In the lecture hall of the London Pathological Society, a brilliant young surgeon, Frederick Treves (ANTHONY HOPKINS) shows an incredulous group of doctors a truly astonishing and horrible sight - a man so hideously deformed that he is condemned to a life as a freak in a circus sideshow, where Treves has found him. His name is John Merrick (JOHN HURT) and he is known to circus audiences up and down Victorian England as The Elephant Man.
After a detailed examination of his appalling (and incurable) affliction, Treves sends The Elephant Man back to the circus in a horse-drawn carriage. But his "owner," Bytes (FREDDIE JONES) beats him up during a drunken rage and Treves takes him into the London Hospital, although the Chairman of the Hospital Committee, Mr. Carr Gomm (SIR JOHN GIELGUD) warns him that incurables are not to be admitted. Nonetheless, Gomm allows that he can stay until a proper home can be found for him.
With the help of Mothershead (DAME WENDY HILLER), the Head Matron, Treves washes years of filth from The Elephant Man's grotesque body and settles him into his room. Word quickly spreads of the newcomer's presence, and after dark the Night Porter (MICHAEL ELPHICK) pays him a visit. Immediately, the porter formulates a way of making some money by charging admission, after hours when the regular staff is no longer around, to view this most unusual being.
Merrick appears to be an imbecile, unable to think or talk for himself, but with tremendous patience, Treves does manage to get him to repeat certain phrases. Flushed with this success, Treves asks Mr. Gomm to see him, but he refuses, saying that The Elephant Man must be moved elsewhere. As he leaves Gomm's office, Treves is accosted by Bytes, who demands his man back. Carr Gomm hears the commotion that follows and comes to Treves' aid. Bytes leaves in a fury, and Carr Gomm decides that perhaps he'd better see this Elephant Man, after all.
At home that night, Treves explains his dilemma to his wife, Anne (HANNAH GORDON): What is in The Elephant Man's mind? Is he an imbecile, beyond all help, or is there an intelligent man trapped in the body of a monster? The next day, Treves rehearses Merrick for his meeting with Carr Gomm, but the latter sees that The Elephant Man's conversation has simply been learned, parrot-fashion. Treves apologizes for the deceit, pointing out that he was only trying to protect his patient. Carr Gomm is sympathetic, but the man must go. As they are talking outside Merrick's room, they hear him beginning to recite the 23rd Psalm, having been taught the first few lines by Treves. But, astonishingly, The Elephant Man goes on to complete it, to the amazement of the two medical men. Having established that The Elephant Man does have a mind and a voice of his own, Carr Gomm agrees to ask the Hospital Committee to make an exception and allow him to stay in hospital.
However, at the Committee Meeting, Broadneck (HUGH MANNING) will have nothing to do with The Elephant Man, insisting that the London Hospital is no place for freaks and incurables. Carr Gomm's motion to allow Merrick to stay is defeated, but he is allowed to be moved into two rooms nearby for the time being. Carr Gomm decides to write to The Times about his predicament in the hope that readers will contribute enough money to pay for his upkeep somewhere else.
An interested reader of the letter, when it appears, is the Night Porter, who reads it out loud to the clientele of his local pub, telling them that he will soon be able to show them The Elephant Man - for the right price, of course. Treves takes Merrick home one day and introduces him to his wife, Seeing photographs of the Treves' children and Anne's parents, The Elephant Man produces a small framed portrait of a beautiful woman - his mother. He recalls how kind and good she was, and says that his pitiful condition is due to the fact that she was knocked down by an elephant when she was four months' pregnant. His love for her is so strong that Anne is moved to tears. From the window of his new rooms, Merrick can see the top of St. Phillips Cathedral and he begins to make a model of it out of cardboard. The nurse who is looking after him, Nora (LESLEY DUNLOP), encourages him by bringing some more cardboard and some glue.
A surprise visitor to London Hospital is Mrs. Kendal (ANNE BANCROFT), toast of the West End stage and one of London's leading society hostesses. She gives The Elephant Man a framed photograph of herself and invites him to come and see her in a play. Where Mrs. Kendal leads, others are sure to follow, and more of London society lines up to make calls on The Elephant Man. Mothershead is highly critical of this, pointing out to Treves that he is just being stared at all over again, only now in better surroundings and by a better class of people. This bothers Treves, but when he discusses it with his wife, she tells him that The Elephant Man is now happier than he has ever been, thanks to him.
At another Committee Meeting, Broadneck is furious that The Elephant Man is still in the hospital and demands that he be moved at once, but he is interrupted by the arrival of Princess Alexandra (HELEN RYAN), Princess of Wales. She brings a letter from Queen Victoria, thanking the Committee for helping such an unfortunate person. Broadneck is deflated, and all vote to allow their incurable patient to stay.
When the Night Porter decides to show The Elephant Man to those from the pub willing to pay the price, one of those who pays to go along is Bytes. The drunken crowd breaks into The Elephant Man's room and humiliates him shamelessly. When they have finally dispersed, Bytes grabs his old sideshow attraction and drags him away. In order to evade the British authorities, Bytes takes The Elephant Man to Belgium and puts him in a circus there. So badly does he treat him, the other freaks in the circus take pity on The Elephant Man, scrape together enough money for a ticket and while Bytes is in a drunken stupor, put his hapless exhibit on a train to London. Merrick arrives at Liverpool Street Station and is soon the quarry of prankish boys and then a nasty mob of hostile people. He collapses as the police arrive. The authorities take him to London Hospital where Treves is overcome by his friend's pitiful condition.
It is obvious that The Elephant Man has not long to live, but Mrs. Kendal's renewed invitation to the theatre does wonders for his spirit. He sits in the Royal Box with Princess Alexandra and together with his friends from the hospital, they watch a production of the magical Christmas pantomime "Puss in Boots" at the Theatre Royal, Drury Lane. At the end, Mrs. Kendal appears on stage and dedicates the performance to him, and he receives a standing ovation from the packed audience.
Later, back in his rooms, Merrick thanks Treves for his wonderful evening at the theatre, and when his friend has left, he puts the finishing touches to his model of St. Phillips Cathedral, which has been such a labor of love. Satisfied, he signs his name at the base of the spire. Then he moves to his bed. He is very tired and in considerable pain. He gazes at his mother's picture on his bedside table as a slight breeze billows the curtains, moving them softly over his face, like a mother's touch . . .
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