8/27/2009

Missing the Real Drama


Lately I've been watching Jada Pinkett Smith in HawthoRNe on TNT. I'll admit it is a fairly sappy little show with few redeeming qualities. The acting is sub-par and the story lines suffer from an identity crisis: Are we a drama, a comedy, a soap opera?

But, what is positively crystal clear in this series is that no one doing the writing knows the first thing about the real world of medicine. As I watched the latest installment where Smith's character goes to bat for a family friend who needs to get into a clinical trial for a cancer treatment, I couldn't help but think that they have completely missed the real drama that happens every moment in a hospital.

None of the patients at Hawthorne's hospital every have a problem with insurance. No matter how great the treatment, how unlikely the outcome, or how poor the patient - everyone obviously has the best insurance. No patient ever has to make choices about getting treatment or paying the rent.

In this episode Christina's (Smith) friend has his cancer recur. There is a new clinical trial for a treatment at this hospital. Amazingly, it is being run in house because her public non-teaching hospital has its own research department. But, let's set that aside for a moment. There's only one spot in the trial for this promising miracle cure. The spot has been promised to a man with a family though.

In the opening scenes we see one of the doctor's is speaking to the patient and his wife. The patient has gone off his antibiotics and gotten an infection because he didn't like taking the pills. This jeopardizes his position in the trial. What could have shaped up to be an intriguing look at patient cooperation flops when the patient promises to take his medicine and is re-instated. How much more interesting to explore that topic fully. How much more interesting to talk a little about real world health care rationing. Instead of not taking drugs because he just didn't want to, how about talking about the real fact that many patients don't take their medication or self-ration because they can't afford them. Would that not have been more intriguing?

But, we go down the tired old path of Christina Hawthorne wanting to save her friend and ending up in a moral dilemma over whether to get her friend in the trial who has a small chance of surviving or a dedicated family man who has a good chance of being saved by the treatment.

Meanwhile, the shenanigans continue around her to provide levity and secondary drama.

Yet, none of it is remotely real or emotionally gripping. Her hospital functions like none that have ever existed. She has sexual tension with her friend who is Chief of Surgery but seems, like her, to be a super hero. He's a surgeon, a neurosurgeon, orthopod, oncologist, ER doctor, pediatrician, OB-GYN, and probably moonlights as a Chiropractor/psychiatrist.

Hawthorne is also the only "Chief of Nursing" that seems to spend all her time treating patients on every floor and department of the hospital rather than mired in the paperwork and endless meeting that are the realm of the Administrative Nurse.

I've made it pretty much through this first season only because when I'm dealing with insomnia I can grab it On-Demand and kill some time. Yet, it lacks any depth or any connection to real world issues in health care. In the end, you have to wonder if any of the mega-rich people involved, like Smith, have a clue what it means to need health care in today's world where insurers try their best to deny that care, where 47 million+ people have no access to care, and where nurses who actually treat patients often find themselves at odds with their own bosses to provide even minimum standards or care to those who need it.

Maybe, one day, someone in Hollywood will learn that real life can be much more dramatic than hackneyed story lines tied up with nice bows at the end of an hour.

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