Warning! This article contains major spoilers for Prime Video's Dead Ringers. If you've yet to watch the show and don't want to know how it ends, turn back now!
Dead Ringers, the new Rachel Weisz-led series on Prime Video, borrows a lot from David Cronenberg's film of the same name; its protagonists, twins Elliot and Beverly, are both gynecologists, whose ambitions lead them down a dark, morally questionable path. But it has plenty of differences as well; the doctors are both women, they're based in New York City, and are in the business of monitoring pregnancies and delivering babies.
Perhaps the biggest and most shocking change the small screen adaptation makes however is in its conclusion, which alters Elliot and Beverly's respective fates. In a new interview with GamesRadar+, showrunner Alice Birch explains why the show's all-female writers room made such tweaks to the twisted tale.
"The idea for the ending was there from quite early on. I was really interested in the ultimate twin swap; that felt like a fun, super thriller-y type ending," she tells us. "We didn't want to just mimic the film, at any point really, but we wanted to borrow from it and be respectful towards it. We're fans and we love it, but we wanted to tell a new story… We knew that had to mean doing something different right at the end and this just felt so uncanny and creepy and unsettling."
So how does Dead Ringers end? Well, in the final episode, a heavily pregnant Beverly heads home to her and Elliot's apartment after her actor girlfriend Genevieve (Britne Oldford) leaves for a four-month shoot. There, she finds the place in disarray before picking up a worrisome phone call from Elliot, then heading to their swanky birthing center to try and patch things up with her spiraling sister. You see, Elliot hasn't been handling Beverly's increasing independence and relationship with Genevieve very well...
When Beverly arrives, she comes across Elliot lying on the floor. After showing Beverly the babies she's been growing for her "deliciously perfect" sister, Elliot tells Beverly she can't live without her, as Beverly admits to never feeling satisfied with her life, despite it seeming like she has everything she ever wanted.
"They have to climb inside you now," Beverly says of her unborn babies. "There was only ever supposed to be one of us. You always were a better me."
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The scene cuts, then, to a smiling Beverly lying on an examination table as the twins jokingly sing, "Don't forget the good part". A beaming Elliot administers anesthesia to Beverly, as the latter tells the former that she loves her. "It's time to go home now," Beverly states, handing Elliot her hair tie. Elliot then slashes her own abdomen and stitching it up, presumably to look like she'd received a C-section, before putting on a patient gown and cutting Beverly's babies out. Bloodied infants in her arms, Elliot rushes out to the lobby of the birthing center, urging someone to help her, while Beverly bleeds out elsewhere.
Later, Susan (Emily Meade) and Rebecca Parker (Jennifer Ehle) meet a recovering "Beverly"/Elliot in hospital and ask after "Elliot", as "Beverly" suggests her sister helped her safely deliver "her" babies.
A few credits roll, before an add-on scene sees Genevieve return to New York – and reunite with Beverly... who, if it's not clear already, is actually Elliot. Later, the couple can be seen enjoying a sunny day in the park with "their" babies. When Genevieve stops off at a stall to get them some refreshments, a woman approaches Elliot thinking she's Beverly, and tells her how great it is to see how well she's doing. When Elliot/"Beverly" quizzes the stranger on how she knows her, the woman reminds her that she was in her grief counseling group – you know, the ones that Beverly has been seen attending in the flashforwards that have been popping up since the end of the first episode? Elliot seemingly never knew anything about those sessions, which makes you wonder whether Beverly has been plotting her death, and her sister's warped adoption of her life, for a long time.
In Cronenberg's movie, Beverly disembowels Elliot in a drug-induced daze, in the misguided hope of "separating the Siamese twins", before passing away from drug withdrawal himself – curled up in dead Elliot's arms, no less – the following day.
Dead Ringers is available to stream now. If you've already finished it or psychosexual thrillers aren't your bag, then check out our list of the best shows on Amazon Prime for some viewing inspiration.
I am an Entertainment Writer here at GamesRadar+, covering all things TV and film across our Total Film and SFX sections. Elsewhere, my words have been published by the likes of Digital Spy, SciFiNow, PinkNews, FANDOM, Radio Times, and Total Film magazine.