X-Ray (1981), the Final Woman, and the Medical Slasher Film

October 15, 2020 Posted by Webmaster under Volume 28, Number 1, September 2017

Murray Leeder (bio)
University of Calgary

Abstract

This essay discusses the declining academic and continued popular currency of Carol J. Clover’s concept of the Final Girl, and examines the term through X-Ray or Hospital Massacre (1981), a film of the first slasher cycle with a more mature protagonist than most. It extends Clover’s ideas by showing how X-Ray is heavily concerned with medical issues, in particular the Foucauldian “medical gaze.” The titular X-ray becomes a structural model for the invasive, destructive gazes deployed throughout the film, both by its villain and by the medical environment itself.

Carol J. Clover’s phrase “the Final Girl” has penetrated public consciousness in a way few academic terms have. Introduced in her 1987 article “Her Body, Himself,” it was popularized by her 1992 book Men, Women and Chain Saws: Gender in the Modern Horror Film. In recent years, there have been films called both Final Girl (2015) and The Final Girls (2015). The page for Final Girl on the popular culture website TvTropes.com has hundreds of entries and only a smattering of acknowledgements of Clover. The concept itself is simple: a slasher film supplies many “girls,” most of whom are killed off by the slasher until only one remains:

She is the one who encounters the mutilated bodies of her friends and perceives the full extent of the preceding horror and of her own peril; who is chased, cornered, wounded; who we see scream, stagger, fall, rise, and scream again. She is abject terror personified. (Clover, Men 35)

And yet she is also generally the one who battles the killer, alone or with help: “Finally, although she is always smaller and weaker than the killer, she grapples with him energetically and convincingly” (40). Arguing that she is boyish–often with an androgynous name, like Laurie (Jamie Lee Curtis) in Halloween (1978)–and phallicized, Clover resists reading the Final Girl as legitimately female, but rather sees her as a figure of transvestitism, a boy in drag: “to the extent that she means ‘girl’ at all, it is only for purposes of signifying male lack . . . To applaud the Final Girl as a feminist development . . . is, in light of her figurative meaning, a particularly grotesque expression of wishful thinking” (53). Although Clover’s concept has come to roost in popular culture, it has been roundly critiqued in academia. Barbara Creed argues that the Final Girl should not be understood as the phallicized “false boy,” but as an incarnation of the femme castratrice (158). Other scholars have tried to recuperate the Final Girl as a potential figure of female or feminine agency and resistance, against Clover’s objections (e.g. Pinedo 1997, Short 2006). Perhaps the most trenchant critiques–for example, by Richard Nowell and Janet Staiger—suggest that the concept is simply not accurate, that Clover’s corpus of films is too small and her interpretation of the character type too selective. In slasher films, Staiger writes,

[w]omen are usually the victims and the heroines, but they are not always ‘Final Girls’ in the strong sense Clover implies. They may be quite feminine. Boyfriends, fathers or father figures, even other women and children, often support and aid them. They learn from those people so that they do take control of their battle with the killer. And they are rewarded not just with survival but also with romance. (222)

Similarly, Jeremy Maron notes the presence of male characters in the structural position of the Final Girl, and suggests that “Final Subject” is more apt.

The decline of the Final Girl as the dominant explanatory framework for the slasher film is a positive development, allowing us to explore the genre’s diversity more fully. But do we still need the Final Girl paradigm, or should we consign it to popular culture? I argue that critics should not discount Clover’s ideas altogether, but rather explore their possible extension through connections with other discourses. Here, I examine an obscure slasher film that both fits within and extends Clover’s model of the Final Girl. Directed by Israeli director Boaz Davidson and distributed by exploitation specialists Cannon Films, it was released both as X-Ray and Hospital Massacre in 1981, in the thick of the first slasher cycle triggered by Halloween.1 Never discussed by Clover or other early thinkers on the slasher film like Vera Dika and Robin Wood, X-Ray is almost absent from the now-voluminous scholarship on the slasher film. Certainly, many of the character dynamics of Clover’s model are at play in X-Ray, especially in the relationship between the “assaultive” and “reactive” gazes. Yet its setting in a thinly-populated urban hospital—in contrast to the rural and suburban settings of most slasher films, but constructing a similar dynamic of isolation—permits those gazes to operate within the paradigm of a Foucauldian “medical gaze.” In so doing, X-Ray invokes a range of anxieties about masculine medicine, its spaces, and its practitioners.

Medical Gaze, Medical Horror

Wood distinguishes between two related cycles in the 1970s and 1980s that he calls the “teenie-kill pic”—largely coterminous with the later constellation of the slasher film—and the “violence against women movie,” a higher-rent and glossier (though often more misogynistic) variant associated with filmmakers like Brian de Palma (194). X-Ray is a hybrid of the two: it borrows structurally from the slasher film, but involves older characters;2 has the stock sexually frustrated villain, but no emphasis on virginity or promiscuity; and sexualizes its protagonist Susan (Barbi Benton) significantly more than most slasher films sexualize their protagonists, making her the only woman to appear naked in the film. X-Ray also fits within a longer history of horror in medical contexts. Its villain echoes the deranged surgeons of Golden Age films like Mad Love (1935) and The Raven (1935), both motivated by twisted, impossible love for a virtuous woman. Later films also play up the fear inherent in medical settings, as in Les yeux sans visage/Eyes Without a Face (1960) and Horror Hospital (1973). The key director associated with medical horror is David Cronenberg (especially for films like Rabid (1977) and Dead Ringers (1988)),3 yet the slasher film had its dalliances with medical settings too. In his book on the slasher film, Adam Rockoff dismisses X-Ray and Visiting Hours (1982) as “inferior films which effectively killed off the minor trend of hospital slashers” (129) alongside the better-known Halloween II (1981). X-Ray‘s most significant predecessor might actually be Coma (1978), Michael Crichton’s more mainstream Hollywood medical thriller and certainly one of Wood’s “violence against women” pictures. X-Ray echoes Coma in its chases through sparsely-populated medical facilities and in its third act, in which the female protagonist (in both films named Susan (Geneviève Bujold in Coma)) is strapped to a medical table for an unnecessary procedure meant to kill her.4 Though the lofty considerations of medical ethics in Coma are nowhere to be found in X-Ray, Davidson’s film contains many of the same anxieties about the hospital space, masculine medicine, and (especially female) bodies that are on display in a less intellectual fashion.5 The formal differences between Coma and X-Ray are instructive, especially in terms of their medical settings. Coma‘s mise-en-scène favours brightly-lit, self-consciously bland modernist spaces with brutalist influences; the dark conspiracy at the centre of the film ironically goes on in spaces of apparent transparency. By contrast, the hospital in X-Ray is a gloomy place full of narrow corridors, vacant floors, implausibly low-key lighting, cluttered, dangerous areas, and grotesque patients. It epitomizes what Clover calls the “Terrible Place” (30), redolent of Victorian medicine crossed with torture and sadism (echoes of Jack the Ripper and Dr. Jekyll and Mr. Hyde). Thomas M. Sipos observes that the film (as Hospital Massacre) “draws much of its terror from a mise-en-scène that magnifies all our paranoid fears about doctors and hospitals” (45); furthermore, a careful deployment of a horrific variation on the medical gaze is a major part of its queasy effectiveness. Not only does X-Ray take place almost entirely in a hospital, but its villain is a medical professional: the seemingly helpful intern “Harry” (Charles Lucia), who disguises his identity behind a medical mask and manipulates medical imaging to his vile purposes.

The film also develops its paranoia through a recurring emphasis on the medical gaze. In using this term, I am of course evoking a concept introduced by Michel Foucault in The Birth of the Clinic (1963). What has been variously rendered as the “medical,” “clinical” and “observation gaze” is a feature of Foucault’s modern episteme as it emerges around the beginning of the 19th century; “[f]acilitated by the medical technologies that frame and focus the physicians’ optical grasp of the patient, the medical gaze abstracts the suffering person from her sociological context and reframes her as a ‘case’ or a ‘condition'” (Hsu and Lincoln 23). The gendering here is no mistake; in reducing the patient to a passive position or even rendering her corpselike, the medical gaze makes its subject essentially feminine. Graeme Harper notes that “in Anglophone film circles, we must be wary of interpreting Foucault’s translated discussion of the clinical ‘gaze’ too literally as a primary version of the filmic gaze. The French word Foucault uses is ‘regard’ which can mean a gaze or a look or an expression or a glance” (99-100). This caveat actually suits my argument here, because the “medical gaze” on display is not limited to an individual character—indeed, almost every medical practitioner in the film falls far short of the standards of objectivity, although empowered by those standards—but is rather attached to the clinical environment itself. The ur-slasher Halloween transforms the town of Haddonfield into a haunted environment in which Michael Myers’s gaze is implicitly unpinned from his physical body and becomes omnipresent.6 X-Ray does something similar with less supernatural coding; it detaches the gaze of the killer from Harry and attaches it instead to the hospital itself, creating a space replete with many “gazes.” Almost all of these gazes are pointed at Susan, and like the X-ray itself, they ultimately aim to penetrate her body.

In the X-Ray

In this paper, I use the title X-Ray over the more descriptive Hospital Massacre, partly because the 2014 Blu-Ray/DVD release from Shout! Factory uses X-Ray, and partly because it is the more poetic and evocative, and in a strange way, more appropriate title. True to its name, the film’s opening titles unfold over a succession of X-ray images, blue and luminous as if displayed on a light box. The first is a skull, its empty eye sockets staring directly “towards” the camera. Already the spectatorial theme formulaic to the slasher film is emphasized. The next image shows a pelvis; as with the eyes, genitals are suggested by their absence, introducing a sexual theme (although the sex of the body is not clear from the image—shades of Clover’s discussion of gender ambiguities in the slasher film).7 Following this image, a skull appears again, this time in profile and facing right. The fourth image shows vertebrae, with something denser than bone alongside them: a stethoscope, alluding to the film’s medical setting (perhaps this is an image of the film’s villain). Next, a skull in profile again, this time facing left. Then a rib cage, another view of the pelvis, and lastly the skull again, over Boaz’s director credit.

Accompanied by a nervous synthesizer-heavy score, the title sequence establishes the medical gaze as a key theme and taps into the cultural history of medical imaging in general and of X-rays in particular. The X-ray was unexpectedly discovered by German physicist Wilhelm Conrad Röntgen in 1895; relatively easy to replicate and largely circulating through the popular press rather than scientific channels, it triggered an “X-Ray Craze” that threatened to overshadow the debut of cinema that same year (Crangle 1998). X-rays were mindboggling, unthinkable, and arrived in a fin de siècle climate hungry for novelty. The “living” skeleton was previously a contradiction in terms and served mainly as an artistic representation of death, but with Röntgen’s discovery, it was suddenly observable. The tensions raised by the technology were articulated by Thomas Mann in The Magic Mountain (1924), when Hans Castorp’s glimpse of his own X-ray triggers a profound reckoning with his mortality and corporeality:

Hans Castorp saw exactly what he should have expected to see, but which no man was ever intended to see and which he himself had never presumed he would be able to see: he saw his own grave. Under that light, he saw the process of corruption anticipated, saw the flesh in which he moved decomposed, expunged, dissolved into airy nothingness.(215-6)

Yet the X-ray did not so much show the skeleton as turn bodies inside out, reducing “solid” flesh to a ghostly but still perceivable half-presence. As Catherine Waldby writes:

The surface of the body, its demarcation from the world, is dissolved and lost in the image, leaving only the faintest trace, while the relation between depth and surface is reversed. Skeletal structures, conventionally thought of as located at the most recessive depth of the body, appear in co-registration with the body’s surface. (91)

Of course, the “deathly” qualities of the X-ray would take on a different inflection once it became clear that the rays were dangerous, capable of inscribing themselves on living bodies and causing nausea, hair loss, and burned or peeling skin. Most experimenters ultimately displayed these symptoms to some degree, and the numerous victims of the X-ray entered the annals of medical history as martyrs who suffered and even died to advance scientific research (Herzig 85-100). The only female “X-Ray martyr,” Elizabeth Fleischmann-Ascheim, was exalted as “America’s Joan of Arc” after her death, sanctified much as Marie Curie would be as a fellow experimenter and victim of radiology (98).

As unsexy as skeletons might appear, the X-ray developed a powerful erotic potential in its apparent ability to dissolve all those layers of Victorian clothing.8 An 1896 letter to the Pall Mall Gazette complained of the “revolting indecency” of the ability to “see other people’s bones with the naked eye” (qtd. in Goodman 1043), and other texts expressed anxiety about “the X-Ray’s perceived capacity to dissolve sexual identity by figuratively decomposing the organs and flesh” (Cartwright 119), rather the same way that the opening images of X-Ray are at once sexualized and de-sexed. The deathly/erotic dynamic of the X-ray is also on display in The Magic Mountain, where Castorp makes a fetish of an X-ray image of Clavdia Chauchat. Simultaneously, the X-ray is associated with destruction, invasion and penetration. Akira Mizuta Lippit writes: “To see and to burn. The two functions and effects are fused in the X-Ray, which makes the body visible by burning it. The extravisibility of the X-Ray is an effect of its inflammatory force . . . It sees by burning and destroying” (50). In X-Ray, the villain embodies the looking/destroying duality of the X-ray: a spectatorial agent of the gaze in familiar slasher villain form, with a penetrating medicalized force that destroys as he gazes. If the tensions concerning X-rays seem to have been soothed by the 1980s, X-Ray makes the interesting decision to evoke them from its opening moments. A literal X-ray plays a brief if crucial role early in the plot, serving to mislead and manipulate, and makes a third act cameo long enough to be splattered with blood. The film exploits many of the issues that the X-ray and the broader culture of medical imaging have raised historically: professionalism, eroticism, privacy, interiority and exteriority, and death.

What Becomes of the Broken-Hearted?

In her study of the “stalker film,” Vera Dika notes a conventional two-part structure derived from Halloween. Its initial setup occurs in a section marked as the past:

  1. 1. The young community is guilty of a wrongful action.
  2. 2. The killer sees an injury, fault or death.
  3. 3. The killer experiences a loss.
  4. 4. The killer kills the guilty members of the young community.

X-Ray replicates this structure. It opens with a short sequence that establishes who the killer is and why he targets the “Final Girl.” A title card identifies “SUSAN’S HOUSE, 1961,” and the setting’s “pastness” is signaled formally by a slight, gauzy overexposure. The sequence is full of hearts–conventional Valentine’s Day hearts have been cut out and placed all over the young Susan’s (Elizabeth Hoy) house–and it soon introduces a gaze. The boy Harold (Billy Jayne) is looking in the window at the object of his precocious obsession, accompanied by a point-of-view (POV) shot zooming in to her face. Harold leaves a bright red envelope on her doorstep, matching the color of his coat and a pattern on his shoes.9 He knocks thrice and flees, and then watches as Susan and her friend David (Michael Romero) open the envelope. Inside is a red heart-shaped note. The words “BE MY VALENTINE” are written crudely on the outside, and on the inside it says, “TO SUSAN FROM HAROLD” and, barely visible, “I [HEART SYMBOL] YOU.” Susan and David laugh at the discovery that the card is from Harold, crumple it, and toss it on the floor. When she goes to the kitchen to slice a birthday cake with an overdramatically huge knife,10 she returns to find that David has been murdered with surprising speed and quietness, hanged from a hat rack; she turns to see Harold grin maniacally from the window and then run away. The camera lingers on the literal “broken heart” on the floor.

X-Ray joins Halloween, New Year’s Evil (1980), You Better Watch Out (1980), Prom Night (1980), My Bloody Valentine (1981), Graduation Day (1981) and more in taking place on a holiday, or more precisely on two different Valentine’s Days. Be My Valentine . . . Or Else is given as an alternative title for the film (a pre-release title, according to the Internet Movie Database; perhaps it was discarded because the film was not released in February).11 Valentine’s Day plays an almost literal background role in X-Ray through the mise-en-scène of the hospital festooned with banners and hearts. Curiously, Susan never mentions the murder she witnessed on a Valentine’s Day two decades before (are we supposed to conclude that she has repressed the memory?),12 but the heart symbol ties in with the killer’s motivation: to claim Susan’s heart. In keeping with the emotional stunting of slasher film villains, Harry fails to discriminate between poetic metaphor and corporeal reality. Martin Kemp writes that, despite a tendency to insist that the heart symbol bears little resemblance to a real heart, in fact, “[t]his lack of resemblance is considerably overplayed” (85).13 The symbol does derive from the shape of a literal heart, with its two atria in place and much else excluded. The heart symbol migrated from anatomy to become an easily commoditized symbol of romantic love; Harry has reversed that trajectory.

As X-Ray continues past the opening sequence, another title card reads “19 YEARS LATER” over the base of a skyscraper; as in so many slasher films, the tree-lined suburban streets of Halloween vanish after the opening. Here we are introduced to the adult Susan Jeremy (Barbi Benton), and find that she is unlike the virginal cliché of the Final Girl. She is a divorced woman who has a daughter, a bitter relationship with her ex-husband, and a current boyfriend. Her dark red business attire and the thick binder she carries associate her with success and professionalism.14 This Final Girl is distinctly a Final Woman. Indeed, all the victims in the film are adults, except the pre-pubescent boy of the opening sequence. But while other women are killed in X-Ray (doctors and nurses), none are Halloween-style “friends” of hers, and with some she never comes into contact at all; Susan is afforded a “specialness” they lack. In part, that specialness is carried over from off-screen. Benton was best known as a Playboy model, having been on the cover of the magazine three times by then (and again in 1985), as well as being Hugh Hefner’s girlfriend for a period in the 1960s and 1970s. The most obvious precedent for casting her as the lead in a horror film is Marilyn Chambers in David Cronenberg’s Rabid. Though Chambers was a hardcore pornographic film actress and Benton a nude and semi-nude model, both carry their extra-cinematic star personas through to the comparative “mainstream” horror film.15 Chambers’s and Benton’s characters are replete with the “to-be-looked-at-ness” that Laura Mulvey famously ascribed to women on screen (809), in each case deployed within a medical arena. Like most Final Girls/Women, Susan is not only the subject of the look of the killer (and other males), but increasingly possesses an investigative gaze of her own.

The Eye of (Medical) Horror

Clover suggests that horror is, “intentionally or unintentionally, the most self-reflexive of cinematic genres” due to its compulsive thematization of looking (Men 168). She discriminates between the masculine “assaultive gaze,” often represented by POV camerawork, and the feminine “reactive gaze,” linked to femininity and vulnerability. However, she argues that “over and over, horror presents us with scenarios in which assaultive gazing is not just thwarted and punished, but actually reversed in such a way that those who thought to penetrate end up themselves penetrated” (Men 194). X-Ray certainly does not match the complexity Clover finds in Michael Powell’s Peeping Tom (1960)–itself interested in the long-term consequences of the medical gaze of the protagonist’s psychiatrist father–but it does something interesting in its own right by affiliating the typical voyeuristic-sadistic killer’s gaze of the slasher film with the “medical gaze.”

From the moment Susan arrives at the hospital, where she needs to pick up test results required for a new promotion, she is being watched. As a quick tilt and zoom reveals, an unseen man in surgical garb observes her from a hospital window when she enters the building for her tests; later we see his POV in a darkened room, caressing a framed portrait of Susan as a child with an elastic-gloved hand. When Susan checks in, a creepy janitor leers at her undisguisedly, drumming his fingers on a desk. Soon we realize that the killer has causal control over the environment of the hospital, trapping Susan in an elevator and luring Dr. Jacobs (Gay Austin) to a deserted floor of the hospital with the intercom. Jacobs is spooked by a skeleton, a medical specimen seemingly “staring” at her, and by a medical dummy stretched out on a table like a corpse, but she overlooks the real danger; she is jumped from behind and knifed to death, plumes of blood squirting onto the killer’s surgical garb. With her dies the hope of a “feminized” medical establishment.16 Susan loses the regular physician with whom she feels comfortable and is thrust into the “care” of a range of sinister male doctors, especially the decidedly unprofessional Dr. Saxon (John Warner Williams), whose diffident manner leads us to suspect he may be the killer. Before meeting Susan, Saxon is introduced taking off a medical mask and stashing it in a drawer in which medical instruments are casually stored–but he is not actually the murderer. Though he is a red herring in narrative terms (and is himself murdered), he is central to the film’s deployment of the medical gaze, which feels leering and prurient under the barest pretense of medical objectivity.

The purpose of Dr. Jacobs’s murder, we later learn, is to tamper with Susan’s files so that she is required to stay longer than necessary in the hospital. Several other murders, including that of Saxon, occur when characters come close to uncovering Susan’s actual (healthy) medical status and thus allow the pathologizing of her body to persist. Later, when Saxon examines her X-ray, he finds a huge mass of what looks like snakes or worms in her abdomen. One by one, male physicians look at this (putative) image of Susan’s body and react with contained horror (including Harry, who logically must be playing along). Her apparent condition is not disclosed to her right away; they contrive to detain her for further tests, and—rather like the female protagonists of Dark Victory (1939), The Bells of St. Mary’s (1945) and The Nun’s Story (1959)—she is “benevolently” misled about her apparent malady by the masculine medical establishment.17 More specifically, she is denied a certain variety of reactive gaze–the ability to look on images of her own body and make decisions accordingly. This exchange follows:

Susan:
But this whole check-up is just a . . .
 
Saxon:
A what? 

Susan:
A simple formality. I've been promoted and I just need some sort of medical certificate for my new insurance. 

Saxon:
No check-up is ever just a simple formality, Miss Jeremy.

Next we are shown most of the film’s themes in miniature. Saxon insists on an examination, instructing her to “get undressed” and adding only a half-hearted “please” to his order. Up to this point in the film, Susan, having come to the hospital directly from work, has worn business attire (it only reappears in the very last scene, signaling the return of her independence from the masculine medical gaze). Her low-key battle of wills with Saxon ends with her reluctantly giving into the authority of male medicine, her own agency compromised. Susan undresses behind a scrim; backlit, her silhouette reveals the contours of her body, and in pure Mulveyan fashion, Saxon stands and watches, the audience sharing his gaze.

Fig. 1.
Dr. Saxon (John Warner Williams) observing Susan Jeremy (Barbi Benton) undress. Still from X-Ray © Shout! Factory, 1981.

This striptease–and so it appears, a performance for an audience rather than simply a character undressing–is reminiscent of a peepshow, or even of the “keyhole films” of early cinema like Esmé Collings’s A Victorian Lady in Her Boudoir (1896) and Georges Méliès’s Après le bal/After the Ball (1897), in which a woman undresses before the implied gaze of a male spectator whose perspective is shared by the viewer (Nead esp. 186-94). The sequence feels like a pornographic scenario thinly repurposed for a horror film.18

Yet the film then begins to establish the significance of a counter-gaze: Susan’s own. Dr. Beam (Den Surles) casually intrudes. He and Saxon first discuss the disappearance of Dr. Jacobs and Saxon says that he wants to explain “this,” at which point he shows Beam the suspect X-ray of Susan. At this point we switch to Susan’s perspective, gazing out from behind the scrim, giving us her POV shot, a narrow view of the two men. The doctors’ voices become inaudible from her perspective and the object of the male gaze suddenly becomes an investigative gazer herself, even as the men scrutinize what is purportedly an image of her body. This scene is echoed later when she observes the killer from behind a similar scrim. It is the Final Girl’s formulaic act of “reversing the gaze” (Clover, Men 241), here literally looking past the medical establishment. As Beam leaves, Saxon summons Susan over to the table. He removes her gown (literally unveiling her), exposing her breasts, and reaches behind her to adjust her hair, gestures that feel intrusively sensual rather than professional and clinical–as if he is reorienting her for his personal gaze rather than for any medical reason. Donning his stethoscope (and recalling the opening sequence), Saxon listens to her heart and takes her blood pressure (heartbeats on the soundtrack add tension and increase our affiliation with Saxon’s perspective); the shot starts behind Susan and tracks around in a semicircle to reveal her breasts. “Lie down on the bed,” Saxon says, once again adding a perfunctory “please.” The examination couples the visual gaze and auditory examinations facilitated by medical technology to a tactile exploration of Susan’s body. Roy Porter explains that physical examinations emerged in the 18th and especially the 19th century and, despite having a relatively limited utility, “the sick have so far come to expect being physically examined . . . that they regard the doctor whom omits ‘hands-on’ examination as negligent” (179). Despite her obvious discomfort, Susan reflexively permits the unannounced touching of her body by Saxon as a necessary feature of the medical environment. He runs his hands up her leg before probing her abdomen. The camera follows up the length of her legs and places her breasts fully in frame as he moves his stethoscope about, repeating “in, out” in an unmistakably sexualized fashion.

We then see a face at the window, peeking through a gap in the curtains. It is another red herring character, a drunken mental patient named Hal (Lanny Duncan) whom Susan encountered earlier; the film alternates between his leering face and his POV gazing at Susan, framed by the askew curtain and the edge of the door to emphasize the theme of voyeurism.

Fig. 2.
A voyeuristic shot of the examination from Hal’s point of view. Still from X-Ray © Shout! Factory, 1981.

But Hal’s voyeurism is itself public; a nurse says, “I see you” and asks what he’s doing. He says, “Nothing . . . sight-seeing.” She orders him back to his ward, but he barely makes it a few steps before he paws at another female patient and then resumes peeping at Susan. Hal is still presumably watching the remainder of the examination unfold, though we get no further shots of him to confirm as much–his gaze diffuses into the medical environment itself.19

An extreme close-up of Saxon’s stethoscope applied to Susan’s stomach returns us to the examination. Dr. Saxon places his hands around her neck, presumably to check nodes but framed as if to strangle her; the camera holds on her frightened expression. The next cut is elliptical, moving to a POV shot from Susan’s perspective of Saxon’s eye that rack-focuses to an ophthalmoscope he switches on, beaming a bright light into the camera; we cut to her eye dilating as the light is trained on it. A blood sample follows; he slowly ties an elastic around her arm and just as slowly reaches for the syringe. As he uncaps the needle, it is framed against her eye, the focus racking between her face and the needle in his hand–another striking visual of Susan’s double status, as subject and object of the medical gaze. Saxon swabs her arm and the film edits between her flinching, his obsessive expression, and the needle’s insertion. Susan momentarily loses her composure and flinches (a classic example of the reactive gaze). The needle fills with blood and the final shot of the sequence shows in extreme close-up Saxon extracting the needle, which results in a small, orgasmic spray of blood–foreshadowing the penetration and extraction that Harry intends for Susan. The interplay of Saxon’s assaultive gaze and Susan’s reactive one in this overwrought medical examination is so paramount that it approaches self-parody. The scene could be described as a piece of empty titillation with next to no narrative justification (why does she have to be topless throughout, exactly?), and yet it also taps into a set of powerful images of male science dominating a female body. Although Saxon is putatively checking her body for evidence to support the conditions indicated by the X-ray, his professional aim is thoroughly obscured by the film’s presentation of the examination, which stands firmly at the juncture of horror and pornography. Meanwhile, Susan’s counter-gaze begins (however tentatively) to scrutinize the medical gaze deployed against her. The themes in this sequence become literal at the film’s climax.

Nature Unveiling Before the Slasher

In her book Sexual Visions: Images of Gender in Science and Medicine between the Eighteenth and Twentieth Centuries, Ludmilla Jordanova examines the theme of “unveiling” a female body through Louis-Ernest Barrais’s 1899 statue of “Nature Unveiling Herself Before Science.” The statue depicts a young woman veiled except for her breasts, which she is in the process of uncovering. Jordanova writes that the statue “mobilizes . . . a number of devices commonly used over many centuries: personification, veiling, the use of breasts to denote femininity, the gendering of both science and nature” (87). The affiliation of science with masculinity and nature with femininity obviously resonates with the examination scene, where Saxon is “probing” Susan’s body for non-existent secrets and imperfections hidden within her idealized body. Jordanova notes that medicine has historically evoked masculine sadism towards women, but also that “an idealization of women is as prominent a theme as violence–possibly these two constitute two sides of the same coin” (62). X-Ray idealizes Susan’s body as an image of feminine perfection that Harry’s machinations have transformed into an object of scrutiny. From the examination scene on, Susan wears a thin, translucent hospital gown that suggests “veiling” in its skimpiness and draws attention to Susan’s body (and to Benton’s) even as it conceals it. The recurring use of scrims, which simultaneously conceal and reveal bodies, functions similarly.

Themes of the gaze and female bodily idealization versus degradation also inform X-Ray‘s strangest subplot, that of the three old women with whom Susan shares a hospital room. They echo mythical and literary witch trios (the Graeae in the myth of Medusa, the “weird sisters” of Macbeth, etc.) and are associated with Christian imagery (rosaries and icons of saints). They stare at, taunt, and judge Susan. After overhearing Saxon finally tell Susan (without specifics) that she may have a serious illness, they have this exchange: “They say she’s terribly sick.” “But she’s so young and lovely.” “Young and lovely on the outside, maybe, but old and rotten on the inside. Putrid, foul . . . All her bones are decaying and her organs are all rancid and her blood is malignant as slime.”20 The puzzling trio plays a minor role in the conclusion, accidentally distracting the killer long enough for Susan to escape, but their principal function is thematic. Philip Brophy suggests that “the contemporary horror film tends to play not so much on a fear of death but of one’s own body, of how one controls and relates to it” (8). The women’s dialogue externalizes Susan’s (ultimately unfounded) fear of a loss of bodily control, and, like Dr. Saxon’s nurses, they function as patriarchal women who perpetuate the system that constrains them. Their barbs articulate a key, perverse theme of internal and external natures in X-Ray that ultimately applies to Harry, both in his self-preservation (the façade of a trustworthy medical professional concealing the psychopathic murderer) and in his goal (the extraction of Susan’s heart).

Several of the film’s themes come together in the climactic image of Susan lying on a medical table while the killer pants behind his identity-concealing facemask. The atmosphere is inexplicably smoky, functioning formally to echo the overlit glare of the opening sequence. The killer fondles dissection equipment and holds a serrated tool aloft. Susan pulls off his mask, revealing Harry: “It’s not Harry, it’s Harold,” he says, “It’s Harold,” cuing a black and white montage that ends with the broken Valentine’s heart from the opening scene. “What do you want?” Susan asks, and Harry answers, “What I’ve always wanted.” The film cuts to her face and hair being fondled by his latex-gloved hand before he adds, “Your heart.”

Fig. 3.
Harry (Charles Lucia) plans his dissection of Susan. Still from X-Ray © Shout! Factory, 1981.

The image of Harry looming over Susan while clutching the tools of dissection echoes a body of 19th and 20th-century artwork that Jordanova discusses, in which one or more figures of medical science stand over the body of a beautiful young woman preparing for an autopsy. Jordanova draws attention to the paintings of anatomist-artist John Wilkes Brodnax (1864-1926), preoccupied with such scenes of erotic dissection, sometimes depicted as dreams and including skulls and other symbols of death.21 A poem written by Brodnax—published posthumously in a college yearbook and entitled, curiously enough, The X-Ray—reads:

This comely maiden, once buoyant in life 
            By the dread hand of disease expires,
Is now subject to the dissector's knife,
             To carve and mutilate as he desires. 
                                                                                       (qtd. in Jordanova 104)

Jordanova understands Brodnax “not as reveling in or celebrating male medical power over the female corpse, but as attempting to come to terms with what appears obvious to him: the relationship between anatomist and anatomized is quintessentially gendered” (104). In X-Ray, Harry is a version of the slasher villain (“permanently locked in childhood” (Clover, Men 28)) crossed with Brodnax’s obsessed anatomist. In formulaic slasher film fashion, not only is he a penetrator but is also himself penetrated. Susan snatches up a knife and stabs him before escaping. In the subsequent chase through the hospital’s vacant corridors, she douses him with a convenient “flammable liquid” sitting lidless on a shelf and flees onto the roof. She beats Harry with a metal pipe; again formulaically, he does not die, but grapples with her one last time. In unmistakably sexual imagery, he climbs on top of her (her legs visibly splayed), wielding the knife he has extracted from his own body, and they struggle before she uses a lighter to set him on fire. The film’s last indignity to the human body is one of overt conflagration rather than the subtler “burning” implied by the X-ray, now turned back onto the medical “gazer.” The blazing slasher makes one last run at Susan before falling off the roof and collapsing spectacularly to the ground.

Leaving the Hospital (Massacre)

X-Ray‘s climax is standard slasher fare, and its medical setting becomes all but irrelevant once the chase moves to the roof. Its denouement is oddly sudden: a few seconds of Susan collecting her wits on the hospital roof, and then a cut to a daytime scene of her leaving the hospital, wearing the same dark red business attire she wore on the way in and being greeted jubilantly by her daughter. A freeze frame of their embrace while the ex-husband stands nearby remains on screen as the credits roll. The film is putatively without what Vera Dika calls the “but the heroine is not free” ending that she finds structurally vital to the “stalker” film (60); instead, it insists unconvincingly on the restoration of normalcy and on Susan’s resumption of the role of mother and perhaps of wife in the potential reconciliation with the ex-husband. Her victory anticipates a more “triumphant” strand of the Final Girl, emblematized by Stretch (Caroline Williams) in The Texas Chainsaw Massacre 2 (1986): Final Girls who do not simply survive, but win. At the same time, however, the normalizing tendencies of X-Ray‘s ending are opposed by the tensions it articulates about the medical gaze, which outlast Harry, the “hospital massacre,” and the film. One can read into its truncated conclusion a certain restless unwillingness to deal finally with its own implications. On some level, it is difficult to dispute Rockoff’s assessment that X-Ray is a minor, “inferior” slasher film, in part because of the film’s unintentionally comedic tone. Many sequences—for example, when blood appears to drip onto Susan’s shoe, but is revealed to be ketchup from Hal’s hamburger—seem more appropriate for a parody like Student Bodies (1981) or Scary Movie (2000). In the interview accompanying the Blu-Ray release of X-Ray, Davidson says that he tried to direct the film straight, but got compliments that suggest it was received as a comedy.22 The film’s tonal ambiguity lends it a sickly quality that goes well beyond the killer’s individual pathology, and is attached instead to the entire medical establishment. X-Ray may not be some lost subversive masterpiece, but from its messiness comes a peculiar fascination that remains unblunted by the normalizing, formulaic ending.

As I have noted, the apotheosis of the Final Girl in popular culture has been in almost direct opposition to its declining academic credibility. X-Ray is an example of a film in the first slasher cycle, but one that doesn’t fit Clover’s model neatly; the slasher film, even in its definitive stage, is a more diverse form than Clover and others have articulated. A person so inclined could create a checklist of Final Girl characteristics that do and do not apply to X-Ray: “[s]he . . . is the only character to be developed in any psychological depth” (44), check; “her inevitable sexual reluctance” (48), no check. Conversely, one could see X-Ray and films like it as a reason to discredit the Final Girl altogether. Neither approach is ultimately productive. Rather, as I have tried to show, the path forward lies in extending Clover’s ideas and linking them to related discourses, in this case, to discourses of medical horror and to the medical gaze.

Footnotes

1. Richard Nowell terms Halloween a “trailblazer hit” (48), the unexpected success of which ensured a wave of imitators. He mentions X-Ray only in passing.

2. Barbi Benton was in her early 30s when filming X-Ray, and her character Susan is clearly meant to be around the same age.

3. One can also point to later slasher-influenced films with medical settings like Dr. Giggles (1992), Anatomie/Anatomy (2000), and Valentine (2001). The latter seems to show X-Ray‘s influence through its hospital and Valentine’s Day setting.

4. Elizabeth Cowie has shown that Coma‘s “strong woman” protagonist is actually narratively undermined by the film’s deployment of its conspiracy/mystery structure (36-71).

5. Coma‘s more legitimate descendants include medical thrillers like Flatliners (1990) and Extreme Measures (1996).

6. See Leeder, Halloween, esp. pp. 44-54.

7. See Clover, Men, esp. pp. 27-30.

8. See Leeder, The Modern Supernatural and “Eroticism and Death.”

9. Allan Cameron observes that, in a horror film, all uses of the color red tend to suggest blood (89). The many red objects in X-Ray‘s opening foreshadow the blood to come.

10. Though it perhaps foreshadows her eventual stabbing of the villain, the cake-cutting is a cringe-inducing bit of misdirection that briefly suggests X-Ray might be a killer child movie; indeed, the same actress, Elizabeth Hoy, starred as a 10-year-old murderer in Bloody Birthday (1981) the same year.

11. The West German video release was called X-Ray: Der erste Mord geschah am Valentinstag; rather prosaically, “The First Murder was on Valentine’s Day.”

12. At one point, Susan stares at a photograph of a heart extraction on Dr. Saxon’s wall, both a bit of foreshadowing and a gruesome counterpoint to the stylized hearts casually strewn throughout the hospital.

13. For more on the heart icon and the broader role of the heart in Western culture, see Vinken (2000) and Young (2003).

14. While it’s possible to read Susan as being “punished” for her status as a career woman and divorced mother, the film does relatively little to support that interpretation.

15. See Moreland (2015) for a discussion of porn-horror stardom.

16. Dr. Jacobs contrasts strongly with the two nurses who do Dr. Saxon’s bidding throughout; while superficially feminine, they act as instruments of the masculine system. This is most dramatically apparent when they strap her to a bed, insisting that “it’s for your own good.”

17. Later, the film takes on the Hitchcockian “no one believes the truth” structure. Susan’s increasingly distraught behavior (because she rightly believes she is being stalked) is misread as hysteria by the doctors and nurses; this development is deeply reminiscent of the way hysteria (derived from the Latin “hystera,” “womb”) has been used as a rhetorical device to subdue “rebellious” women (Showalter esp. 145-64).

18. For the classic treatment of the propinquity of horror and pornography, see Williams (1991).

19. The interview with director Davidson contained in the DVD release indicates a gaze of a different sort. It notes that the staff was all in attendance when Benton’s nude scene was filmed: “Everybody was there. Even the catering people came to the set.”

20. Compare Mother Nature’s (Tracey Ullman) excoriation of plastic surgery in Amy Heckerling’s I Could Never Be Your Woman (2007): “You can jump and peel and nip and tuck but your insides are still rotting away.”

21. For comparable research, see Bronfen (1992) and McGrath (2002).

22. Davidson is better-known as the director of sex comedies like the Israeli Eskimo Lemon or Lemon Popsicle series (1978-1982) and The Last American Virgin (1982).

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