Production History (Coma) Coma

Crichton adapted his friend Robin Cook's novel before it was even published

Michael Crichton was announced as writer-director on December 1, 1976 -- months before Robin Cook's novel Coma reached bookstores in April 1977. The two had met when Crichton was doing post-doctoral work in biology at La Jolla's Salk Institute and Cook was a Navy physician stationed in San Diego. Their shared medical backgrounds made the handoff natural. (afi)

Crichton saw something personal in Cook's premise. A Harvard Medical School graduate who had abandoned clinical practice, he carried deep frustrations about how medicine treated patients:

"Much of medicine, as it was practiced in those days, I simply didn't agree with. I didn't agree that abortion on demand should be illegal. I didn't agree that patients had no rights and should shut up and do whatever the doctors told them to do. I didn't agree that, if a procedure presented a hazard, the patient shouldn't be worried with the facts. I didn't agree that terminally ill people should have treatment forced upon them, even if they wished to die in peace. I didn't agree that, when malpractice occurred, doctors should cover it up." -- Michael Crichton, Travels (1988)

Adapting someone else's work turned out to suit him:

"I found it much easier to adapt someone else's work than to adapt my own... Writing original screenplays is more fun. But Coma to me is very interesting... it's the kind of story that I like, because it's based on a premise that is not impossible." -- Michael Crichton, michaelcrichton.com (n.d.)

Crichton was between Westworld and The Great Train Robbery

Coma was Crichton's third feature as director, following Westworld (1973) -- the first theatrical film to use 2D computer-generated imagery -- and the TV movie Pursuit (1972). He would go directly from Coma into directing The Great Train Robbery (1979), adapting his own Victorian heist novel with Sean Connery. The medical thriller sat at the midpoint of a run that established Crichton as a genre filmmaker who could deliver commercial hits built on technical premises. (wikipedia)

His medical training gave him a tool most thriller directors lack -- the ability to build authentic atmosphere from institutional detail:

"The relationship between real experience and fiction is complicated. Coma isn't meant to be a documentary." -- Michael Crichton, The Harvard Crimson (1978)

Yet the specificity mattered. He used his clinical rotations at Boston City Hospital to ground the film's environments, drawing on memory to, as he put it, "establish a tone, a political atmosphere." (thecrimson)

Crichton fought the studio to keep a female lead

The novel's protagonist was a woman -- a medical student who stumbles onto a conspiracy -- but MGM initially resisted. Crichton described a studio culture reflexively uncomfortable with a female-driven thriller:

"I wanted to do a movie about a woman who wasn't a hooker or a housewife." -- Michael Crichton, The Harvard Crimson (1978)

The studio talked about recasting the lead as male and pursuing Paul Newman, but Crichton insisted the story required a woman protagonist. He also emphasized the broader context:

In a January 1978 interview with Modern People, Crichton spoke about "the importance of telling stories about female accomplishments, which he thought were lacking in current cinema." The fight paid off -- Coma arrived a year before Alien and gave audiences a genre heroine who relied on intelligence rather than physical dominance. (afi)

Bujold was cajoled into the role by her friend Crichton

Genevieve Bujold was Crichton's first choice for Dr. Susan Wheeler but was initially reluctant. According to AFI production records, she was "cajoled" into accepting by Crichton, a personal friend. She found appeal in playing a character traditionally written for male actors. (afi)

The casting proved inspired. Andrew Sarris, reviewing the film in The Village Voice, identified what made Bujold's performance work within the genre:

"Instead, she confronts all the menacing hirelings of a high-level medical conspiracy single-handedly... one senses that a new feminist spirit is rising upward in compensation." -- Andrew Sarris, Le Cinema Dreams (1978)

Michael Sragow zeroed in on a specific detail that captured the film's tonal break from convention:

"Bujold must be the first lead in a thriller who has to dispose of pantyhose before moving into action." -- Michael Sragow, Le Cinema Dreams (1978)

Michael Douglas took the supporting role of Dr. Mark Bellows, Susan's boyfriend and fellow resident. Richard Widmark played the chief of surgery, Dr. George Harris. The cast also included Elizabeth Ashley, Rip Torn, Lois Chiles, and -- in very early career appearances -- Tom Selleck and Ed Harris. Selleck, according to press material, earned his role as patient Sean Murphy "based on his billboard appearances as the Salem cigarette man." (afi)

The film was shot in real Boston hospitals and on MGM soundstages

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 student. Additional Massachusetts locations included a Boston subway station, Crane's Beach, Rockport, and Marblehead. (afi)

The production then moved to Los Angeles, where interiors were built on four soundstages at MGM Studios in Culver City. Supplementary locations included USC Medical School (for the dissection room), Los Angeles City Hall, and an air-conditioning plant in Century City. The budget was $4.5 million. (afi)

The mysterious, Brutalist-style building used as the exterior of the Jefferson Institute was actually a Xerox Corporation regional headquarters at 191 Spring Street in Lexington, Massachusetts. The building's cold, institutional geometry gave the Institute its unsettling presence on screen. (limelightmagazine)

The hanging bodies were real actors suspended in six-minute intervals

The Jefferson Institute interior -- a sterile warehouse where comatose patients hang from ceiling tracks like stored garments -- is the film's most iconic image. Production designer Albert Brenner built the set on the MGM soundstages, with special effects supervisor Joe Day engineering the suspension system. (afi)

Real actors portrayed the suspended bodies. Hydraulic jacks positioned each performer, and when the jacks were removed, the actors held rigid postures supported by slings at the hips and smaller slings at the limbs. The physical demands were extreme -- performers could only hang for six-minute intervals, and the sequence took three days to film. Two versions were shot: one with nude figures for theatrical release and a draped version for television broadcast. (afi)

Crichton restricted access to the Jefferson Institute set during production, determined to prevent the visual from leaking before audiences could experience it in theaters. The secrecy worked. One reviewer captured what made the image land:

"Naked coma victims, dangling from wires on life support." -- Roger Moore, Movie Nation (2023)

The practical approach gave the sequence a tactile reality that has aged better than comparable CGI might have. The bodies sway slightly, the wires catch light, and the sheer scale of the room -- rows of figures stretching into the background -- creates a dread that depends on the viewer knowing these are real human forms.

Victor J. Kemper replaced the original cinematographer during production

Gerald Hirschfeld began as cinematographer, shooting the Boston location work and the Jefferson Institute sequences. In August 1977, during the MGM studio phase, Victor J. Kemper replaced him. Kemper, whose credits included Dog Day Afternoon (1975) and The Friends of Eddie Coyle (1973), brought a clean, institutional naturalism to the hospital interiors that suited Crichton's approach. Hirschfeld retained additional photography credit. (afi)

The reviewer at Every 70s Movie noted the visual strategy's effectiveness:

"Crichton's distance from the material was probably a good thing... one of the smoothest narratives of any of Crichton's film projects." -- Peter Hanson, Every 70s Movie (2013)

The look favored long corridors, fluorescent lighting, and sterile surfaces -- an environment designed to feel both mundane and menacing. A Den of Geek retrospective observed that Crichton excelled at "establishing locations" and used "long corridors, medical instruments and cadavers" to generate dread without relying on score in the film's first half. (denofgeek)

Goldsmith scored only the final hour and eliminated the brass section

Jerry Goldsmith composed the score -- his second collaboration with Crichton after the TV movie Pursuit (1972). The two would work together again on The Great Train Robbery and Runaway. Goldsmith made an unusual structural decision: he left the film's first hour entirely unscored, composing only 42 minutes of music for the second half. (jerrygoldsmithonline)

The orchestration was stripped down and deliberately alienating:

"Goldsmith eliminates a brass section, reduces the percussion, and utilizes four pianos on top of strings, woodwinds, keyboards, and cimbalom to create an alienating environment." -- Christian Clemmensen, Filmtracks (n.d.)

He used an echoplex machine to imitate the metallic sounds of surgical instruments, weaving processed electronic textures through the acoustic ensemble. The result was a score built on unease rather than melody:

"Consistent rhythms are almost nonexistent in Coma, the meter edgy and unpredictable in its shifts." -- Christian Clemmensen, Filmtracks (n.d.)

The sole exception was a light, contemporary love theme for strings, piano, and acoustic guitar -- heard in "Cape Cod Weekend" -- which one reviewer described as "the only upbeat and playful cue in the score." A disco variant of this theme served as source music. (jerrygoldsmithonline)

The Jerry Goldsmith Online review placed the work in the context of the composer's career:

"One of the composer's finest examples of his thriller scoring technique. A style that is sadly lacking these days." -- Jerry Goldsmith Online, jerrygoldsmithonline.com (n.d.)

MGM released the film in early 1978 to strong commercial returns

MGM distributed the film with a January 1978 release. On a $4.5 million budget, Coma grossed $10.7 million in its first 28 days and reached $30 million by the end of June 1978 -- a substantial return that validated both the material and Crichton's approach. (afi)

The film's convincing medical detail had unintended real-world consequences. Operating room number 8 was removed from Women's Hospital in Tampa, Florida after patient complaints. Organ donation rates reportedly declined 50 to 60 percent in some cities in 1978. The Illinois Eye Bank received approximately 24 inquiries from people asking about selling their eyes. (afi)

Crichton reflected on the tension between authenticity and responsibility:

"Working in films has been good for me personally... you learn a lot about compromise. It has been a healthy contrast." -- Michael Crichton, michaelcrichton.com (n.d.)