Boston Memorial Hospital as Setting (Coma) Coma

Crichton used real hospital locations where he had trained

Production began on June 20, 1977, with eight days of location shooting in Massachusetts. Crichton filmed exteriors at Boston City Hospital, where he had done his own clinical rotations as a Harvard Medical School student. The choice was deliberate -- he was drawing on memory, not research. In a 1978 Harvard Crimson interview, he described using his clinical experience to "establish a tone, a political atmosphere" rather than documentary accuracy. (afi, thecrimson)

Additional Massachusetts locations included an MBTA subway station (for the chase sequence), Crane's Beach, Rockport, and Marblehead (for the Cape Cod weekend scenes). The production then moved to Los Angeles, where hospital interiors were built on four soundstages at MGM Studios in Culver City. Supplementary locations included the USC Medical School dissection room, Los Angeles City Hall, and an air-conditioning plant in Century City. The budget was $4.5 million. (afi)

The hospital functions as a character built from corridors and fluorescent light

Crichton and cinematographer Victor J. Kemper designed the visual approach around institutional architecture: long corridors, fluorescent overhead lighting, sterile reflective surfaces, and the ambient hum of medical equipment. The hospital is not a gothic space. It is aggressively ordinary. The horror comes from the contrast between the normalcy of the environment and the conspiracy operating inside it.

Aliya Whiteley at Den of Geek identified the director's specific skill: "He's so good at establishing locations," using "long corridors, medical instruments and cadavers" to generate dread. The absence of Jerry Goldsmith's score in the film's first hour -- see Jerry Goldsmith (Coma) -- amplifies the effect. The audience hears only what Susan hears: paging systems, ventilation, the murmur of clinical conversation. (denofgeek)

Kimberly Lindbergs described the transformation:

"Cold, reserved and unappealing institutions... Crichton transforms the sterile setting into a funhouse ride where nothing is exactly as it seems." — Kimberly Lindbergs, Cinebeats (2020)

The Jefferson Institute exterior was a Xerox building in Lexington

The Brutalist-style building that served as the Jefferson Institute was a regional headquarters of Xerox Corporation at 191 Spring Street in Lexington, Massachusetts. Its cold institutional geometry -- concrete and glass, elevated and isolated from the surrounding landscape -- made it the visual opposite of the hospital's interior warmth. The hospital pretends to be a caring environment. The Jefferson Institute does not pretend. Its architecture announces that the people inside it are being stored, not treated. As of 2021, the building houses the offices of Mimecast. (limelightmagazine)

Ken Anderson captured the architectural argument:

"A concrete and steel variation on the typical thriller haunted house." — Ken Anderson, Dreams Are What Le Cinema Is For (2012)

The setting connects medical authenticity to paranoid atmosphere

Crichton's medical training gave him a tool most thriller directors lack: procedural credibility. The morning rounds, the anesthesia instruction, the surgical terminology, the tissue-typing protocols -- all of it registers as institutional reality rather than Hollywood approximation. Bob Thomas of the Associated Press identified the effect:

"A medical thriller of obvious authenticity... Crichton exploits the suspense with enough skill to make you overlook the far-fetched nature of the premise." — Bob Thomas, Associated Press (1978)

The authenticity is what makes the paranoia work. A hospital that looks like a movie set would distance the audience. A hospital that looks like the place where they had their last surgery puts them inside Susan Wheeler's fear.