The medical diegesis is used across genres from comedy to crime, from sitcom to soap opera. The events that the characters are caught up in are always punctuated by how medical activities impact upon them, and their moral worth is measured by how they respond. The private life of the medic is a facet of this diegesis.
Filmmakers' Treatment of the Medical Diegesis
Film productions featuring male doctors have occurred since the early days of cinema, probably a hundred produced by Hollywood before the world war two dip in interest. During that war Harlequin bought into general publishers, Mills and Boon, because they were doing good business selling 'Doctor-Nurse' romance novels featuring injured war heroes, a trope that carried over into war movies.
The professional medical world as diegesis was influenced by the 1930s success on both sides of the Atlantic of A.J. Cronin's novels and short stories, which gave rise to films, e.g. King Vidor's The Citadel (1938), radio series, and the highly successful TV series, Dr Finlay's Casebook (1962-1971). This is the doctor hero as part of the community, a doctor with a social conscience.
Post-war, nursing as a career featured in a definable group of films explicating how the new (UK) National Health Service worked, such as White Corridors (1951) No Time for Tears (1957) and the comedy, Carry On Nurse (1958). The hospital itself forms a useful diegesis, where the audience recognise a range of visual signifiers allowing the filmmaker scope to develop the drama. These films often draw on narrative tropes from the melodrama as well as social realism, and seem to warn against the 'dangers' of romance.
Medical Fictions in Film and TV Format
This diegesis functions through a powerful iconography focusing on the doctor in a white coat and, until the 1990s, the glamour of the nurse's uniform hat, frock and cape. The homely diegesis of the country doctor's office becomes swept away by the images of progress enshrined in the modern multi-storey hospital building and sterile stainless steel implements. Medical screen fictions mainly stem from print fictions and fall into a range of forms and sub-genres:
- Medical comedies: Dr In the House 1950s series of movies based on novels, that were parodies of the hierarchies of hospital life, and M.A.S.H. (novel 1968, movie 1970, TV series 1972-1983) which pave the way for medical sitcoms such as Scrubs (2001-2010).
- TV drama series: initially set in small communities, like Peak Practice (1993-2002), slice of life stories against a paternalistic medical background. The large city hospital melodrama, e.g. BBC's prime time Casualty, running since 1986, uses the accident and emergency room diegesis, while its spin-off is the surgical ward based, Holby City (1999-). Michael Crichton/Stephen Spielberg's ER (1994-2009) gained a global audience.
- Soap Operas: for example, America's longest running soap General Hospital (1963-) and the British Emergency Ward –10 (1957-1967).
- Med-tech thrillers: emerge as science develops rapidly and takes on, or bestows on medics, godlike powers, problematised as medical care becomes commodified. Robin Cook, Coma (novel 1977, movie 1978) and Michael Crichton, Andromeda Strain (novel 1969, movie 1971, TV miniseries 2008), both practising physicians, produce science fictions within the medical diegesis that explore the potential for corruption and crime in modern technical environments.
Discourses within this diegesis are of scientific and social progress, with critiques of power and responsibility; these are also workplace narratives for an educated audience offering a critique of the real world and its expectations of moral and competent judgments from professionals. Gendered relationships, dilemmas of sexuality, desire are powerful themes explored within it.
New evolving versions demonstrate post-modern approaches, such as the House, M.D. TV series (2004-), which plays with hospital tropes in posing the (sick) doctor as health detective, and the stylistically chick-lit and melodrama related, Grey's Anatomy TV series(2005-), that nevertheless serves the critical functions of its predecessors. The medical diegesis proves useful across a range of narrative categories or genres, drawing on audience knowledge of its tropes and contexts as a satisfying mode of storytelling.
The number of mainstream movies focusing on the experience of disease and treatment, movies that explore how disease impacts on individual lives, have proliferated at a great rate and deserve detailed consideration elsewhere, since they are not always dependent on the medical diegesis and its discourses.
Sources:
Feuer, J. (2009) 'Spinning Off, Crossing Over Grey's Anatomy/Private Practice' at Flow TV Pittsburg University, accessed 23 June 2010
Moody, N. & J. Hallam (1998) Medical Fictions Liverpool John Moores University & Association for Research in Popular Fictions
You may also wish to read these related Film School articles: Understand Key Terminology in Screen Narrative Analysis: Diegesis and Understanding Screen Audiences: Uses and Gratifications of Genre
Valerie Williamson - Dr. Val Williamson is a freelance journalist and academic specialising in historical and popular culture topics.
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