Call­ing Dr. Se­in­feld …

Modern Healthcare - - OUTLIERS -

The most eye-catch­ing ref­er­ence in a re­cent Health Af­fairs re­port on pa­tient fears when deal­ing with “au­thor­i­tar­ian” doc­tors did not get an end­note ci­ta­tion. That’s be­cause, in­stead of com­ing from a med­i­cal jour­nal, it came from a clas­sic episode of the “Se­in­feld” TV show.

The re­port cites a 1996 episode where the Elaine Benes char­ac­ter, por­trayed by Ju­lia Louis-drey­fus, learns that physi­cians have writ­ten in her charts that she is a “dif­fi­cult” pa­tient and, sub­se­quently, are un­will­ing to treat her.

Lead au­thor, Do­minick Frosch, with the Palo Alto Med­i­cal Foun­da­tion Re­search Foun­da­tion, said the Se­in­feld ref­er­ence wasn’t in the first draft but was added af­ter an anony­mous re­viewer men­tioned it while dis­cussing the re­port’s find­ings. Frosch said he and his co-au­thors de­cided to add it to the re­port be­cause “it was a good ex­am­ple” of pa­tient fears and “it was im­por­tant to ref­er­ence that it has been brought up in pop­u­lar cul­ture.” So Out­liers got to won­der­ing if “Se­in­feld” ref­er­ences turned up in other med­i­cal jour­nals.

The New Eng­land Jour­nal of Medicine archives re­vealed one men­tion of the show—a quick ref­er­ence in a 2006 re­view of two books on cir­cum­ci­sion. It’s noted that the book Marked in Your Flesh— de­scribed as “less a his­tor­i­cal nar­ra­tive than a polemic”—has “a col­lec­tion of eclec­tic and loosely struc­tured ob­ser­va­tions on dozens of sources span­ning three mil­len­nia, from the book of Gen­e­sis to the tele­vi­sion sit­com ‘Se­in­feld.’ ”

In the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion, in a 1985 let­ter on Sig­mund Freud, au­thor Lynne Lam­berg quotes a source say­ing that, to get the jokes on “Se­in­feld” or “The Simp­sons” and ap­pre­ci­ate Al­fred Hitch­cock films, “you have to un­der­stand some con­cepts of Freud.”

And of course, “Se­in­feld” also ref­er­enced Freud, in one of Out­liers fa­vorite quotes from the show, about Ge­orge: “You re­ally need some help. A reg­u­lar psy­chi­a­trist couldn’t even help you. You need to go to, like, Vi­enna or some­thing. You know what I mean? You need to get in­volved at the univer­sity level, like where Freud stud­ied, and have all those peo­ple look­ing at you and check­ing up on you.”

Out­liers isn’t sure even Freud could help Ge­orge, how­ever.

GETTY IMAGES

Out­liers would never call Elaine dif­fi­cult. Now Ge­orge, how­ever ...

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