Friday, June 27, 2014


Vincent Edwards as Ben Casey

For months I was trying to remember the name of the doctor series that dominated TV for a while.  You know -- that cranky but handsome brute who was always right, an exemplar of the grandiose narcissist, a lion with a thorn in his paw.  It was quite awhile ago and evidently all my informed friends were just too young.  I ended up prowling on the internet a good bit, resurrected some memories, signed up for some med news services, and ended up hooked on “House, MD.”  

Then a couple of nights ago someone making a joke on that program gave me the name:  “Ben Casey.”  Early Sixties.  “Ben Casey” was one of the places Sydney Pollack developed his directing style -- Alpha male exploitation.  Casey was so popular that in Vietnam the name was used as code for doctors.  An older doctor was on-scene as mentor and the main romantic interest was a patient who awoke from a coma.  (Maybe not all the way?)

Hugh Laurie as House, MD

House has the ego but not the face of Ben Casey.  What revived the concept was adding a team of three “types” who reflect on his murderous brilliance, a close friend who is his age and sometimes his roommate, and an executive who, as he says, dresses like a trollop and is trying to get pregnant, possibly all by herself.  This is comedy.

I can only hope that people don’t get the idea from the show that all patients have the kinds of dramatic symptoms the scripts use.  In the early episodes things were more realistic, but by the end of the first year the show was mostly playing for laughs and soliloquies.  At the moment I'm watching there's a new character as strong and authoritative as House, a cop who is pursuing House’s addiction to painkillers, and who has introduced a new dimension.  (Third year, I think.)  The old irresistible force meets the immovable object ploy.

David Morse as a Cop getting to the bottom of it.

As for the symptoms, they are most often
1.  collapse and coma 
2.  spitting up blood
3.  seizures
4.  suffocation
5.  strange test results
6.  impending death as the machinery beeps 

Emergency treatment always includes injections with big needles, intubation, electric paddles to restore heart beating, lumbar puncture, MRI, surgical biopsies including brain surgery, and organ transplants.  All the while everyone claims the patient is dying but these massive and in real life traumatic techniques are treated as usual, even casual.  In actual practice the success rates are not the best.

The real subject, if you can find it, is most often human foibles of the ethical kind and the twisted psyche of just about everyone, but esp. House.  The female team member, Cameron, falls in love with anyone needy.  How she would have loved Ben Casey, which many fans at home did, but without Casey ever turning around and mocking them for it as House does.  Not that Cameron (Jennifer Morrison) is discouraged.  It only fans the flame.

Where's Omar?

Here we go!  Omar!

The black team member (Omar Epps) is the closest to an equal, not least because he is a former felon and can suss motives, but mostly because he’s just as smart and not dependent.  The white Aussie handsome fellow (Jesse Spencer) is no Dr. Kildare, though he looks a bit like Richard Chamberlain.  The surprising aspect of Kildare was that Lionel Barrymore, the older mentor, pushed him out of his own series.  Chamberlain went on to become a priest in “Thornbirds” and -- in real life -- an acknowledged gay man who adopted his lover since marriage was not an option and a lot of money was involved.  Times change, which is the point of this post.

Richard Chamberlain

So doctor shows are an indicator of the times in which they are written and viewed.  It is true to life that these days docs are managers of tech teams and merely sign off at the end of the episode.  It is also true that the names of the diseases, conditions, and parasites are more familiar to us.  We don’t just know that guinea worms have about been eradicated (thanks to Jimmy Carter) but we’ve all watched them being teased out of living flesh on You Tube.  Sometimes I recognize diseases from my chaplaincy: Wilson’s and Kawasaki made impressions.  It was a big regional specialty hospital, so I saw some anomalies.  But treatment was never this dramatic.  

Nowadays many conditions simply require on-going monitoring and blood tests, like diabetes and HIV.  It’s boring, repetitious, expensive, and sucks up time and travel from your life.  Maybe care is provided in a charity clinic where the employees distinguish themselves from the patients by showing contempt.  One becomes a human dipstick.  These features are not so likely to be discussed by House.  The hospital on the series is also a major institution in an urban area.  What the screenwriter knows.  No episodes about what to do if your nurse is your next-door neighbor, the nosy one, or if your doctor is a former student.

Doctors complain all the time that patients search the Internet for their symptoms and are soon suffering from the exotic multisyllabic afflictions that appear on House, except that it’s all in their head.  But I would claim it is self-defense to check the Web.  Many of my symptoms are simply advancing old-age.  I have trouble distinguishing new phenomena from the background noise.  The docs are in a hurry.

Our little clinic has a problem with tumbling docs.  The one I had left in the night with no warning.  I don’t know why.  The nurse-practitioner who took her place said lactic acidosis (a complication -- potentially fatal -- of metformin that is stated on the label) is very rare so therefore I don’t have it.  But no test, so I still don’t know whether my symptoms are background noise or worthy of panic.  But I’m opposed to overtesting.   On “House MD”  they run a zillion tests, some of them expensive and requiring experts plus amazing equipment.  We’ve come to expect that.  Simple observation is discounted.  Also med labels.

Hugh Laurie and Robert Sean Leonard

For Valier residents there is a small clinic that sends someone over from Shelby, Teton County, once a week.  The other choices are Cut Bank, where my dentist just quit, or Conrad, where the hospital is in financial trouble.  Also in Shelby is my pharmacist, who is now saying she’s going to get out as soon as possible.  She is an older woman, honest and conscientious, sometimes a necessary alert system, though she’s working for a Big Box store that refuses to keep enough pills on hand.  This policies come from headquarters where roads never close and all driven by profit.

I wonder whether watchers have really noticed that one of House’s strategies is to search the patient’s house, with or without a warrant, looking for toxic substances, drugs, clues.  Home invasion may be the next step in the mommy version of medical care.  House and his whole team would note that, and do it anyway, though Cameron and Omar might object.   But the program is off the air now anyway -- just on Netflix.   “House search” may be the trend.  After all, it’s only to save the patient.  Your privacy or your life?  Um -- can I get back to you?

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