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LOS ANGELES — Two at the Telluride Film Festival, three at the Toronto International Film Festival and one at the Mill Valley Film Festival.


If that were a list of trophies for the new movie “127 Hours,” which opens Friday, the filmmakers would be overjoyed. In fact, it’s a partial tally of people who have collapsed during early screenings of the movie about a real-life hiker who amputated his forearm after a falling boulder pinned his hand in a remote canyon.


“I started to feel like I was going to throw up,” said Courtney Phelps, who was watching “127 Hours” at a recent Producers Guild of America screening in Hollywood and grew ill just as the amputation scene ended. “So I went to the bathroom, and then I started feeling dizzy and my heart started racing.”


Phelps fainted on the restroom floor, and was treated by paramedics who had been called when another moviegoer suffered an apparent seizure. “I have never had, even remotely, an experience like this,” she said. “I’m a television producer. I know this stuff is not real.”


Evidently, that doesn’t matter.


Filmmakers always hope their work will affect audiences in powerful ways. But the strong physical and emotional responses generated by “127 Hours” have not only surprised director Danny Boyle and his creative team — they’ve also presented a delicate marketing challenge for Fox Searchlight, which co-financed and is distributing the $20-million movie.


“I would prefer that people not pass out — it’s not a plus,” said Stephen Gilula, the studio’s co-president. “We don’t see a particular publicity value in it.”


Still, Gilula said the swoons — besides the incidents in Telluride, Toronto and Mill Valley, there have been at least eight more at other preview screenings — prove the film’s artistic power. “It’s the most empathetic experience I’ve ever seen,” he said. The movie, rated R for “language and some disturbing violent content/bloody images,” opens Friday in limited release, with more cities set to be added in the coming weeks.


Such fainting spells aren’t unprecedented in Hollywood, though they’ve been much more commonly caused by horror movies like “The Exorcist” and “Alien,” nightmare-inducing films intended to shock patrons with scenes of projectile vomiting and creatures bursting forth from human abdomens.


In some cases, extreme audience reactions have been used to help drum up interest in the film. Last year’s “Paranormal Activity” was promoted with shots of moviegoers recoiling in their seats, and the colorful B-movie producer William Castle stationed fake nurses in theater lobbies for his 1958 release “Macabre” and offered life insurance for ticket buyers who feared they might die of fright.


But “127 Hours,” loosely adapted by Boyle and screenwriter Simon Beaufoy from hiker Aron Ralston’s memoir, is hardly a fright flick. It is intended to be, and critics are singling it out as, a highbrow drama for sophisticated moviegoers. Awards prognosticators have picked it as a likely nominee for best picture in this year’s Oscar race. (Boyle’s last movie, “Slumdog Millionaire,” won eight Academy Awards, including best picture, director and adapted screenplay.)


“127 Hours” stars James Franco as Ralston, who in 2003 was trapped by a falling chockstone in an isolated gully in Utah’s wilderness. Having told no one where he was headed and hiking with scant supplies, Ralston knew that if he didn’t free himself he would perish from starvation, dehydration or exposure. Five days into his ordeal, Ralston figured out that if he broke the two bones in his right forearm, he would be able to use a dull multi-tool to saw through the flesh, muscles and tendons that bound him to a certain death.


Although Boyle does not depict Ralston’s backcountry surgery in medical-school-like detail, his cameras do not shy away from some of the amputation’s grislier steps, such as when the hiker snaps a spaghetti-like nerve strand. Like much of the movie, the procedure is filmed in a realistic, documentary style, with the camera sometimes mere inches from Franco’s body.


Boyle employs a variety of sound effects during the amputation, amplifying the bone breaks with a gunshot and the nerve-cutting with an electronic vibration. As he’s chipping away at his flesh, the hiker quietly says — in a line perhaps directed as much at the audienceas himself — “Don’t pass out.”


In real life, it took Ralston nearly an hour to sever his arm; the sequence in the film lasts only a few minutes. But for a small percentage of moviegoers, its intensity outstrips its brevity.


In addition to the film festival faintings, four people dropped at a “127 Hours” preview at Pixar Animation Studios, according to a person in the theater; three people fainted at the Producers Guild screening; and one person passed out at a research screening in Huntington Beach, Calif. (the studio and test screening company Screen Engine said that the last casualty returned to the theater to give the movie a grade of “excellent”). There have been no reports of lasting sickness, and Fox Searchlight says it is not changing its marketing materials to caution moviegoers.


The team behind “127 Hours” has different theories about why the movie is affecting some people so strongly, many of them hinging on Boyle’s filmmaking style. Other directors might have cut away from Ralston to show the rescue effort, but Boyle keeps his attention on Ralston in the canyon. Boyle said he intended moviegoers to share Ralston’s predicament so intensely that they would root for him to escape as if their own lives hung in the balance. “I wanted it to be a subjective experience,” Boyle said.


Perhaps he succeeded too well.


“I am almost looking into the camera at times, and it almost feels like I am talking to the audience,” Franco said. “It’s a very intimate experience. One of the reasons the reaction is so intense is because you’re so invested in the character. When you go to a horror movie, you know the characters are just expendable. So you don’t care at the same level.”


Although some early “127 Hours” viewers have averted their eyes during the amputation scene, few people have walked out of the theater, which producer Christian Colson said is “a testament to the power of the movie.” He said the fact that it dramatizes an actual event magnifies the audience’s reaction. “That makes it more real for people,” Colson said. “They are in the experience. And that’s for the whole audience, not just the fainters.”


Gary Meyer, a co-director of the Telluride Film Festival, where “127 Hours” enjoyed its world premiere in September, said that if he books the film into his two-screen Balboa Theater in San Francisco, he would post a sign warning patrons about what’s in store. “I believe we will say that the film includes intense sequences, or something to that effect,” Meyer said.


Jason Squire, who teaches about the movie business at the University of Southern California’s School of Cinematic Arts, said that the fainting reports might actually boost box-office receipts for “127 Hours.” “Are you kidding? I think it really helps,” Squire said, speculating that the film’s intensity could prove especially appealing to teens and young adults. “They’ll wait in line an hour earlier.”

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