Character Analysis
We're fans of Malcolm right off the bat. Why? Because he seems like a nice guy who really cares about the people around him—including his young patients.
But he does have some issues. And really, should we be surprised? How would there be a movie otherwise?
Let's take a look.
"He Used to Be a Good Doctor"
"He used to be a good doctor": that's what Malcolm tells Cole toward the beginning of the film, and we believe him. The film opened with him and his wife celebrating an award he just received for helping the kids of Philadelphia with their various psychological needs.
But his post-award swagger gets cut short when he goes upstairs that night and finds a former patient named Vincent hiding in his bathroom. Vincent is, uh, agitated, since apparently the good doctor failed to help him out of his difficulties as a child. He's so out of sorts that he shoots Malcolm and then kills himself.
Malcom's professional confidence takes a serious hit, so helping Cole becomes a kind of do-over opportunity with Vincent. Malcolm sees parallels between Vincent and Cole; the case strikes him as a perfect opportunity to get things right this time.
He explains this to Cole midway through the film:
MALCOLM: Once upon a time, there was this person named Malcolm. He worked with children. He loved it. He loved it more than anything else. And then one night, he found out that he made a mistake with one of them. He couldn't help that one. And he can't stop thinking about it, he can't forget. Ever since then, things have been different. [...] And then one day, Malcolm meets this wonderful little boy, a really cool little boy. Reminds him a lot of the other one. And Malcolm decides to try and help this new boy because he feels that if he can help this new boy, it will be like helping that other one too.
Mind you, Malcolm never really clued into what was really going on with the first boy. For a while at least, it's questionable whether he'll be able to help Cole with the exact same issues. In any case, the backstory explains why Malcolm is so committed to helping Cole even when it's costing him a lot elsewhere.
And while we're on that topic…
He Used to Have a Good Marriage
Unfortunately, in Malcolm's view, helping Cole is contributing to some marital problems he's been having since the shooting. We see him try to interact with his wife, but those attempts aren't successful; she never acknowledges his presence and refuses to respond to anything he has to say. She seems to be getting close to one of her employees, Sean.
This chilliness seems like a big shift from their relationship at the beginning of the film, when he and Anna were devoted and affectionate. Sure, Anna made a passing reference to how she sometimes felt like she came second to Malcolm's work, but overall, they seemed pretty lovey-dovey—which makes their estrangement even more heartbreaking.
Malcolm alludes to his marital issues in his big heart-to-heart with Cole about why he's so intensely committed to their therapy sessions. In telling Cole the story of his life after the "Vince-ident," Malcolm (talking about himself in the third person) digs into his issues with Anna:
MALCOLM: He's not the same person that he used to be, and his wife doesn't like the person that he's become. They barely speak anymore—they're like strangers.
When Malcolm realizes his wife is dangerously close to getting cozy with another dude, he abruptly tells Cole he needs to stop his sessions so he can focus on his family. Apparently, fixing things with Anna is more important to him than righting whatever wrong he committed with Vincent in the past. As he tells Cole, he just wants things to go back to the way they were before:
MALCOLM: I want to be able to talk to my wife again. The way we used to talk to each other. Like there was no one else in the world except us.
COLE: How are you going to do that?
MALCOLM: I can't be your doctor anymore. I haven't paid enough attention to my family. Bad things happen when you do that. Do you understand?
Of course, it'll be kind of hard for Malcolm and Anna to get back to where they were because of one tiny detail.
He Used to Be Alive
Yup, that's right—he's dead.
He's been dead the whole time.
Now that you know, wasn't it obvious? His wife not speaking to him? That's because she can't see or hear him.
Malcolm died during that run-in with Vincent at the beginning of the film, and he just couldn't admit the truth to himself—at least, at first. So, instead of moseying along into the afterlife, he's been sticking around trying to help Cole (which makes him feel like he can make up for what went wrong with Vincent). Through his relationship with Cole, Malcolm finally comes to grips with his own death and finds a way to say goodbye to his wife: just like Malcolm suggested to Cole, find out what the ghost wants and help him get it.
He just didn't realize he was one of them.
Malcolm ends the film at peace and redeemed, having helped Cole and finally found a way to communicate with his wife long enough to say a proper goodbye.
And, of course, he gives us one of the best twists in movie history. So…thanks for that.
Malcolm Crowe's Timeline