|Remember, if you're a patients, they're the stars|
There have been many medical dramas, some good some bad. Here’s a partial list: St. Elsewhere, ER, Grey’s Anatomy, House, Marcus Welby M.D., Doctor's Lives, Scrubs and M*A*S*H. When we think about patients and doctors, we think about them as equals or the yin and yang of a give and take relationship. The patient, sick, needs the doctor’s help; in turn, the doctor needs the patient in order to practice his art. Or to state it a little more crudely: doctors can’t be doctors without the sick. Without the sick, there’s no such thing as the heroic doctor, a lucrative and prestigious role, but one reliant on the misfortune of others. In the best of worlds this imbalance is redressed by both medical ethics and the fact that patients are more than their illnesses; that they often get better and go on to lead productive lives.
Medical dramas rather than unraveling this imbalance use it as a way of perpetuating a number of misconceptions about what it means to be a patient, both as someone in need of medical care and, more fundamentally, a fellow human being. Instead, medical dramas are more interested in replicating Hollywood’s star system than in examining the complex relationship between doctor and patient, the back and forth drama of the expert healer and the sick. In medical dramas patients are just the sickness, the disease, an afterthought. They aren’t really human in the way we normally think about people. Patients are just there to provide background color, their deaths serving to highlight not their own humanity but the greater drama of their doctors’ emotional lives. Needless to say, we should all find this morally and ethically suspect.
The point of any type of drama is to draw the viewer in and to make us sympathize with the characters. Weirdly, medical dramas almost never allow us to sympathize with the patient. ER was a fantastic show, unique in that it cared about the patient and the doctors equally; it was a show, which you could truly call a medical drama and not a drama with medical stuff sprinkled on it. Still, even in ER the true stars were the doctors. It’s important to understand the dynamics of viewer sympathy in its purest form, before seeing how it operates in medical dramas and why most of these shows are objectionable in their treatment of the patient.
Ironically, we have to look to a non-medical drama to understand how sympathy for the sick should work. A recent episode of Desperate Housewives does a great job of understanding what it means to be ill. In episode “If…” the producers put all four of the housewives in a “what if” scenario. Lynette’s (Felicity Huffman) “what if” scenario was the most striking, at least from a medical perspective. The situation was simple but effective. Lynette must sacrifice one of her unborn twins to save the other and even then the surviving one will be disabled.
The episode made me cry because, one, I cared about Lynette; and two, it so perfectly captured the difficulty of having a sick child. It reminded me of how my parents must have felt after I had a stroke. Desperate Housewives shows how sympathy and identification can work in an ethical and realistic manner. The child is not just a piece of disease, but a real person who we care about and who happens to be ill. Being sick is not this child’s world or identity, but a condition that affects everyone around him. It was only a “what if” but the episode captures the ongoing difficulties and triumphs of being a patient and of being someone who loves that patient. In this way Desperate Housewives is a perfect example of a drama that cares about people who are sick and treats their condition in a humane way. It’s funny that one of the best moments of medical drama comes in a series that, well, isn’t a medical drama.
THE WORST: GREY’S ANATOMY
|What you must understand is that these doctors will kill you|
Grey’s Anatomy is all about the drama of the doctors and rarely deals with the drama of the patient. This show doesn’t deserve to be called a medical drama: if you have a serious medical issue you are going to die…on this show. For example, in “Migration” Doctor Robbins (Jessica Capshaw), one of the main characters of the show has a friend, Nick, who dies of an inoperable tumor. In one crucial scene, while operating on Nick, Doctors Teddy Altman (Kim Raver) and Callie Torres (Sara Ramirez) discover that his tumor is much deeper than they imagined and might be impossible to cut out. At the same time Robbins is watching the operation with another doctor. The doctors banter back and forth about the best way to proceed and then Robbins realizes that they don’t know what to do. The important thing to notice is that all the drama resides in the decisions and feelings of the doctors. It becomes about their technical abilities and their emotions. What’s most striking is that through all this Nick is unconscious. He is little more than where the drama takes place; he might as well be a car.
In the next scene, Nick asks Robbins, “Am I cancer free?” and she explains to him why the doctors weren’t able to cut out the tumor. At first he doesn’t get it, but once he realizes his situation they both start to cry. If this were the first two seasons of House or ER the patient would have gotten the chance to live, because those shows are interested in the drama of the patient as a human being, but Grey’s Anatomy is just interested in the patient as a source of drama. Nick must die and in a fundamental way he doesn’t even matter. In episodic television, he’s not a regular and is not only dispensable, but also not very interesting either. Again, the dominant image of Nick in the show is anesthetized, completely unconscious and barely human, a body to be acted upon and not a person we care about or who has any kind of chance to live or even die with dignity. In Grey’s Anatomy we only care about the living and they are always the doctors.
|That doctor is a patient. Well, now we must save her|
One of the most telling moments in the series’ long run is at the end of the eighth season when most of the main characters are in an airplane crash. Some of their injuries are minor, some major. In a season nine episode, “Walking On a Dream,” we hear doctor Meredith Grey (Elle Pompeo) talking about the effects of a phantom limb. While we hear this, Robbins goes out for her morning jog and then gets a page that she needs to go to the hospital. Once she gets there her leg starts to deteriorate. As she wakes up panting and scared from this nightmare, she feels pain where her left leg used to be and we hear Dr. Gray’s conclusion, “This is called phantom limb.” The whole episode is about her coming to grips with losing her leg. Grey’s Anatomy is great at being a drama whose characters are likable, but when it tries to be a compassionate medical drama it fails. What’s interesting about this scene is that in a show that’s often horrible in in its treatment of patients, the only time it shows any concern for a patient’s pain is when the patient is a doctor. Grey’s Anatomy can only imagine real pain as being a doctor’s pain and so the only moments we get of what it feels like to be a patient come when the doctor happens to be a patient. The lack of imagination is stunning.
HOUSE, A BETTER SHOW AND A BETTER DOCTOR—FOR A WHILE
|House cares about patients--at least in the first two seasons|
In its first two seasons House was a fairly good medical drama that kept a strong balance between House, a brilliant but mentally unbalanced doctor and the patients he treated. There’s no doubt that the star of the show is House, played by the charismatic Hugh Laurie. Yet, because House cares so much for his patients, we do too. We know that they’re worthwhile because he feels them to be worthwhile. The show operates much like the Desperate Housewives episode in which we learn to care about Lynette’s disabled son, because Lynette does. We need stand-ins to show us how to care. There’s a difference between treating the sick and caring for the sick and it is the latter that lets us see the value of people who are ill and suffering. In a simple way, we learn to care about people by watching other people care and this happens in medical dramas only when we understand the ill in human rather than clinical terms.
A good example of this chain of caring is the “Sex Kills” episode from season two. In it Henry Arrington, sixty-six years old, is suffering from flesh pulmonary edema, which attacks your brain, heart and testicles. House’s team of doctors, Doctors Eric Foreman (Omer Epps), Allison Cameron (Jennifer Morrison) and Robert Chase (Jesse Spencer) come to the conclusion that there’s no hope and that Arrington is going to die. House tries to get him a heart transplant, but the hospital’s board of directors turns him down because of Arrington’s age. House doesn’t stop there, but continues searching for a heart. Again, it can’t be emphasized enough, he sees each patient as worthwhile and because of that so do we.
|House will save this man and give him gonorrhea|
In an attempt to save Arrington, House comes up with the idea of finding a damaged heart that no one wants but that might help Arrington. He finds a perfect candidate: a car accident victim close to death, obese and with a bad case of gonorrhea. House thinks perfect and approaches her husband about an organ donation. The husband knees him in the balls. What’s important is that even though House seems callous, he’s actually not. For House, the sick and dying always have value. Even the crude joke he tells Arrington, “Got your heart, but you’re going to have gonorrhea for a couple of weeks,” is a sign of the show’s humanity. There are so many ways that a life can be significant and none of it is about perfection.
Unfortunately, House joined the ranks of most medical dramas and by its third season lost interest in the humanity of the patient. In an especially galling season three episode, “One Day, One Room,” the hospital is overrun with patients. House, who in the first two seasons is all about the individual patient, here treats everyone he encounters as no more than a mass of indiscriminate annoyance. What’s awful is that illness is treated as if it were a game, as House taunts the assembled sick: “Those of you who have a runny nose IT’S A COLD, GO HOME! Those of you who stayed obviously don’t and will get assigned to a doctor immediately.” Unlike the gonorrhea joke, there’s no care here, only a sense of entitlement. No matter what happens in the episode, and there is a rape victim and death, the patients are just background noise to House’s witticisms.
|He soon ceases to care|
In the first two seasons House gets annoyed and acts out, because people, sometimes the patients themselves, get in the way of sound and humane medical practices. House wants to help the sick and sees them as individuals. From the third season on, the patients are just there so that House can perform his act. In this way, a once promising medical drama becomes no more than an unpleasant Grey’s Anatomy and we’re again in a world where the only feelings that matter are the tender emotions of doctors. In a situation like that, God help the sick.
©CCA Arts Review and Patrick Campbell