Category Archives: medical drama

values and truths, or my chief complaint is oppression

So it all started when I got obsessed with Grey’s Anatomy.    I don’t watch that much TV, but when I do, I can get wrapped up in melodramatic plot lines like the way a cat can get into a ball of yarn.  There are some really smart critiques of it out there already, but what about  the ways that doctors depicted on TV shape how we relate to our own healthcare? As a health worker committed to untangling the lines, lessons, wisdoms, and scars we all carry in our bodies, as well as deciphering the impacts of trauma and oppression on individual and collective illness/wellness, this latest incarnation of The Heroic Doctor Show fascinated me.

Pop culture is a collective story.   It not only reflects dominant culture, but shapes it by embedding its stories, myths, and tales in our individual and collective heads.  Humans love stories, we are social, we like to tell each other what our days were like, we like to share words and names.   We tell each other stories as the basis of interaction, communication, figuring things out together, and just knowing what’s up in each other’s lives.  Stories are a foundation of community and of our selves.  We tell stories in order to understand our experiences.  The telling of stories is a way we actively make sense of our worlds.

The way stories spin out of television is obviously different than the way they come to us out of the mouths of our friends, families, communities.  We don’t get to talk back in any kind of meaningful way.  Sure, we can and do yell at our screens, but… Pop culture presents its stories as definitive: as normal, natural, trumping all of our individual experiences.  It tells us what our world is like, as opposed to asking us how we experience it.  It is the difference between speaking WITH and being spoken TO.  It is the difference between a conversation and a performance of which we are always and only the audience.  So the stories that the racist, sexist, heteronormative, classist, ableist media industry decides are worthy are portrayed on television.  The rest of our stories are invisible.

And we believe it—contrary to everything most of us experience daily, we believe what television tells us: that people can pull themselves up by their bootstraps, that being fat is about a disgusting lack of self-control, that young men of color are just waiting to kill all of us, including those of us who are young men of color ourselves.  Television’s insidious ability to wrap itself around our subconscious and deeply affect how we think is well-known: it is the basis for advertising.  Mainstream media is one of the primary tools that embeds white supremacy, heteropatriarchy, ableism, and capitalism into the cores of us.  It is a huge part of normalizing such an unjust system as the one we live, making invisible the privilege some of us receive at the expense of others, permitting the violence around us to go on.  It tells us which stories are true and which are not, or at least not worth paying attention to.   All of this shapes us, and therefore, the stories we tell about ourselves and each other.

So it’s a small leap to realize that the way hospitals, doctors, and the healthcare industry are depicted on television shapes how we interact with and perceive them.  Meaning medical dramas on TV affect how we think of our own bodies, capacities for healing, what we need in order to get well.  They shape our understandings of ourselves as people who interact with healthcare, creating  a world in which healthcare is done TO us, in which we receive it, in which we passively wait for doctors to cure us, to fix us, in which we give up our own intrinsic wholeness.     Grey’s Anatomy and other shows teach us to value a mainstream medicine that is high-intervention—meaning surgery, elaborate technology over wellness care, prevention, holistic medicines.

When I started watching Grey’s Anatomy, I started thinking about all the ways that we get information and form ourselves, our relationships to our own bodies and the bodies of others, our relationships to healing, to the healthcare system, to those we turn to for advice or authority or expertise or support, or some confusing combination of all those things.   Television is just one way, but it’s big.  We watch these shows, the many medical dramas around us, and we think, oh, it’s a little glamorous.  Patients are objects.  Doctors are just having hot sex and romantic escapades with each other all the time.  They are so sympathetic and sweet and well-intentioned.  We ask dumb questions.   We are moments that are either dull or life-changing in their stories.  The center of the healthcare experience is the doctor, the doctor, the doctor.  It’s not just that doctors star in the world of medical dramas: they star in real, live healthcare as well.

When I worked as a medical assistant at a community clinic, the paperwork I filled out every day included a space for writing the “chief complaint” of whoever was seeking medical care with us.  This terminology is commonly used in medical settings in the United States.    Complaint implies not fact, untruth, something that is subjective.   Everything I wrote down from the “patient’s” perspective was qualified with “patient states…”  Everything that was written by a doctor or nurse practitioner, even a medical assistant or nurse (lower on the hierarchy of knowledge) was stated as fact, as if it were objectively known, indisputable.  This most basic, taken-for-granted word choice matters.  It implicitly sets up a framework in which some people’s stories are more valuable/valued than others.  Some realities are just more real.

This plays out in concrete ways that affect our health and well-being, historically and currently.  Health disparities exist for many different reasons, but evidence and experience tells us that doctors don’t listen to most of us, in large part because of power and privilege differences.    Research has shown over and over again that doctors treat different clients differently based on perceptions and experiences of privilege and oppression. Doctors spend less time with, prescribe life-saving treatments less often, answer fewer questions from, and communicate differently with patients from marginalized communities. (In this link, check out especially the study called  “Physician communication style may depend on characteristics of breast cancer patients”.)

Most of us also know this from shitty doctor’s office experiences, when we haven’t been believed or listened to, when our knowledge of our own bodies has been questioned, when we have been talked down to, when no one has even taken the time to explain to us what is going on, when we have been subjected to things to which we did not consent.  Those of us who do not fit society’s ideal of the perfect body (white, straight, cis, male, rich, able-bodied, etc.) receive different care, different diagnoses, different treatments.  Our “complaints” more often go unheard because they are treated as just that, complaints.  Medicine is not objective: doctors exist in this racist, sexist, classist, homophobic, and ableist society just like the rest of us.  Their enactment of oppression and ignoring of our stories when we turn to them for care has killed and harmed marginalized communities and individuals for centuries.   The medical industry is just one more system that works violence, oppression, and trauma against our communities.

As a white person, I have been taught that I can trust doctors/the healthcare industry, but as a fat person, I avoid going to the doctor because of the ways I know serious things will be attributed to my weight as opposed to what’s really going.  A podiatrist wouldn’t treat me for a disabling foot problem unless I returned twenty pounds lighter.  One time I got a letter from my doctor’s office (ahem, Kaiser) saying that I had all the symptoms of Metabolic Syndrome, a precursor to Type 2 Diabetes.  The symptom set includes elevated blood cholesterol levels, blood pressure, and blood sugar levels.  I checked the numbers and saw that both my blood cholesterol and blood pressure were well within the normal limits, low even.  Because of my weight, I got sent a form letter claiming that I had a serious health condition that I didn’t actually have.  These are pretty small examples, compared to legacies and current practices of misdiagnosing, experimenting on, and denying people treatment in really severe and fatal ways, but it proves the same point.  Doctors have been actively taught to not listen to us: our stories have no value as compared with their interpretation of lab numbers, our appearance, what they expect our problems to be based on assumptions and stereotypes manufactured by oppressive systems.  It’s one of the problems with evidence-based medicine, but that’s another post.

This extends to our collective experiences too: the healthcare industry is not accountable to us and our health needs.  Controlled by corporate/pharmaceutical funding, when was the last time a hospital asked the people living around it what they most needed before constructing a new wing or starting some new research?  Someone, tell me please, if you can see any concrete ways in which the mainstream healthcare industry tries to be responsible to the communities it supposedly serves.

There is a new movement in mainstream medicine that has to do with listening more.  I remember an old co-worker telling me that she chose which med school she was going to because they had started having classes in which they teach doctors to listen to their patients.  How novel.  Narrative medicine is the academic discipline related to valuing the stories that patients bring with them into the doctor’s office as real and true and worth listening to.  Sure, that is all great and should be encouraged, but I think it still misses the point.  Even on Grey’s Anatomy they have a lot of conversations about listening to patients, some lip service to valuing our experiences and feelings.   Truly listening, hearing, and respecting stories includes owning up to the ways you have and continue to mess up.  It’s not enough to just start listening today, without unpacking the ways in which your personal experiences of privilege make you literally unable to hear what other people are saying and while still not being accountable to the trauma, violence, and oppression that the mainstream healthcare system has done.  What about the forced sterilization of women of color throughout the U.S. and led by the U.S. around the globe?  What about the invention of the speculum through violent, unconsensual experimentation on women in slavery?  What would it look like for doctors/healthcare providers to be accountable to oppression and violence that has been literally enacted by their own hands?

I want it all.  I want healthcare that meets our needs and I want us to create our own autonomous systems of healing.  Part of health/healing justice looks like those who provide healthcare actually listening to and respecting all of us.  There is no way to actually hear us without being committed to developing a healthcare that is actively struggling against racism, sexism, ableism, transphobia, classism, and homophobia.  When we take for granted the framework and language of mainstream healthcare and the oppressive systems intertwined with it, there is no way that we can hear what is really being said or work towards creating safer spaces where we want to start sharing our stories in the first place.

Part of health/healing justice also looks like us learning to trust and value our own stories and experiences, the wisdom in our bodies and minds.  It looks like sharing our truths and listening to others as a way of healing, living more deeply in our bodies, being able to trace the outlines of our own scars.  As the brilliant Adrienne Maree Brown writes,

“in my experience the best storytelling is the best organizing…it’s rooted in a truth people have experienced, has some magic in it and something to long for, and a moment of beauty. but it is co-created as it is lived, no one can see the end of it. that allows people to stay in the present moment, and attend to the work before them with intention, seeing the story unfold with themselves in it, rather than directed, with themselves just outside the frame.

I see truth and magic and beauty in the many medicines we can and do and will create, medicines that are by and for us and our communities, that challenge oppression wherever it exists, that allow us space to truly heal from our trauma and our grief, that support us in building ourselves up, that unfold with our stories, with our lives.

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Filed under accountability, chief complaint, greys anatomy, healing justice, health justice, medical drama, medical psychiatric industrial complex, pop culture, story telling