Fifty years after its release, screed-writing screenwriter Paddy Chayefsky’s dark comedy “The Hospital” still has the power to make your jaw drop.
Released amid growing cynicism about institutions that Vietnam inspired and Watergate proved, with documentaries such as “Titicut Follies” laying bare the stark realities of American medicine, and “M*A*S*H” puncturing the TV-burnished image of doctors as “ministering angels,” “Hospital” must have felt like a kick in the teeth.
The ensuing decades have seen nothing that went this far, with only TV’s “Saint Elsewhere” and a few edgier moments on the soapier “E.R.” or comical “Scrubs” etc. even trying.
That said, the black humor in Arthur Hiller’s “comedy” doesn’t really start to work until late in the picture. And it takes the ears and eyes a while to adjust to any visit to Paddy Chayefskyland. Few conversations sound natural. Characters launch into speeches and others in the scene simply yield the floor to them. Casting Oscar winner George C. Scott as the lead meant the near-soliloquies would be epic, scene-chewing rants.
The acclaimed playwright, screenwriter and novelist, already an Oscar winner for “Marty,” was sort of the Stanley Kubrick of screenplays. He demanded complete control over his pictures (“Network,” a few years later, was his masterpiece) based on a cultivated reputation as a “genius.” But look at the years of credits leading to “The Hospital” and name one that earned him this license — casting control, producing control, his almost-unique (in the U.S.) “by” credit, as opposed to “written by” or “screenplay by.”
They gave it to him because, like Kubrick, he had the cheek to demand it. And in a town of hacks, Hollywood knew a genius when it was run over by one. Chayefsky even delivers the film’s biting, cynical opening narration.
Scott plays Dr. Herbert Bock, chief of medicine at Manhattan Medical Center (actually filmed in a new wing of New York’s Metropolitan Hospital). He looks a wreck, and in a theatrical blast of exposition, declares “I’m 53, with all the attendant fears. I’ve just left my wife.” Oh, and by the by, he’s depressed and suicidal.
When we dive into his workplace, a chaotic, noisy and crowded house of healing, we get it. A modern viewer will instantly wonder “How the hell did they keep it all together and keep track of who was whom?” in that pre-digital age.
Because very quickly, the answer becomes obvious — not well at all.
A “horn dog” resident eagerly notes the passing of a patient, giving him and his latest paramour nurse a (semi-private) room for their nightly assignation. He winds up dozing off, getting the dosage of the dead man by a nurse just doing what the chart says, and dying.
Over the course of the next day and a night, others will die, some will be clubbed by an unseen assailant, the hospital will come under siege for its efforts to demolish a neighboring tenement for expansion, the harried chief administrator (Stephen Elliott) will try to juggle all this, Dr. Bock will drink Smirnoff’s and try to pretend that he’s struggling to remember the names of the sea of white (mostly) male residents he leads on rounds and the frazzled billing officer (Frances Sternhagen, funny) will try to get the “Blue Cross? Blue Shield?” particulars from patients because the arrogant medicos — doctors and nurses — can’t be bothered.
“I mean I have to bill these people. I know you doctors are the ministering angels and I’m the bitch from the accounting department, but I’ve a job to do too. I mean, if you don’t mind, Doctor!”
Actors must have loved working for New York Paddy. Such glorious, long, attention-grabbing speeches, with everybody of any note in the cast getting one or even two.
Dr. Bock insults a careless, bottom-line lusting colleague (Edward Dysart, years before “L.A. Law”) — “You’re greedy, unfeeling, inept, indifferent, self-inflating, and unconscionably profitable. Besides that, I have nothing against you. I’m sure you play a hell of a game of golf.
There’s Barbara (Diana Rigg), the half-Bock’s-age (in the script) daughter of a mistreated patient (Barnard Hughes), a woman who brings in an Apache healer from the tribe she and her father minister to in Mexico.
“I fancied you from the first moment you came lumbering down that hallway, upstairs. I said to Mr. Blacktree, “Who’s that hulking bear of a man?” Apaches are reverential about bears. Won’t eat bear meat, never skin bears. Bears are thought of as both benign and evil, but very strong power. Men with bear power are highly respected and are said to be great healers. “That man,” I said, “gets his power from the bear.”
You can be a fan of the writing while acknowledging Chayefsky’s penchant for male wish fulfillment fantasy romantic pairings — ancient William Holden pursued by bombshell Faye Dunaway, Rigg mini-skirting her way through Dr. Bock’s self-declared “impotence.”
Different era, that’s for sure.
Hiller, an accomplished comic director who went on to film “Silver Streak” and “The In-Laws” as well as sappy romances, had already made a dark and semi-daring comedy with Chayefsky, “The Americanization of Emily,” a talk-you-to-death skewering of the notion of “war hero.” Hiller’s chief contribution to “Hospital” was in keeping every shot so crowded it’s a wonder anybody had elbow room to apply a stethoscope, much less a scalpel.
The only player in the cast who treats this as an outright farce is the wild-eyed Hughes, who played two roles (he was also a mustachioed, flabbergasted, error prone surgeon) and kind of takes over the third act. Scott plays it straight, if often over the top and LOUD, as was his style.
But that’s just right for the film’s scathing, perplexed undertone of high dudgeon “How the hell is this allowed to happen?”
Rewatching “The Hospital” now, I was struck by how much impact it plainly had in how such houses of healing are portrayed, how the darkly funny stuff lands a bit softer and how nobody writes dialogue this arch any more, and for good reason. It’s so self-conscious that it takes one right out of the scene, at times.
“You know, when I say impotent, I don’t mean merely limp… When I say impotent, I mean I’ve lost even my desire to work. That’s a hell of a lot more primal passion than sex. I’ve lost my reason for being – my purpose. The only thing I ever truly loved.”
Who in heaven’s name talks like that, tells a beautiful woman they’ve just met that, outside of the printed page? What was Chayefsky confessing here?
The “romance” between Bock and “Miss Drummond” is about as flesh and blood realistic and organically romantic as that moment a guy asks the sex worker “How much?”
Hughes would play many grumpy doctors over the years, in the sitcom “Doc” and later as the curmudgeon “Doc Hollywood” takes over for, a film which also-starred Sternhagen. Nancy Marchand, whose big break was co-starring in Chayefsky’s “Marty,” plays the ever-brow-beaten head of nursing. Her “Lou Grant” co-star Robert Walden plays an internist/confidante to Dr. Bock. And Stockard Channing (in her first screen appearance) and Katherine Helmond pop in the single scene each appears in.
It’s not the over-the-top hoot “Network” turned out to be. The topline characters simply aren’t as interesting, and the surrounding cast is often nameless — so much so that the business of giving Hughes two roles trips the movie up in a too-obvious way.
And whatever Chayefsky’s encounters with soulless “modern medicine” were, the profit-uber-alles world of TV he knew like the back of the hand he slapped it with. Still, he, Hiller and Scott created a template for that every drama or comedy (“Scrubs”) that followed with this film about America’s “most enormous medical… entity ever conceived,” built on the profit principle, leading to patients who “are sicker than ever.”
Rating: PG-13 for thematic elements, sexual content and drug references
Cast: George C. Scott, Diana Rigg, Nancy Marchand, Stephen Elliott, Frances Sternhagen, Robert Walden, Richard Dysart and Barnard Hughes.
Credits: Directed by Arthur Hiller, scripted by Paddy Chayefsky. A United Artists (MGM/UA) release on Tubi, Amazon and other streamers
Running time: 1:43