This review was originally published on September 7th, 2013 as part of Film.com's coverage of TIFF 2013.

We first see him in a dirty, sweaty, hay-strewn pen, fornicating at the rodeo. Matthew McConaughey's Ron Woodroof is living like an animal. By the end of "Dallas Buyers Club" he will have touched the lives of thousands, using a mix of cunning and strength fueled by self-preservation. The Oskar Schindler of Texas’ gay underclass in the mid-1980s, Ron Woodroof is a difficult man to like at first, and director Jean-Marc Vallée doesn't hurry his transformation into a hero, but when the Hollywood mechanics of this top notch "prestige picture" kick-in, good luck seeing this without a handkerchief.

A staff electrician for a shady Texas drilling concern, Ron also deals a little narcotics, runs a small time gambling operation, drinks to excess, gets in fights, lives in squalor, never bathes, has a hacking cough, screws floozies who don't have much to say and maintains a rather nasty (and fiercely homophobic) demeanor. After an accident lands him the hospital he's told he has HIV and an extremely low T-cell count. He's given 30 days to get his affairs in order.

Day 1 is dedicated to getting loaded and laid, but eventually he he heads to the library to read up about AIDS. He learns of some trial drugs (specifically AZT) and heads back to the hospital to get some. Here, doctors Jennifer Garner and Dennis O'Hare teach him a hard lesson in bureaucracy. There are blind trials, but FDA rules prevent just handing out new medication.

After prayers to a higher power for some sort of sign (a clever gag reveals he's at a strip joint, not a church) he works an angle to get some stolen AZT. Further leads bring him down to Mexico, where an American doctor whose license has been revoked (an unrecognizable and fantastic Griffin Dunne) cleans him up, takes him off AZT and gives him a cocktail of new proteins, vitamins and drugs. Thinking back to some of the desperate people he saw in support groups - and particularly his hospital roommate - Woodruff casually mentions "hey, you could make a lot of money off this."

"Dallas Buyers Club" then effortlessly glides into a different gear, with Woodruff smuggling in carloads of unapproved (but not illegal) medication. Even though he has his own relative health as proof to potential buyers (he still looks rail thin, but not death's door sickly) he begrudgingly teams up with that former hospital roomie for a distribution network.

That man is Rayon, a trans* individual played by Jared Leto, a perfect performance coming to us at a perfect time. Rayon isn't just the wacky gay friend - he is a complex and heartbreaking figure, and Leto tears into this role with everything he's got. His portrayal of Rayon is imbued with such heart that no one will doubt that his struggles are enough to change the heart and mind of someone so rough-around-the-edges as Woodruff. With "Dallas Buyers Club" Leto elevates directly to the top of the A-List. His career will never be the same.

Not to disregard McConaughey. His physical transformation for this role is remarkable, as is his ability to somehow win our sympathies before his attitude changes. Once Woodruff has a clear mission, it is quite fun to rally behind him. It makes you wish he'd found this industrious side of himself before getting sick.

But "Dallas Buyers Club" is by no means perfect. It definitely takes large leaps in terms of presenting the science, medicine and care behind Woodruff's for-profit scheme. And while the Reagan-era FDA deserves plenty of hisses (choose from any number of documentaries on the topic for more) the institution is presented here with as much subtlety as "Ghostbusters" portrays Walter Peck's EPA.

The specifics of plot (or any formal eccentricity) aren't what's going to stay with you, however. It's all about the performances. McConaughey and Leto don't just give voice to the disenfranchised of the 1980s, but all people suddenly faced with impossible challenges. The fireworks caused by pitting never-say-die Texas bravado against heartlessness is a powerful mix, and "Dallas Buyers Club" somehow manages to be an inspiring tale amidst all this sadness.

SCORE: 8.5 / 10