RvB's After Images: The Hospital (1971)

With the second biggest opening for a documentary in movie history, Sicko will continue to cause unwellness in the health care industry. Moviegoers can find contradictory viewpoints to Michael Moore's theory of the greatness of the British and Canadian health care systems, though: Denys Arcand's The Barbarian Invasion gets in some firm critiquing of the Canadian system when it gets gouged by cutbacks. And Lindsay Anderson's broad satire Britannia Hospital shows an institution plagued Frankenstinean experiments, labor troubles and cannibalism. Since Moore's investigations of single-payer health care elsewhere included Norway (these scenes will probably be seen on the DVD), one could also toss in Lars Von Trier's ie Kingdom (aka Riget later remade by Stephen King) to show that there's something rotten in Scandinavian hospitals, or at least the ones built on hellmouths.

As for Romanian medicine, we've seen what happened to the unfortunate Mr. Lazarescu. At heart, Sicko is about cleaning up our own yard here in the US, not the problems of other countries. And as Moore has been saying, the evidence he presents isn't even news. Kvetching about hospitals goes back to the arch-kvetch Paddy Chayefsky in his 1971 The Hospital. Chayefsky's lines in Network were fresh enough for journalist Greg Palast to quote at length in his book Armed Madhouse...what might Chayefsky have to say about the health care mess that would still ring true 36 years later?

"Arrrrrrrgggggggggggggggghhhh!" That's the sound of George C. Scott, tearing into himself, a human buzzsaw hitting raw pine. Whether he was snarling at a trembling coward (Patton), fighting with his son for possession of his own wife (in his self-produced drama (The Savage is Loose) or witnessing a porno film starring a member of his family ("Oh my God--that's my daughter!"--Hardcore) the great Scott was the 1970s go-to man whenever the movies needed the burning smell of a white middle-aged guy having his hide chapped. In The Hospital, Scott's 53 year old Dr. Herbert Bock is divorced and suicidal. He's recently kicked out his two useless hippie children; of his son, he notes, "I grabbed him by the poncho and threw him out!"

Impotent and proud of it, Bock spends his free time in his grubby divorce hotel drinking vodka straight from the bottle. When working, he supervises the staff at Manhattan Medical Center, a dingy, crowded abattoir where patients are stacked up in gurneys in the hallway. The place is coming apart at the seams. Greedy, lecherous or careless doctors operate on the wrong bodies. Mrs. Christie (Nancy Marchand of The Sopranos) flits around looking for ways to cut costs, and dying people are quizzed about their Blue Cross information. One special cause for contempt is Dr. Wellbeck (perennial swinester Richard Dysart), a sleek physician in a double-breasted suit who incorporated himself long ago. This butcher drops in now and then to critically injure a patient. Outside the hospital, a minor urban insurrection is building up because a slum tenement is about to be bulldozed to make room for the hospital's expansion.

At the film's opening we hear one drily-narrated story of malpractice, an old man misdiagnosed to death...the seemingly minor incident is the first in a string of deaths. Director Arthur Hiller contrasts this mystery with a love story. Bock is lured out of his own bitterness by Barbara (Diana Rigg) the New Agey daughter of a patient. Barbara's father Drummond (Barnard Hughes) was a Harvard medical school grad who turned Pentecostal and went to the hills in Mexico to preach to the Apaches. Caught between an awakened lust for life and trying to solve the killings, Dr. Bock gets his groove back slowly. Like many of the time, he's tempted to chuck it all and get back to the land. To Mexico, if necessary, accompanied by this lady half his age.

One notices here some studies for Network: Drummond is a mad prophet of destruction, just as Peter Finch was later on, both shrieking Book of Jeremiah prophecies to the street. Rigg's Barbara explains the seemingly motiveless crush on a hard-drinking and dour doctor as a thing she has for middle-aged men; it's the same way Chayefsky explained the Faye Dunaway/William Holden liaison. The point of this comedy--and Chayefsky's comedies were basically nothing but point--is about how a man must resist that temptation to go native. Civic decay is rampant and yet, as Bock mutters, "Someone has to be responsible...everyone's hitting the road...but someone's got to be responsible." Scott does an excellent job of showing what it's like to be a doctor when the work is important and intellectually challenging. Bock's scene of a consultation with Dr. Brubaker (Robert Walden) has the kind of chuckling intimacy of a pair of conspirators in a Shakespeare play. Both actors convey the pleasure of outwitting a crafty, shape-changing disease. Scott's meaty, old-time theatrical acting can really ennoble his lines: "I'll defrock those two cannibals," Bock growls, ready to go get the licenses of a pair of inept doctors.

Still, the heaviness of Chayefsky's hand is present, and it was a hand that would grow weightier as he aged. Today, Chayefsky's social stereotyping of third-world hotheads and braying feminists is too thick for Limbaugh, even. And the overstatement of case in this Oscar-winning script is a hold over from his television days. The supposed golden age of television has its partisans, but since the early TV visuals were so flat and the sponsors were so nervous, big named writers like Chayefsky and Rod Serling had to both overstate and over-balance their cases. The characters got blocky. Every important idea had to be counter-stated right into wishy-washiness. Barbara, for instance, makes the Mexican mountains sound like purgatory (she's been up there eating "Raw rabbit and pinon nuts"). At the time, the real seductiveness of the fantasy of leaving the city, going back to the land and learning to play the bamboo flute, was the way people talked it up. If Barbara were more persuasive, the counter-argument of working at a crowded, lethal and hateful hospital would be harder to sell to an audience.

The film clips along, though. Director Hiller, coming off of his international hit Love Story. reprises the unaffected visuals that made the world cry buckets. The morning streetscapes of New York are sadder than Bock's plight, even, forlorn brick towers with little plumes of dirty steam coming out of them, as if the buildings were giving up the ghost. In a cinema that idolized doctors, The Hospital's authentic grubbiness and crowdedness was a shock to 1971 viewers...though decades of television ran with the idea, from St. Elsewhere to House. What Chayefsky and his mouthpiece Scott have to say is still on the level: "We have established the most innovative medical enterprise ever concieved and people are sicker than ever!" It's unchanged, that danger of infection, incompetence and personal bankruptcy that makes hospitalization one of the scariest things that can happen to you. As a doctor told a friend of mine, today's choices are succinct: "Go out and die in the woods or leave your wife a pauper." Despite its flaws, The Hospital was there paving the way for Sicko; while this 1971 movie changed nothing, the possibility for change is ripe today.