Just as similar things can be said for the lawyer shows that screw up legal procedure, and the various science-fiction franchises that play fast and loose with physics, those same medical dramas that can get so much wrong have also inspired countless people to pursue careers in medicine. Medical dramas over the past three decades have also been a place where the inadequacies and inequities of healthcare policy have been raised in popular culture and dramatized. Moreover, the genre is one that allows for not only prime-time soap opera relationships, but also stories that can examine the human condition in life-and-death circumstances.
So I thought for this week's post I would ask: Which medical dramas really stand out? Which were the best at exemplifying the themes of the genre? Jump below the fold for discussion.
"Where doctors save lives and make love, often simultaneously. Our stories, ripped from the headlines. Our passions, unbridled. Our cafeteria, eh… Make love to me, Ann. I know I’m just a surgeon and you’re a hotshot upstart administrator, but damn the rules, damn the system, damn our two foot height disparity, I want you."In the grand scheme of television fiction, there are three professions that comprise the Holy Trinity of most TV series premises:
—Jeff Winger from Community
- God the cop
- God the lawyer
- God the doctor
In each situation, it allows for high stakes drama and character development that comes through struggle and loss that becomes poetic, heroic and futile when looked at in the abstract. One way or another, all of us are going to cease to exist and be released from this mortal coil one day. In armor of green and blue, every day doctors and nurses try their best to fight away death and suffering just for a little while, in a battle they know they're doomed to lose. But if it means a child might live long enough to kiss his or her prom date, or that a mother can see her baby take its first steps, then you take the small victories of a losing battle and cherish them.
The medical drama takes all of those larger metaphysical questions about existence and uses it as the subtext of the setting, while telling a story. That story could be about the mysteries surrounding disease, or the broken characters trying to cure that disease, or the effect poverty and race have on healthcare access, or just the doctors and nurses who want to fuck each other like bunny rabbits and all the drama that causes.
So what are some of the premiere examples of the genre?
► ER (1994-2009)
During much of the 1990s, ER was the biggest show on television. Contrary to NBC's current somewhat dysfunctional state, ER was one of the anchors of a Thursday night lineup that had the powerhouses of Friends and Seinfeld to dominate all of the networks. Based on a screenplay written by author Michael Crichton that was based on his own experiences as a resident physician in a hospital emergency room, ER is centered around the goings-on at fictional County General Hospital in Chicago, Illinois, with actors like George Clooney, Julianna Margulies and Anthony Edwards standing out in the early years.
The series reinvigorated the medical drama and it also marked a point when television dramas started becoming more serialized, and more complicated with the characters and situations they exhibited. It's generally regarded as one of the show's that started a new "Golden Age of Television."
From Carrie Raisler at the A.V. Club:
The thing to know about Mark Greene (Anthony Edwards) going into this episode is that he’s a great doctor. He’s a little passive and insecure in his personal matters, sure, but on the emergency room floor? Dr. Greene is in his element. If your chips are down and you end up in the emergency room, he’s the guy you want saving your life. “Love’s Labor Lost” does a great job of weaving this narrative right into the first act, stressing Mark’s dedication to emergency medicine (he’s just been promoted) and showcasing his easy bedside manner and ability to make quick connections with his patients, in this case a very pregnant woman who comes in with what appears to be a bladder infection. They laugh, they smile, and he discharges her with instructions and a prescription.As the seasons progressed, new faces were shuffled in and out, and the series became more about disaster events, celebrity guest stars and ratings stunts. However, one thing I loved about the show, and I don't think many others have been able to capture, is the sort of engrossing, frantic feeling of chaos and that "all hell is breaking loose."
Then everything goes to hell.
The setup feels like classic horror, with everyone having a carefree time—they even make time for random denture jokes!—right until the dread sets in, and Dr. Greene, his staff, and an expectant couple go through the worst day of their lives. The episode is even shot and scored like a horror movie at times, with cameras circling the action as Dr. Greene desperately tries anything he can think of to save this woman and her baby. Throughout the ordeal, even as the situation becomes a perfect storm of everything that could possibly go wrong with no positive outcome to be anticipated, there’s still one persistent thought in the back of your mind: “Mark Greene is a great doctor. Mark Greene can save them. He can save them both.”
But he can’t. He’s a great doctor, but even great doctors are just humans, and humans aren’t perfect. This episode has many virtues, but the thing that has always resonated with me from the very first viewing is how effectively it tells Mark Greene’s story without directly commenting on the man at all. By watching his decision-making throughout the case, seeing where things went right and went wrong, then subsequently showing his reaction to his patient’s death, ER took an awful tragedy and used it to crack a character wide open. Watching the episode again floored me in exactly the same way it did the first time, and it will floor me again the next time, and the time after that.
► M*A*S*H (1972-1983)
Setting a comedy in a setting where people are sick and dying is one thing, but this was a series set during the Korean War, starring army doctors who deal with death every day, had a theme song about suicide and it's considered one of the best comedies/dramadies in television history. Adapted by writer Larry Gelbart from Robert Altman's 1970 film, which itself was based on Richard Hooker's novel, "MASH: A Novel About Three Army Doctors," the series follows the doctors and staff of the 4077th Mobile Army Surgical Hospital in Uijeongbu, South Korea.
I always find it impressive whenever a story can shift from "ha ha" funny to being dead serious and make it work. One of the defining features of M*A*S*H was its ability to find a balance in tone, with some of the comedy and drama being allegory for the Vietnam War.
Probably the most memorable event in the history of the show is the season 3 finale, in which actor McLean Stevenson wanted out of the series and the writers killed off Colonel Henry Blake.
► House M.D. (2004-2012)
At its core, House was an updated take on the Sherlock Holmes story, with the disease of each episode being the "killer of the week" that must be caught to save a life, and Hugh Laurie's Doctor Gregory House being a brilliant but extremely flawed character tasked with solving the case. For House, medical ethics are merely suggestions instead of hard and fast rules. To that end, House will go to almost any ends to solve the puzzle of the case he's working on. And did I mention that House is high on Vicodin while doing it most of the time?
The early seasons of the series focus more on the medicine, with the character development coming from how House and his team do or don't react to the situation. Around Season Four, the show became more a character study of House and the cases are incidental to the "will they or won't they" love story of House and Cuddy (Lisa Edelstein). To me, House was always interesting when it was a study of Greg House and the medical cases expounded on the character. His love of Cuddy, and his inability to express it because of his aversion to pain and being hurt, made for an interesting dynamic for whether the character could ever change, stop drowning himself in Vicodin and somehow be happy.
► Grey's Anatomy (2005-)
Grey's Anatomy is for all intents and purposes a soap opera, with the medicine being secondary. But Shonda Rhimes' series is probably one of the best medical soap operas ever. Centered around the surgical residency of Dr. Meredith Grey (Ellen Pompeo), the series follows the lives of Seattle surgeons, and their cases usually feature a hot-button issue in the news that somehow connects to what's happening in the characters' lives.
Every conceivable disaster has happened at some point or another at this frickin' hospital (e.g., plane crashes, ferry fires, superstorms, someone with a gun running through corridors, etc.), and the place is a death trap for its characters. There have also been at least three failed weddings. I know this is a staple of romantic comedies/dramas, and I should never believe what I see on TV, but has anyone ever seen someone stop a wedding? And more importantly, try to stop a wedding and have it work?
► Chicago Hope (1994-2000)
Created by David E. Kelley, who's probably best know for L.A. Law, The Practice, Boston Legal and Ally McBeal, Chicago Hope is similar in that it's focused on a group of eccentric and quirky people. The initial seasons are notable for Mandy Patinkin's performance as Dr. Jeffrey Geiger and the quasi-legalistic tone of the series. Patinkin's Geiger is sort of Hugh Laurie's House without the limp, and in truth there are points where this is more of a legal series set in a hospital than a medical drama, especially in Season One. Many of the early episodes are centered around debates of medical ethics that end up in court.
For example, is it animal cruelty to use a baboon's heart as a temporary fix for a patient waiting on the transplant list? Should a doctor be fired and sued if he hesitates when told a patient is HIV positive?
► St. Elsewhere (1982-1988)
Set at fictional St. Eligius, a teaching hospital in Boston's South End that practically no one wants to visit under any circumstances, St. Elsewhere is remembered for more than a few things. Usually in old TV series, there was very little continuity. If something happened in an episode, it would more than likely never be mentioned again and added no weight to the characters' development. St. Elsewhere had overlapping story lines spread across multiple episodes. And a lot of those story arcs dealt with topics that weren't usually covered in TV series at the time (e.g. breast cancer, AIDS and drug addiction). It's also one of the first medical series to show the practice of medicine at a hospital as not a pristine profession done under ideal circumstances, but as a tough job with long hours and shitty resources, where the patients may not like or thank you. The series had a huge cast of characters featuring many notable actors, including William Daniels, David Morse, Alfre Woodard, Bruce Greenwood, Ed Begley, Jr., Mark Harmon, Denzel Washington and Helen Hunt.
However, the series is infamous for its series finale, which revealed the entire show to have occurred within the mind of an autistic child (Chad Allen's Tommy Westphall) while he stared at a snow globe.
From William Gallagher at BBC News:
Since St Elsewhere featured a crossover episode with Cheers and some characters later appeared in Homicide: Life on The Street, the boy imagined those shows and maybe more too.
"Someone did the math once," said producer Tom Fontana in 2002, "and something like 90 per cent of all television took place in Tommy Westphall's mind. God love him."
► Scrubs (2001-2010)
Even though Bill Lawrence's Scrubs could be a wacky and surreal comedy at times, many physicians will tell you it's the most realistic at capturing the range of emotions for someone attempting to be a doctor. When you or someone you care about is sick, you probably want a doctor who's confident, knows what the hell is going on and will assure you that everything is going to be okay. The reality of the situation for a young resident though is that you're thrust into a situation where someone's life is placed in your hands for the first time and there are many moments of self-doubt.
Scrubs follows J.D. (Zach Braff) as he trains in residency at Sacred Heart hospital. His mentor is Dr. Perry Cox (John C. McGinley), who's a jerk with ego. However, Cox believes in teaching through tough love. Along for the ride are nurse Carla Espinosa (Judy Reyes), who's the shoulder to cry on for the residents, Dr. Elliot Reid (Sarah Chalke) J.D's on-again, off-again love interest and possibly the only doctor on staff more nerdy and psychologically messed-up than he is, Dr. Robert "Bob" Kelso (Ken Jenkins), the hospital's Chief of Medicine who's always thinking of the bottom line, the "Janitor" (Neil Flynn), who dislikes J.D. and torments him every change he gets, and Dr. Christopher Turk (Donald Faison), who's J.D.'s best friend and an amazing dancer.
If you look past the cartoonishness, you find a series that's quite in tune with the real lives of doctors—and unlike your typical medical drama, one that's not required to end each episode with a climactic surgical procedure or whiz-bang diagnosis ... Doctors say they recognize in J.D.'s internal monologue the real thought processes of a young doctor at work.
"He says exactly what a resident feels, day in or day out. 'Am I hurting the patient? Am I learning what I should? Am I kissing up too much to the attending?' " says Jonathan Samuels, an attending rheumatologist at the NYU Hospital for Joint Diseases. "I always thought Scrubs was right on."
If the show feels like somebody's real-life experience, that's probably because it is. Creator Bill Lawrence, the man behind Spin City, Clone High, and the upcoming Cougar Town, built Scrubs around stories from his college friend Jonathan Doris, now a cardiologist in Los Angeles and a medical adviser to the show. He found humor in Doris' experiences, he says, and also a truth about human nature that's not often seen in medical shows. "In television, we like our doctors to be very heroic and very dramatic, and they kick doors open, and they say the word stat a lot," Lawrence says. But: "If your buddy was a funny kind of goofball that made jokes out of everything in college, then as a doctor, he's the same guy."