In the film Dallas Buyers Club, when Ron Woodruff is told he has AIDS, he’s also told he has thirty days to live. Much is made of this countdown to mortality, with helpful onscreen title cards occasionally providing an update on how long its been since the pronouncement was made. It conveys the urgency of Woodruff’s dilemma, but perhaps in a way that’s unnecessary and even fussy. Surely the diagnosis itself, accompanied by honest dramatization of the era–the grinding helplessness of doctors, the immediate bigotry of Ron’s friends and colleague, the physical ravages of those afflicted–is enough to express the seriousness of the moment, even for those who don’t have long enough memories to call up a time when the letters HIV were tantamount to a death sentence. Therein lies the dilemma of director Jean-Marc Vallée’s film: it is well-meaning and even affecting, but it also dogged by a tendency to deliver its message in ways that weaken its overall impact.

Matthew McConaughey plays Ron, having undergone the sort of extreme physical transformation that automatically earns plaudits. He’s startling gaunt, but it’s his regained whiplash creativity of recent years that’s the truly impressive part of the performance. Toning down his wild-eyed tics in favor of a wired intensity, McConaughey signals the tenacity and invention that lead to Ron’s survival better than anything in the script (co-credited to Craig Borten and Melisa Wallack). When the doctors basically tell Ron that there’s very little they can do for him save orchestrate his inclusion in a drug study (in which he’s as likely as not to be receiving a placebo instead of actual medication), Ron takes matters into his own hands. Researching other innovative treatments happening across the globe and finding ways to bring the necessary drugs, proteins and other materials into the States, Ron becomes his own stealth physician. Eventually, he expands his operation to include anyone willing to pay a monthly fee and the Dallas Buyers Club is open for business.

This is precisely the sort of self-preserving scholarship and defiance of slow-moving authority that typified much much of the early response to the AIDS epidemic, when the President of the United States couldn’t even be bother to speak the name of the disease (and even when he finally did for the first time, did so in the service of moralistic hectoring, essentially arguing against sex education and treatment). The efforts of Dallas Buyers Club to dramatize this movement is commendable, and the filmmakers must believe they’ve got the perfect story to do it in Ron’s entrepreneurship of survival. A straight man who the film implies caught the disease after unprotected sex with a intravenous drug user, in some ways Ron has a longer journey to make, overcoming his own virulent prejudice to better serve the community he once disdained. The film initially plays up this element of Ron’s personality, but there’s not enough conviction to the storytelling to make that a meaningful throughline. Essentially, once he’s befriended a transgender patient (Jared Leto, far better than he’s ever been on film before), the personal growth is complete and largely forgotten about. Only Ron’s late-film rumination on whether he’s done anything of value in his life–in a scene that is hackneyed and dull–hints at anything deeper than the surface conflicts.

In its best moments, Dallas Buyers Club has a bit of flinty charm, an unchastened moxie that suits the actor in the lead role. Indeed, on the basis of the lackluster mechanics that are evident in the rest of the film, it’s entirely possible that it’s only the flecks of ingenuity it picks up from McConaughey, almost by osmosis, that makes the film work at all.