Sunday, January 8, 2017

The Hospital

SPOILER ALERT! The plot of the movie will be discussed.

Plays concentrate on words. Film scripts focus on the picture, the image. However, there are a few writers, such as Aaron Sorkin and Woody Allen, for example, whose words make listening to a movie just as important as watching it. Paddy Chayefsky was such an artist. He received an Oscar for the film, Marty, and won one for this motion picture. He would go on to receive the writing award again for the brilliant Network (see the prior post on that one) before leaving us all too soon.
This 1971 story targets the medical profession, and it is as timely as ever. The focus is on Dr. Herbert Bock (George C. Scott, brilliant, and nominated for Best Actor for the role). Satires usually spend their time on the object they are attacking and spend little effort on character development (Dr. Strangelove, Wag the Dog are examples). Not here. Bock is a fully fleshed out person. He is an eminent Harvard-educated physician who is Chief of Staff, and teaches, at a New York City hospital. But, he ironically is sick, mostly in a helpless, life-stricken way. We see him not showing up for rounds at the medical center, oversleeping, and smoking and drinking to excess. When he receives the call that one of his staff doctors died due to hospital negligence, we see a weary look on his face, as if another in a long line of spiritually-depleting weights has landed on his weakening shoulders.

About that doctor. His name is Schaefer (Lenny Baker). We are told in an omniscient narrator opening (spoken by Chayefsky) that he is a young stud who has been having sex with multiple nurses in various uncomfortable places, and now is excited because he has a vacant bed. It became available because a patient named Guernsey (slaughtered like a cow?) (Roberts Blossom), who occupied it, died because of a misdiagnosis by a nursing home physician. The narrator says that it is “axiomatic,” that all nursing home doctors are “wrong.” Those who have had, or have, loved ones in these facilities can judge whether even today that impression is correct concerning the mostly contracted out doctors employed at these establishments. The hospital staff compounded Guernsey’s health problems with further misdiagnoses and incorrect treatment, resulting in his demise. The next time we see Dr. Schaefer, he is a corpse in that same bed. The nurses, thinking him to be Guernsey, stuck an IV into him. We learn that he was diabetic. Nursing supervisor Mrs. Christie, (Nancy Marchand, no Christ-like figure here), says to Bock, “These things happen,” as if accidents are an acceptable way of life in a hospital. She gives as an excuse the fact that nurse “floaters” who move from floor to floor don’t know individual patients. Bock yells at her, saying, “Now what am I going to tell this boy Schaefer’s parents. That a substitute nurse assassinated him because she couldn’t tell the doctors from the patients on this floor?” He is outraged, and says, “I mean, where do you train your nurses, Mrs. Christie, Dachau?” Pretty bad when a supposed place of treating the sick rivals a Nazi concentration camp. In addition, instead of compassion, we hear a hospital administrator’s concern for the bottom line, as he worries about a lawsuit concerning Schaefer’s death.
Bock is confronted by John Sundstrom (Stephen Elliott), the hospital administrator, who knows how Bock has been dodging his responsibilities, and that he has recently separated from his wife. He suggests seeing a hospital psychiatrist. After seeing protesters outside angry at the hospital’s eviction of neighborhood residents to accommodate the expansion of the medical center, he then hears a list of other problems from his assistant. He decides to pay a visit to the shrink, Dr. Joe Einhorn (David Hooks). This narrative device provides exposition to understand Bock’s back story. He admits to bouts of depression, which date back to suicidal thoughts when he was younger. He tells the psychiatrist that he was from a middle-class family and his parents were proud of their brainy son. However, he was terrified of women and bad at sports, which implies feelings of inadequacy as a man. He says his seventeen-year-old daughter had two abortions and was arrested for drug dealing. He evicted his son, who he scornfully describes as a shaggy-haired Maoist who hypocritically espoused universal love while despising everybody. But, Bock heaps guilt upon himself, saying he was at fault for these “worthless” children. He admits to being impotent, but hasn’t had a chance to even have sex in quite a while. When asked about suicidal thoughts, he shows that he has given considerable thought about using potassium which would not show evidence of self-harm, and, thus, making sure his family would receive the life insurance payment. Thus, his need for responsibility even carries on into death. Einhorn is concerned, since he sees a man who is exhausted, guilt-ridden, and isolating himself, possibly preparing for death. Bock says he just has to throw himself into his work.

We see, despite the efforts of modern medicine, an emergency room filled with sick people, and how the business bureaucracy part of the hospital comes off as unfeeling in the person of Mrs. Cushing (Frances Sternhagen, although there is nothing “cushioning” about her attitude). In the middle of all the suffering, she harasses ill patients for insurance information, and chastises doctors for not clearing their activities with her first. When she interrogates one inactive patient, she determines that he is dead. When she informs a physician that there is a dead man in the corner of the ER, he asks how does she know he is deceased. Her answer is “Because he wouldn’t give me his Blue Cross number,” which shows her only criteria for a vital sign.
The patient in the bed next to where Guernsey died is a man named Drummond (Barnard Hughes). Bock is curious about the man’s visitors, one, a beautiful young woman, the other a half-naked Native American. The senior resident, Dr. Brubaker (Robert Walden), tells Bock that Drummond, a Methodist missionary who lives with the Apaches in Mexico, came in and was found to have protein in his urine. He was then bullied into a biopsy where a blood vessel was damaged. Everything went downhill from there, with the man having one kidney removed, the other damaged, and him becoming comatose. The woman, Barbara (Diana Rigg), his daughter, wants to return her father as soon as possible to Mexico. Bock tells Brubaker to let him go, “before we kill him.” The Apache, a shaman, is Mr. Blacktree (Arthur Junaluska), who does a dance while a thunderstorm rages, from which he supposedly can draw some cosmic healing power. The storm itself seems to be symbolic of the destructive professional climate inside the medical institution. Bock asks Barbara if she really believes the Native American can help, to which she answers that he can’t do any harm. That is the creed by which doctors are supposed to live by, and, in this ironic story, it is the “medicine man” who is the only one who appears to adhere to this ethic.
 Bock invites Barbara to use his phone to make arrangements to have an ambulance remove her father. She uses the opportunity to provide a lengthy personal history of how her dad, a doctor in his own right, was at a religious service when he started speaking in “tongues.” It turned out that Drummond spoke in an obscure Apache dialect. Believing he had received the word of God, he moved to Mexico to be with the Apache and worked at a mission. Barbara became a Hippie, took drugs, and had incestuous dreams about her father. She had a breakdown, but eventually wound up at the mission. This story was her way of saying that she was attracted to middle-aged men, and especially to Bock. He admits to his impotency, which he explains goes beyond a physical problem. He tells her, “When I say impotent, I mean I have 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’ve truly loved.” Bock lists medical advances that we still explore today, including work in genetics and cloning. But despite creating “an enormous medical entity,” ironically, children in the surrounding neighborhood have not been vaccinated. His feeling of helplessness is palpable as he bellows out into the supposedly nurturing halls of the hospital, “we’re sicker than ever. We cure nothing! We heal, nothing! The whole goddamn wretched world, strangulating in front of our eyes.”

Bock says that there is no viable alternative for him except death. At first Barbara tries to dismiss the doctor’s rant as self-pity. He dismisses her. But, she returns, rightfully concluding that his suicidal threat may be real. She finds Bock about to inject himself. He is enraged by this suicidal interruptus (the needle substituting for his flaccid penis), and sexually assaults Barbara, who actually doesn’t mind, since she wants him. As it turns out she says that during the night he ravaged her three times (ironically, a religious number, if one considers the “Holy Trinity). And, in fact, Bock is reborn, sexually, and as it turns out, spiritually. He actually says that she “resurrected” feelings in him that were dead (If you use a Schwarzenegger dialect, his last name could be “Back,” which means he has returned to the man he once was). He wants to personally take care of her father, but she has had ominous dreams about the whole hospital staff heading in a suicidal march to the sea. In the context of this film, dreams and portents are more reliable than medical science. She declares her love for Bock, and says he should come with her and her father back to Mexico where he would be needed the way he once was, and purpose in his life will, in essence, will return. She says he has a choice between the mountains of Mexico or the bottle of potassium.
But, there are more deaths among the employees of the hospital. We see one in the lab get clubbed by a mysterious person. He shows up as the dead man in the ER. His name is Dr. Ives (Robert Anthony). A young nurse is also knocked out, and turns up on the operating table instead of a middle-aged woman scheduled for a hysterectomy. The nurse dies of a reaction to the anesthesia. These victims, along with Dr. Schaefer, were involved in the mistreatment of Guernsey and Drummond. In addition, there have been reports of a doctor wearing the dead Dr. Schaefer’s ID badge around the hospital. Bock, who has decided to leave with Barbara, remembers that he saw Schaefer’s jacket in Drummond’s clothes locker. When he goes to check it out, Drummond, not comatose at all, tries to strangle Bock, who is rescued by the entrance of Barbara. Thus, Drummond, too, appears to have come back from death, to fulfill a purpose. He proceeds to say he is the “angel of the bottomless pit,” and the “wrath of the lamb,” who is to exact biblical retribution, “an eye for an eye,” Those who committed medical negligence would die “by irony,” being made patients in their own hospital. He was given this mission, he believes, by Guernsey, who was in fact God, and who came to Drummond after his death. Thus, we have another resurrection, in this case a symbolic one, whose purpose is to restore balance to the wrong deeds perpetuated against innocent people.

Drummond sedated Schafer, put the doctor’s own insulin into his IV, and the nurses allowed his death to occur by not recognizing the wrong person was in the bed. Drummond emphasizes medical incompetence by saying he wanted time to carry out some of his actions, so he rang for his nurse, “To ensure one full hour of uninterrupted privacy.” And, he put the young sedated nurse prior to the hysterectomy surgery outside the x-ray department, where a patient left for an excessive number of hours would not be considered anything unusual. The man who died in the ER was Dr. Ives. Drummond had given him Digoxin, brought him to the ER in time to be treated, but his heart gave out, because, as Drummond says, he was, “simply, forgotten to death.” As he tells Bock and his daughter about Dr. Ives, he provides a chilling, horrific epic catalog of the sick people who are in the ER, and the illnesses replace their names, as they become their afflictions: the fractures: the infarcts; the hemorrhages; the old lady mugged in the subway; the rapes; the septic abortions; the colonic cancers; the asthmatics; the overdosed addicts, etc. To sum up, Drummond calls them, “the whole wounded madhouse of our times.” The implication is that perhaps Bock’s speech that despite scientific advances, we are sicker than ever.
There is one more person on Drummond’s hit list, Dr. Welbeck (Richard Dysart), whose name itself is ironic, because instead of getting people “well,” he has shown up inebriated at several operations, including the one he performed on Drummond, and is an incompetent surgeon. Welbeck is all about the money, as he counsels younger doctors on how to give themselves bonuses at the same time they avoid paying taxes. Cosmic irony does Welbeck in, instead of Drummond, as he discovers on the phone that his partner has stolen everything and gone off to Brazil. Welbeck sustains a fatal heart attack and dies in Drummond’s room. The staff assumes it is Drummond who died, which Bock confirms, thereby giving Barbara time to get her father out of the country. On the way out, Drummond says before anyone can confirm that it was Welbeck who died, they will remove the body, send it to Mexico, and people will think Welbeck was in on the scam with his partner, who he joined in Brazil.
Instead of going with Barbara, Bock sees that between the protests, financial problems, and medical ineptitude, the hospital is falling apart, and he must be there to help. As he told her earlier, his middle-class background taught that it isn’t love that triumphs over all, it is responsibility. But trying to fix things, as Sundstrom says, is “like pissing in the wind.”
Some may say that feeling may be reflected today in the United States as we try, seemingly with no viable plan, to deal with an aging population with more illnesses, younger people with more asthma and allergies, and soaring costs for doctors’ bills, nursing homes, and medications that seem to have more harmful side-effects than beneficial ones.

The next film is Birdman.

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