By 1970, screenwriter/novelist/playwright Paddy Chayefsky had reached the pinnacle of cinematic heights. With one Academy award behind him already (for "Marty" in 1955)and two more to follow in the 70's, Chayefsky had just as much power as a director or producer. Like screenwriting peer Robert Towne a few years later, his pen turned paper into gold. And this position of power was mandated with the release of "The Hospital" one year later in '71 . Not only did Chayefsky get another Oscar for this work, but he got top billing upon release. There's the title, followed with "by Paddy Chayefsky" and then a quick directing title for Arthur Hiller. It must be nice at the top.
But, I'm not complaining. "The Hospital" is one great script. Like "Network" which would be written later in his career, Chayefsky tackles an institution (the medical profession) and turns it inside out, reveling in its bureaucratic uglies, taking sardonic swipes at its individuals and essentially bracketing the whole profession as one huge three ring circus without a ringleader. And in the midst of the neglect and mounting confusion of its merry-go-round cast over one long night in their New York hospital, there stands George C. Scott as Dr. Bock... a depressed, burned out live wire who is just as royally condemned as the homeless man left in the corner to die. Chayefsky certainly has an affinity for that 'off the reservation' maverick. He crafted an Oscar winning role for Peter Finch years later in "Network" as the demented TV broadcaster who turns into a cult leader for the disenfranchised and psychotic, and Scott's performance as Dr. Bock is basically the foundation for this type of professional defect. Held to a much lower key than Finch, Scott still burns fiercely, and when it comes time to deliver a long, rambling monologue about the state of the medical field, his own failures as a father and his impotency, Scott owns the scene. Many have tried to imitate Chayefsky's verbose brilliance, but no one comes close. When his characters deliver a monologue, you feel it in your bones.
Chayefsky's treatise on the horrors of hospitals isn't the only one. Romanian filmmaker Cristi Puiu's "The Death of Mr. Lazarescu" from 2006 is an equally damning representation. But Chayefsky got there first, and not only does "The Hospital" induce cringing as a lady from accounting calls out insurance numbers while someone dies on a gurney behind her, but it also creates great laughs in the way his characters stroll around in a state of eternal confusion. There's a casual disregard for death and mistakes. When one patient (who may be a doctor from the hospital) ends up dead in the hospital bed of a missing patient, it takes a full 2-3 minutes before one nurse convinces the other to come see what's wrong. It's to the credit of Chayefsky (and we should mention, I guess, director Arthur Hiller who keeps the whole thing fresh and paced) that he manages to wring great ironic humor out of assembly line human waste.
"The Hospital" isn't all gloom and doom. Without spoiling much, George C. Scott's Dr. Bock isn't a casualty in the engulfing morass. Chayefsky's script cares too much for him, throwing him a rekindled sexual appetite in the form of a beautiful visitor to the hospital played by Diane Rigg. And just when things seem darkest and the impending forces of the outside world descend in the form of urban protests from low-income tenants of a housing project destroyed by the hospital's plans for expansion, Scott turns a responsible corner and becomes the film's moral compass. While it's not Chayefsky's most fully believable character arc, Scott delivers his intentions with such determination, that's it hard to not root for him. Like "Network", Chayefsky's intentions are broad strokes against an empirical setting. Not only does he create vivid characters virtually swallowed up by their surroundings, but every now and then one of them gets out alive. In the hospital of this 1971 film, that's all the more fantastic.