Abstract
The “heroic” doctor has long been a staple part of U.S. popular culture, with memorable characters like Dr. Kildare, Hawkeye Pierce, and Gregory House, among others. In this “new and expanded” 2010 update of the 1989 book of the same title, Joseph Turow of the University of Pennsylvania thoroughly examines seventy years of television’s representations of the medical profession, heavily influenced by institutional and intertextual contexts. Turow weaves together a rich history of these portrayals, using interviews with television producers, writers, and others involved with production, popular press articles, and detailed examples from medical dramas and other genres that portray doctors. His comprehensive book is valuable, not just for fans or television scholars studying medical dramas, but for anyone interested in the use of entertainment media as a prosocial tool, and in the relationship between media and institutions.
Playing Doctor begins with an updated introduction, in which Turow provides a detailed explanation of the television production process, emphasizing that an array of external factors, including the medical institutions in America, health care policies, and medical organizations, indirectly and directly influence the characters, story lines, and other elements of a “doctor show,” which work together to create a “reality” that is far from an accurate mirror of American health care. At the same time, the stories told by these programs mark moments in cultural history that change and evolve—for example, the eternally optimistic 1960s Marcus Welby, M.D. differed greatly from the much darker St. Elsewhere, although both share some generic components.
Turow explains the rise of the “heroic” doctor as a figure in popular culture by outlining the shift in medicine from a trade in the late 1800s to an esteemed profession. He then begins his impressive history of representations of medicine, starting not with the first television doctors of the 1950s, but with Dr. Kildare and other film characters of the 1930s and 1940s, demonstrating how these depictions originated the formulas replicated over the next seventy years. The chapters that follow move chronologically through each decade, addressing even failed (and therefore extremely obscure) fictional medical programs, as Turow takes us through the medical archetypes established in early dramas, controversies about bringing humor into the operating room in M*A*S*H, the new cynicism of St. Elsewhere, and other themes that emerged as this genre evolved. Throughout, Turow skillfully situates all of the fictionalized stories to the people, organizations, and formulaic constraints that helped create them.
This updated 2010 version includes two additional chapters on contemporary entertainment medical programming, beginning in the 1990s with the failed Clinton health care plan. He discusses the influence of ER and, to a lesser extent, Chicago Hope on transforming the medical drama genre. These shows were much more graphic and diverse than earlier medical dramas, with far more emphasis on the personal problems of the physicians. Medical reality programs and other 2000s shows have continued these trends, along with the visceral crime dramas that became popular at this time. And yet, like earlier medical dramas, ER, Chicago Hope, Grey’s Anatomy, House, and other television shows have preserved much of the traditional “doctor-show” formulas that began in the 1930s and 1940s. These programs continue to showcase physicians, downplaying other types of health care providers, with story lines that are generally apolitical, overlook institutional barriers, and convey the message that superb health care is free and widely available. Playing Doctor concludes by explaining why institutional pressures have resulted in the continuation of the traditional formulas. This concluding argument is compelling and thought-provoking, as Turow highlights the implications of the “doctor shows” eschewing contemporary health care issues on a viewing audience at a time when health care debates are at the center of political discourse.
At the same time, although the new chapters touch on contemporary health care issues and popular culture, this section is not quite as detailed as the preceding chapters. The contextualization, for example, does not mention the Institute of Medicine reports in the late 1990s that prompted a flurry of popular media stories on medical errors, ultimately resulting in significant improvements to patient safety. Also noteworthy in a discussion of media and medicine is the emergence of online information and its role in changing doctor–patient relationships. Since “doctor shows” have largely ignored these issues as well, including these events would strengthen the book’s central argument, especially given that Turow contends that patients have a diminished role in contemporary dramas. And although Turow briefly addresses the historical absence of diverse physician characters and the increase in racial diversity in 1990s dramas, it would have been interesting to further explore the impact of this diversity, particularly when the dramatic rise in racially diversity was paired with a heightened focus on physician characters’ personal issues, at a time in which medical mistakes dominated popular media.
Even with its minor drawbacks, however, the updated edition is a quality book, mostly because it builds on the material published in the first edition. Turow makes a solid argument for the importance and growing recognition of using entertainment television to educate viewers on health issues. And, of course, the behind-the-scenes details and interviews with producers and others are engaging for fans and intriguing from a television research perspective. Overall, this book is a resource for the study of medical representations that would be nearly impossible to replicate.