Articles Irish Times Television

Doctor, Doctor! – Medical TV Dramas

Saturday, July 15, 1995

‘You work in a pool of excrement. Your job is to swim to the shallow end’

‘Nurse, the screens!’

‘Yes, doctor, I know. They’re full of hospital dramas.’

Rescued from the mid-afternoon limbo of Young Doctors and A Country Practice, medical programs are now back in prime-time. Casualty has finished another successful season, but now we also have ER, Cardiac Arrest and Chicago Hope.

One of the most notable features of all these shows is their convincingly incomprehensible technical vocabulary. The instructions barked over the speeding trolleys make very few allowances for a non-medical audience.

Pursuing realism is fine, but what do we get out of this emphasis on obfuscation? We get security. It is comforting to place yourself so completely in the care of a doctor who speaks an obscure, almost sacred, language.  You don’t want to know what it all means, so long as these magically cryptic words (such as ‘intubate’ and ‘O neg’) somehow make you better.

The hospital dramas might use the same language on both sides of the Atlantic, but they’re saying different things with it. The American shows (Chicago Hope and ER) are much less bleak than their British cousins, which often concern themselves with the way political and medical issues interact.

Chicago Hope is named after the hospital in which it is set, but the abstract noun in the title is telling. In each episode we only see a handful of patients, and there seems to be the time (and the elaborate offices) in which to discuss abstract issues such as hope, morality and religion.  Where we do see medical procedures being carried out, however, they are detailed in the extreme, placing the discussion over issues into context, and showing us that the safe technical terms describe startlingly physical actions.

In ER (short for Emergency Room), on the other hand, everything happens very quickly, and you can see why they had to abbreviate the title – there’s no time for anything more. The fast cutting and hand-held camera work show you each new crisis with great immediacy, but while it’s very exciting to watch, it lacks Chicago Hope’s more considered stance.

Things work out in the end, and however stressful it gets, you know eventually Dr Doug will go out and picturesquely shoot some hoops, having pulled another child back from the brink. The show purports to tell it like it is, but after a stage-managed shock it offers a sugary reassurance – it’s got a good bedside manner.

Cardiac Arrest, on the other hand, has no manners at all. Written by a disillusioned former doctor, the show is the blackest of comedies. Unlike ER, things go badly wrong, and there’s no feelgood coda at the end. American medics are shown to care, whereas their English counterparts don’t have time to – they’re too busy ringing round for a bed, or treating patients on trolleys in the middle of corridors. In a recent episode, a new junior house officer was told, ‘You work in a pool of excrement. Your job is to swim to the shallow end’ – not the sort of dialogue you hear in Chicago Hope.

The British shows are much more concerned to show the political influences affecting health care. In ER, we never think to ask why the staff are busy, and hospital managers don’t figure as characters – the consultants are surgical not financial. In Cardiac Arrest, and Casualty to a lesser extent, we are shown who’s to blame for the chaos, and left in no doubt about the skewed priorities of the thrusting new NHS Trusts.

In addition, Casualty has a bit more time for its patients than the other shows. We often see them before they’ve had their accident or been struck down by their disease, and so we know something of their lives as people before they become cases. This is laudable, but it does lead to a certain fatalism. You know that everyone you see fit and well at the start of the show will end up in Holby General at some point in the next hour.

This emphasis on developing the patients’ characters means that often we forget their medical complaints and concentrate more on their relationships with their loved ones, who choose a busy emergency department to reveal their innermost feelings. Too much of this and you end up thinking that the only people to suffer physical injuries are those who need emotional counselling.

Despite some new ideas, each of these shows also draws on the existing traditions of hospital dramas. Nurses are pretty, and fall for handsome doctors, and the flow of new patients each week is balanced with the slower development of the staff’s storylines.

Also, Casualty, ER and Cardiac Arrest observe the medical unities, with the action of each episode most often taking place during one shift. Hence the familiar move in the closing scene from the claustrophobic and exhausting atmosphere of the hospital to the world outside, as the medical staff knock off and go home. To watch Chicago Hope, probably.

(first published in The Irish Times, Saturday July 15th, 1995)