Chayefsky is like a small, affable tornado…. His characters are famous for their loquacity and it's easy to see where they get it.

Chayefsky began earning the respect of critics during the Fifties. At first, he wrote as a naturalist, mapping the folkways of lower middle class New Yorkers, cupping his ear to catch the unique flavor of their speech in Marty and in his play The Middle of the Night (1956). He later wrote slightly more avantgarde theater pieces, cultivating a mystical strain in The Tenth Man (1959) and in the biblical drama Gideon (1961)….

In his latest, finest incarnation, Chayefsky has been reborn as a surreal satirist…. Social satire has never been a rarer commodity in American films than today, and Chayefsky's Swiftian ferocity exhilarates audiences.

As a satirist, Chayefsky is no less fascinated by language than he was as a naturalist. He has given his movie creatures a new voice: an involuted, neo-Shavian speech. Conversations bloom with allusions, paradoxes, word play, and little sprigs of poetry. On occasion, Chayefsky's lines are windy and redundant but more often they put sinews of wit and literacy onto the flab of Hollywood dialogue. It is a rare pleasure to hear movie characters use words like "unregenerate" and "piquant." What other screenwriter would have a doctor bellow about "the wounded madhouse of our times"? (pp. 23, 25)

Like all his films, Altered States pits one man against an American institution. The David and Goliath story has clearly fascinated Chayefsky at least since The Americanization of Emily, in which his protagonist took on the entire U.S. Army. In subsequent skirmishes, Chayefsky's abrasive but idealistic heroes have battled the medical establishment in The Hospital, ratings-obsessed broadcasters in Network, and dehumanized science in Altered States. In these contests, David never defeats the giant….

In the case of Altered States, it is not the movie hero who ultimately succumbs to the power of the institution; it is Chayefsky. In a sense, the writer has become one of his own characters. He has battled another institution—Hollywood—and in doing so has not heeded his own wisdom. All his recent films have illustrated the folly of such one-sided warfare. With Altered States, Chayefsky has become his own mad prophet. (p. 25)