Setting the pulses racing


Hugh Adler discusses the public’s fascination with medical shows and wonders just what makes House so appealing

Why do people find medical TV shows so fascinating? I know I do, having become addicted to ER at the age of 14 (may God have mercy on the dearly departed). As a medical student, I must be honest and say there were moments when I wondered if putting “DN002: Medicine” at the top of my CAO form was over-influenced by the antics of the staff and patients of County General Hospital. It was definitely a factor in my decision.

I didn’t like Scrubs so much when it first came out, but I started watching it again when I was in Pre-Med. Now I love it. I also watch House whenever I can, and I guiltily enjoy Grey’s Anatomy. I’ve even been known to watch Private Practice and The Clinic on occasion.

Most medical students watch medical dramas. We all know they aren’t especially realistic – even if we hadn’t always known, the scales fell from our eyes on the first day of clinical rotations. Unlike House, no single real doctor is capable of performing genetic analyses, looking at samples under microscopes, delivering babies, and operating on every part of the body while simultaneously diagnosing every disease known to man. Real emergency departments aren’t always as exciting as they are on ER, and real-life janitors are much scarier than they are in Scrubs. All the same, most of these shows – yes, even Scrubs – do portray a decent approximation of a hospital environment, and contain a few medical facts.

Is Patrick Dempsey – ‘Dr McDreamy’ – the reason why medical TV is so appealing?
Is Patrick Dempsey – ‘Dr McDreamy’ – the reason why medical TV is so appealing?

It should be added, for the sake of assuring those who might need medical attention at some point in the future, that medical students don’t rely on these shows as revision for exams, and certainly don’t advocate taking them as gospel. After all, Dr Neela Rasgotra described the kidney’s blood vessels backwards once, and Dr House got his bacteria confused in one episode, mixing up Clostridium perfringens and Pseudomonas aeruginosa. It can happen to the best of us.

Like all TV shows, medical dramas are meant to be escapist. Viewers – including med students – watch them for their entertainment value and not necessarily for their dubious educational content. However, med students feel like we should understand what’s going on, as our friends and family keep asking “what’s wrong with him?”, “why did she just collapse?”, “what does ABG mean?”, and so on ad infinitum. (People also expect us to know Latin, for some reason.) As the years go by, we gradually do come to recognise the acronyms and obscure diseases – in many ways, our comprehension of medical dramas acts as a barometer of our progress through medical school.

In fact, some med students are eventually turned off by these programmes, precisely because they understand them too well – when you understand everything that’s going on, some of the thrill factor is lost. After you’ve seen a real surgery, televised blood and guts aren’t quite as awe-inspiring as they were before.

Escapism explains why everyone loves ER (it’s exciting) and Scrubs (it’s hilarious). But what about House? This programme features extremely detailed conversations about pathological processes, genetics and molecular biology. It’s all well and good for me to enjoy it – I’ve been studying the stuff for four years. I understand… well, most of it. While I don’t want to seem patronising, I’m intrigued that “lay viewers” enjoy it too – what is it that people find so fascinating about this show?

There are, of course, many TV shows with science-based plots; I know that audiences aren’t stupid. The CSI series have a huge following and have opened peoples’ eyes to what forensic investigators can achieve, even if these programmes do exaggerate radically. All the other medical dramas I’ve talked about deal with complicated diseases and moral issues. However, unlike Grey’s Anatomy or CSI, House doesn’t simplify things very much. Perhaps non-medical viewers approach House from a different angle.

I’m sure much of the show’s appeal lies in its protagonist’s comedy value. The character of Dr House is undeniably excellent – Hugh Laurie’s character is abrasive, unpleasant and often completely unethical. House does everything that med students are taught not to do with patients. Real doctors have even written articles complaining about what a bad example he’s setting.

The other unique thing about House is the mystery-solving nature of the show. More than any other doctor on TV, House is a detective. People love detective stories – especially when the detective is a maverick, loose cannon employing unconventional methods, but who always gets his man. House is the medical Dirty Harry. We don’t need to understand the science behind House’s thought process any more than we need to understand the inner workings of a .44 Magnum – it doesn’t interfere with our appreciation of a good adventure.

In fact, detective stories have now come full circle. Joseph Bell, a 19th century Scottish surgeon, was famous for his powers of deduction. He could glean all manner of information about a person after briefly observing their appearance and mannerisms. He later became the model for a great detective who pioneered “scientific” techniques of investigation: Sherlock Holmes.

Perhaps it’s the human angle of everyday medical life that the world finds so appealing, or perhaps it’s the eye candy of George Clooney or Patrick Dempsey. Either way, it seems the enduring allure of medical TV is unlikely to flatline anytime soon.