Magazine article The American Prospect

Doc Hollywood

Magazine article The American Prospect

Doc Hollywood

Article excerpt

Physicians have always had a symbiotic relationship with Hollywood. From Lew Ayres in the 1930s Dr. Kildare films to Andre Braugher in Gideon s Crossing and Melina Kanakaredes in Providence, movie studios and TV networks have enlisted the support of individual doctors and their organizations to provide story ideas, expert advice, and, more recently, high-tech medical equipment and snappy jargon.

As Joseph Turow documented in his book Playing Doctor: Television, Storytelling and Medical Power, medicine has exacted a high price for its cooperation and seal of approval. Directors, producers, and screenwriters once were expected to portray doctors and their treatments in the best possible light, reinforce their conservative values, and support the kind of public policy and scientific agendas doctors favor. (For example, Hollywood mirrored organized medicine's opposition to so-called socialized medicine and downplayed the limitations or failures of expensive high-tech and experimental procedures.) Many TV shows even had a doc on the set to enforce the American Medical Association's definition of authenticity.

Hollywood--along with journalism--has been an active partner in the creation of a heroic medical narrative that has shaped Americans' view of health care, inspired "consumer demand" for the latest treatments, and conferred status on medical practitioners and specialists. This narrative places physicians at the center of the health care stage. Medical knowledge and science--what Howard Gardner, author of the theory of multiple intelligences, would call abstract rational intelligence--is, in Hollywood, the only knowledge that counts. It is what convinces us that doctors should be the captains of the health care ship, in charge not only of their own practice but of nurses, social workers, physical therapists, and other health care professionals--all of whom are seen to function in servitude or in thrall to the physician's knowledge and judgment. Although real patients know that doctors do relatively little caregiving in hospitals, in the heroic medical narrative physicians do all of the curing and most of the caring. Nonphysician caregivers are all but invisible in films and TV shows; health care is presented as a series of discrete events focusing on acute illnesses or trauma.

Of course, all of this has evolved since the days of Dr. Kildare or Marcus Welby, M.D., to reflect the anxiety and irony of contemporary culture. Today's TV and movie docs have rougher edges and messier personal lives: They are less omnipotent and are wracked by ethical doubts. They may be women, African Americans, or ethnics of some type. But despite the recasting, the basic story remains remarkably true to formula and has a disastrous impact on our social image of caregiving.

Consider Nurse Betty, one of last year's popular movies. It tells the story of a sweet, credulous woman who yearned to become a nurse but wound up being a waitress married to an abusive used-car salesman. While Betty is watching her favorite daytime hospital soap, she also sees (through a cracked door) her husband being brutally murdered. In response to the trauma, she suffers a delusion that she actually is a nurse in love with the soap opera's handsome doctor star. She goes off to Hollywood to pursue her lover and lands a job as a nursing assistant in a real hospital. How does she get the job without references or credentials? She performs a life-saving medical procedure that she learned from watching TV.

In Nurse Betty, nurses are professionally interchangeable with waitresses. They're kind but stupid. They live to marry a doctor. Nursing is such a snap that anyone who's watched enough episodes of General Hospital can effectively substitute for a registered nurse. (Perhaps Senators John Kerry and James Jeffords should scrap the Nurse Reinvestment Act they've introduced to subsidize nursing education and just encourage more kind-hearted women to watch daytime TV. …

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