In my introduction to this series I made it clear that
ER was always medical drama and Grey’s Anatomy is a soap opera
set in a hospital. I was being too generous
to Grey’s Anatomy on that score. Grey’s Anatomy is a soap opera
set among the surgeons who work at
a hospital.
Now again I do acknowledge that I stopped watching Grey’s
Anatomy on a regular basis at the end of Season 5 and only watched it
sporadically until the end of the eighth season. So I may not entirely be accurate
when it comes to making generalizations. So I’ll ask any of you who still watch
Grey’s Anatomy who might prove me wrong: in the twenty seasons Grey’s
has been on the air has their ever been a regular in the cast (by which I
mean in the credits) who is not a surgeon? Who isn’t a surgical resident,
studying surgery or doesn’t have experience in the OR?
Because for all the diversity we may see on Grey’s when
it comes to racial, gender and sexual barriers being broken during the eight
seasons I watched the show in a critical sense the cast was the most homogenous
of any hospital drama I remember seeing, perhaps in TV history. I don’t
remember ever seeing a single cast member who wasn’t either a surgeon or studying
to be one.
Now I’ll grant you that Grey’s Anatomy does
follow surgeons extensively. But there’s extensively and single mindedly. To explain,
let me use ER as the key example.
From the pilot to the final episode ER never
forgot that it was set in a hospital and that while the ER may have been the
center of the action, it was not just a single set of doctors who made it tick.
We saw ER attendings, starting with Mark Greene, ER residents, starting with
Susan Lewis pediatricians, most famously Doug Ross, med students (John Carter)
nurses, starting with Carol Hathaway, and surgeons, starting with Peter Benton.
And as anyone who watched ER knows, those were merely the first cast. The
cast members who lasting the entire series were nurses, male and female,
orderlies and clerks. (The most famous was Jerry, played by Abraham Benrubi for
the first five seasons and then on a recurring basis starting in Season Eight.)
We also saw that at Cook County there always going to be
specialists called in and we saw quite a number of them almost from the start:
psychiatrists, ob-gyns (Amy Aquino played the role throughout the series) cardiac
surgeons and so on. Benton was a resident at the time so we constantly saw him
interact most frequently with his surgical attendings, played most frequently
in the early seasons by David Morgenstern (William H. Macy) and Angela Hicks
(CCH Pounder). Morgenstern was the head of the ER for the first four seasons,
in Season 3 Donald Anspaugh (the late John Aylward) took over as chief of
staff. (I’m going to get back to both of these characters later on.) Later on,
we met Jeannie Boulet (Gloria Reuben) who took on the ER position of physician
assistant. We also met other members of the staff including oncologists, neurosurgeons
and pathologists and there was frequently a vast array of social workers. We’d
met some version of all of these characters by the time Season 1 of ER was
finished and while we kept meeting new characters, we would also meet the
occasional pharmaceutical rep, research specialists, virologists and other specialties.
By contrast over the first five seasons of Grey’s
Anatomy you could have been forgiven for thinking the only people who had
anything to do at Seattle Grace were surgeons, surgical residents, surgical
teams and the chief of surgery. I’ll admit we would occasionally meet a nurse
who stayed around for a few season, maybe an anesthesiologist or two, but they
only seemed to be there either as love interests for the central characters
(famously George developed syphilis in Season 1 from a nurse he’d been dating –
who’d also been sleeping with Alex) or there for a brief storyline. Occasionally
you’d get a guest star as a paramedic (Christina Ricci famously played one in
Season 2) but as far as Shonda Rhimes was concerned, all of the surgeons and
surgical residents were essentially doing all the work as Seattle Grace.
For all the times surgeons were called to the ER, I
never remember seeing a single ER attending calling them, certainly none that
was a character of note. Because there are apparently no physicians at Seattle
Grace, they have no need for physician’s assistants, there are neonatal surgeons
who apparently do all the work of ob-gyns, there are pediatric surgeons but no
pediatricians, all the med students and interns are solely devoted to surgery
and no other specialties, research entirely has to deal with surgery…well, I
think I’ve made my point.
I don’t know if Rhimes or any of her fellow writers
have made this as a deliberate choice over the years. Rhimes is certainly aware
that there are other kinds of doctors besides surgeons; she made that very
clear in the spinoff Private Practice and we saw a different contingent
play out in Station 19. A large part of it seems to be the egotistical single-mindedness
that surrounds every surgical resident I saw at the start of the show: it has
been clear from the start that as far as Meredith Grey and her colleagues concerned,
there is surgery and nothing else matters. But that doesn’t track either: three
years earlier Scrubs debuted and from the start to the finish, it was
clear that DJ and Turk knew very well that they couldn’t do their jobs without
the other and as we all saw Turk famously married and had a family with Carla
one of the nurses at Sacred Heart.
There’s also the unbridled arrogance we see among so
many of the surgical interns from the start of their career that seems utterly
unmerited based on the fact they admit their cluelessness at the start. It
compares horribly with the story of Carter who spent much of the first season
struggling to pick a specialty, decided to become a surgeon because of his bond
with his resident Peter Benton but at the end of his first year he realizes he
is not cut out for surgery and decides to go back to the ER. This is the
hardest decision of his career and Benton needs a lot of time to forgive him
for it. At the start of Season 4 the two are not speaking and Benton finally
expresses his anger. He says he spent so much time with Carter – something he clearly
hasn’t done with any med student in a long time – and he’s angry because
Carter, when he was struggling with the decision, went to Anspaugh and not him.
“I thought you’d talk me out of it,” Carter admits. “I wish I’d been given the
chance,” Benton concedes.
None of the residents in Grey’s Anatomy – not the
first five, not any that came after – ever had a scintilla of doubt that
surgery was their calling. Even Christina’s period in the wilderness during
Season 7 she considered leaving medicine if she couldn’t be a surgeon. And I
have little doubt that had any of them had decided to shift their focus – as Stevens
or O’Malley very well could have – Yang or Karev would have had no problem
freezing them out for not being able to cut it.
We see this scorn throughout their residency: Meredith
and Christina openly mock other specialties such as psych and dermatology as
jokes and can barely be seen talking to anyone who isn’t a surgeon. And this goes
all the way to the top; for all Miranda Bailey’s willingness to be human at the
times, I never saw her interact with anyone in the hospital who isn’t connected
to surgery and Richard Weber famously is willing to put surgeon’s salaries ahead
of the nurse’s demands, which leads to a picket line. And Weber can only see
making a hospital better through surgery: when Seattle Grace drops from 2nd
to 12th in the medical rankings, he goes through a series of ‘improvements’
– but we only see them in surgery. That same episode the hospital floods when
he spends that season ignoring the warnings from his staff, he purchases a new
medical animatronic device for surgery, only to spend its first use making fun
of O’Malley and he focuses so much energy on the first solo surgery he ignores
the fact that the current set of interns have started operating on themselves –
until one of them tries to remove their own appendix.
Cook County, it’s worth noting, is always underfunded,
scrambling to deal with budget cuts and is always dealing with its share of
bigger problems – power outages, contaminant leaks, custodial strikes and the
endless chaos that just seems to come with being in an ER. But throughout the
series run, you kept seeing all of these doctors as never being arrogant,
always being compassionate and always trying to adapt because the people in
this ER depended on it. Seattle Grace was one of the richest and best hospitals
in the country - and for so many of the
residents and attendings, the only reason they were there was to perform
surgery. If they saved lives, that was almost incidental.
Let me share a particular storyline from the sixth
season of ER. We’ve been introduced earlier that season to ‘Doctor Dave’
Malucci (Erik Palladino). In just the space of two episode he’s already become
one of the most unlikable characters on the show, always interested more in exciting
traumas than patient care. He will only get worse as the season progresses,
constantly bellyaching about the lame procedures, trading ‘dull’ cases for
exciting ones, and eventually revealing his incompetence. By the end of the
season he is told in no uncertain terms he doesn’t have what it takes.
We get the first real sense of that in ‘Sins of the Father’.
A teenager has come in with an attempting hanging. “Looks like a bad case of rope
burn,” Dave says cheerfully, a term so tone-deaf the paramedic stops her
briefing to say: “Excuse me?” Malucci badgers Greene to let him insert a G-tube,
a procedure he hasn’t done yet.
While this is going on Dr. Gabriel Lawrence (Alan Alda
in a role that would earn him an Emmy nomination) comforts the girlfriend and
goes to check on the trauma. He asks how things are going and Dr. Dave cheerfully says “Great’ because of how well
his procedure went. Lawrence turns to Greene and asks for an update. Mark says
the prognosis is hard to tell and Malucci again dismissed it because of the
oxygen deprivation. “We’re probably look at veggie-burger here.” At that moment the girlfriend has entered and
hears this. She runs off in tears.
Lawrence has been relatively mild in his disposition.
He turns to Malucci:
Lawrence: “You’re
a resident right.” Before Dave can finish his yes:
“Well, one thing you still have to learn is that every
patient is somebody’s boyfriend. Girlfriend. Brother. Sister. Mother. Father. They
don’t exist simply for you to learn new and more interesting procedures.”
Dave weakly says he didn’t see her.
Lawrence: “Yeah,
well maybe next time open your eyes before you open your mouth.”
Now Greene has little patience for Lawrence, who was
hired without his consent. He’s also generally mild with his criticism compared
to everyone else.
Malucci: “What’s
with the new guy, right?”
With scorn we almost never hear from the mild-mannered
attending:
Greene: “Which new guy would that be? Dr. Lawrence or you?”
He snaps off his gloves and walks out.
It’s worth noting that for the two seasons he is on
the series Dave never truly picks up either the nuances or tones of being a
doctor and when he is finally fired at the start of Season 8, though the
circumstances are dicey few could argue he’d be missed. The hospital had given him every opportunity
to improve and every chance he dropped the ball.
Now consider some of the things that the five interns
who start Grey’s Anatomy do in their first year of residency (which
encapsulates the first three seasons). Both Meredith and Christina sleep with
their attendings and begin affairs with them, despite the fact that is against
the rules. It’s eventually cleared by the hospital but only after it becomes
obvious for both. Both residents use their attendings as a push for favoritism throughout
the first year and after some pushback, no one objects that much from the chief
of staff.
When Preston Burke is shot and suffers tremors, rather
than tell the Chief Christina assigns herself all of his surgeries and performs
them rather than him. She keeps it a secret out of fear of Burke’s career but
doesn’t seem to mind that she’s performing surgeries that the attendings should
be, which might be considered a liability issue for the hospital. (She also
shows no guilt about it; in a later season she actually says her illegal work
should be a reason she’s allowed more responsibility in this hospital.)
Alex Karev has multiple affairs with almost every
female on the staff, and at one point begins an emotional affair with a trauma
victim from a crash who has amnesia and needs facial reconstruction surgery. While
Denny’s emotional affair with Izzie was going on, he was dating her and knew
how wrong it was but sees no problem with it – even when he later learns his
patient is married.
All of the attendings, as I mentioned in the first
article, are guilty of some form of conspiracy involving Denny Duquette’s case
that eventually leads to his death. None of them display much in the way of
bedside manner (they periodically have lunch in the coma ward) and almost none
have any real connection with their patients or feel they even have to talk to
them. All of them view them as ‘new and interesting procedures’ – at best.
None of them receive so much as a reprimand during
this period or it should be mentioned well past their third year of residency,
even though all of them have engaged in behavior that is at best incompetent
and as worst malpractice. I’d say the residents get away with murder were that
not copyrighted by a different Shondaland show. It’s one thing that they’re bad
people - that’s basically de facto what
all Shondaland characters are – but they’re not even good doctors.
Now to be fair, throughout ER’s run we see over
and over that the surgical residents and surgeons have the same arrogance to the point of
obliviousness. The most hated character on the series Dr. Romano famously
isolated everyone during his rise to the top and showed no compassion even when
he was injured. His identity was wrapped in being a surgeon and he seemed fine
showing a lack of compassion to everyone – including the people who might offer
sympathy to him.
But Romano serves as a contrast to most of the surgeons
we meet at ER who do have a better work-life balance. Famously when Eriq
LaSalle left the show in Season 8, the arc that led to Benton leaving the show
involved his having to take custody of his son Reese who he’d fathered out of
wedlock back in Season 4. When his mother dies in a car wreck Benton soon
becomes involved in a custody fight with Reese’s husband Roger (played by Vondie
Curtis-Hall in the arc). In the custody dispute, it becomes clear that Reese is
not Peter’s biological son and that for most of Reese’s life, Peter has
shafted custody duties on Carla and the rest of his family to pursue his
career. As Roger points out “Reese has spent more time in our house than Peter’s.”
In order to accommodate this Peter gives up his
full-time residency for a less-demanding job at the hospital where his
girlfriend Cleo Finch (Michael Michele) now works. Romano refuses to accommodate
his demands and when Peter resigns, he is enraged: “You’re going to quit to play
Mr. Mom?” he shouts as Peter leaves his office. But it is clearly a big
decision for a man who spent his entire life built on his surgical career. It’s
telling that Meredith Grey never considers a similar option even after giving
birth - and refuses to consider moving
to DC when Derek gets a job offer there.
And its worth noting that Dr. Morgenstern, after
suffering a heart attack in the Season 4 premiere, after coming back in the
middle of the season, eventually chooses to resign because “I just don’t feel like
I belong here.” When the series begins Weber
is contemplating named a successor for which Derek and Burke are the prime
contenders. No matter how much his marriage is on the verge of first failing,
or when his wife first develops Alzheimer’s and then dies has Richard ever
contemplating leaving Seattle Grace for good and he seems no closer to doing so
after twenty seasons.
In what would be their last exchange as Mark Greene
leaves the ER for the last time, Kerri Weaver turns to him and asks: “How many
shifts should I sign you up for next month?” She knows Mark is dying of cancer
but she cares for him so much that she thinks by letting him keep working is a
sign of their trust and bond. Mark, who has just decided to die on his own
terms, turns to the woman who has been rival and frenemy for seven seasons. “Never
let your work become your life,” he says sincerely. “Live a little, Kerri.”
No one in 20 seasons of Grey’s Anatomy has
seemed capable of understanding the simple truth of that statement. For one of
the longest running shows on TV work is life. In the real world, where so many
people are coming to question whether they spend too much time at work as a
rule, this message seems remarkably tone-deaf. On a show where all of the doctor’s
personal life, happiness, marriages and friendships have been sacrificed in the
name of this job, it seems insane.
Now I do realize that this argument would seem to
booster my claim that Grey’s Anatomy is just a soap opera set in a
hospital. But the message that work is supposed to provide you with more fulfillment
then your personal happiness is a very toxic message for a TV show to provide. And
what makes it all the more galling is that over and over on ER we saw far
better that love stories could happen at work – and you could have it all.
In the next part of this series, I’ll explain why ER
showed romantic love far better than the supposed greatest love story of
this century – Derek and McDreamy – ever did on multiple occasions.
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