Together with police procedural shows, medical drama is one of the most popular genres in television. It seems that we just can’t get enough of doctors and nurses, life-saving surgery, obscure illnesses and stroke-of-genius diagnosis. Check out the Twitter trend topics on any given Tuesday or Saturday nights in the UK, and the chances are that the hashtags #Casualty and #Holby will be trending. And yet, should you admit to watching either of those shows, you are risking derision. You might get away with Holby City, but Casualty is generally considered, well… naff! It’s the kind of programme that your Aunt or Grandmother would watch on a Saturday night, while you are on a date with a box-set of The Wire. Casualty is not a show to be discussed over a drink with your mates in Hoxton. It’s a bit of a dirty secret.
As a long-standing fan of both shows, I am now ready to admit that even I am beginning to suffer from viewer fatigue. I have been growing tired of Casualty for a while; the big disaster-led storylines that I used to like, the train wrecks, the collapsing building sites, house fires and other assorted horrors are now a rare occurrence, and have largely been replaced by character-led plotlines and the occasionally recurring patient. What we have now is a show that is not quite a soap-opera and not quite the ‘gritty medical drama’ that the BBC thinks it is still producing. Instead, Casualty and, to a lesser extent, Holby, now rely on a formula which can be summed up as follows:
1. Main Character Story 2. Medical crisis 3. Patient Parable 4. Underlying Threat
In other words 1. Character ‘A’ gets has the majority of dialogue dedicated to them as his/her own personal dilemma or moral crisis is outlined. 2. A patient is wheeled in and uncannily, this patient’s situation mirrors Character A’s own conundrum. Eventually, Character A sees that there is a lesson to be learnt – often by the ham-fisted device of 3. A neat little lecture given to him/her by the aforementioned patient – I call this the ‘Patient’s Parable’
Running through the entire episode, there is also always the spectre of 4. An Underlying Threat. In Casualty, it used to be the *insert thunder here* THE CLOSURE OF THE EMERGENCY DEPARTMENT!! Over at Holby, it was A MERGER WITH ST JAMES’!! At the moment, the leitmotiv is, of course, The Cuts. Every single episode will devote at least a few lines to budgetary cuts and possibly feature the appearance of unspecified heartless, soulless Important People ; ‘The Trustees’, ‘The Board’, a Sir or Lord Something. These people are portrayed as either complete corporate puppets or cold, callous Dragon Den types who don’t give a damn about medicine.
The problem with this structure is that on one hand, the Patient’s Parable™ is clearly contrived and unlikely, but on the other hand, the Underlying Threat is a plausible presence, especially considering the chronic funding shortage faced by the NHS and the current Government’s cuts to, well, everything.
It’s as if these shows, particularly Casualty, are written by two headed Hydra with one head wanting to write panto and the other an episode of Panorama. The panto guy writes all the patients’ stuff; have you noticed how two-dimensional the patients’ characters are?! Screeching old Harpies, bumbling buffoons, bossy former nurses with Nazi tendencies, oh and how about the Three Blonde Bimbos (a mother and two daughters) who promised Chrissie a manicure in one scene and threatened her with a lawsuit in the next? Then, out comes Panorama guy with his part of the script which sends a shiver down your spine. Nurses lose their jobs, wards are closed, and at least one character will utter the line “You are putting patients’ lives at risk!”. If done well, a mix of light comedy and serious themes make the ideal TV show, but to achieve this balance the comedy has to be subtle, the characters believable; the threat must, at some point be resolved. None of this happens in the Holby/Casualty world.
The result is a product that is both confusing and depressing; Confusing because the narrative is being constantly shifted between farcical and pseudo-gritty. Depressing because, quite frankly, we all know that the NHS is constantly under threat and we don’t really need to be reminded that all the time and besides, this is supposed to be about some medical stuff, right?
It’s not that viewers don’t like gritty, or challenging. The success of shows like The Wire, The Shield or the lesser-know SouthLAnd prove that we are not all placid sheep wanting to be fed the latest gossip from The Kardashians.
Medical drama though, is a rather different kind of beast. It has almost universal appeal because health problems and illness are an inevitable part of life all over the world. Hypochondriacs relish the endless revolving carousel of possible conditions and ailments and feel empowered by the scattering of random medical knowledge they acquire. Uniform fetishists will ogle the nurses uniforms, or the surgical scrubs (in my case, it’s the scrubs. Always the scrubs). There is little time left in the narrative to really construct a credible social commentary when a patient is bleeding out on trolley with a piece of metal stuck through their chest. This is why, in the US hit show House, realism is firmly left outside the theatre door. Medicaid and ObamaCare are shunted aside whilst a team of astonishingly good looking doctors shout random names of diseases at each other in between searching their patients’ homes for clues.
It’s unrealistic to expect our licence fee funded BBC to compete with the likes of Fox, but neither should we accept lazy writing, and the kind of hackneyed storylines that a first-year Media Studies student could write with the help of Scriptwriting for Dummies. And let’s not mention the in-house script recycling between shows, of which the most recent example is The Reformed Paedophile who wants to be chemically castrated. This as a storyline has only just been brought to conclusion in Casualty, yet already, airing only a few days later, has been re-hashed and adapted ‘upstairs’ in Holby. Could this be because of the cuts, too?
As viewers as well as fans of the medical drama genre, we can’t just sit there and catatonically lap this up. The weekly mass commenting that goes on under the #Holby hashtag proves that these shows’ most loyal fans are also the most critical. And so we should be! We should demand more medicine and less politics. More gore and less ideology. More pneumathorax and less pantomime. And more hot young doctors in scrubs, to make us dream.
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