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All the heightened drama and medical inaccuracies aside, Chabrerie says it’s the emotional challenges of being a doctor that these shows tend to get right.
“I do think the emotional aspects get brought up more in shows like Scrubs,” she says. (She’s not the only one—a 2009 Slate article says that despite the show’s “cartoonishness,” it’s “quite in tune with the real lives of doctors.”) ~ Julie Beck
Palmer told me that because of Tezuka's Black Jack, people in Japan are much more aware of the issue of medical corruption than in most other countries.
"Imagine if Batman were about medical corruption," said Palmer. "When a new movie comes out, the whole nation talks about it. That has had a vast impact on how the Japanese nation thinks about doctors." ~ Cian O'Luanaigh
Television portrayal of medicine may have a profound effect on patient’s medical knowledge and decision-making. A survey of geriatric patients demonstrated that 42% of older adults named television as their primary source of health information. ~ Rosemarie O Serrone, Jordan A Weinberg, Pamela W Goslar, Erin P Wilkinson, Terrell M Thompson, Jonathan L Dameworth, Shawna R Dempsey, Scott R Petersen
The value of incorporating ‘realism’ into the literary, visual, and dramatic arts with respect to reaching and appealing to a wide audience has long been recognized by authors, artists, and playwrights alike. Since the dawn of the television drama in the 1950s, the portrayal of realism has been of similar concern, with the goal of sustaining mass market consumption of television programming. Recognizing the influence of this new medium, the American Medical Association (AMA) created the Physicians’ Advisory Committee for Radio, Television and Motion Picture in 1955, with the goal of establishing organizational influence and control regarding the medical issues being portrayed on such early television serials set in hospitals as Ben Casey and Dr. Kildare. In exchange for consultation regarding accuracy in the portrayal of disease, appearance of operating rooms, use of medical instruments, and performance of emergency room procedures such as cardiopulmonary resuscitation, television procedures were able to display the seal of approval of the organization in the credits, effectively providing an aura of realism as sanctioned by an authoritative body. ~ Rosemarie O Serrone, Jordan A Weinberg, Pamela W Goslar, Erin P Wilkinson, Terrell M Thompson, Jonathan L Dameworth, Shawna R Dempsey, Scott R Petersen
  • A 2005 survey by the Centers for Disease Control and Prevention found that the majority of primetime TV viewers reported learning something new about a disease or other health issue over six months of viewing. About one-third of viewers took some kind of action after learning about a health issue on TV.
    Many medical shows have physicians consult for accuracy, and an article in the American Medical Association Journal of Ethics notes that starting with ER in the ’90s, TV shows began using more detailed medical jargon to describe conditions and procedures. But there are still inconsistencies. Treatments for patients with seizures are sometimes downright dangerous, with doctors trying to hold patients down, or put things in their mouths (they could choke). Patients tend to survive cardiac arrest more often on television than they do in real life, making CPR seem more effective than it often is.
  • On TV, the patients that have these compelling rare diseases are played by a revolving door of guest stars. The characters we really get to know are the doctors themselves. And the way doctors have been portrayed on television has changed markedly over the years. Medical shows in the ’50s and ’60s, like City Hospital, Dr. Kildare, and Ben Casey, showed doctors as noble, infallible heroes. These shows apparently received “creative input and guidance from the American Medical Association,” according to an article in Annals of Emergency Medicine.
    Starting in the ’70s and ’80s with shows like M*A*S*H and St. Elsewhere, the pendulum swung toward portraying doctors as the flawed humans they are. We’ve been firmly in the era of flaws for a while now with shows like Grey’s and House, MD (whose rude, drug-abusing titular character gets by on his brilliance). This perhaps explains why, in a 2003 study (on which Chory was an author), watching more prime-time medical shows was associated with “perceiving doctors as more uncaring, cold, unfriendly, nervous, tense, and anxious.”
  • All the heightened drama and medical inaccuracies aside, Chabrerie says it’s the emotional challenges of being a doctor that these shows tend to get right.
    “I do think the emotional aspects get brought up more in shows like Scrubs,” she says. (She’s not the only one—a 2009 Slate article says that despite the show’s “cartoonishness,” it’s “quite in tune with the real lives of doctors.”)
    “In med school, this is what we did. We lay in our beds and watched Scrubs,” Chabrerie says. “At the end of the day, we see [the same things] all the time. We lose patients all the time. It’s never easy. [On these shows], the young doctor gets really upset, and the older, wiser doctor comes in and says ‘You have to let it go.’”
  • Fictional medical programs have long been a staple of television drama. In the 1960s and 1970s, television doctor heroes such as Dr. Kildare and Marcus Welby populated the airwaves. On these programs, the primary focus was on the patient’s story, and the doctors generally could do no wrong. However, the 1994 premieres of ER and Chicago Hope ushered in a new era of fictional medical programming. These programs—in particular ER—prided themselves on techniques such as using medical jargon, increasing accuracy as much as possible without sacrificing entertainment value, and hiring physicians and other medical professionals to serve on the writing staff.
  • To our knowledge, there has never been a formal, rigorous systematic review of the literature assessing the ability of medical television programs to affect important public health outcomes such as viewers’ health-related knowledge, perceptions and/or behavior. Considering the continuing availability of medical television programming and its potential for continued influence, this is an important gap in the literature. Therefore, we conducted such a systematic review in order to synthesize extant research, make recommendations for future study, and explore opportunities to creatively leverage the infrastructure around these programs.
  • Overall, our results suggest that fictional medical programs do influence viewer knowledge, perceptions and behaviors. Thus, it may be valuable for medical and public health professionals to work with fictional medical television writers, producers and directors to ensure that programs are as accurate as possible while maintaining their entertainment value. Furthermore, there may be opportunities for health professionals to work with these programs to augment current public health and health education campaigns. For example, in 2014 the CDC spent $2.1 million on national tobacco education campaigns, but working with existing medical television programs to incorporate anti-smoking plotlines into episodes could provide additional education to millions of viewers at little to no additional cost.
  • She began working on a live-action role-playing game that reflected a variety of experiences around abortion, but pivoted to creating Childfree when she came across two other Larps that weren’t explicitly anti-abortion but used “the future of the potential child” as narrative motivation. “This felt deeply wrong to me,” says Cazeneuve. What mattered more, she felt, what needed to be centered and given more weight, was not the “potential” of an embyro but the life of the human being carrying it. “This is a humanist issue. Live-action role-playing, as a medium that fosters agency among its players, is a tool we can use to make people more deeply aware of that,” says Cazeneuve. “Unlike theatre, Larp maintains the agency of the subject – the player playing the pregnant person – and that was crucial to understand the topic.”
  • For many people making games that address reproductive rights, the goal is not to force players to accept a single perspective or conclusion, but to contend with the numerous tangible, personal experiences of people dealing with unintended pregnancies. Most of all, they ask players to consider the very real human beings trying to make difficult decisions about abortion. These people are often erased by simplistic, judgmental political stances – or legally prevented from making those decisions altogether.
    “What I aim for is just making people more aware of how we receive and process norms, and how deeply we are affected by them,” says Cazeneuve. “I also aim to show that they always have a choice, even when everything seems to be against them.”
  • One of the most vivid examples of the tactile quality of the TV image occurs in medical experience. In closed-circuit instruction in surgery, medical students from the first reported a strange effect-that they seemed not to be watching an operation, but performing it. They felt that they were holding the scalpel. Thus the TV image, in fostering a passion for depth involvement in every aspect of experience, creates an obsession with bodily welfare. The sudden emergence of the TV medico and the hospital ward as a program to rival the western is perfectly natural. It would be possible to list a dozen untried kinds of programs that would prove immediately popular for the same reasons. Tom Dooley and his epic of Medicare for the backward society was a natural outgrowth of the first TV decade.
    • Marshall McLuhan, Understanding Media: The Extensions of Man, (1964), chap. 31:
  • Black Jack remains one of the most popular manga of all time in Japan. "I have never met a Japanese person who wasn't familiar with Black Jack, even those who don't usually read manga," said Palmer. "If Astro Boy is the Japanese Superman, Black Jack is the Japanese Batman. Everyone knows him, even far outside the comics world, and when people think of him people think of his fierce critique of the medical world."
    Palmer told me the character is often brought up in debates about medical reform. The Hitachi medical group used Black Jack's image in their advertisement in 2006, for example, because his image is synonymous with good medical care.
    However, Tezuka's message was not always welcome. "There were a number of Black Jack episodes which drew complaints from the medical establishment in Japan and which Tezuka agreed to suppress and not allow to be reprinted in book form," said Gravett. Two of these three "sealed issues", issue 41 Vegetable and issue 58 Seat of Pleasure, which deal with the vegetative state and lobotomy respectively, were considered politically sensitive and never re-published.
  • Palmer cited Naoki Urasawa's Monster and Chiho Saito's Say Hello to Black Jack as examples of manga inspired by the Black Jack series. The latter is a gritty, realistic portrait of corruption and incompetence in the Japanese medical school internship process.
    "The subject of the manga is literally that every medical student in Japan starts medical school wanting to be Dr Black Jack, and then has to face the trauma of discovering that isn't possible in the real world," said Palmer. The comic is beautifully illustrated with a detailed medical realism in tribute to Tezuka.
  • Palmer told me that because of Tezuka's Black Jack, people in Japan are much more aware of the issue of medical corruption than in most other countries.
    "Imagine if Batman were about medical corruption," said Palmer. "When a new movie comes out, the whole nation talks about it. That has had a vast impact on how the Japanese nation thinks about doctors.
  • The value of incorporating ‘realism’ into the literary, visual, and dramatic arts with respect to reaching and appealing to a wide audience has long been recognized by authors, artists, and playwrights alike. Since the dawn of the television drama in the 1950s, the portrayal of realism has been of similar concern, with the goal of sustaining mass market consumption of television programming. Recognizing the influence of this new medium, the American Medical Association (AMA) created the Physicians’ Advisory Committee for Radio, Television and Motion Picture in 1955, with the goal of establishing organizational influence and control regarding the medical issues being portrayed on such early television serials set in hospitals as Ben Casey and Dr. Kildare. In exchange for consultation regarding accuracy in the portrayal of disease, appearance of operating rooms, use of medical instruments, and performance of emergency room procedures such as cardiopulmonary resuscitation, television procedures were able to display the seal of approval of the organization in the credits, effectively providing an aura of realism as sanctioned by an authoritative body. It was obvious to the AMA, at a time when media psychology was a nascent science, that the portrayal of the medical profession on television could have significant influence on the public perception of doctors, hospitals, and the practice of medicine in general.

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