What to make of TV med­i­cal dra­mas

The doc­tors por­trayed on TV are of­ten a mixed bag — from help­ful to non­sen­si­cal


When I was a kid in the 1960s, years be­fore I went to med­i­cal school, I was ad­dicted to TV med­i­cal dra­mas. Dr. Kil­dare and Ben Casey were sim­i­lar; both had young physi­cians rail­ing against the sys­tem, un­der the guid­ance of older and wiser men­tors. It wasn’t the medicine but good sto­ries about pa­tients on the brink of life and death that at­tracted me and even inspired me to be­come a doc­tor.

When I was in med­i­cal school in the 1970s, a class­mate rec­om­mended I watch Emer­gency! — a show about paramedics that was so ac­cu­rate that it helped me, and many of my col­leagues, to re­mem­ber the cor­rect doses of life-sav­ing med­i­ca­tions such as li­do­caine and ep­i­neph­rine. The ‘ER’ years Then there was ER. Cre­ated by physi­cian Michael Crich­ton, ER was one of the first shows that at­tempted to give view­ers an al­most hy­per­re­al­is­tic por­trayal of a busy, ur­ban emer­gency depart­ment by to­tal im­mer­sion.

The sets were de­signed to en­able the cam­era to move from am­bu­lance bay to trauma re­sus­ci­ta­tion room in one track­ing shot — giv­ing the viewer a real-time sense of ER medicine at its most fre­netic. The pac­ing and mu­sic kept the ten­sion high. The char­ac­ters wore au­then­tic scrub suits; they held and used sur­gi­cal in­stru­ments like doc­tors be­cause physi­cians acted as med­i­cal ad­vis­ers and taught them how to do so.

ER was also one of the first scripted med­i­cal dra­mas in which the physi­cians and nurses spoke the ar­got or se­cret lan­guage of med­i­cal jar­gon. You be­lieved that Doug Ross — played by Ge­orge Clooney — was a pe­di­atric ER physi­cian be­cause he talked like one. Like a med­i­cal stu­dent thrown into the deep end of emer­gency medicine, view­ers were ex­pected to pick things up as they in­vested time in watch­ing the show.

And did they ever! For much of the 15-year run of ER, the show was in the Top 10 on TV.

Too much drama More re­cently, shows like The Night Shift, Rem­edy and Code Black — which de­buted this fall — have fol­lowed the same tem­plate to rat­ings suc­cess.

But I gave up on shows like these. The ac­tion and drama are non-stop; you’d think doc­tors are only worth watch­ing when we’re crack­ing open chests and squeez­ing hearts. The char­ac­ters are pit­ted against one other in open war­fare in ways that would make it nearly im­pos­si­ble to work to­gether. As some­one who has ex­am­ined mod­ern med­i­cal cul­ture, I think this is the worst thing about med­i­cal dra­mas. They con­vey an out­sider’s sense of how health pro­fes­sion­als should be in­stead of how they re­ally are — or­di­nary hu­man be­ings with a lot of inse­cu­ri­ties who try and fail like ev­ery­one else.

The Knick Re­cently, I found a med­i­cal show that en­ter­tains me although it doesn’t look or feel at all like a day at the of­fice. It’s called The Knick, short for the Knicker­bocker Hos­pi­tal in New York City. The show is avail­able on HBO Canada; Sea­son 2 pre­mieres Oct. 16.

Un­like mod­ern med­i­cal pro­ce­du­rals, The Knickis set in the year1900 — mak­ing it seem fa­mil­iar yet strange. With crude X-rays in­stead of ex­quis­ite MRIs, these doc­tors are lit­er­ally grop­ing in the dark to make the di­ag­no­sis. With­out an­tibi­otics, blood trans­fu­sions and mod­ern sur­gi­cal skill, young pa­tients die with alarm­ing fre­quency.

It gets even bet­ter. The Knick’s Dr. John Thack­ery — a bril­liant sur­geon played by Clive Owen — is an ego­ma­niac who per­forms fu­tile ex­per­i­men­tal oper­a­tions be­fore rapt col­leagues seated in the op­er­at­ing room gallery. Thack­ery is also a co­caine ad­dict with lousy veins whose sup­ply has run out. The char­ac­ters in­clude an even more bril­liant Har­vard­schooled and Paris-trained sur­geon whose ca­reer path is blocked be­cause he is black. The guy who runs the hos­pi­tal is skim­ming funds and selling dead bod­ies to pay off se­ri­ous gam­bling debts.

Co­caine ad­dic­tion among physi­cians is a his­tor­i­cal fact born out of ig­no­rance of the drug’s habit-form­ing prop­er­ties; so is racial big­otry.

But who cares? Be­cause I don’t know medicine circa 1900, I’m quite happy to sus­pend my dis­be­lief and leave the chal­lenge of plau­si­bil­ity to Dr. Stan­ley Burns, the show’s med­i­cal ad­viser. His med­i­cal archive has inspired ev­ery­thing from set de­sign to some of the show’s most en­ter­tain­ing sto­ry­lines.

Doc­tors make mis­takes in the same way we all do. That’s why I find the por­trayal of physi­cians as flawed pro­fes­sion­als re­fresh­ing. It’s a form of es­cape that I rel­ish. Dr. Brian Gold­man hosts White Coat, Black Art on CBC Ra­dio One, and is the au­thor of The Se­cret Lan­guage of Doc­tors. He is an emer­gency physi­cian and as­sis­tant pro­fes­sor in the Fac­ulty of Medicine’s depart­ment of fam­ily and com­mu­nity medicine. Doc­tors’ Notes is a weekly col­umn by mem­bers of the Univer­sity of Toronto’s Fac­ulty of Medicine. Email doc­torsnotes@thes­tar.ca

ER, with Ju­lianna Mar­guiles and Ge­orge Clooney, had med­i­cal ad­vis­ers be­hind the scenes.

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