Few things are as universally fear-inducing like the the need to undergo a surgical procedure, no matter how minor. But what if that relatively minor procedure were the part of something much more nefarious? This is the question posed by the 1978 film COMA, which was based on physician-turned-author Robin Cook’s 1977 bestseller of the same name.
The success of the novel made it a natural for being adapted as a feature film. Enter another writer who had originally attended medical school: Michael Crichton. Crichton had already made a name for himself with a number of novels including “The Andromeda Strain” and “The Terminal Man”, both of which had a medical angle to them. Crichton had also written and directed the technothriller WESTWORLD (1973), and he was called upon to write the screenplay for COMA and also to direct.
The story centers around physician Susan Wheeler (Geneviève Bujold), whose friend undergoes a relatively routine surgical procedure only to end up comatose. Her superiors and colleagues, including fellow resident/boyfriend Mark Bellows (Michael Douglas), encourage her to accept what happened as a random, unfortunate medical event. However, Susan isn’t ready to give up looking for answers, especially when another patient in for orthopedic surgery (look kids, it’s Tom Selleck!) also winds up in a coma.
Through the course of her investigation, Susan runs into resistance from the chief of anesthesiology Dr. George (Rip Torn) and Chief of Surgery Dr. Harris (Richard Widmark), and discovers the mysterious Jefferson Institute, where long-term coma patents are being sent. Her guided tour of the facility (as part of a weekly tour for physicians) produces one of the more striking images in medical cinema: rows of coma patients suspended from the ceiling by wires run through their bones (to prevent bedsores, it’s said). The visual of dozens of patients hanging from wires coupled with the sound of multiple ventilators is effectively eerie, as is the almost robotic way that Ms. Emerson (Elizabeth Ashley) describes the facility (she gives an even more distant and disturbing performance earlier as she meets Susan outside the doors to the Jefferson Institute). The entire scene is wonderfully creepy and simultaneously fantastic and completely plausable.
Here be spoilers
In consultation with two pathologists at the hospital (including Ed Harris in his first film role) begins to suspect that someone has slipped carbon monoxide into the anesthesia. This causes her to begin suspecting Dr. George, and her suspicions are also strengthened when she discovers a radio-controlled gas line that runs into one of the hospital’s operating rooms. Later, when she sneaks away from a tour of the Jefferson Institute, Susan stumbles upon the truth: patients are being put into comas and then moved there so that their organs can be harvested and sold on the black market. When she overhears two workers talking about “George” she becomes convinced of her suspicions.
After a (somewhat hokey) escape from the institute, she brings her findings to Dr. Harris, expecting him to immediately call to have Dr. George arrested. However, it turns out that HE is the one behind everything (his first name is George). Early in the scene, Dr. Harris and Susan both have a drink of scotch. It turns out that he has slipped a drug into her drink that gives her the symptoms of appendicitis. As the drug takes effect, Dr. Harris gives a rather strange soliloquy about medical decision-making (Richard Widmark does good work here, but what he rambles about just doesn’t seem to make sense to me).
I’m fine with Dr. Harris being the ultimate villain (though it’s not really a surprise), but this scene gives rise to my biggest issue with the film. Because of the drug, Dr. Harris is able to convince everyone that she has appendicitis, and that he will be operating on her himself. Of course, the operation will be performed in O.R. 8, which has the secret carbon monoxide line. Luckily for Susan, she is able to clue Mark in enough that he begins to believe what she has been saying. He eventually finds the radio device and stops it before Susan has breathed enough of the poisonous gas to do significant damage.
This is frustrating on a number of levels. Susan has been the driving force throughout the film. Even when everyone else (all men, including her boyfriend) urge her to give up on the investigation, she persists and eventually uncovers the truth. But here, in the final moments of the movie, she becomes a frustratingly cliché “damsel in distress.” Not only that, but Mark has been a naysayer for the entire film, constantly questioning Susan’s line of investigation, but here, he “comes around” at just the nick of time.
I suppose it’s not as bad as in the novel, where Susan’s fate isn’t even addressed (the reader is left hanging as to whether or not she survives), but it’s still annoying to have a film with a driven, professional female main character only to see her sidelined at the very end, dependent on her boyfriend to save her life.
That moment at the end does result in one of my favorite directorial touches that Crichton does in the film (his style is relatively perfunctory, with only a few moments of “flash”). I’m not even sure why I like it as much as I do, but there’s something clever to me about how they (literally) turn out the lights on Dr. Harris and his scheme, followed by a hard crash to the credits:
Of course, this scene also provides a good example of the music in the film, which was composed by the late, great Jerry Goldsmith. Goldsmith, who would work with Michael Crichton a year later on THE GREAT TRAIN ROBBERY (1979), turns in a score that works incredibly well in the film, but is a rather difficult listen in isolation.
Goldsmith had famously used a device called the Echoplex in previous scores, most notably PLANET OF THE APES (1968) and PATTON (1970). Essentially a tape delay effect, the Echoplex allows for notes to be repeated synthetically (again, the most famous use of this may be the fading trumpet notes in PATTON). For COMA, Goldsmith would again use this effect to a great extent, particularly for a two-chord motif that forms the backbone to the entire score.
“Stranger on the Street”
Notably, the entire first half of the movie is unscored, with the music only beginning once Susan notices a strange man watching her from across the street. I should say that this man follows Susan throughout the middle third of the film, culminating in a VERY creepy visit to where they store medical school cadavers…
This cue features both the Echoplex motif and the main “suspense” theme for the film: an unsettling melodic line in the high strings. Much of the score is similar in feel, working much better in the film than as a stand-alone listen.
“Cape Cod Weekend”
In addition to the main theme, Goldsmith wrote a love theme for Susan Wheeler and Mark Bellows. Played over a, frankly awkward montage, the theme is unfortunately a rather generic pop-score mishmash of “generic Goldsmith melodies.” I don’t mean to sound harsh, but the theme is simply out of place for the rest of the score (and the film), and it comes off as a Goldsmith-lite of sorts. Not one of my favorites…
Worse still, because this was the 70s, the score album contains the requisite disco version that I will spare you from.
Much more interesting is the cue that follows Susan and Mark as they stumble upon the infamous Jefferson Institute. After the main theme returns, this time on low register clarinets, the strange, brutalist-style building comes into view accompanied by a swirl of piano and percussion that sounds reminiscent of Goldsmith’s PLANET OF THE APES (1968) score. After a (I can’t believe I’m going to say this) Herrmann-esque series of low clarinet chords, Susan approaches the building as thick string chords play a motif that is very much similar to what Goldsmith would write a year later in his superb score to STAR TREK: THE MOTION PICTURE (1979).
All in all, COMA is a rather effective and largely realistic medical thriller that suffers somewhat by an unfortunate lapse into a stereotypical “damsel in distress” ending. Given the controversies even today surrounding organ donation, the plot isn’t all that far-fetched. Plot issues aside, all of the actors perform their roles well, and while I can’t really recommend the music as a stand-alone listen, Jerry Goldsmith turns in a typically effective score in the film itself.
If this blogathon has turned you on to the idea of watching some Medicine In The Movies, and you like a solid medical thriller, I definitely recommend checking out COMA. Just don’t watch it if you have any procedures planned in the coming weeks!