The novel was on the NYTimes best seller list for over a year before the movie debuted, Interestingly, Paramount had options on the novel and supported Puzo while he wrote it. But the studio still hesitated to make a movie, even after the novel made good, because they were in dire financial straits. They'd also made a Mafia movie in '68, "The Brotherhood," that was a critical success but flopped at the box office.

Lucy and Jules, the gynecological operation, and all the Nino and Hollywood BS, was Puzo showing off what he had learned through his connection to the movie industry. I bet a female friend or relative had had that operation, and Puzo created the Lucy/Jules chapters just so he could write about it. Hollywood BS nearly ruined "The Last Don."