When the role of Dr. Tuskin was still written as male, Alan Arkin, Richard Dreyfuss, Chris Sarandon, George Segal, Martin Sheen, Gene Wilder and David Carradine were considered. Director Sir John Boorman passed on Sarandon, and Segal's salary demands were too high. When the decision was made to make Dr. Tuskin a woman, the screenwriter suggested Jane Fonda or Ann-Margret before Boorman decided upon Louise Fletcher who was originally cast as Chris MacNeil when the role was still in the script.

Film

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