Bruce LaBruce’s Academy of the Underrated: The Hospital

Despite being an Oscar winner, Arthur Hiller and Paddy Chayefsky's dark satirical drama is now overlooked and richly deserves fresh attention.

The Hospital (1971), written by Paddy Chayefsky and directed by Arthur Hiller, isn’t precisely an underrated film – it won an Oscar for Best Original Screenplay, and its star, George C. Scott, was nominated for Best Actor – but it tends to be overshadowed by Network (1976), Chayefsky’s later masterwork, for which he also won an Oscar, or even Marty, which won Best Picture and Best Screenplay Oscars in 1955. Some critics complained about abrupt tonal shifts in the movie, but considering the staggering complexity of the screenplay, the juggling of genres (black comedy, sociopolitical satire, farce, drama, murder mystery), and the ambition of its critique of the medical and hospital establishments (a much more convoluted and less sexy target than network television), it’s a remarkable piece of filmmaking. It can also be regarded as a kind of blueprint for Network, sharing many of the same themes and motifs, although in many ways, it’s equally as great.

Arthur Hiller is also an underappreciated director, perhaps not considered as distinguished as Network’s Sidney Lumet, who directed such serious fare as Twelve Angry Men (1958), The Pawnbroker (1964), and Dog Day Afternoon (1975); I would argue that Hiller’s more melodramatic movies, such as Love Story (1970) and Making Love (1985), are underrated because of their unapologetic populism and romanticism, even with a “social problem” film such as the latter. In 1964, Hiller directed another Chayefsky screenplay, The Americanization of Emily. That film artfully mixes comedy and drama, a great strength of Hiller’s work which is also evident in his Neil Simon adaptations, The Out of Towners (1970) and Plaza Suite (1971). The Hospital, however, is undoubtedly his best work, channeling Chayefsky’s righteous anger and intellectual dexterity with impressive brio and panache.

The parallels between The Hospital and Network are striking, the two films acting as iterations of the same formula applied to different subjects. George C. Scott plays Dr. Herbert Bock, a craggy, middle-aged surgeon and chief of medicine at a teaching hospital experiencing a debilitating case of “morbid menopause.” It’s as if Chayefsky split Bock into two characters for Network. Like William Holden’s character Max Schumacher, who is also going through a midlife crisis, Bock is in charge of a large institution that is being threatened by a new, youthful order that challenges its fundamental principles and values. The hospital he runs is under assault by hip community protesters and young doctors within the facility for annexing a nearby low-rent apartment complex in order to build a drug rehabilitation center. The protesters are demanding that the hospital find replacement housing for the displaced occupants. (In Chayefsky’s cosmology, moral ambiguity is present in almost every situation or issue almost to the point of vertigo.) In Network, Faye Dunaway, as Diana Christensen, represents a more sinister new generation challenging the establishment, one more akin to the current alt-right, using amoral gonzo tactics and politically incorrect strategies to increase ratings. Like Howard Beale (Peter Finch) in Network, Bock is suicidal, but unlike Beale, who feels he is being put out to pasture (before divine intervention redeems him), Bock feels that all his achievements have come to naught at the hands of a broken, corrupt institution. The mad prophet aspect of Beale is split off into two characters in The Hospital: Bock, who, in a suicidal rage, yells his critique of the healthcare system out the window during a thunderstorm (Mad Prophet of the Airwaves Beale encourages his viewers to vent their anger in the same way, also during a storm), and Drummond (Barnard Hughes), the crazy Methodist missionary (also a doctor) who has had a divine intervention and starts to wreak his revenge on the hospital that has misdiagnosed him and almost killed him.

Both Network and The Hospital begin with voiceover narration by an omniscient, unidentified narrator, in the latter case voiced by Chayefsky himself. In The Hospital, we are informed of the chain of misdiagnoses and wrong medications that have killed a patient named Guernsey, freeing up a bed on which the “prickly young buck” Dr. Schaefer can “zap” (Chayefsky-speak for “have sex with”) a technician from the hematology lab. After she exits, Schaefer falls asleep on the bed and a nurse, mistaking him for the patient Guernsey, hooks him up to an IV that somehow has been loaded with insulin, and the young buck, a diabetic, dies. It seems that someone has deliberately killed the doctor, setting up a complicated series of misadventures that are skillfully interwoven throughout the screenplay and deftly depicted by the director. We eventually discover that it is Drummond, the doctor who is a patient in the hospital, who has committed a series of murders by ingeniously setting up situations wherein doctors and nurses unwittingly kill the medical practitioners that he knocks unconscious and inserts into the system, the very same doctors that have butchered him, having taken a perfectly healthy patient into their care for a routine check-up, and ending up chopping out one of his kidneys and damaging the other. It’s an adroit scenario, giving the doctors a taste, so to speak, of their own deadly medicine.

Against the backdrop of this complicated whodunit and grim farce is the dramatic story of a man whose life, in middle age, is a shambles, and of the young woman who reinvigorates him after he thought his lion years were past him. It’s a theme that obsessed Chayefsky, first turning up in Marty (Marty is only 34, but he seems to be having a premature middle-aged crisis), then in Middle of the Night (1959) (Frederic March invigorated by a much younger Kim Novak), and finally in The Hospital and Network. In The Hospital, the young invigorator is Barbara Drummond (the formidable Diana Rigg), the daughter of a murderous Methodist missionary with whom she runs a religious mission among the Apache Indians in Northern Mexico. (Her father – a widower, like Howard Beale – had had a rather strange middle-aged crisis of his own, experiencing a religious ecstasy at a Pentecostal meeting resulting in him being able to speak fluently an obscure Apache dialect.) Barbara, a former nurse with the mother of all Daddy complexes, is trying to spring her father from the hospital before they kill him, but in the meantime she sets her sights on the menopausal Dr. Bock, who invites her into his office to use his telephone. What follows are two riveting monologues, one for each character, that only a writer as audacious as Chayefsky could conceive. As she seductively displays, while seated on his desk, her serious gams poking out from under her mini-skirt, Barbara recounts her life story, about how she had her “obligatory affair with a minority group, in my case a Hopi Indian,” followed her father to Mexico after his “afflatus” to open a mission in the mountains, “lived in a grass wickiup and ate raw rabbit and crushed pinon nuts” and “masturbated a great deal.” “Within two months,” she says, “I was back in Boston, a hollow shell and dizzy with dengue, disenchanted with everything. I turned to austerity, combed my hair tight and entered nursing school. I became haggard, driven and had shamelessly incestuous dreams about my father.” When she cracked up and they found her “walking to work naked and screaming obscenities,” she returned to Mexico to be with her father, becoming “curiously content.” Barbara makes it clear that she’s coming onto the good doctor, who responds with a blistering monologue of his own about his life, and a spirited defense of impotency. He tells her about his hippy son, the “Pietistic little humbug” and “shaggy-haired Maoist” who “preached universal love and despised everyone,” (liberal hypocrisy is one of Chayefsky’s favorite targets) before delivering a scalding critique of the medical establishment:

“When I say I’m impotent, I mean I’ve lost even my desire for work, which is a hell of a lot more primal a passion than sex. I’ve lost my raison d’être, my purpose, the only thing I ever truly loved. It’s all rubbish anyway. Transplants, antibodies, we manufacture genes, we can produce birth ectogenetically, we can practically clone people like carrots, and half the kids in this ghetto haven’t even been inoculated for polio! We have established the most enormous medical entity ever conceived, and people are sicker than ever! We cure nothing! We heal nothing! The whole goddam wretched world is strangulating in front of our eyes! That’s what I mean when I say impotent!”

A precursor to the virtuosic monologues of Howard Beale and Arthur Jensen (Ned Beatty) in Network, this drunken jeremiad is delivered by George C. Scott with startling invective, particularly when he spits the lines “We cure nothing! We heal nothing!” out the window into the raging storm, his back turned to the camera, making it all the more powerful. (Incidentally, Scott diverges slightly from Chayefsky’s original line in the take, mistakenly saying “we have established” rather than “we have assembled,” then grasping for a word to replace “establishment” to avoid repetition and coming up with “entity” as an ad lib. The director loved the moment and kept it in.) When Bock confesses his intent to commit suicide and Barbara dismisses it as “a familiar case of morbid menopause,” Bock tells her to get out, saying he’s not about to let “some cockamamie 25-year-old acidhead … reassure me about the menopause.” “Twenty-seven,” she corrects him, before exiting, and Bock indeed does proceed to try to kill himself with a shot of potassium. Barbara returns, thinking she might have misread him, and prevents him from doing the deed. The ensuing scene, in which Bock rips the clothes off Barbara and “ravishes” her, might not play very well in the current climate of sexual moral absolutism, but in the context of the stories both characters have told, has an internal logic to it. But let’s consider Chayefsky’s description of the act in the original script:

“He moves around the desk, a shambling bear of a man, a leather belt dangling dementedly from his arm, tears coursing down his cheeks. He advances on her in a stuporous shuffle. She regards his lumbering approach with a faint, grotesquely sensual smile. He reaches with his naked left arm to the neck of her dress and, with one savage wrench, rips her stark naked, sobbing through hysterical tears. He is on her, crushing her down into the shadows of the couch, ravenous at her neck and shoulders in a brutish assault, sobbing. Throughout the scene, CAMERA MOVES SLOWLY IN through the flesh and fury to an INTENSE TWO-SHOT of this terrified act of love. Then slowly over Bock’s plunging shoulder to the woman’s face. She gasps at the moment of penetration, then her lovely face slowly shapes into smiling serenity. Bock sobs; even in the shadows we can see the path of the tears on his cheek.”

The scene is clearly “rapey” in tone, and yet somehow Barbara seems to be the one in control, fulfilling her own sexual fantasies, including the ravishment. (It must be said that Diana Rigg’s intelligent performance helps turn the scene from potentially cringe-worthy to believably feminist.) The post-mortem the two characters conduct of the event retroactively reinforces the consensual nature of the act, Barbara saying, when Bock calls her “Miss Drummond,” “I expect you can call me Barbara, considering you ravished me three times last night.” She also brags about “punching a couple of holes in your crusade for universal impotence.” Even beyond this, the violent act of love-making has caused the two of them to fall madly in love with one another, and Barbara tries to convince him to leave his job at the hospital and return with her to Mexico. “If you love me,” she says, “I don’t see what other choice you have, “ to which Bock replies, “What do you mean, if I love you. I raped you in a suicidal rage. How did we get to love and children all of a sudden?” She reminds him he told her “a half a hundred times” the previous night that he loved her, even bellowing it out the window at one point. When Bock says they were expressions less of love than of gratitude “for resurrecting feelings of life in me I thought dead,” Barbara replies, “Well, my God, what do you think love is?” This is one of my favorite definitions of love in cinema.

It’s tempting to interpret this scene, written and directed by men, as a grotesque male sexual fantasy, but in the context of a black comedy, and with the psychosexual lives of the characters as explained by the monologues, it seems more like an honest portrayal of the deeply complex and sometimes disturbing nature of sexuality, which sometimes includes rape fantasies. As a counterpoint, one should consider the scene in Network in which Faye Dunaway mounts William Holden while talking business and TV shares right up to and during her premature orgasm, and post-coitally as well. Also played for broad black comedy, the scene is a critique of post-feminism, but reads as unmistakably feminist, thanks partly to Dunaway’s brilliant performance. Diana Christensen turns the tables on the powerful, middle-aged man, using him as a sexual object strictly for her pleasure, much as Barbara does with Bock in The Hospital.

But the great pleasure of the film remains the dialogue, as Chayefsky is certainly the screenwriter with the best vocabulary I can think of. (Who else would use words like “solicitous,” “precipitous,” “unreconstructed” and “inspirited”?) In one inspired scene, Bock berates the Director of Nurses, Mrs. Christie (a shrewd turn by the wonderful Nancy Marchand of The Sopranos fame), asking her, of the death of Dr. Schaefer, “Didn’t anybody bother to go in and check on him during the night even under the impression that he was merely a patient?” He also tells her that “the incompetency here is absolutely radiant,” the choice of the word “radiant” elevating the line to a different and unexpected level. And to top of the scene, Bock spits out, “My God, where do you train your nurses, Mrs. Christie? Dachau?” Perhaps only Chayefsky could get away with such an impertinence.

Considering the current state of the healthcare system in America, and all the misanthropy and malfeasance that the debate around it has engendered, The Hospital can only be regarded as another prophecy of Chayefsky’s, like his anticipation of reality TV and the corporate takeover of the world in Network, that has come to pass. He’s the Nostradamus of modern cinema, and we must all atone.

Bruce LaBruce is a filmmaker, writer, photographer and artist based in Toronto, Canada. Recently there have been retrospectives of his films at the TIFF Bell Lightbox in Toronto and at MoMA in New York City. His latest feature, The Misandrists, will be released in 2018.