I know this may sound judgmental, but here goes. Most medical shows on TV, at least recent ones, are inept, contrived, and far from the reality of what real doctors, nurses, and patients encounter every day. Did I mention they are also boring? “Grey’s Anatomy”? I’ll take a pass. “House”? Couldn’t stand it. Looking back, we can also jettison “Scrubs,” “ER,” “Doogie Howser,” “Trapper John,” and quite a few others.
But hold on. A remarkable show just finished its second season on HBO, and I want to highly commend it to all readers of this blog. The show is “Getting On,” and it examines life in the extended-care wing of a California hospital. The setting seems imprudent, and the show is indeed irreverent and brazen. But it is also painfully honest and richly funny. The main characters are two nurses, Dawn and Didi, and their supervising physician, Dr. Jenna James. A large array of supporting characters also populate the show, including adorable but irascible elderly patients, assorted staff members, and, yes, clueless hospital administrators.
While the show’s producers identify it as a comedy, and it can be very funny, it is more than that. The episodes frequently capture the texture of medical workers’ lives in a nuanced way. Dr. James is embarrassingly unaware of what goes on among the staff she supervises. On one occasion she prattles on to Dawn and Didi about how much she relished her recent expensive vacation, while Didi and Dawn are just trying to figure out how to make ends meet at home. Dr. James can be doctrinaire and authoritarian, barking orders at nurses and medical students alike, but she also can demonstrate flashes of compassion and empathy that reveal something much deeper about why she went into medicine. The nurses do their best to navigate the conflicting and competing demands placed on them by Dr. James, other staff, the patients, families, and the hospital administration. They try to negotiate their way through myriad no-win situations, frequently failing to do so successfully, but always maintaining their humanity.
“Getting On” pokes fun at almost everyone, but a common target is hospital administrators who devise one feckless campaign after another to motivate the hospital staff to perform better. Actually, no one is spared. The show confronts racial, gender, sexual, and language discrimination. Doctors are skewered on a regular basis. With many of the extended-care unit’s patients on hospice, end of life issues are a frequent focus.
“Getting On” will not change anyone’s life nor the way we practice medicine. It misses the mark at times and can be very awkward. Keep in mind the program is not a documentary about working in a hospital, and much of the show stretches reality to near the breaking point. A prime example is that the nurses’ and doctors’ patient loads are absurdly light, allowing them much time to engage in sundry non-clinical activities. No hospital would tolerate such low levels of productivity. But the show touches enough nerves and mocks enough pretensions that it is worth a watch. I do not recall having seen anything like it on television. “MASH” comes the closest, but how can you compare the Korean War to the extended-care wing of a 21st century hospital whose management espouses Lean methodology? If you can find “Getting On” to stream and can avoid taking the show’s barbs personally, I think you will enjoy it. You may not agree with everything you see and hear, but I suspect you will find much that is familiar. At times, painfully so.
Richard Fleming, MD