Playing Doctor: Television, Storytelling, and Medical Power

10. A Different Spin

10 A Different Spin The drama immediately plunged the viewer into the chaos of an emergency room. A doctor tells a hysterical woman, about to give birth to her fourth child, that she should also agree to sterilization. Cut to a burn patient, the victim of a bomb. Is it worth treating what may be a hopeless case, or should the person be given an overdose of morphine? The more routine cases—the super‹cial wounds, the broken bones—are lined up, on hold. Standing in the midst of it all is an idealistic intern, terribly disquieted by what he sees. Later he pours his frustrations out to an older, more experienced nurse with whom he is having an affair. “Don’t try to be the world’s greatest intern, its righter of wrongs,” she advises. “If you do, you become a target for all the doctors to take pot shots at.” But unlike his fellow interns, the young man is unable to contain himself. He soon confronts one of the hospital’s most powerful doctors, who wants to perform what the intern considers a needless hysterectomy . The ending is a double whammy: the intern’s career in the hospital has been shattered, and the patient dies. The movie marked the start of Medical Story, an anthology series which in its Thursday 10 p.m. time slot on NBC would skewer many of the comfortable assumptions that had driven TV’s images of medicine 232 over the past decades. Medical Story’s creators still used the hospitalbased world of acute care, and they highlighted the work of surgeons to the virtual exclusion of other specialties. High-pitched life-and-death drama was what they were after. But on this show the formula’s rules were clearly changed. Rather than the patient or the guest star physician being the problem, now it was the system. The show didn’t last. Neither did its in›uence, or the in›uence of a few other programs that also attempted to build a basic questioning of the medical system into the heart of their plots. They were roads that were explored brie›y but afterward felt by programmers and producers to be too dark, too critical, too unfamiliar to draw large audiences. This chapter investigates these medical dead ends and the questions about the portrayal of medical reality that they raised. Their failure forced serious re-evaluations in Hollywood’s creative community about the viability of the doctor show. The formula seemed to be caught in a bind between the unacceptable old and the unacceptable new. Where, people began to ask, can the doctor show go from here? The Biggest Villain Medical Story was not the ‹rst TV story that pivoted around the inadequacies of the medical system. As far back as the turn of the 1960s, a live TV version of Sinclair Lewis’s Arrowsmith, produced by David Susskind, was aired. It placed a mildly negative light on the medical establishment of decades past. During the 1960s, The Nurses sometimes tackled system-wide issues in a tough way, in one episode even underscoring the power of organized physicians to squelch certain kinds of debates about Medicare. Still, that kind of trenchant criticism was rare. On Medical Story, power politics stood out front and center as episodes dissected such problems in U.S. medicine as abortion, unnecessary hysterectomies, malpractice ethics, the right to die, the wholesale sterilization of welfare mothers, and the overcrowded poverty of public hospitals. When these issues had been dealt with previously on TV, the bite, the tone, had been very different. In the Bold Ones episode about a patient’s right to die, in Dr. Kildare’s depiction of malpractice cases, the general spirit toward medicine was generous. Doctors were mostly good. On Medical A Different Spin | 233 Story, physicians were mostly bad—cynical, overworked. And the system , impersonal and disastrously dif‹cult to change, was the biggest villain of all. The approach may have been in the Hollywood air. By the mid1970s , the vigorous criticisms of the medical establishment that had begun in universities and special interest groups at the start of the decade had become familiar throughout much of educated society. In the mid1970s , some extremist writers were getting popular attention by questioning whether the medical system had done any good at all. The 1969 theatrical ‹lm M*A*S*H, which was to lead to...