Personal Essays

But I Play One on TV

Saving lives is hard enough—what medical professional has time for significant romantic moments in the supplies closet? A lifetime of TV role models.

I should’ve been a hot neurosurgeon.

The thought haunts me each time I see an episode of Grey’s Anatomy. If only I’d been wiser in med school, I could be spending my nights saving lives with a sexy intern I occasionally sleep with and my days exchanging sarcastic banter with my sometimes-estranged-yet-fairly-hot wife. Removing nails from children’s heads, performing radical brain resections, containing Code Blacks—all in a week’s work. And I’m not the only one who has these thoughts: Every patient’s eyes seem to say, “Why can’t Dr. Drayer be a little less scrawny? Must his nose be that crooked? And why so many chins?” I’m waiting for one of the 20 acne-suffering teens I see each day in my dermatology practice to ask me, “Who the hell came up with this character? He totally doesn’t play on screen.”

Unfortunately, they’re right.

Television transports us into foreign and often dangerous situations where, in the safety of our homes, we can ask ourselves whether we could break out of prison, solve a murder, or be able to stand Nell Carter day after day without strangling her to death. But the characters we measure ourselves by don’t simply disappear when we turn off the TV—they stay with us, often our only points of reference to parts of the world beyond our own maps.

I first thought of becoming a doctor back in the ‘70s, when the pre-cable era forced me to watch whatever reruns WUAB desired. Stuck sometimes for an entire hour in the same room with Ben Casey and Dr. Kildare, I began to see medicine as a reasonable enough career. They looked like good guys; hard-working, clever, and kind. And besides, there were far worse fates than having the elderly ladies of the town bake you cookies every day, or plead with you to date their daughters. Sure, it was a make-believe town. But within it, those guys were beloved. Hell, I wanted to be beloved.

I wore a big television smile for my very first patient. Knocked on her door, strode into the room, and pulled a chair up to her bedside in such a way that told her I wasn’t there solely to glean the facts—I was there to talk. No, in fact—and I demonstrated this by suddenly and probably terrifyingly slinging my chair around backward, so I could straddle it like I imagined empathetic people during the ‘60s often did—I was there to chat. To get past the surface symptoms and hammer out a cure. “Mrs. Hawkins,” I said, using the kind of straight talk I knew real people craved from their healers, “I’m a medical student, and I’m here to help.”

“Gimme some morphine.”

I smiled wider; the doctor-patient bond was not built in a day. I needed to create trust. I put a hand on her knee. “Why don’t you tell me about your pain?” I asked.

She looked at me like I was a complete, unconditional asshole.

“I know it’s difficult, but maybe if you could communicate why you feel you need morphine, I could better—”

“I want my doctor.”

“Ah,” I said, a part of me sensing the situation slipping away. “Well, I’m actually a student doctor, and I’ve been sent here to—”

She moved faster than I would have predicted. And though I avoided the magazine aimed at my head, I did fall off my chair in a very un-Trapper-John-M.D. sort of way. A few cooling-off minutes later, Mrs. Hawkins came to understand I was not trying to kill her, and I learned she felt she needed morphine for the horrible metastatic bladder cancer eating through her intestines and lung. In the end, I believe we were both right. Memo to self, though: Marcus Welby would have read the chart first.


* * *

We all know TV is different from real life. How else to explain Anna Nicole Smith? But when it’s one of our biggest windows to the world, our opinions of the world are subsequently affected. There’s no real way to get an idea of what it’s like to live your life in a hospital, so we take the closest approximation, and imagine. When I went to med school, I didn’t just watch Noah Wyle playing a part—I saw him living a life. A mesmerizing, fast-paced, thrill-ride of a life. I wanted a basketball hoop outside my ER; I wanted to win the respect of my unbearably tough but ultimately loyal resident; I wanted to find love amidst the blood and meaning within all the death. On TV, doctors laugh louder, they hurt deeper, they fight illness with an unmaintainable ferocity, and most of all, they live every second to its fullest. That’s a tough act to measure up against. It’s why these days, when I watch Grey’s Anatomy star Patrick Dempsey play a practical joke on a co-worker and then walk into surgery to cut out a brain tumor, I often find myself thinking, “Wow—it sure would be great to be a doctor. I wish I could do that.” Med school didn’t prepare me for feeling like this.

Another thing med school didn’t prepare me for was the gray cloud of misery hanging constantly over hospitals. Television had promised me that even 11 years spent ensconced in a Korean M.A.S.H. unit could be crazy and fun. Because I didn’t just want to be a scrawny, crooked-nosed doctor—I wanted to be one who made people laugh. I wanted to be Hawkeye.

Maybe I’d even get my own nickname. That’s what I was thinking my first day of internship, my white coat still creased and fresh. Already I had a whole list of patients on my service, each one no less than a captive audience waiting to be cured by the combined healing powers of laughter and a guy who only vaguely understood the renal system. It was the perfect set-up. I was ready.

“Which one of you is Mr. Kaplan?” I asked. Both the elderly man lying face-down on the bed and his wife in the chair next to it looked up. “So tell me,” I went on. “You ever have a rubber tube stuck up your nose?” The man shook his head, uncomprehending. “Me neither,” I said. “But I’ll flip you for it.”

Maybe he’d never seen M.A.S.H? Who could tell? All I knew was that the terrified man could only watch helplessly as I rolled him onto his back, then raised the bed until he was crunched upright like a human letter L. With a flourish, I produced the aforementioned rubber tube. Hawkeye and I were nothing if not men of our words.

“You’re feeling bloated,” I said, applying a healthy dose of SurgiLube to the end of the tube, “because you’ve got a blockage below your stomach that’s keeping it from emptying. So, I’ve gotta do it for you. Now”—and at this point I inserted the tube into the man’s nostril—”you ever hear the one about the guy who goes to the psychiatrist, wearing only a sheet of Saran Wrap?”

The man gulped several times, and slowly shook his head.

“Psychiatrist told him, ‘Listen—I can clearly see your nuts.’”

Our eyes met. Slowly his mouth turned up in a smile and for an instant, he seemed to forget the tube being shoved through his pharynx and halfway down his throat and the big plastic bin I was holding to catch his stomach contents. We were forming a bond.

“Almost done,” I said, matching his grin. “Now how about this: A priest, a rabbi, and a duck walk into a bar—”

It was a good joke. Perhaps too good. In seconds, poor Mr. Kaplan’s laughter, partially thwarted by the length of plastic pressing through his esophageal sphincter, shot the brown and partially digested residents of his stomach up the tube like a garden hose in summer. Bile dripped down my face and onto my once bright, white coat.

From that moment on, I had my nickname: Pukey. And I finally knew why Hawkeye had gone insane.

But there’s more to doctoring than one’s bedside manner, or even medical acumen. With the title comes a responsibility to educate one’s patient, and include him or her in the decision-making process, a skill that’s often lost in the miasma of med school’s clotting cascades and stomach enzymes. Fortunately, though, I had been a teenager in the mid-’80s, without many friends and with a whole lot of spare time—enough time, it turned out, to internalize the teachings of St. Elsewhere. Somehow, the doctors at St. Eligius always had that extra minute to discuss the intimate details of treatment. They made sure they had not only the best plan of care, but also one the patient could agree to, and understand. And this in only 43 minutes a week.

I was an older, wiser intern when I began my obstetrics rotation that spring. Only a day earlier I had delivered a healthy baby boy with my own two hands. Now it was time to deliver some integrity, too.

“Mrs. McClure,” I said, and smiled at the 12-pound bundle of newborn joy in her arms, “It’s time to take Matthew for his circumcision.”

And for most doctors, that would have been enough. But not this time, I thought. Not yet.

There’s a tradition in Western medicine as old as bacteria called “informed consent,” wherein a patient has to certify that he or she’s been warned of the risks of an upcoming procedure. Of course, since humans fixate on the worst-case scenario no matter how low the odds, doctors tend not to inform their patients as fully as possible. But if it was good enough for Hippocrates and Ed Begley Jr., I thought, then dammit, I could do it too.

“Now, I’ll just need you to sign a form stating you understand the risks of the procedure.”

Immediately the young woman’s expression froze. Her muscles tensed.

There’s no standing up against these wunderpeople, these men and women of Seattle Grace Hospital who sleeplessly yet sexily handle their own soap-opera relationships and oh-so-relatable angst while making their city a healthy place to live.“It’s really not a big deal,” I continued. “There’s a chance of bruising from the injection of anesthesia, which should go down in a couple days. Of course, as with any procedure, there’s a small chance of infection, but that almost never happens, and can be quickly treated with antibiotics if it does.”

At which point Mrs. McClure’s face thawed and her breath returned. She met my compassionate look and was soothed. Everything was going to be fine.

“There’s one more thing,” I said, “and this almost never, ever happens. Really. And that’s where there is the tiniest chance, like one in a million, where the doctor will make the incision too low and we won’t be able to get the foreskin to fuse with the shaft, such that we might—and really, this almost never ever happens—we might have to remove the penis and give your child hormone therapy, in which case you’d raise him as a girl.”

The resultant shrieking was legendary. At times, I still hear it in my dreams. And somewhere in the world, there’s a seven-year-old kid with a nickname he doesn’t understand and a paralyzing fear of showering with the other kids after gym. He has only Ed Begley Jr. to blame.

And so it goes. During the ‘90s I finished my internship and went to residency, while E.R. combined with hordes of internet billionaires to teach me not only that doctors are more flawed and human than everyone else, but also that, despite workable financial models, they make a lot less money. When I finally made it into practice as a full-fledged dermatologist, House began showing me that even with seven zillion years of educational loans, I could still never know enough to cure the insane glandular deficiencies and exotic African parasites that, apparently, I’ve been misdiagnosing all along. And just when I thought I understood my place in the world, Scrubs mocked me for not learning an important life lesson every goddamned week.

Which brings us to my current Grey’s Anatomy dilemma: I’ve finally met my match. There’s no standing up against these wunderpeople, these men and women of Seattle Grace Hospital who sleeplessly yet sexily handle their own soap-opera relationships and oh-so-relatable angst while making their city a healthy place to live. I can barely figure out the gas cap on my car.

So I should just stop. Comparison, after all, is for the insecure. Aren’t the images I absorb from my flatscreen nothing more than a reflection of myself? Rather than use them as barometers, why not accept each image as a sort of x-ray, allowing me to look within and uncover my own illnesses? After all, the doctor would advise, only then can I begin to cure them.

This, I think, explains why I’m glued to my television: the healthy desire to better myself. I may not be saving lives every day or engaging in illicit romances, but hell—I’m doing all right. I’ve got my comfy couch, my gourmet popcorn. Why not join 28 million other viewers to watch a bunch of square-jawed, irrepressible, and, yes, heroic doctors experience every moment to the fullest, enriching not only their own lives but those of everyone around them? It’s captivating fun, just plain old good TV.

And as the credits roll, getting up to hit the bathroom before bed, before another day at the office, I inevitably find myself gazing one last time at Dr. McDreamy up there on the screen. And for just an instant, I always see staring back at me the one invariable truth in my life:

I totally should’ve been a hot neurosurgeon.