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The
medical docudrama emerged after the success of fictional medical dramas in the
1990’s and shortly after the medical reality show followed. A docudrama is
considered to be “any narrative film that is based on historical reality that
seeks to re-create an ‘honest’ presentation of past events” (Stephen Lipkin,
2002). Untold Stories of the ER was
one of the first medical docudramas and premiered on TLC on April 12, 2004 and
continues to be filmed today. The television show interviews ER doctors about
their most shocking encounters at the hospital, and intercuts with dramatizations
recreating the event using actors. Following the popularity of this show, a new
series which was reality based called Boston
Med premiered on June 24, 2010. This program was different as it did not
use dramatizations of medical emergencies, but instead followed doctors and
nurses in real emergencies and day to day hospital operations. The purpose of
my paper is to explore the medical docudrama and reality TV, specifically Untold Stories of the ER, and Boston Med and show how the format of these
programs have developed for the audience and explores the social constructs of
ER doctors by using filming techniques, as well as confessionals to portray the
true nature of people in the medical profession.
The way
in which docudramas and reality shows are filmed and formatted sets them apart
from other programs. Silvio Waisbord notes in the article “McTV, Understanding
the Global Popularity of Television Formats” that the audience enjoys the
familiarity of TV, and that recurring themes make the audience more interested
in a program (2013). The creators of Boston
Med and Untold Stories of the ER
appear to agree with this outlook as they both follow traditional reality TV
and documentary formats during production. The camera is used in television
shows such as Boston Med and Untold Stories of the ER in a very
specific manner. Either the camera is in the fly on the wall position, where it
is treated as a ghost in the room who receives front row viewing of a medical
emergency, or the camera is in the position of the doctor, placing it in an
authoritative position. The camera is positioned to watch as a patient is
rushed into the hospital and the doctor is put in charge of treating an often
life threatening injury. This is an example of Direct Cinema, where the
audience is put an observational position by the camera, and is also on the
authoritative side by being placed in the viewpoint of the doctor.
Untold Stories of the ER uses the angle of the camera to signify the position of
the viewer during the dramatization portions of their episodes. The camera
during the recreations which sets up the story for the ER visit is filmed in a
very documentary-style fashion where the camera follows the actors closely as
if they are at the scene with them, when in reality they are on a soundstage.
This is an example of using Direct Cinema, but in a fictional manner which is
very common for the docudrama genre. For example in one episode, a woman and
her friend go hiking in the mountains and the unnamed woman is attacked and has
her face mauled by a mountain lion. The camera can be seen shaking up and down as
the victim is being attacked as if the camera is also being attacked. However,
the camera also works in a traditional fictional television manner where it
takes the position of the victim as the mountain lions jaw encloses around the
face, placing the camera back into a fictionally vulnerable position where the
viewer sees through the eyes of the victim (Fields, 2006).
Untold Stories of the ER differs from Boston
Med because the dramatization of scenarios allows the program an
opportunity to indulge on the scenes of accidents in a fictional manner where Boston Med must work with what is on
film and occur during the time that the camera is present, meaning that anything
that happens prior to the presence of the camera cannot be recreated. In
addition, the producers of Untold Stories
of the ER have the opportunity to take some liberties with the stories they
choose to film. As the victims themselves are generally not invited to appear
on Untold Stories of the ER, the
creators of the show must recreate the scenes of accidents, such as the
mountain lion attack with no real knowledge or assistance except for the second
hand information which is received from the doctors who are interviewed. While
the camera films these scenarios in a documentary style fashion where the
camera shakes and moves around as if the person holding the camera is running
through a forest, there is little, if anything documentary about it. It falls
strictly into a fictional category because the producers of the show do not
contact the victims, thus are unable to verify if their stories are accurate or
not (C. Neufeld, Personal Communication, March 8, 2014). This differs from
typical reality television as the audience is aware that what they are seeing
is a completely fictional dramatization of a traumatic event, thus affecting
the audience in a less emotional manner.
The
filming style on Boston Med is
strictly of the classic reality TV genre. The program relies on the camera
following around the doctors and nurses of Boston General Hospital on a day to
day basis. The show was shot over a four month period, and the most interesting
information was pasted together to create the series. The camera follows the
doctors and nurses through times of trauma and also follows them into the
background of the hospital, further into their personal and professional lives
that a patient wouldn’t normally see. For example, during the first episode of
the series, two resident doctors are sitting in their break room drinking
coffee together and discussing their dating lives (Wrong, 2010a). The camera
sits in between the two doctors and creates a triangle. The camera is
positioned as if to be a party to the conversation. Doris Baltruschat notes
that this form of filming is meant to create a sense of “immediacy and
intimacy” between the camera and the people on film which makes it seem as if
catching people talking as opposed to instructing them to act The camera is
used as an active participant in the show as well as being a “fly on the wall”
(Reality TV Formats: The Case of Canadian Idol, 2013). While their conversation
about dating does not directly relate to the medical field, it is placed in the
program to attempt to break down the socially constructed wall that is
generally placed between doctors and the public.
The
confessionals are also a very important aspect of the development of these
programs and the construction of social realism. The confessionals explore the deeper emotions
of the doctors on the show, which can be both hilarious as well as
heartbreaking. By looking deeper into the emotions of doctors through the
confessionals, the show is giving permission for not only an inside look into
the gory details of working in a hospital but the emotional reactions that
doctors and nurses have in high intensity and emotional situations. In the case
of the confessional the viewer can see that the doctors are not always strong
and knowledgeable, they are occasionally confused, lost and weak. For example,
in the third episode of Boston Med a
doctor breaks down crying when she speaks of a patient that dies (Wrong, 2010b),
the camera appears to capture this vulnerable moment on a whim, when it was
likely intentional. Baltruschat relates that the confessional is meant to make
the audience feel as if they are having an intimate encounter with the
participant (Baltruschat, 2013). This form of filming is what is defined as
Cinema Verite. The camera acts as a catalyst to engage the person speaking and
encourages the person to reveal their true nature.
In another
episode of Boston Med, we see a
resident doctor who speaks in the confessional booth about her dating life, how
her parents had always pressured her to marry someone from India but she has
always been so passionate about her career that dating falls by the wayside
(Wrong, 2010a). While one might question how this is relevant to a show about a
hospital, the show is offering an inside look at women in the medical
profession, and the audience is being
asked to make a judgment to praise her for following her career or condemning
her for being single. This insight creates an emotional connection between the
viewer and the doctor. When the scene switches later in the episode to her
performing surgery on a male who has been stabbed during a fight, the audience
has appreciation for the doctor and what she does because they have heard from
her firsthand what she has given up (a traditional life and marriage) for her
career. The confessional plays an integral part of Boston Med because the show is looking at the social constructs of
the medical profession and how the ideals of society affect a woman’s choice of
career over family.
Untold Stories of the ER uses the process of the confessional in a different
manner. The doctors on Untold Stories of
the ER are not asked to reveal their true characters, but to retell and
recreate with words the event which is being played out for the viewer via
dramatization. These confessions are then used as a voiceover throughout the
episode dramatization. Through this form of confessional the viewer receives an
inside account of a doctors reaction in the face of a medical emergency. In an
episode segment entitled “Cougar Town” a stoic doctor discusses how a drunken
woman enters the hospital with a face pouring with blood due to falling on a
curb. The doctor uses the confessional to chastise the woman’s sordid, drunken
behaviour and assert his dominance as a doctor through his retelling of the
story. He ridicules the woman’s antics and reveals an unsavoury side of his
character by doing so, something that he would not have been able to do at the
time of the accident (Bradshaw, 2014). The doctor’s confessional intertwines
with the dramatization which creates a back and forth narrative between the
doctor of the present, and the medical emergency of the past.
The
confessional in Untold Stories of the ER
is also used as the framework for the dramatization and therefore is the most
important part of the show, as the doctor speaks, the program cuts away to the
dramatization to prove a point and then recreates his account of the medical
emergency (C. Neufeld, 2014). For example, in the episode with the drunken
woman the doctor states that she and her friends came in “laughing like hens”
(Bradshaw 2014), the program then cuts to the dramatization of three
forty-something women in short, bloody dresses stumbling through the hallways
of the hospital. The combination of the confession and the dramatization is
satisfying as it takes a mundane scenario of interviewing a mundane and cocky doctor,
and makes it interesting and humorous with the dramatization. On the opposite
side of this, the interview gives legitimacy to the dramatization as the doctor
is confessing this outlandish story to the camera. In addition, the article “Factual
Entertainment and Reality TV” notes that by mixing the genres of fiction and
documentary, a wider and more diverse audience will likely be reached and
therefore the show is more likely to be successful. The balance between the
confession and the dramatization is essential to ensuring that the series is well
rounded (Beck & Aeschbacher, 2012).
Caroline
Neufeld is a writer on Untold Stories of
the ER, and notes that the gender, age, race and sex of the people who are
seen on the show are regularly changed so as to make the person indiscernible
or more interesting to the story. A 40 year old 350lbs white man may become a
20 year old, 100lbs, African-America female during the recreation of an episode
to hide identity of the real person who was involved in the medical emergency.
The outcome of a procedure may also be changed to create a conclusion. In one
episode of Untold Stories of the ER,
a little girl is admitted to the ER with thousands of splinters and cactus
needles all over her body after falling down an embankment (Fields, 2006). The
camera is positioned from the inside of the hospital to see through the eyes of
the doctor from the moment that the patient enters the facility and throughout
the procedure. The dramatizations of the situation are filmed to look as if the
medical emergency is really happening, and while the viewer can appreciate that
the child on the camera is not really in any pain, the producers of the show
are essentially using the child’s suffering to make an entertaining television
show, when this patient may never have been a child at all. The decision to
switch the complete profile of people is not only to protect the identity of a
person, but to change the way that the situation is perceived. A female child
falling down an embankment is more emotionally taxing than an adult man. The
program takes a real situation and attributes all the effects of the fictional
narrative format by making it as dramatic as possible. The audience also
receives a greater amount of satisfaction when the story resolves and the
little girl is okay. True to a fictionalized format, there is a happy ending in
which the little girl leaves the hospital happy and healthy.
The
program Boston Med closely follows a
soap opera format that could come straight out of a fictional program. The Beck
and Aeschbacher article notes that reality TV programs have a higher success
rate when they use a similar format to traditional programming (2012). In Boston Med the music swells in the
opening credits and a view of the city landscape of Boston is seen. At this
point the narrator begins to speak about the different medical centers in
Boston and the people who work in them, before focusing in on Massachusetts
General Hospital. The audience is treated to uplifting music in the background
as we are introduced to the cast of characters. The camera pans around and we
see a doctor asking out a nurse, babies being born, and a fight breaking out –
essentially all the entertaining pieces to be enjoyed in a fictional drama can
be found in Boston Med, and with the
bonus that it’s “real”.
Boston Med,
in documentary style opens following a surgeon on his morning rounds as he
greets two transplant candidate patients and their families. Through interviews
with the patients and the family, the show tells the story of how the patients
come to be in the centre receiving transplants, giving a heartwarming feel to
the episode. The cameras also follow the doctors into surgery, which gives the
episode its climax. At the end of the episode the patients go into surgery,
receive their transplants and come out healthy and begin their recovery, which
gives way the denouement of the episode. The doctor in the episode is
exceptionally modest about his life saving surgical ability and the patients
praise him profusely. The program works to place the doctor in the social
position of hero and saviour. This is similar to a fictionalized drama where
the doctors are charming and all knowing. The conclusion of the program neatly
wraps up the story in the episode and gives a full conclusion to the happenings
on Boston Med. This further proves
the notion that the program uses a medical drama formula, and attributes it to
reality television.
The
docudrama has become a large part of modern television. Merging the traditional
aspects of the reality TV show and prime time medical drama these two programs
have developed a format which is attractive largely because of how camera work
such as Cinema Verite and Direct cinema are used to position the audience. Untold Stories of the ER uses Cinema
Verite through the camera and the confessional to create a setting for their
episode and to develop the story being told on the screen. Boston Med uses Direct Cinema filming techniques as well as the use
of the confessional to glimpse at the social nature of ER doctors. In addition,
Boston Med follows the same format of
a primetime soap opera and allows the program to provide depth and give the
viewer an insight to the real life of hospital workers in the USA. Whether the
show is based on reality, or whether it is based mainly on dramatizations, both
programs follow a format which creates television that blends reality and
fiction, and paints a glorious and dramatic life of ER doctors and nurses.
References
Baltruschat, D. (2013).
Reality TV Formats: The Case of Canadian Idol. The Television Reader (pp. 185-199). Toronto: Oxford University Press.
Beck, D., Hellmueller, L.
C., & Aeschbacher, N. (2012). Factual Entertainment and Reality TV. Communication Research Trends, 31(2),
4-27.
Bradshaw, L.
(Writer), & Benz, P. (Director). (January 4, 2014). Creepy Crawlies [8] Untold Stories of the ER. Vancouver,
British Columbia: GRB Productions.
Fields, T. et al.
(Writer), & Benz, P. (Director). (June 27, 2006). Mountain Lion Attack [4] Untold Stories of the ER. Vancouver,
British Columbia: GRB Productions.
Goodman, M. (2006). Real
Emotional Logic: Film and Television Docudrama as Persuasive Practice. Journal
of Film & Video, 58(1/2), 112-113.
Neufeld, Caroline. Interview
by author. Personal interview. Vancouver, BC, March 8, 2014.
Waisbord, S. (2013).
McTV: Understanding the Global Popularity of Television Formats. The Television Reader (pp. 367-383).
Toronto: Oxford University Press.
Wrong, T. (Writer),
& Bednar, R. (Executive Producer). (June 24, 2010). Episode #1.1 [1] Boston Med. Boston, Massachusetts: ABC
News.
Wrong, T. (Writer),
& Bednar, R. (Executive Producer). (July 8, 2010). Episode #1.3 [1] Boston Med. Boston, Massachusetts: ABC
News.
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