Many of the patients in the Pilgrim State Hospital's ward scenes were played by real life hospital staff.
The original broadcast included the following disclaimer: "This story is based on the tragic lives of Adam and Ewa Berwid. Adam's violent behavior is not intended to be a general reflection of the mentally ill, the vast majority of whom never commit a violent crime. Indeed, they are not more prone to violence then [sic] the non-mentally disordered."