Most filmgoers who were born before 1965 know Paddy Chayefsky as the playwright who penned the teleplay Marty and later won an Oscar for the 1955 screenplay adaptation. Contemporary movie fans, however, remember him as the creator behind the 1976 media satire Network, which was nominated for 10 Oscars and won four including Best Screenplay, Best Actress (Faye Dunaway), Best Supporting Actress (Beatrice Straight) and a posthumous Best Actor Academy Award for Peter Finch as unhinged news anchor Howard Beale. (Bryan Cranston is currently playing Beale in a Broadway stage production based on Chayefsky’s film). What tends to get overlooked in Chayefsky’s filmography is The Hospital (1971), an equally audacious movie that prefigured Network’s outrageous blend of black comedy and social commentary and appeared five years earlier. 

Synopsis: Dr. Herbert Bock (George C. Scott), the Chief Resident at a sprawling, chaotic New York City hospital, is on the verge of a crack-up. Recently divorced, estranged from his children, overworked, and impotent, he is no longer the man he used to be, one who enjoyed a reputation as a medical genius. To complicate matters, members of Bock’s hospital staff are dying under mysterious circumstances, suggesting a lunatic may be on the loose. The gallows humor of The Hospital was years ahead of its time when it first appeared in 1971 and the film’s unusual mixture of macabre comedy and cynical outrage still appears fresh when compared to more formulaic and soap opera-inspired TV medical series like E.R. and Grey’s Anatomy. 

 Screenwriter Paddy Chayefsky was partially inspired to write this attack on institutionalized medicine after his wife’s unhappy experience in a hospital while suffering from a neurological disorder. The incompetence and hospital staff apathy she encountered so enraged Chayefsky that he funneled his frustrations into this screenplay. He also interviewed numerous doctors, nurses, surgeons, and administrators and poured over actual malpractice suits before his scenario began to take shape.

Although Chayefsky had only worked on one film – the 1969 multi-million dollar flop, Paint Your Wagon – since his last critical success, The Americanization of Emily in 1964, he was still able to secure full creative approval on every aspect of The Hospital. His first choice for the role of Dr. Bock was George C. Scott even though United Artists wanted him to consider Burt Lancaster and Walter Matthau. Even though Scott’s salary demands were at first refused, Chayefsky persisted and got his leading man in the end.

For director, Michael Ritchie was hired but almost immediately clashed with Chayefsky over the set design. He was soon fired and replaced with Arthur Hiller, who had worked with Chayefsky previously on The Americanization of Emily. The Hospital also marked the first film for co-producer Howard Gottfried, who would go on to work with Chayefsky on his final two films, Network and Altered States (1980).

As Barbara Drummond, the hospital visitor who seduces Dr. Bock in his office, Jane Fonda was first considered but Scott reportedly vetoed the offer with his comment, “still too much of a hippy, and in need of a bath.” Ali MacGraw and Candice Bergen were also considered but Chayefsky had his heart set on Diana Rigg, a graduate of the British Royal Academy of Dramatic Arts and an acclaimed London stage actress.

At first Rigg turned down the role but she changed her mind after Barnard Hughes (cast as her father in the film) visited her in her dressing room after a performance of Abelard and Heloise and told her she was crazy to pass up an opportunity to work with Chayefsky.

In a 2015 interview with Stephen Bowie of The A.V. Club, Rigg offered a slightly altered version of being cast: “It’s courtesy of Paddy Chayefsky that I got that part. He saw me in Abelard And Heloise, on Broadway, and he fought for me to get the job. We adored each other. We used to play Scrabble when we had time. He’d put Yiddish words down on the board and I’d scream at him.” Chayefsky would later champion Rigg for the female lead in Network but Faye Dunaway, the bigger name, was cast instead. As a concession, the screenwriter named the Dunaway character after Diana.

Filmed at the Metropolitan Hospital on the Upper West Side of Manhattan, The Hospital had its share of expected “fireworks” during production which was no surprise since both Chayefsky and George C. Scott were volatile, opinionated men who rarely compromised on their artistic principles. Scott was going through a difficult period in his marriage to Colleen Dewhurst at the time and was drinking heavily during filming.

Some days he simply didn’t show up on the set while other days he arrived drunk and unable to work. In some ways his behavior was startlingly similar to the angry, suicidal character he was playing. Rigg acknowledged this in her A.V. Club interview, stating, “He was a brilliant actor, undoubtedly. But he was very troubled. And he did disappear from time to time, for quite lengthy periods…I liked working with him hugely, because you never knew what he was going to do, and there was this sort of power emanating from him. It was, like, reined in, and you never knew when it would burst. I loved it. It was very exciting, and I think our scenes were quite good. So I enjoyed the whole thing.”

Despite Rigg’s personal experience, Scott was not an actor who took direction easily. Chayefsky found this out when he offered some acting suggestions to Scott for a specific scene and Scott exploded, screaming, ‘You do your f**king writing! And I’ll do the acting!” Somehow Scott pulled himself together and gave a magnificent performance, which earned him a Best Actor Oscar nomination (He previously won Best Actor for Patton in 1970 and received Best Supporting Actor nominations for Anatomy of a Murder (1959) and The Hustler (1961). Chayefsky did even better. His script for The Hospital won him his second Academy Award for Best Screenplay (He would also win it for Network in 1976).

In Mad as Hell, a biography of Paddy Chayefsky by Shaun Considine, director Arthur Hiller commented on the acclaimed playwright: “People often say to me, ‘You’ve done two pictures with Paddy, how did you get through it?’ My answer always is, ‘When a genius speaks, I listen.’ He’s really the only genius I ever worked with. He was way above the rest of us.”

One aspect of The Hospital that is particularly fascinating today is the supporting cast which is chock full of great character actors. Richard Dysart (the TV series L.A. Law, The Thing), Andrew Duggan (Seven Days in May, It’s Alive), Nancy Marchand (Tony Soprano’s mother in the TV series The Sopranos), Roberts Blossom (Deranged, Doc Hollywood), Lenny Baker (Next Stop, Greenwich Village), Katherine Helmond (Brazil), Frances Sternhagen (Misery, Outland) and Robert Walden (Blue Sunshine, the TV series Lou Grant) all have brief but juicy bits. According to IMDB, you can also spot Stockard Channing (Grease), Dennis Dugan (Happy Gilmore) and Christopher Guest (This is Spinal Tap) as extras though I haven’t been able to confirm this yet.

The critics’ response to The Hospital in 1971 was mostly positive although some noted the often jarring tonal shifts between black comedy and social critique such as Vincent Canby in The New York Times: “Melodramatic farce is a pretty far remove from the slice-of-life things that Mr. Chayefsky once did so well. However, the writer’s intelligence, and his only recently exercised gift for fantasy (which reminds me a bit of Evelyn Waugh’s) save “The Hospital” from a couple of serious seizures that, toward the end, overtake the movie when it feels called upon to certify its serious purposes and to straighten out its peculiar plot.” Other critics like Pauline Kael found it less impressive as a sharp-edged satire but still deemed it an “entertaining potboiler…Low comedy, to be sure, but funny and lively.” And the film holds up well today and can be seen as a dry run for the even more outrageous Network, released five years later.  The Hospital was first released on DVD by MGM in 2003 as a bare bones edition with no extras. It was more recently released as a limited edition Blu-Ray by Twilight Time in January 2018 and was a significant upgrade in terms of the digital transfer and audio mix. The only extra was the original theatrical trailer.

*This is a revised and updated version of an article that originally appeared on the Turner Classic Movies website.

Other website links of interest:

https://gointothestory.blcklst.com/how-they-write-a-script-paddy-chayefsky-2912eee0e9f7

https://www.thenational.ae/arts-culture/books/medium-rarity-1.456279

https://www.dga.org/Craft/VisualHistory/Interviews/Arthur-Hiller.aspx

https://www.rogerebert.com/interviews/george-c-scott-in-memoriam

https://tv.avclub.com/diana-rigg-on-the-avengers-mrs-peel-game-of-thrones-1798281429

https://www.youtube.com/watch?v=HftRP0NAJYg