TV medical dramas suffer from a reality bypass
Long before the wretched medical voyeurism of programs such as Embarrassing Bodies, there was widespread hope for television as influencer and educator. When Marshall McLuhan wrote his optimistic work Understanding Media in 1964, the world was decades away from encounters with a prolapsed rectum and, so, you can kind of forgive the guy for thinking that hospital dramas would produce better doctors and patients.
What television did produce, or at least enhance, was not greater interest in medicine but a great interest in the drama of the body. Medical narratives began appearing shortly after television test broadcasts ceased and, following the 1951 debut of US drama City Hospital, they never stopped.
Those playing doctor in the first decade of TV were compelled both by the ideals of the age and the American Medical Association to do so with great accuracy. The producers of City Hospital and many medical dramas that followed did not permit fancy such as one might see on House M. D., where specialist doctors break into patients’ homes to find the source of a rare illness, or on ER, where George Clooney’s glorious face was never covered by a surgical mask. Not even in surgery.
Australia’s earliest television doctors came to us in 1959 by kinescope with GTV9’s Emergency. Filmed on the advice of the Royal Melbourne Hospital and scripted by an overworked radio writer, this show was as wooden as a postwar prosthetic leg. It didn’t last much longer than six months. But, in the spirit of the age, it did strive for medical accuracy.
Gradually, medical drama looked less to anatomical textbooks than it did to sociology for inspiration. Debuting at the end of the 1960s, the popular Marcus Welby, M. D. focused, as ’80s Aussie drama A Country Practice would, on “issues”. Welby treated patients with newsworthy disorders. In one episode, he even cured a man of homosexuality.
With behaviour such as this, of course, doctors would themselves become the object of scrutiny on TV.
By the 1970s, television had largely given up the business of educating its viewers. It had also given up treating doctors with absolute reverence. Programs such as M*A*S*H in the US and Australia’s long-running soap The Young Doctors made possible the irascible Gregory House, the ambivalent Meredith Grey of Grey’s Anatomy and the hipster whimsy of The Mindy Project’s Mindy Kaling.
These days, and despite what McLuhan had to say, TV doctors have little to do with evoking the pure drama of the body. Or even the drama of the social body. While nearly all medical dramas retain scientific advisers and some maintain a focus on “issues” – there has been no moment on Australian screens more unwatchably worthy this year than ABC1’s nurse drama ANZAC Girls – their task of healing any physical or social ill is all but abandoned.
Blockbuster House M. D., while creditably written and shot through with the Vicodin sexiness of its leading physician, rarely made the merest effort to seem real or socially useful. Hugh Laurie’s doctor was an improbable man doing improbable work on improbable cases. There was no task, from lumbar puncture to bedside flower arranging, that House’s select team of highly paid medical detectives could not capably effect, and there was no bodily dysfunction that the doctor, unlike real medical science, failed to understand.
An exotic man whose towering genius produced boundless funds for the study of very rare illness, House was himself the subject of a little cultural pathology. This year in the journal Human Communication Research, results of a survey taken from viewers of House M. D. and three other medical programs was published. In Medical Dramas and Viewer Perception of Health: Testing Cultivation Effects, author J. E. Chung found contemporary medical drama was bad for our health. Nearly 12,000 serial viewers of episodic medicine were interviewed and found to be more uncertain in medical matters than the general population. They were less likely to be able to assess and reduce their risk for those common illnesses such as cancer and cardiovascular disease for which the elite Dr House had no time. Having seen so many television deaths, they were more fatalistic.
Fantastic plot lines dressed in ordinary white coats can tend to persuade some viewers that visits to the doctor are pointless. But TV long ago renounced its responsibility to the truth or to its viewers.
There are now medical-lite shows such as Offspring or The Mindy Project that don’t pretend their stethoscopes have function beyond jewellery. An emerging genre of popular, romance-focused medical dramedies do not trouble themselves at all with garbled medical jargon or badly mimed CPR. It’s probably a good thing Asher Keddie’s obstetrics practice is so barely sketched. Otherwise viewers of reproductive age might start believing that pregnancy always causes quirky romance and adorable outfits. Along with the tremendously stupid new US show Forever, which traces the fortunes and genius of a centuries-old medical examiner, such programs are exactly as far from a reasonable depiction of medicine as the AMA had feared when it insisted on giving technical advice to screenwriters back in the 1950s.
But medical dramas may not have become entirely empty of social purpose or cultural value. Sure, there are some very silly narratives about immortal Georgian gentlemen and wide-eyed sweetie-pies with cheeky haircuts who just happen to be doctors, and it would seem that the genre, which has never been much chop, has run out of useful things to say. But that is if we don’t count a shift that began to occur with the medical drama disguised as a crime show, Breaking Bad.
It is cancer and the hopelessness of the US health system that turns patient Walter White from a nice high school chemistry teacher into a meth-making Titus Andronicus. While the celebrated program assays a number of uniquely American grievances, it is built upon a critique of the health industry. In an effort to save himself and his family not only from the ravages of disease but the horror of insurers, Walt himself becomes a corrupt death-monger.
Two newer period medical dramas also ask questions of the institution of medicine. Jon Hamm, accustomed to critiquing the present through a look at the past as Don Draper in Mad Men, stars with Daniel Radcliffe in A Young Doctor’s Notebook. Based on the Mikhail Bulgakov roman à clef, the slightly clumsy show never lives up to the Serious Literary ambitions of its producers, but it looks great. The scenes of surgery performed in crude conditions as the Russian Revolution unfolds and contemporary medicine is birthed are marvellously gross. And they remind us, as does Steven Soderbergh’s The Knick, set in a fin-de-siècle New York hospital, that medicine is not a vocation but an institution.
Clive Owen plays a surgeon of brutal aspiration whose body count starts in the series’ first five minutes. A bit like Gregory House, who has traded Vicodin for medical-grade cocaine, Dr John Thackery is a nasty-but-brilliant piece of work. When he’s not proving that this is a Soderbergh production by forcing a nurse to inject amphetamines directly into his penis, he is reminding us what heartwarming dramas such as Grey’s Anatomy cannot: that medicine is not so much a caring profession as it is, by necessity, a dehumanising institution.
With its fixity on personal ambition and its intellectual laziness, The Knick is not half as good as it could be. But it’s a darn sight better than most medical dramas and any effort to explain medicalisation – that modern process by which human sickness came to be recognised and treated by medicine – is a worthwhile effort.
The institutions of modernity are so vast and so organised they often exceed the needs of the individuals they are designed to efficiently serve. And although we have deaths and other gruesome institutional snafus in these two dramas, which chart the birth of the clinic, we don’t have much sense of the milder horrors of medical bureaucracy such as we saw in Breaking Bad.
Where we can see the awful and slow evil of organised medicine is in Getting On. Co-written by English comedian Jo Brand, this dramedy has both British and US versions and they’re both my new favourite show. Written around the lives of healthcare workers in an aged-care facility, this script engages with the horror of medicalisation almost to the satisfaction of a sociology grad. The US iteration is more comprehensively depressing – possibly because the US healthcare system is more comprehensively depressing – and its contrast of bland corporate speech about “customer focus” and “happiness outcomes” with feeble, underserviced seniors who are surplus to the needs of a cruelly peppy America is heartbreaking and marvellous.
There is an especially good scene that explains the protocols for managing “inappropriately placed” faeces. In this extraordinary horror show, there is no basic human function that is not regulated and coldly demonised by the institution of medicine and the efficiency of the age.
Here, doctors are not gods whose onscreen depiction is protected by the AMA, but mortal parts of a naked institution. Here, we might see McLuhan’s hope for an instructive medium realised if only for a moment.
• THEATRE Beyond Desire
Hayes Theatre Co, Potts Point, Sydney, until December 14
• MUSIC Max Richter: Vivaldi Recomposed
Melbourne Recital Centre, November 24
• IN CONVERSATION Richard Dawkins: An Appetite for Wonder
Melbourne Convention and Exhibition Centre, November 29; Brisbane Convention and Exhibition Centre, December 1; Seymour Centre, Sydney, December 4
• FESTIVAL Corroboree Sydney Festival 2014
Museum of Contemporary Art, Sydney, until November 30
• FESTIVAL Supanova Pop Culture Expo
Adelaide Showground, until November 23; Brisbane Convention and Exhibition Centre, November 28-30
This article was first published in the print edition of The Saturday Paper on Nov 22, 2014 as "Reality bypass". Subscribe here.