On "MDs" and "Presidio Med," rogue, renegade and maverick doctors search for a cure for HMOs.
“MDs,” ABC’s new medical dramedy, premiered on Wednesday night with a group of exhausted medical interns wrapping up their first all-nighter on the surgical circuit. Just as they are getting ready to shuffle home, a door swings open and someone bursts in. The Medevac is three minutes out! It’s a Code 2-K! Nobody’s going anywhere! Cue running, cue music, cue Steadicam operator hauling ass down hallways and across a rooftop helipad. Anxious interns look on as a red cooler is rushed into the O.R. Is it kidneys? Hell, no. It’s fresh Krispy Kreme doughnuts, courtesy of the wacky-but-gifted Dr. Bruce Kellerman (William Fichtner.)
As the grateful interns eagerly tuck in to the warm pastries fresh from the deep fryer — and the human-transplant tissue container — Nurse Poole (Jane Lynch) an officious R.N. with a Ph.D. in management, pops in to see what all the unauthorized expense is about. She squints menacingly, but is foiled again.
Dr. Kellerman is the head of cardiothoracic surgery and latter-day Trapper John at Mission General, a fictional San Francisco hospital its denizens refer to affectionately as “the Mish.” Kellerman is the type of character writers of press releases like to call a “rogue,” a “renegade,” a “maverick” or, if possible, all three at once. By the end of the episode, he will have met his own Hawkeye Pierce in the person of Dr. Robert Dalgety (John Hannah, the Scottish guy from “Four Weddings and a Funeral” and “Sliding Doors,”) a war-trained trauma specialist fresh from Bosnia. “Perfect,” the hospital’s director notes, “for an inner-city hospital.” Together, they find an ally in the young, idealistic intern, Maggie Yang (Michaela Conlin).
By now, it should be clear we’re watching “M*A*S*H” in the Mission, or, for that matter, any medical drama/comedy hybrid that is unafraid to toss some light, existential laffs in with the wrenching pathos. (“We’re talking about this patient’s life here … Ho! Hey! There’s a small intestine in my shoe!”) The sound-alike name of the facility itself is apt, considering what we have here is a mash-mish of bureaucracy-bashing, morbidity jokes and rueful last-gasp reckonings. “The Mish” may not be a mobile army medical unit, but that’s not to say there’s no war going on. It’s being waged between, on one side, the uninsured masses and the doctors who risk their jobs to help them, and on the other by the Scrooge-like hospital administrators who say things like, “They did not misdiagnose it, they missed the diagnosis — and that’ll hold up in court.”
Like the “M*A*S*H” boys, Kellerman and Dalgety have a little problem with authority, especially when it’s stupid, dogmatic and inhumane. The uptight Nurse Poole and her petulant sidekick, sad-sack HMO administrator Chester Donge –”MDs’” very own Frank and Hot Lips duo, sans the mad love — are dying to have the two doctors fired. But the rebel surgeons are in luck, it seems, because the hospital’s board of directors has just hired a squeamish former amusement park manager, Shelly Pangborn (Leslie Stefanson), to run the hospital. As an outsider, she can see both sides of the pressing issue of the day. (Plus, she’s hot.)
Of course, such lofty idealism can’t just go unmitigated. Lest the two protagonists come across as less Trapper and Pierce and more “Dr. Kellerman and Dr. Dalgety, Medicine Men,” we are soon informed that Kellerman has been a lousy husband and father. When we first meet Dalgety, he is getting on famously with a cute member of the housekeeping staff in a linen closet. “Gee, Dr. Dalgety,” she giggles, “most of the other doctors don’t even speak to housekeeping.” To which he replies, “I’m a Doctor Without Borders.”
Which is funny, because, at precisely the same moment on CBS’s “Presidio Med,” Dr. Rae Brennan (Dana Delany), another Doctor Without Borders, is sharing a cot in Pakistan with the George Clooney-esque Dr. Nicholas Kokoris (Oded Fehr). Dr. Brennan may be fooling around in a G.I. tent with a cute Greek surgeon who isn’t her husband, but soon, she will rejoin her intense colleagues on this week’s other new medical drama, which previewed this Tuesday but will run directly opposite “MDs,” Wednesdays at 9 p.m.
“Presidio Med” takes place, curiously, just across town from ABC’s Mission General, though in a far fancier neighborhood. The staff consists mostly of female doctors, including Dr. Harriet Lanning (Blythe Danner), a patrician OB/GYN; Dr. Letty Jordan (Anna Deavere Smith), a frowning cardiologist; Dr. Jackie Colette (Sasha Alexander), a shallow but plucky plastic surgeon; and Dr. Jules Keating (Julianne Nicholson), an idealistic pediatrician. If medicine is a calling, character is specialty.
Although they will do it with a straighter face, the ladies of “Presidio Med” (which was created by “West Wing,” “ER” and “China Beach” executive producer John Wells, along with Lydia Woodward) will face the usual medical drama stuff, just like their downtown colleagues a few stops down the dial: ravaging diseases, ripped-from-the-headlines social dilemmas, coldhearted bureaucrats, avaricious HMOs and, of course, their own personal demons, interpersonal problems and romantic travails. Dr. Brennan’s marital difficulties are bound to get worse now that her same-time-next-year Greek beau has gotten himself a job at the adjacent hospital. Dr. Keating has just found out that she has a tumor on one of her ovaries, and the prospect of never having children has her tense and depressed. Dr. Colette is not feeling the love of her fellow doctors, which may explain why, next week, she will put aside her thing against burn victims and agree to operate on an injured fireman.
The driving force behind both shows is the gonzo doctors, the ones brave and crazy enough to mess with the HMOs. On “Presidio Med,” that doctor is Colette, who takes a decision to deny her patient coverage straight to the newspapers. On “MDs,” of course, it is Kellerman and Dalgety, who team up in the hospital’s morgue to remove a tumor from a patient who would have otherwise been sent home for lack of coverage. Strangely enough, both shows cast the same actress, Vernee Watson-Johnson, as an incidental bad guy. On “MDs,” she plays an admitting nurse who guards the doors to the hospital like a sentry; on “Presidio Med,” she plays the insurance adjuster who denies a sweet old lady her brand-new titanium knitting knuckles.
In order to uphold their Hippocratic oath and defend their patients from rapacious administrators, doctors on both shows have to strain their imaginations and find inventive ways to dodge hospital policy. When the doctors on “MDs” are taken to task for performing an unauthorized procedure, Dalgety complains, “If we hadn’t done what we did, that woman would still be walking around with a tumor growing inside of her.” To which a hysterical Donge replies, “If everyone out there with a tumor came to the hospital and just demanded that we remove it, then the system would collapse!”
Interestingly, these shows arrive on the heels of a Kaiser Family Foundation-funded study that set out to find, among other things, how HMOs and health policy are portrayed in movies and on television. The study, which was released in July, found that every mention of HMOs during the 2000-2001 television season was negative. That same month, the American Association of Health Plans, which represents over 1,000 HMOs, hired the William Morris Agency to help their members improve their TV image, “build bridges” with writers and producers and maybe dabble in the occasional plot line.
Not even this level of involvement is new. The TV landscape has rarely been without a major medical drama since the early ’50s, and the medical community has kept a close watch on its fictional counterparts since then. “Medic,” which first aired in 1954, was the third medical drama to appear on TV, but it set the tone for future doctor shows by working closely with the medical community and addressing real issues confronted by doctors, including actual cases. The show was filmed on location in real hospitals, and in return, gave the Los Angeles County Medical Association control over the medical accuracy of the script.
According to Joseph Turow, author of “Playing Doctor: Television, Storytelling and Medical Power” (as well as author of the Kaiser study), LACMA members made sure “that the physician’s image in the show fit organized medicine’s ideal image. They even considered what a doctor drove and how he spoke (the physician was almost always a man). Cars that were too expensive and language with slang or contractions were ruled out.”
“Medic” was followed by “Dr. Kildare,” “Ben Casey,” “Marcus Welby, M.D.,” “M*A*S*H” and other shows that broke ground early on, before the genre mushroomed into overdeveloped sprawl. These shows created the templates for the three basic kinds of doctor shows we’ve come to expect: Clenched-brow character dramas featuring brave and dedicated medics who plunge into lives and sternums with equal degrees of commitment and aplomb; life-affirming dark comedies featuring brave and rebellious doctors who aren’t afraid to break the rules and have fun while saving lives; and tender fantasies about old-fashioned, small-town doctors who’d rather have you call them “Doc.”
Those were also the first shows to confront prickly medical or social issues on television. “Medic,” for instance, was the first series to show a live birth on TV. “Marcus Welby, M.D.” was the first to deal with social issues like drug addiction and rape. It also created controversy by showing a doctor so fabulous he made real doctors look bad by comparison.
As Turow writes, “With previous doctor shows, the concern of physicians was to cultivate as favorable an image as possible. Now some physicians worried that Welby’s incredibly solicitous and loyal bedside manner was leading their patients to question why they did not act toward them as Welby would.”
“M*A*S*H,” although set in Korea, was — like the Robert Altman film from which the series was adapted — initially understood as a critique of the Vietnam War. And, in 1983, “St. Elsewhere” became the first prime-time series to show both an AIDS patient and a doctor’s butt.
Now, as always, the medical community has something to say about how it’s portrayed on the small screen. According to a recent Associated Press story, the AAHP bought ads this year “deflecting the focus of anger from insurance plans to ‘a runaway litigation system and expensive government regulations.’” Someday, no doubt, these efforts will result in a fantastic show. (“Damn it, we’re talking about somebody’s life here, and if it weren’t for a runaway litigation system and expensive government regulations, we could get the HMO to authorize this emergency tracheotomy! Stat!”)
By focusing more intently on the HMO issue, “MDs” and “Presidio Med” may have found a relatively new scourge to battle, if not a terribly exciting one. Obviously, the AAHP didn’t get to the “MDs” set on time. “Presidio Med,” on the other hand, makes a valiant show of balance. Several speeches pop up at odd moments in the narrative, explaining how denying procedures to some will ultimately benefit the whole. (For such a profit-driven business, it can sound oddly Marxist at times: To each according to his coverage, from each according to his premiums.) As for the HMOs’ reported attempts at an image makeover, it’s one thing to get your predigested opinions on managed care and public health policy from a fictional melodrama and quite another to empathize with the insurance companies. For that, you’d have to get the George Clooney lookalike to play the claims adjuster, at least.
This is not to say at least one of these series won’t stick around for a while. That’s the thing about medical dramas. They deal in the same themes year after year, but they’re big themes: Love, birth, death and plantar warts (comedy, it has been said, is other people’s pain.) How can you go wrong?
After a while, though, it’s hard to tell whether we find shows about doctors so compelling because they tackle the big existential questions or because they play to our own latent hypochondria like millions of tiny violins. As long as they keep delivering the cancer patients, the bullet-felled youngsters, the idealistic interns and the little latex newborns fighting for their lives, we’ll keep on rubbernecking. But sometimes it’s hard to watch yet another pair of hysterical parents burst through the doors with yet another bleeding child without wondering what we’re doing spending another perfectly good evening in the emergency room.
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