Reality TV and the Docudrama

 

 

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.