Us and Them
Towards the end of MDs’ pilot, the managers of the Mission General Hospital look down from their second-floor office to the hospital lobby swarming with patients—residents of San Francisco’s impoverished and racially diverse Mission District. “It’s us versus them,” proclaims assistant administrator Frank Coones (Robert Joy). MDs depicts the “war” between HMOs and sick American citizens in a loose remake of M.A.S.H., the popular 1970s show about Korean war medics, originally received as an anti-Vietnam-war satire. Unfortunately, while the two MDs modeled on Pierce and McIntyre lovingly call their hospital “the Mish” and claim to help those exploited by HMOs, the show mostly focuses on wealthy white doctors and administrators. With the class and race implications of managed health care left out, MDs’ comedic rebellion against the authority of the health care industry fails to hit its target.
The central participants on both sides of the HMO war on patients, in specific, are white upper-level hospital employees. On the “good” side are two funny, skilled, and irreverent doctors who ignore hospital rules and treat uninsured patients. Head of cardio-thoracic surgery Bruce Kellerman (William Fichtner) hasn’t shown up to a staff meeting in five years. The new trauma doctor Robert Dalgety (John Hannah) comes straight from Bosnia, steeped in the “Macedonian procedure,” i.e. examining patients for free without the knowledge of hospital administration. The two meet when Kellerman, Dalgety, and an intern, Dr. Maggie Yang (Michaela Conlin) perform a biopsy on an uninsured patient as an “autopsy”—they operate in the morgue and then declare the “dead” patient miraculously alive. On the “bad” side, the doctors battle against heartless greedy managers Frank Coones and Nurse Poole (Jane Lynch). So, the MDs’ escapades and bureaucratic squabbles with administrators take up most of the airtime, leaving little time for the uninsured patients and representation of the actual damage inflicted on them by HMOs.
Just as the audience is about to be convinced that HMOs are evil, the docs encounter an unlikely ally—the new “good” hospital administrator Shelly Pangborn (Leslie Stefanson). Pangborn is there to demonstrate that, if managed properly, a hospital bent on profit-making can treat patients with proper care—exactly the claim the show purports to ridicule. A former amusement park manager, she faints at the sight of blood but boldly defends the renegade doctors to her boss because she feels their work in expensive heart and trauma surgery might bring profit to the hospital. Pangborn is shown as smart, compassionate, and sexually liberated to boot—she visits doctors in the shower to update them about staff meetings and doesn’t mind that the photos of her flashing the theme park camera are posted all over the hospital. With such a liberal-minded boss, Kellerman and Dalgety no longer fight the actually existing corrupt HMO system, but only the few cartoonishly backward administrators, soon be replaced (the show implies) by the likes of Pangborn.
In their other relationships with the hospital staff and patients, the two MDs rarely step out of their role of wise, benevolent, and racist mentors. Kellerman demonstrates to a black attending physician, Dr. Quinn Joyner (Aunjanue Ellis), that his surgeon’s instinct can see medical problems better than her sophisticated technology. Kellerman and Dalgety inspire Maggie Yang to break hospital rules for the good of the patients, but in the meantime can’t figure out whether she is Chinese or Korean. Dalgety has sex in closets with a Latina cleaning woman but refuses to have an actual conversation with her. Only after the snooping Coones accuses him of sexual harassment does Dalgety manage to declare his “feelings” and ask her to dinner. And the patients mostly serve as props for the doctor’s rule-bending stunts. While Kellerman and Dalgety try hard to empathize with their ailing wards, they clearly understand the administrators much better than the people they are supposed to help.
MDs thus preserves M.A.S.H.‘s celebration of good doctors helping the weak, but can’t reproduce its social and political urgency because it refuses to acknowledge the disastrous state of the American health management industry. As Sigmund Freud and anthropologists of humor tell us, a joke is funny when it instantly invokes to the audience the two sides of a power relationship it seeks to undermine. But the show really presents no “us” and “them,” only the united front of privileged white people. Given that MDs of MDs are unsure where and how to direct their criticism, viewers are likely to agree with Coones, who remarks, upon learning that a TV crew would be filming in the General Mission hospital: “Just what the world needs, another medical show.”