Why we love medical drama

The patient is hurriedly wheeled into a room washed with fluorescent light. A flurry of clinicians attach leads and sensors to his naked body. A bloody, open wound spills out onto the polished linoleum floor.

Doctor King: “Sir, can you feel me touching you? Can you wiggle your fingers?”

Patient, squirming: “Y-yeah!”

Doctor King” “Good radial pulse!”

Doctor McKay: “E-FAST is negative” 

Doctor Robby: “Okay, what’s next Doctor McKay?”

Doctor McKay: “Ancef and gentamicin. Sedate for traction, countertraction…”

Doctor Garcia, interjecting: “And he needs a CT angiogram to rule out vascular injury!”.

A typical scene in HBO’s break out show The Pitt set in a busy Pittsburgh trauma centre and led by the ruggedly handsome senior attending physician Doctor Michel “Robby” Rabinovitch, played by Noah Wyle of ER fame. The medical drama is now entering into its second season, and looks set to continue the success of many of the medical shows which preceded it from Grey’s Anatomy to House. 

It is no shock that hospitals are appealing locations for serialised entertainment. The fast pace of emergency interventions and the high stakes of life or death decisions make the possible plot trajectories virtually limitless. Throw in a measure of interpersonal conflict amongst beautiful, young, tortured physicians and you have the perfect narrative fodder for a long-running series.

But ripe situations for compelling storytelling are only part of the explanation of the appeal of serialised medical drama. Something a little abstract and a little strange is also fuelling our attraction to clinical theatrics: a touch of the erotic.

Narrative accounts explain why this genre works, not why it thrills. “Erotic” in this context isn’t sexual arousal (although the sexy nurse trope is no accident) but the ways in which clinical iconography and relations of care provoke bodily intensities and affects that draw the viewer in.

This deeper pull can be glimpsed in other popular clinical themed oddities, from popular YouTube videos simulating patient care to the allure of medical-themed attractions such as the infamous Body Worlds exhibition.

Certain professions lend themselves well to an erotic frisson. Following the daily life of a police officer, a lawyer, or a doctor reliably garners an audience, while any attempt to serialise the life of a scientist, social worker, or plumber would likely fall flat.

Spectacle has been built into the medical profession for centuries. Long before the modern operating theatre, medical interventions were staged events for onlookers, as in the late medieval anatomy lessons at Bologna, where dead bodies were opened before assembled scholars. Early anatomical illustrators, in their attempt to systematise anatomy, also produced sublime and striking depictions of the flesh unveiled. Bodies were flayed, opened and posed with an aesthetic eye, their grisly interiors arranged for maximum legibility.

By the late eighteenth and early nineteenth centuries, particularly in the Paris hospitals of the French Revolution, diagnosis became grounded in mass observation. Michel Foucault would later chart this change in The Birth of the Clinic, where he described modern medicine as an epistemology of visibility — a system in which truth is produced by compelling the body to disclose itself. “The purity of the gaze provides unmediated access”, he wrote. 

The camera loves the medical gaze because the medical gaze is already cinematic. It promises the “big reveal” by treating the patient’s body as a crime scene filled with latent evidence. The audience is permitted to play the role of diagnostician, forensically examining the passive convalescent. 

The relations between doctor and patient — like many relationships of care — take on an almost sadomasochistic interplay: one party strips, examines, restrains, penetrates and hurts the other, all for their own good. 

In the latest episode of The Pitt, Dr Robby treats the burn wound of an elderly Jewish woman, after the noise from fireworks causes her to drop her samovar. He carefully inspects and picks debris from her wound, which she uncovers only for him. Her disclosure then becomes emotional, confessing to witnessing the aftermath of the 2018 Pittsburgh Tree of Life synagogue shooting, the cause of her flightiness (the show has a habit of awkwardly cramming in social commentary).  

Fans of medical drama can spectate and identify as either side of this power dynamic, whether as the ultra-competent practitioner with an implausibly encyclopaedic knowledge of illness and cure, or as a confused and despairing patient.

Surprisingly, in visual media, the greatest pleasures are often found in identifying with the passive recipient. Carol J Clover author of Men, Women and Chain Saws noted this in her analysis of fans of slasher films, where thrill seeking teenage boys play against type by rooting for the final girl over the vicious killer. 

In hospital dramas, most audiences are as bewildered by the rapidly spouted medical jargon and confusing beeping machines as the patients. As such, their fantasy becomes one of being the receiver of care from the handsome doctor. The phenomenon of ASMR, an oddly pleasant sensation brought about by soft voices, deliberate movements and simulated personal attention captures the distinct pleasures of being on the receiving end of treatment.  

Researchers have explained the sensation — often described as “brain tingles” —  as a form of self-calming linked to experiences of intimacy, including the receiving of medical care.   

Such morbid imagery has always fascinated human beings

The final ingredient in this erotic mix which makes medical narratives so compelling is the sheer delight of gory imagery. Medical shows, particularly those in adult oriented time slots, don’t hold back in showing every visceral aspect of trauma and disease. Ruptured organs, necrotic limbs and blood spurts dance across the screen, the threat of death looming over every scene.

Such morbid imagery has always fascinated human beings from the torn off limbs in Roman amphitheatres to the haunted gallows across Europe. If there’s bodily disfigurement and dismemberment, you can always expect a crowd. 

Julia Kristeva captures this odd fascination both horrific and alluring, in her concept of “abjection”. Abjection is everything which disturbs the borders between the inside and outside. When it comes to medical dramas it is the surgical slice, the needle puncture, every leaking orifice or arc of vomitus. For Kristeva, the abject provokes an array of negative emotions: disgust, anxiety, horror, but also occasionally certain pleasures.

Medical contexts can often tame our revulsion to graphic imagery because of the “whodunnit” aspect of diagnosis. Every abject object whether blood, faeces or urine — can be transformed from smelly, vile expulsion to a promising clue. In this case, the abject fascinates more than it repels.

The human body, with its ooziness and gassiness, is also an underappreciated source of abject humour. A running gag in the first season of The Pitt involved a hapless medical student named Whittaker repeatedly being splattered with bodily fluids and having to constantly change scrubs. 

In interviews for the show’s second season, The Pitt cast have been quick to sell its unflinching realism. “[T]here’s no artifice on this show” Noah Whyle assured the New York Times. “It is a naked representation of what is, supposedly, reality”.  However this raw realism is hardly unmediated. The medical drama, even when constructed with an eye for detail, is always rich for projection. 

Audiences don’t tune in for faithful depictions of clinical protocols but for psychically charged intimacy combined with visceral imagery. Such erotic intensity requires such an intricate spectacle of vulnerability and carnality, the kind only the good doctor can prescribe.