‘Up Against It’ Review: An Uneven Medical Dramedy Relies on Sincerity to Mask Its Flaws

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Let’s get this out of the way: Some of the plot points in “Up Against It” are absolutely ridiculous. Already insulated from some of life’s harsher realities by their obvious economic privilege, the characters in this British blended-family rom-com also seem to suffer from a bad case of solipsistic decision-making. Rose (Eden Hamilton) has an excuse — she’s 14. But her long-since-divorced parents, famous conductor Alvaro (Antonio Banderas) and paralegal Saffron (Eva Birthistle). also seem incapable of behaving in anything but the most selfish of ways. This can make for a frustrating watch, particularly when paired with some of the film’s more unlikely narrative contrivances. But it also, ironically enough, leads it to its most meaningful truth: Step-parents are parents, too.

I became a step-parent a little over a year ago, and while the specifics of my situation are very different from those of the characters in this movie, the arguments and the hurt feelings are similar enough to give the relevant scenes in Trudie Styler’s second fiction feature a feeling of authenticity. (Styler has also directed two documentaries.) At first, Saffron’s fiancé Kingsley (Arinze Kene) and Alvaro’s live-in girlfriend Lara (Úrsula Corberó) appear to be mere emotional wallpaper, non-entities who are there mostly to be so much better — but a lot less exciting — than their partners’ exes. Kingsley loves Saffron fiercely, unlike the indifferent Alvaro; Lara is a natural caregiver, nurturing Alvaro in ways that Saffron never could.

Rose is in that phase of post-divorce adolescent life where she hates one parent (her mom) and dotes on the other (her dad), and lands herself in the emergency room early on in the movie after making a spectacle of herself at Saffron and Kingsley’s engagement party. (She does this after chugging an entire pitcher of margaritas, and her parents’ baffling response to a 14-year-old giving herself alcohol poisoning could be the product of cultural differences, careless writing, or both.) There, a blood test reveals that the rare form of leukemia Rose had as a toddler has returned. (No, her parents never told her about this — the movie is full of these moments, there’s no point in litigating them all.) Suddenly, everyone’s priorities shift.

This is where “Up Against It” introduces its core premise, from which the entire movie was presumably reverse-engineered: Since Rose has no siblings, in order to increase her chances of survival oncologist Dr. Augustus Abara (Forest Whitaker) suggests that Alvaro and Saffron should conceive another child in hopes that the baby could serve as a stem-cell donor. ‘Savior babies” are indeed a thing, but “Up Against It” never bothers to stop and consider the ethical implications of the idea. No one asks at any point what this child or children might think about being born to serve as tissue donors — although given their earlier actions, one might assume that Saffron and Alvaro might never tell them about it. And what if the baby isn’t a perfect match? What then?

That’s a more nuanced question than this film is prepared to address, and “Up Against It” continues to make Saffron and Alvaro the center of its emotional universe while saying that it’s all about Rose. Then Lara storms out of a meeting, infuriated that Saffron has suggested that she serve as a surrogate for this Hail Mary pregnancy. Kingsley follows, and confides in Lara that, although his body isn’t on the line, he’s also uncomfortable being pressured into parenthood under these circumstances. They care about Rose, too, but they feel forgotten and taken for granted in similar ways amid all this talk about biological parenthood. Their alliance thus solidified, they go about supporting Rose while her birth parents concentrate on their own fears and resentments, an emotional shift that brings a welcome sense of grace to the film.

By comparison, the sex-farce and infertility comedy elements are uninspiring. Once again, the supporting players — with the exception of Richard E. Grant, who appears to have agreed to appear on his lunch break as a favor — are the MVPs: This movie is the best advertisement the NHS could ever ask for, as the family enjoys a team of dedicated support staff led by Dr. Abara and the cheeky Dr. Choy (Selena Tan). If these doctors and nurses have other patients, we don’t see them or hear about them, and although Styler and screenwriters Camille Griffin and Chloe King do include some thoughtful nods to even more peripheral figures in Rose’s treatment and recovery — the courier who drives blood donations between hospitals is a recurring, if silent, figure — the “it takes a village” message doesn’t really come through until the very end of the film.

Part of this may be the container this message is poured into: “Up Against It” is very much shot in the style of an ’80s rom-com, with cheerful musical cues from prolific composer George Fenton and clean lensing from Academy Award nominee Dante Spinotti. An initial credits sequence that flies over the streets of London has a pleasingly retro feel, evoking the famous openers of Rob Reiner’s “Working Girl” or the Dolly Parton/Lily Tomlin/Jane Fonda vehicle “9 to 5.” The sexual politics of this movie are about as broad as those in the aforementioned titles, and the conclusions about family and commitment just as neat. It’s a ludicrous movie, but a well-meaning one, and it’s nothing without its supporting characters — which is fitting, whether or not that’s by design.