Television drama and popular film as medical narrative.

The appeal of both television drama and popular film focusing on medical issues appears to be the product of a number of factors. Among these factors may be the anxiety many Americans feel about the overwhelming power of health care professionals and institutions, interest in life and death decision-making, particularly in the hospital setting, and the desire for information about advances in medical treatment and technology. Much attention has been paid within the medical humanities to medical literature, both fiction and autobiographical writing, and its impact on the understanding of illness and the delivery of health care. However, as forms of medical narrative, television drama and popular film are particularly valuable for those in the general public who may be less likely to read books and stories with a medical theme. Television dramas, such as ER and Chicago Hope for example, have value first for the acquisition of information about the delivery of health care in the institutional setting. These series increase familiarity with medical situations, choices, and their consequences that may, in turn, facilitate the kind of "shared power" within the patient-provider relationship recommended by Howard Brody (61-65). Martha Nussbaum has employed a number of Aristotelian concepts to demonstrate the value of literature for moral learning. She believes that literature enhances our "perception," that is, "the ability to discern, acutely and responsively, the salient features of one's particular situation" (37). The "perception of particulars," on this view, takes priority over strict moral rules and principles (38). Nussbaum interprets Aristotle as claiming that "emotion and imagination are essential components of practical knowing and judging" (83). Thus, she argues that certain novels may develop in their readers the "moral attention," or responsive perception of particulars and emotions, as well as the moral imagination essential, according to Aristotle, for practical wisdom (37-43, 125-67). As she explains: Novels, as a genre, direct us to attend to the concrete; they display before us a wealth of richly realized detail, presented as relevant for choice. And yet they speak to us: they ask us to imagine possible relations between our own situations and those of the protagonists, to identify with the characters and/or the situation, thereby perceiving those similarities and differences. (95) These same concepts can be applied to medical drama. Medical drama provides an opportunity for the perception of particulars in terms of choices within the health care context and their consequences for oneself and for others. This form of narrative engages the viewer emotionally as well as cognitively. It develops and exercises moral imagination through identification with the characters portrayed, especially patients and their loved ones who are often forced to act as surrogate decision-makers. Moral learning in this situation is enhanced, as it is in literature, by aesthetic distance. Aesthetic distance combines emotional engagement and the detachment necessary for critical reflection. Nussbaum explains the effect of aesthetic distance in the following way: "A novel, just because it is not our life, places us in a moral position that is favorable for perception and it shows us what it would be like to take up that position in life. We find here love without possessiveness, attention without bias, involvement without panic" (162). Aesthetic distance in response to medical drama allows the viewer to identify emotionally with the characters portrayed and yet retain a detached perspective from which critical evaluation of their choices and actions is possible. Medical series, such as ER and Chicago Hope, portray decisions being made by patients and family members in particularly stressful situations. Viewers can become emotionally engaged with these situations and yet take a critical attitude toward the choices made in terms of their consequences for patients and others. …