reached such a point of contrivance and plasticity that only the slightest inflection was needed to render them surreal, uncanny and unsettling – in a word, to reveal everything about them that rendered them fantastic in the first place. That quality very much dominates the opening scenes of Doc Hollywood, as Jones encounters a swathe of caricatures so broad that they wouldn’t really be out of place in a comedy about the South made in the 1930s or 1940s, with some scenes even broad enough to translate more or less seamlessly into a silent register. That all changes, however, when Stone meets Vialulu, at which point Caton-Jones immediately offsets this plasticity with a series of softcore dream sequences that lend a mistily-lit romantic communion to the remainder of the film, especially when it touches on this central romance. It’s during these scenes that Fox’s performance really comes into its own as one of the screwiest and most beautiful of his career, suffused with the mild incredulity – looking up quizzically mid-sentence – that he does to perfection in his comic roles. For, while Vialulu undoubtedly grounds Stone’s experience of Grady, she also refines and rarefies his bewilderment as well, until he spends virtually the entire film in a nonplussed state so mild and distended that he barely needs to say anything for most of the key comic moments – the slightest inhale or exhale of breath is enough – making for a film that often seems to consist entirely of reaction shots from Fox.

In the process, both Fox and Warner (but especially Fox) exude a heightened naturalism that pointedly contrasts with the caricatured plasticity of the townscape around them, as it turns out that Vialulu’s previous boyfriend was a slave to plastic surgery, and that she has been trying to find an alternative to his obsession with physical perfection ever since. Although he never appears, this boyfriend – an exotic dancer “with an extremely high opinion of his legs” – haunts the narrative with the spectre of how “regular” men might one day be emasculated by plastic surgery, if only by being held to the same rigorous physical standards as women. The irony is that both Fox and Warner have fairly normative Hollywood faces and bodies themselves, forcing Caton-Jones to dissociate them from the plasticity of this emergent Hollywood dystopia by perpetually and exponentially showcasing them at their most understated, tremulous and (above all) nonplussed, as if to capture a certain ineffable, silky, facial tactility that no amount of plastic surgery can rival or muster. As the Southern days lengthen, and the humid heat of the bayou suffuses the surface of Fox and Warner’s skin with one bead of perspiration after another, Caton-Jones’ mise-en-scenes brim with an unspoken insistence that synthetically augmented skin just can’t register sensuality in the same way as “real”; after all, the most plastic figure in the town is bereft of sweat glands.

For all the preposterous premise and stock characters, that central conceit makes for quite an entrancing and cinephilic experience, as Caton-Jones filters Stone and Vialulu’s burgeoning romance through a meditation on how “real” skin can prove its “realness” through minute shifts in affect and perception. With the romance taking centre stage about halfway through, the hokey town centre of Grady gives way to a more naturalistic and lyrical depiction of the Deep South, in which the passage of affect and sensation across Fox and Warner’s faces is fused with the passage of wind and sunlight that dapple them through the omnipresent weeping willows, low-hanging clouds and all the other natural phenomena that can’t be plasticised and that speak to a relation between the camera and the natural world (including the human body) that can’t be mediated through the artifice of plastic surgery. In the most curious transformation of the film, even the most plastic corners of the town take on this lyricism as the narrative proceeds, as if Caton-Jones were reversing a plastic surgery before our very eyes. Whether it’s through the local doctor regaling the townsfolk with Walt Whitman’s “Song of Myself” (now oddly reimagined as a work of Southern literature) or Fox’s recourse to the works of John Muir (now oddly imagined as a corpus of Southern exploration), Doc Hollywood gradually suggests that what tenuous connections between cinema and American Romanticism still remain are destined to be entirely jettisoned if Hollywood embrace the next generation of plastically enhanced actors.

At stake, then, in Doc Hollywood, is the elegiac awareness that a certain cinematic classicism or naturalism has come to its end, suffusing even the most burgeoning and emergent moments in Stone and Vialulu’s relationship with a melancholy and very Southern sense of belatedness. While the film may notionally juxtapose South Carolina and Los Angeles, Grady is really more of a dialogue between two different tendencies within Hollywood itself, as Fox finds himself called upon to diagnose and determine the health of each, and their optimal relationship with one another. As Hollywood Boulevard starts to percolate its way into Grady’s comic texture (gay men, vegetarianism, DJs), Los Angeles feels more like a representative horizon than an actual place, which is perhaps why the penultimate sequence in California is so cursorily stylised and curiously abstracted from the rest of the film, as if arriving at a destination we have already been partly occupying all along. Conversely, the more Stone settles into Grady, the closer he comes to a the ostensibly “real” legacy of Hollywood, culminating with a walk down Main Street on the annual Squash Festival that ends with an outdoor screening of a Buster Keaton film for the enraptured townsfolk. Yet if this is the most bucolic moment of Doc Hollywood, it’s also the ugliest, as a black woman accompanying Keaton on the accordion cements a townscape in which blackness is entirely associated with service positions, and in which blackness only exists to service a white nostalgic fantasy of Hollywood, reminding us this fantasy can only exist by casually dismissing the racial politics from which film classicism emerged in the first place.

What Doc Hollywood reveals (or perhaps enacts) so eloquently, then, is the extent to which anxieties about Hollywood becoming synonymous with plastic surgery are also anxieties about the white body being deracinated by the discovery that it is every bit as plastic, contrived and caricatured as the black bodies it defines itself against. The fear of synthetic bodies is, in that light, a fear of black bodies, or a fear of emasculation at the hands of blackness, which is perhaps why Grady’s bucolic environs quickly constellate around Stone’s renewed ability to scrutinise “real” female bodies, as if the sheer possibility of plastic surgery and synthetic femininity had ineradicably disrupted, debilitated and deracinated the white male gaze. After all, plastic surgery accommodates itself so categorically to the male gaze that it inevitably denaturalises the male gaze in the process, exposing it as a contrivance of Hollywood production rather than a mere reflection of the natural – and naturalistic – state of things. In that sense, Doc Hollywood wants to have its cake and eat it too – wants to consciously reinstate the male gaze, but as something invisible, unquestioned and “natural” – just as it wants to renaturalise the conventions of Hollywood romance and beauty, inhabiting them thoroughly but never too obviously or “tastelessly.”

This, in the end, is the definition of classicism, and especially the classicism which pervaded Hollywood in the early 90s, as the film responds to an era in which has become possible to over-identify with Hollywood standards by asking us “merely” to identify with them, divesting the male gaze of its plasticity and palpability by subsuming it in a caricatured Southern townscape that naturalises it by comparison. No surprise, then, that there was such an outcry when the plot of the film was rumoured to have been lifted for Pixar’s Cars, not least because Stone’s own car plays such an important way in negotiating this shifting space between identifying and overidentifying with Hollywood. From Stone’s initial breakdown, which lands him in Grady in the first place, to his final decision to deliver a baby (his first baby) from a local patient rather than save his car from being wrecked by an oncoming truck, this car is the main way in which Hollywood is mediated – and in a film so steeped in classical Hollywood, a film in which the Deep South becomes the “Shangri-La” of Frank Capra’s Lost Horizon, this car cements Doc Hollywood as a spiritual sequel to Sunset Boulevard, where a sudden breakdown also places its protagonist at an uneasy remove from the city and culture industry that he had previously assumed was destined to sustain him.

So central is the car, then, that it’s not a great stretch to think that Cars might used this as a point of departure for its own visions. Yet by incorporating Stone’s car into a fully synthetic world, this Pixar classic also pointedly confirms that the Hollywood doctoring that Doc Hollywood prophecies has come to pass, even of especially as it is packed in such a benevolent way. Less an adaptation or derivation than a devolution of the film’s worst anxieties, Cars now feels eerily continuous with Caton-Jones’ epilogue in Los Angeles, where the city’s top plastic surgeon assures Stone that new media will usher in a new era of surgery, against a backdrop so sleek, angular and austere that it effectively plays as digital animation after the homeliness of Grady. In retrospect, the Pixar universe is not unlike the dystopian horizon of Doc Hollywood, and yet the paradox of the film is that it is only after rejecting Hollywood and returning to Grady that Stone can effect a Hollywood ending within Grady, since even if the town doesn’t take plastic (a source of multiple comic tableaux) it’s still indebted to the plasticity of the world outside, a world firmly anchored in Hollywood.

Like The Hard Way, then, Doc Hollywood is prescient that no actor was able to chart this shifting space on the fringes of Hollywood simulation quite like Fox, who was both dazzling enough to appear in the biggest budget movies but also irreverent and homely enough to feel as if he might represent some kind of exception to the Hollywood rule as well. For that reason, no actor quite embodies the transitions taking place in Hollywood at this time like Fox either, whose talent has always inhered in barely modulated realisations, nuances of expression that no plastic or prosthetic surgeon can rival, and a consummate taste for comic timing that makes him feel embodied in even the most airbrushed scenarios – talents that have persisted right up to his performance as Louis Canning in CBS’ The Good Wife, one of the defining moments of the quality television era. While it may not be the best film he ever appeared in, then, Doc Hollywood offered Fox one of the best roles in this part of his career, a role that is all the more screwy and nonplussed for the film’s contradictory and often schizoid efforts to decide upon just how much of itself to situate within the world it depicts.