can I say? It's obviously there. I didn't set out to put it there; that's simply what the imagery turned out to be, and I'm not about to change the imagery just to eliminate that. Brain Damage makeup effects artist Gabe Bartalos later acknowledged the phallic nature of Aylmer's design, including its overall shape and veiny texture, and said that such elements were encouraged during the design process. In 2003, author Scott Aaron Stine noted Aylmer's design as being "a bit phallic", writing, "do I sense someone making a statement about male sexuality?" In 2017, academic Lorna Piatti-Farnell listed Brain Damage as being among a number of films released in the 1980s which highlight "a disturbing fascination with parasitic creatures and aliens crawling in and out of human mouths, leaving not only a disturbing sense of discomfort in the viewing audience, but also a good dose of raised highbrows and open mouths, as far as latent meaning of oral interactions are concerned". Specifically, she writes that "the mouth lies at the center of a broader alien plot" in Brain Damage, in that Aylmer "uses ingestion [...] to gain control over its victims." Reviewing the film's 2017 Blu-ray release, Chuck Bowen of Slant Magazine wrote that "Brian's degradation suggests the crack epidemic of the '80s, and the threat and alienation of AIDS lingers over the outré, sexualized set pieces, especially when Brian cruises a nightclub called Hell and picks up a woman, who's murdered by Aylmer just as she's about to go down on Brian." In 2022, Henry Giardina of Into wrote that the film contains elements of homoerotic subtext and serves as an allegory for the transmasculine experience, citing Aylmer's phallic design and Brian waking up to find himself covered in blood (which Giardina likens to menstruation), as well as comparing Aylmer's "juice" to both semen and hormone replacement therapy (HRT). Production Development and casting The film's working title was Elmer the Parasite; Henenlotter conceived of the name Brain Damage when he "was literally writing the last scenes". Initial plans by the New Jersey-based company Rugged Films—who had temporarily owned the distribution rights to Henenlotter's debut feature film Basket Case (1982)—to finance Brain Damage did not come to fruition. Brain Damage was ultimately financed by Cinema Group, who invested $1.5 million into the production. In the original script, Aylmer speaks to Brian inside his head with a whispery voice that