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Doctors in the Movies: Boil the Water and Just Say Aah
By Peter E. Dans, M.D.
Medi-Ed Press
384 pp $34.95

Perhaps because doctors move in such intimate proximity to life and death, stories of medicine have long fascinated writers, artists, and the public. It is no wonder then, that the Hollywood film industry, our modern mythmaker, is rife with medical stories. What can top the drama of a critically injured hero waking up to the music of Mozart after a suspenseful brain surgery? How about a longed-for baby being delivered aboard a Concorde in flight over the Atlantic?

Now it's the doctors' turn to focus on Hollywood. In a witty and absorbing book, Doctors in the Movies, Dr. Peter E. Dans, an internist and member of the medical faculty at Johns Hopkins University, has dissected Hollywood films dealing with medical themes. His diagnosis? Hollywood is looking at medicine through the spyglass of popular culture, with its marked tendency to blur the boundaries between myth and fact.

"Myth, like denial, is central to human existence," writes Dans in his introduction to his reviews. "History may tell us what we have been, but myths tell us what we could have been and might still be, as well as what others think we are. In this century the most influential mythmakers have been moviemakers. [They have] shaped how we think about ourselves and those around us by reinforcing old stereotypes and creating new ones." In this thoughtful collection, Dans explores the way these stereotypes reflect society's changing and often fickle view of medicine over the last century.

As we thumb through this book, two facts emerge at once: First, Hollywood has spun an astonishing variety of stories around medical motifs, limited only by the imagination of its scriptwriters. And second, Dans has a deep and abiding love for film.

For a self-professed film buff who apologizes for "thousands of hours of movie watching" and confesses to "not having been schooled in film techniques," Dans meets his goal admirably. Each of the book's 10 chapters begins with an engaging introductory segment, followed by an analysis of story lines from representative movies. This analysis serves as a point of departure for a discussion on the changing image of doctors through the decades.

The earliest films discussed were made during a period known as the Golden Age of Medicine, when admiration for doctors' work was perhaps at its zenith. During this period, the 1930s to the 1950s, public opinion polls ranked physicians on a par with or better than Supreme Court justices. Dans links this "era of good feeling" in part to a series of brilliant scientific breakthroughs we now take for granted, including the creation of a compound to treat syphilis, the production of vaccines and antitoxins, the discovery of insulin, the ability to perform blood transfusions, and the development of vaccines for polio. During this period, during which medicine saved millions of people from diseases that had formerly proved fatal, movie images of doctors were overwhelmingly positive.

After the 1950s, movies about medicine underwent a sea change. "These films were made during medicine's fall from grace, which was due in large part to its successes," Dans writes. "As acute, life-threatening diseases declined, they were replaced by chronic diseases less amenable to the administration of a 'magic bullet.' A generation that hardly knew serious illness came increasingly to view good health as a right rather than a fragile blessing." As medicine became increasingly corporate, many patients felt they were entering an alien world of machines and distant technicians. Dans traces the public's alienation and concern about new technologies, as reflected in thrillers such as Coma and Extreme Measures, in which unscrupulous doctors "exploit the unwary for scientific fame or profit."

Dans' collection of essays examines 75 movies (many of which should be familiar to readers), which are grouped into five thematic categories. The first appropriately deals with stories about medical students, or "what it takes to become a doctor." In the early days, Hollywood portrayed the medical student as a person who was sensitive "to the point of weakness" (Of Human Bondage, 1934) or a poor, hardy soul, who earned his tuition by "working in a lumber mill" (Miss Susie Slagle's, 1945). The image evolved into that of "an earnest and likable practical joker" (Doctor in the House, 1954), a character who later metamorphosed into an arrogant and "self-righteous horse's tail" (Gross Anatomy, 1989).

By 1998, the medical student in one film was an antihero who defied the medical establishment (Patch Adams, 1998) while exuding an insufferable self-righteousness. (Dans helped found several migrant worker and community clinics in the 1970s and so is especially annoyed at the film for treating the idea of a "community clinic" as if it had just been discovered.) For its pretentious moralizing, sentimentality, and vulgarity, Dans detests Patch Adams, and chances are the readers will readily agree.

The second thematic category deals with images of good doctors and benevolent institutions. Not surprisingly, the spectacular advances in medicine during the late 19th and all of the 20th century impressed Hollywood, as they did the general public. The canonized medical profession was viewed with hope and optimism for the relief of all of humanity's miseries. Although doctors appeared as egotists, womanizers, and even villains in a minority of these films, until the 1960s they were generally portrayed as kindly, sympathetic healers.

In the 1933 film Doctor Bull, for example, we meet an "old-fashioned family doctor who helps his neighbors postpone their departures [from this world] as long as possible." The protagonist of the 1939 film Meet Dr. Christian is so dedicated that he doesn't even care about money. By the 1990s, however, pragmatism sets in. In Doc Hollywood (1991) we meet the ridiculously competent, if brisk and arrogant, Dr. Ben Stone, played by Michael J. Fox, who in predictable Hollywood fashion turns his back on cosmetic-surgery riches to become a modest small-town doctor.

As in other professions, medicine has its share of bad apples. Drawing on an interesting array of contrasting Hollywood films, Dans explores movies in which arrogant, insensitive, and criminal-minded doctors share the silver screen along with fallen visionaries -- physicians corrupted by fame and greed. These "bad doctor" movies include Kings Row (1942), Sister Kenny (1946), and The Doctor (1991). The dubious honor of being the all-time worst in this category goes to Dead Ringers (1989), starring Jeremy Irons playing twin "doctors from hell" who prey on female patients during gynecological exams.

Despite the gross exaggerations of these films, Dans feels that pushing doctors off their pedestal has been good for both physicians and patients: It has freed doctors from the tyranny of impossible expectations and encouraged patients to take charge of their own healthcare. On the other hand, he writes, the loss of respect for medicine evident in such films bodes ill for the profession -- unless physicians work hard to restore the doctor-patient bond.

Hollywood attacks not only doctors but medical institutions in the second half of the century. In The Hospital (1971), "the blackest of black comedies," and the dramatic One Flew Over the Cuckoo's Nest (1975), we see Hollywood's indictment of ostensibly noble institutions turned evil. While registering the films' cynicism and despair, Dans views them as part of a refreshing wake-up call for reform.

From this reviewer's perspective, the most poignant chapters are those that discuss what he calls "invisible" doctors, such as women and blacks. In "Where are All the Women Doctors?" we see how infrequently women physicians are portrayed in glowing terms or in lead roles. From the demeaning message that women doctors are incompetent in Mary Stevens MD (1933), to the horribly patronizing depiction of female doctors in Girl in White (1952), Hollywood has produced a sad bunch of movies concerning one-half of our population. The worst of the lot, according to Dans, is Woman Doctor (1939), in which an accomplished surgeon ponders abandoning her medical practice to regain her philandering husband. (Mercifully, it has not been released in video.)

Unfortunately, the portrayal of African American doctors has fared little better. Hollywood has tended to give us superhuman black doctors, as if only such persons would deserve our respect and admiration. (There are notable exceptions, such as the film No Way Out (1950) starring Sidney Poitier, who plays a black doctor framed by white racists, and The Heart Is a Lonely Hunter (1968), a stirring adaptation of Carson McCuller's brilliant novel.) But African American doctors in the movies are few and far between. One wishes that Dans had delved deeper into this theme and given us additional insights into its sociological and medical implications.

A delightful appendix offers examples of recurring themes, such as medical students fainting at the sight of cadavers, doctors performing CPR in ambulances, and the perennial romances between male doctors and female nurses. Appendix B provides a filmography, an alphabetical list of facts and figures about the films reviewed.

Of course, the book is not without its minor flaws. After an insightful analysis of each chapter's themes, Dans dwells perhaps too long on the story lines of the movies he reviews. Just as a play-by-play commentary of a baseball game in a book on the history of the game loses relevance as time passes, a scene-by-scene retelling seems less pertinent than the analysis that precedes it. Had Dans cut through dialogues and told us more often why he found certain segments good or bad, it would have made the films more compelling. (Sure, "Say aah" is a cliche, but doctors still make their patients say "aah." The readers want to know what really happens in the world of doctors, in contrast to what they see in movies.) In addition, general readers must be told the meaning of such terms as "epitrochlear node" and "ACTH" -- the book's editor should have clarified such lapses into medical jargon.

These glitches aside, Doctors in the Movies is a valuable contribution to the field of medicine and film -- and it's fun to read as well. Students of medicine will find its ethical and sociological lessons valuable. Film buffs will likely find the dramatic retelling of stories entertaining (who can resist revisiting Dr. Jekyll and Mr. Hyde, M*A*S*H., Dr. Zhivago, Awakenings, and As Good As It Gets?). Meanwhile, the general public can savor it for lighthearted, inspired reading.

-- Dr. Tonse N. K. Raju is a neonatologist and professor of pediatrics, obstetrics, and gynecology at the University of Illinois and is director of the university's neonatal intensive care unit. Dr. Raju writes regularly on medical history for Hippocrates and Lancet, and his fiction has been included in short story anthologies. Dr. Peter Dans is an independent consultant on issues regarding medical ethics, geriatric polypharmacy, and disease management.

First published January 3, 2001
Last updated March 6, 2008
Copyright © 2000 Consumer Health Interactive

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