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It's a real gem of a shocker, and it's fun to figure out why it works so well.

The first surprise for me is how outrageously telegraphed it is. That Akermanesque long shot of the hallway is unlike any other set-up in the film, and Blatty holds it and holds it, then returns to it again and again. Clearly something's going to happen that disrupts the formal rigour and stillness of the shot, unless we genuinely believe that Exorcist III is about to morph into Hotel Monterey II.

Blatty uses repetition and misdirection smartly. He returns to the 'set-up' several times without delivering the expected shock. He moves cops ('protection') in and out of the frame, artificially ramping up and down the 'danger', even though we don't know exactly what that is or where it will come from. He moves the nurse on and off-screen as well, increasing our anxiety. He delivers a side-shock with a classic 'bus' when the doctor rears up from his sleep, and this feint in turn confirms our suspicions that the friendly nurse is Gemini bait by giving us her giveaway name.

The set-up corridor shot at once gives us too much and too little information. All that space around the character presumably presents low-threat areas (i.e. if anything happens, we'll see it coming, since it has to cross the space / the screen to reach her), hence the increase in anxiety when she goes to the edges of the screen or into a side-room - although we've got a clear view of deep space, we've got no view whatsoever of those lateral spaces.

So we're primed for something, we assume it has to come from the side of the screen (ceiling and floor, unlike most other scenes in most other movies, are well exposed in this set-up), so why does it still shock us?

First, there's the old magician's trick of now-you-see-it-now-you-don't, since the threat comes from the very space the nurse has just checked and dismissed as non-threatening, and it comes far too fast for it to have been plausibly concealed, so in terms of character logic, it's coming from the last place you'd expect, and it's super-natural.

I think the other big factor is that the shot, in the space of only a handful of frames, goes from undersaturation of information to information overload. We've been looking at this space for several minutes all told, combing the frame for any indication of action or oddity, and noting only minimal changes (primarily the movement of actors and small sounds) - we're primed for the tiniest confirmation of our worst fears. Suddenly, there's far too much to process: blaring sound, an entirely new figure (and we can't quite make out what it is - the thing sticking out in front is presumably the loppers, but is the flash we get, it reads almost comically as the 'advancing mummy' pose), rapid movement across the screen (again, out of character with that particular shot, but also with what we know about the 'killer') and, perhaps the touch of genius, a rapid zoom in (maybe an optical, and so brief at the end of the shot that it's almost subliminal). The space between the horrific action and our vantage point abruptly crumples at the moment of impact, and this is followed by a shock cut that itself takes a second or two to process, as it weirdly combines the figures of killer (robe, pose) and victim (missing head).

Some very deft filmmaking in this sequence. Bravo, Blatty.