I can't tell you much about how sound and image worked together in that amputation scene, because, honestly, I watched that part through intermittently covered eyes. When the film played at Telluride, there were reportedly audience members who needed medical attention, * and I can understand why: Almost despite myself—indeed, as I continued to assess Boyle's aesthetic choices dispassionately—the close-ups of a human being butchering his own limb like a leg of lamb made me feel icy-hot and clammy, as if I might pass out. (The cucumber-cool social columnist seated to my left seemed amused.)
Boyle's skill at wringing physical and emotional reactions from his audience is impressive; watching 127 Hours is, as intended, an experience of grueling intensity. But in the end, Boyle's maximalist approach has a boy-who-cried-wolf effect; a day after seeing this movie, I remembered only the peak sensations, not the story's emotional trajectory and certainly not the moral lessons (which, as far as I can tell, are pretty much reducible to "When you go on a hiking trip, leave a note"). 127 Hours wants to tell the story of a thrill-seeking adventurer forced to go on a wrenching inward journey, but the movie itself is an extreme athlete incapable of keeping quiet or sitting still.