restricted access 1. "Internes Can't Take Money"
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1 “Internes Can’t Take Money” We are told that writing is mechanical, but now and then a story is written from the heart, to make its mark upon the minds of men. “Internes Can’t Take Money,” by Max Brand, is one of those stories. Brand, whose real name is Frederick Faust, conceived this story of internes who are not allowed to receive fees for operations, while he was lying on a hospital cot recovering from a serious operation. He was grateful to those men in white who had served him and other patients—so he wrote the tale of one of them to go down in history.1 The story about the 1936 ‹lm’s conception is only partly true, exaggerated by the Paramount Pictures publicity department to titillate the public’s romantic inclinations. The publicists were right about one thing, though: Here was a man in white who would go down in history. For Internes Can’t Take Money was the ‹rst rumble in an avalanche of Doctor Kildare offerings that would cover the American media for the next forty years. Kildare inspired ‹fteen ‹lms, seven books, several magazine short stories, a radio series, two television series (one network, one syndicated), a few public controversies, and an uncounted number of toys, lunchboxes, and shirts. The young doctor and his activities also inspired the basic approach that network television producers were to take toward a small army of ‹ctional physicians who followed him. The beginnings of Doctor Kildare point to the roots of the formula. So while theatrical movies are not the focus of this book, it does seem appropri18 ate to start an examination of TV physicians by inquiring into the birth of the one who set the mold. Kildare in the Context of His Time Just forty years before Internes Can’t Take Money was made, near the turn of the twentieth century, it would have been inconceivable that a young physician could become a popular culture hero. Before the twentieth century, medicine was a sometimes near-subsistence occupation whose practitioners had to ‹ght ‹ercely for legitimacy with a spectrum of other contenders for control over human health. One reason was that physicians often didn’t do any good, and too often did terri‹c harm. At the turn of the 1800s, doctors had not progressed all that much beyond their counterparts of the Middle Ages, who had practiced with the aid of philosophy, myth, and prayer. The early nineteenth century saw physicians in the U.S. and elsewhere employing a “therapeutic” system that had no basis in any real understanding of the human body and was not really therapy. Devised by the famous Philadelphia doctor Benjamin Rush, it came from the belief that there was only one disease in the world. According to social historian Paul Starr, The one disease was “morbid excitement induced by capillary excitement ,” and it had but one remedy. This was to deplete the body by letting blood with the lancet and emptying out the stomach and bowels with the use of powerful emetics and cathartics. These stringent therapies were to be used with courage. Patients could be bled until unconscious and given heavy doses of the cathartic calomel (mercury chloride ) until they salivated.2 “Heroic therapy” of this kind dominated American medical practice in the ‹rst decades of the nineteenth century. Not only was it painful, it was deadly. Bloodletting could weaken a sick person even more, and calomel—which was used on anything from the plague to teething pains—was a slow-acting poison that eroded the gums, teeth, and jaw. One contemporary observer wryly described heroic medicine as “one of those great discoveries which are made from time to time for the depopulation of the earth.”3 “Internes Can’t Take Money” | 19 The areas allied to medicine were no better. Surgeons—at the time considered doctors’ helpers—had the status of being one step above barbers. Their handiwork often led to severe infections and death. Hospitals , too, were danger zones. During the Revolutionary War, Benjamin Rush called them “the sinks of human life,” places where the poor and the homeless went to die. The description applied well into the nineteenth century. Trained nursing was virtually unknown. Hospital nurses were often forced laborers taken from the local almshouse or penitentiary.4 It isn’t hard to understand, then, why a great many nineteenth-century Americans cringed at the thought of asking help from a physician. “Regular” doctors looked...