I like reading and sharing pieces I find in the NYTimes, Chicago Tribune, WSJ. THIS IS ONE OF THEM… the title of the piece:
IN A TV SCRIPT, I CAN REWRITE A PATIENT’S FATE by Daniela J. Lamas
Dr. Lamas is a writer and co-producer for the television medical drama, The Resident, though her main employment is that of a pulmonary and critical care physician at Brigham Women’s Hospital in Boston.
MEDICAL DRAMAS AND REALITY
In her piece in the NYT, Dr. Daniela J. Lamas is very aware that she straddles two worlds, finding the writing gig an uplift from the death and dying she sees in her hospital’s Covid unit. When she can retreat to her messy call room, she uses Zoom to join a group of writers struggling with a scene, another medical emergency for Conrad Hawkins (Matt Czurchry), the eponymous hero of the The Resident.
Lamas never works in a vacuum, taking with her the image of the older female patient who now has Covid, her pastor having insisted she not get the vaccine. Dr. Lamas presents this situation to her writing team, hoping they will change the story line. Example: the pastor visits, sees his parishioner suffering and begins to preach from the pulpit that all his people need to get vaccinated. (But like Dr. Lamas, this story line is my creation. Will the writers group accept it?)
Dr. Lamas writes her reality: …though her lungs are slowly improving, her kidneys are worsening, and she is profoundly delirious, not waking up. We stand at the bedside and call her name, her eyelids flutter.
Down the hall, we titrate drips and manage vent settings for a man whose stem cell transplant cured his leukemia but ravaged the rest of his organs. His wife would be at his bedside, but she is at her father’s funeral.
And though the article does not say, I imagine this elderly woman did die from Covid, an unnecessary death.
STORY LINES THE WRITER’S ROOM REJECTS
Dr. Lamas writes: I used to want to show the hospital as it truly exists, to reveal the humor and tragedy and grace that characterizes my world. (She explains with the following examples.)
- The family that came to say goodbye to a dying woman, a misplaced ID card leading them to believe, wrongly, that she was their mother.
- A patient’s brother, with skull tattoos on his shaved head, who told us he could not be in the room when we took his brother off the ventilator. So when he left, we thought we would never see him again, but were surprised when he returned, not to sit by his dead brother, but to collect the man’s prosthetic leg. Another nurse said he spent the rest of the day in the hospital chapel with the leg beside him.
Dr. Lamas writes that even producers and writers for The Resident say such stories are simply too grim. The public does not need or want to be reminded of how quickly things can go bad, how families fall apart, how doctors do their best but patients still die.
Especially now, viewers want to see their doctor as heroes, to follow a formula that has doctors saving lives more than losing them.
IN THE WORLD OF THE TV HOSPITAL
Dr. Lamas writes: “During my first experience on the set…I learned that when things went wrong (a medical word being mispronounced) I was assured, “Don’t worry. We can fix it in post.” She underlines that she loved that phrase, one she wanted to say to her patients over and over. “…to be able to have another chance, to treat the sepsis earlier, to stop the pastor form advising against vaccination, to fix it in the post.”
Dr. Lamas reminds us that during the pandemic, her roles as a critical care doctor and a television writer are often in conflict. Though she wants to honor and remember every patient who died, she also yearns to tell stories that are hopeful, where there is always the chance for recovery, no matter how dire the diagnosis.
“It’s a tension I am still learning to navigate. How do we tell stories that feel true while also keeping viewers engaged? What kind of cheats are acceptable, and which are irresponsible?”
Dr. Lamas then makes a particular reference to the struggle that often ensues when the team is trying to save a cardiac patient. She reminds us that TV characters survive cardiac arrests far more often than people in real life do.
“…and the nurse left alone to clean up after the death…” If our viewers could see that, “they would change the channel.” She is right. I still remember during my Cardiac rotation, watching a team try to save a patient, the family waiting in an adjoining room. The man died. And yes, the floor was littered with medical pads, bottles, wipes, tubing…
IN THE REAL WORLD
Dr. Lamas is right when she stresses that medical dramas are important, that they can provide escape, but also education.
“In the writer’s room, we have a change to …offer a different ending to the story. And in doing so, we can sneak in potentially lifesaving education—early warning signs of certain illnesses, the dangers of overtreatment or the impact of inequities in access to care…television dramas have an unparalleled opportunity to educate and even to change behavior…I have come to believe that it is worth glossing over the facts IF we can weave a story that encourages viewers to trust science, to get vaccinated, to look differently at disease. When I find myself fact-checking what I see on the television monitors, I remind myself of this more important goal.”
Dr. Lamas ends her piece, mentioning a patient that she met one morning on rounds, asking him to mute the TV show he was watching, a medical TV show, as she needed to listen to his heart. He seemed surprised that he had to miss something, explained that medical dramas had been his one constant. The plots reassured him, taught him what might be ahead in his own medical story, while helping him feel less alone on his own medical journey. Dr. Lamas smiled. She understood.
(I confess that one of the reasons I became a nurse after having my three children—was my propensity to be gripped not only by books and articles about medicine, but by watching television medical dramas. I’ve written about that before. I was an avid ER fan. Now it’s New Amsterdam, Chicago Med, and of course The Resident.)