When director Stefan Ruzowitzky sat in on audience screenings of German horror movie Anatomy, he saw a variety of reactions, but the ones that stood out to him were from medical professionals and scientists. The more experienced doctors found the whole premise silly, whereas scientists were less entertained. Meanwhile, the young and idealistic med students in attendance picked up on what makes Anatomy scary. They were disturbed by the story’s underlying concept; not a secret organization of rogue doctors slicing and dicing up patients, but the notion that people should not trust their physicians.

Anatomy (Anatomie) was the first production of Columbia TriStar’s German branch. The 2000 film was the beginning of the American studio’s aim to make stories for local audiences. And considering Germany’s renowned healthcare system, producing a horror film about doctors had potential. Ruzowitzky and co-writer Peter Engelmann’s script shadows Franka Potente’s character as she enrolls at a distinguished university with a dark secret. Her chance of a lifetime soon turns into a mission to expose the school’s role in a rash of recent disappearances.

The film’s cheerful and TV-like disposition at first, intentional subterfuge on the director’s part, is quickly stripped away once Paula Henning (Potente) has to make a choice about her future. Life before accepting a coveted spot at the University of Heidelberg for Paula has been straightforward. She comes from a line of doctors, and it was always presumed she would be one too. Her father did not exactly follow in his prestigious father’s footsteps, much to Paula’s grandfather’s chagrin, and is happiest as a family physician. He wanted his daughter to join him at their small practice, but Paula wants something more for herself. It is the classic scenario of a child defying their parents and pursuing their dreams. Of course in this case, Paula’s decision has more extreme consequences.

Once Paula goes away to college, she finds herself almost alienated for taking medicine so sincerely. Paula chastises her male peers for defiling a cadaver for their own amusement, and she is irritated by roommate Gretchen’s (Anna Loos) incessant hunt for boyfriends. Paula’s resolve is eventually rattled when she recognizes her class cadaver; David (Arndt Schwering-Sohnrey) is a stranger she saved on the train to Heidelberg. His death, however, does not line up with his malady. So Paula now insists something shady is going on beneath everyone’s noses.

As it turns out, not everyone is as oblivious to the school’s seamy underbelly as Paula was. The creepy dissector rouses suspicions early on, but there is a larger and less obvious force at play. Ruzowitzky cooks up a fictional yet plausible society called the Anti-Hippocratics. This sect of doctors opposed rules in the name of research; they survived by killing. The Anti-Hippocratic Society was born in the sixteenth century and continues to reemerge throughout history. Paula has good reason to believe these crooked doctors have returned and are carrying out illegal experiments in the school, but her claim is dismissed.

While Anatomy is remembered as a Deutsche stab at the Scream formula, Ruzowitzky’s film is far less straightforward than a basic teen-slasher. The worst parts of history returning to take a foothold in the modern era is a timeless fear. Ruzowitzky’s story of past evils staging a systematic comeback is sharp without being too didactic or sacrificing entertainment. There is still a good deal of fun to be had here in spite of the weighty parable at hand. The story is somehow never undone by its own absurdities all thanks to a determined sense of intrigue and a stack of immediate pleasures and thrills.

Stefan Ruzowitzky returned for the 2003 sequel, which bears a minor connection to the first film. Anatomy 2 follows small fish and young neurosurgeon Joachim “Jo” Hauser (Barnaby Metschurat) as he starts his rotations at a prestigious hospital in Berlin. Jo’s main goal is to find a way to help his brother’s muscular dystrophy, but he instead gets caught up in a new chapter of the Anti-Hippocratic Society after the one in Heidelberg was shut down. This time the members keep a lower profile by conducting their bizarre experiments on each other; they implant one another with synthetic muscles. 

The “playing God” factor is dialed all the way up as Jo’s colleagues, including the story’s chief adversary Dr. Müller-LaRousse (Herbert Knaup), bend not only society’s laws but also the laws of nature. No random victims are plucked off the streets and cut open in the name of medicine, and there is certainly no whodunit mystery to solve. In fact, Dr. Müller-LaRousse and his underlings are identified as the villains toward the beginning. The majority of the film then details their twisted actions, which rarely involve anyone outside their clique other than Nurse Lee (Rosie Alvarez) and Jo’s brother (Hanno Koffler), who serve as the protagonist’s lifelines.

The first Anatomy film sees a family’s legacy marred by a hidden connection to the Anti-Hippocratics, whereas the second delivers Faustian stakes. Anatomy 2 indeed trades suspense for overlong infighting and half-baked addiction parallels; this new direction neglects the original’s groundwork about the surreptitious rise of neo-Nazism. However, the sequel scores extra credit for simply being so over the top. As divergent as these German horror movies are in both plot and execution, together they rouse and twist preexisting anxieties about doctors and medical conspiracies.

Horrors Elsewhere is a recurring column that spotlights a variety of movies from all around the globe, particularly those not from the United States. Fears may not be universal, but one thing is for sure — a scream is understood, always and everywhere.