The Ether Addict

The plot of The Cider House Rules is far more complicated than the compressed version of the story and its characters that I adapted as a screenplay (over a thirteen-year period, and for four different directors). In the novel, I began with the four failed adoptions of the orphan Homer Wells. By the end of the first chapter, when Homer returns for the fourth time to the orphanage in St. Cloud's, Maine, the orphanage physician, Dr. Wilbur Larch, decides he'll have to keep him.

Dr. Larch, an obstetrician and (in the 1930s and '40s) an illegal abortionist, trains Homer Wells to be a doctor. This is illegal, too, of course — Homer never goes to high school or to college, not to mention medical school. But with Dr. Larch's training and the assistance of Larch's faithful nurses, Angela and Edna, Homer becomes an experienced obstetrician and gynecologist. He refuses to perform abortions, however.

The second chapter of the novel describes Larch's childhood and medical-school years, his first internship in Boston, and the experiences that have made him "a patron saint of orphans" and an abortionist. The history of Homer's failed adoptions and Larch's background are not developed in the screenplay. Larch's ether addiction is developed in both the book and the film, but his sexual abstemiousness, a feature of his eccentricity in the novel, was never in any draft of the script; instead, in the movie, I strongly imply that Dr. Larch may have had (or still has) a sexual relationship with Nurse Angela.

I wanted to make Larch more normal. There is less time for character development in a film than in a novel; a character's eccentricities can too easily become the character. In the movie, I thought Larch's addiction to ether was eccentric enough.

In the screenplay, as in the novel, it is both Homer's conflict with Larch over the abortion issue and Homer's desire to see something of the world outside St. Cloud's that make him leave the orphanage with Wally Worthington and Candy Kendall — an attractive couple who come to St. Cloud's for an abortion. But in the book, Homer spends fifteen years away from the orphanage — in that time, Wally and Homer become best friends, Homer falls in love with Candy, and Wally and Candy get married.

The passage of time, which is so important in all my novels, is not easily captured in a film. In the screenplay, Homer stays away from St. Cloud's for only fifteen months, Wally isn't Homer's best friend, and Candy is the sexual aggressor in her relationship with Homer.

And in the novel, Homer and Candy have a son, Angel, who they pretend is adopted. Wally, out of love for all of them, tolerates this obvious fiction and his wife's infidelity. In the screenplay, there is no child and Wally never knows about Candy's transgressions. Developing sympathy, not unlike developing character, takes time; in the movie, I tried to make Homer more sympathetic by making him less responsible for the affair with Candy. I made less of the affair, too.

But in both the novel and the screenplay, what precipitates Homer's return to the orphanage, where he replaces Dr. Larch as the obstetrician and the abortionist in St. Cloud's, is his discovery of the relationship between a black migrant apple picker and his daughter. Mr. Rose, the picking-crew boss on the apple farm where Wally gives Homer a job, impregnates his own daughter, Rose Rose. In the novel, it is Homer and Candy's son, Angel, who falls in love with Rose Rose and first makes this discovery, but since I eliminated Angel from the screenplay, I made Homer find out about Rose Rose's pregnancy directly.

When Homer acknowledges that he must perform an abortion on Rose Rose, he realizes that he can no longer deny that procedure to other women who want it. All the time Homer Wells is away from St. Cloud's, the aging and ether-addicted Dr. Larch has been plotting how Homer can replace him; in the end of both the novel and the film, Homer accepts the responsibility Larch has left to him. The doctor's young apprentice becomes the orphanage physician.

Left out of the movie was the book-length character of Melony, an older girl who befriends Homer as a young orphan at St. Cloud's. Melony is also the source of Homer's sexual initiation, and she extracts from him a promise he will break — that he won't leave her. But I eliminated her from the screenplay; she was simply too overpowering a character.

Over and over again, the limitation imposed on the length of a movie has consequences. The novel of The Cider House Rules was more than 800 manuscript pages long — it's more than 500 book pages. The finished screenplay was a mere 136 manuscript pages. It pained me to lose Melony, but I had to do it.

It helped me that there'd been a precedent to losing Melony. In several foreign countries where the novel was translated, I lost the title. (Of my nine novels, The Cider House Rules is my favorite title.) In some languages, The Cider House Rules was simply too clumsy to translate. In France, cider is an alcoholic drink; in German, "cider house rules" is one word. I forget what the problem was in Finnish, but the Finns titled the novel The Hero of His Own Life — from the beginning of David Copperfield, which Dr. Larch reads and rereads to the orphans at St. Cloud's. Homer Wells takes the opening passage from David Copperfield personally. "Whether I shall turn out to be the hero of my own life, or whether that station will be held by anybody else, these pages must show."

The German title, Gottes Werk und Teufels Beitrag (The Work of the Lord, the Contribution of the Devil), imitates Dr. Larch's manner of speaking in code to his nurses. (The French made a similar choice for the title: L'Oeuvre de Dieu, la Part du Diable.) This is Larch's way of indicating to Angela and Edna whether he is delivering a baby or performing an abortion. The point being that, in Larch's view, it is all the Lord's work — either he is delivering a baby or he is delivering a mother. (In the film, Dr. Larch's willingness to give abortions is established in the montage over the opening credits. Homer's reluctance to perform the procedure is expressed in the first scene of dialogue between them.)

I felt that a man who takes on the enormous responsibility of life or no life in an orphanage in poor, rural Maine — a man like Dr. Larchówould be deeply scarred. For this reason I made Larch an ether addict.

Ether was first synthesized in 1540 by a twenty-five-year-old Prussian botanist. People have been having ether frolics — and later, laughing-gas parties — ever since. In the proper hands, ether remains one of the safest inhalation agents known. At a concentration of only 1 or 2 percent, it is a light, tasty vapor; some forty years ago, hundreds of cases of cardiac surgery were done with ether and partially awake (even talking) patients.

Some of Dr. Larch's colleagues would have preferred nitrous oxide or chloroform, but Larch developed his preference for ether through self-administration. You would have to be crazy to self-administer chloroform. It is twenty-five times more toxic to the heart muscle than is ether, and it has an extremely narrow margin of safety; a minimal overdose can result in cardiac irregularity and death.

Nitrous oxide requires a very high (at least 80 percent) concentration to do the job, and it is always accompanied by a degree of what is called hypoxia — insufficient oxygen. It requires careful monitoring and cumbersome apparatus, and the patient runs the risk of bizarre fantasies or giggling fits. Induction is very fast. Coleridge was a laughing-gas man, although the poet was certainly familiar with ether, too. It was unfortunate for Coleridge that he preferred opium. Ether is a kinder drug addiction to bear. But no drug addiction is without risk — and no self-administered anesthesia is safe. After all, in both the novel and the film, Dr. Larch accidentally kills himself with ether.

When I first thought about the grounding for Dr. Larch's character, I kept one principle foremost in mind: he goes to extremes. In the novel, he has sex just once, with a prostitute who gives him gonorrhea. He starts taking ether to numb himself to the pain of the gonococci; by the time the bacteria burns itself out, Larch is addicted to the ether. I thought that he should be no less extreme as a doctor.

In the movie, Larch's onetime experience with the prostitute, his case of the clap, and his subsequent sexual abstemiousness are gone. What remains is his ether addiction; without a history, it seems more desperate, more extreme. Homer defends Larch's reasons for taking ether by saying that Larch needs it to help him sleep ("He's too tired to sleep"), but the ether numbs Larch's overall pain. He takes it to relieve his angst, his Weltschmerz.