The Truth in Scrubs
Truth #2: The Worker Bee
One of the best parts of the show is that the medicine interns JD and Elliot are rarely called by their real names. When training to be a doctor, you have no personal identity in the hospital. It’s something you actively fight to establish when you first arrive and you struggle daily to maintain, although the struggle gets slightly easier as you move from medical student to intern to resident.
The nurses don’t know your name and don’t ask (YOU have to introduce yourself – politely and with the appropriate humbleness; see Truth #4). It may be days before your attending remembers your name. This may not seem like a long time, but if you spent 13 hours per day with someone anywhere else, you can bet they would remember your name. Plus, we’re talking about a person who has committed millions of facts about physiology, pharmacology, and disease to memory. The fact is, they don’t care enough to remember your name until you’ve proven yourself useful to them. And yet, despite being both invisible and anonymous, you must also be omnipresent, constantly buzzing about the hospital taking care of patients. This means knowing everything there is to know about their diseases, and keeping up with all their procedures, tests, ongoing symptoms, and discharge issues. Plus, you’ve got to be totally accessible to everyone above you in the hierarchy (should they chose to grace you with their attention), 80 hours per week.
Dr. Cox, the hard-ass, emotionally-stunted attending, calls JD a different woman’s name or female-nuanced noun (like “Tiny Dancer”) throughout the length of the show, never actually referring to him as “JD” or “Dr. Dorian,” although JD is a 26-year-old doctor. His attitude towards JD is not only de-humanizing, but also infantilizing. Interns have been in school for two decades by the time they get to the hospital, and all the degrading and diminutive connotations that cling to the term “student” don’t dissolve overnight. It’s apt that Dr. Cox’s only departure from women’s names is to refer to JD as “the kid.”
Dr. Cox and Dr. Kelso refer to Elliot exclusively as “Barbie” and “sweetheart,” which of course rings true in a way; as a woman training to be a doctor, you’re always going to run into an old-school male doctor or two whose default concept of you is Barbie until you prove otherwise.
Another layer of personal vulnerability seems to come with the transparency that every medical trainee takes on at the hospital. It’s a rather unfair one-way mirror. Those above you in the chain of command seem to be able to predict every miserable detail of your existence in and out of the hospital, while they maintain an impenetrable aloofness that you will only achieve when you get to their position. They’ve seen it all: the pimping, the dying patients, the sleep deprivation, spending every waking moment with your colleagues in the hospital. And, every so often, they let you know what they know.
Dr. Cox looking at Elliot and JD: Bravo, just a big bravo, heaven help me I love newbie theatre. Honest I do, it’s the way you both play your parts with such wonderful commitment, that almost had me believing that you aren’t having whiny, neurotic, extremely pale sex with each other!
Truth #3: Masochism
In medicine, everyone’s a martyr. Well, not everyone – just the medical students, residents, and doctors. The nurses are usually a little smarter; they join unions and follow work-hour laws and rarely volunteer to do anything beyond what’s in their job description (partially because, frankly, what isn’t in their job description?).
When you train to be a doctor, however, you become a person who will skip a couple hours’ sleep (of the four total available to you) just to study up for the opportunity to be pimped, although it’s supposed to be so you can take better care of the patients. You’ll become the person who never eats lunch before four o’clock in the afternoon. You’ll become the person who subsists entirely on cafeteria pastries and coffee. You’ll also encounter – and become – one of those people taking on awful work as long as it bolsters their evaluations and gets them noticed by the attending. Again, the approval thing.
In one episode, Elliot is trying to get Dr. Cox to notice her (fighting for her identity), and there is a scene where she walks up to JD and Carla, the RN, sobbing. As concerned friends, they ask her what is wrong. Beaming through her tears, Elliot answers, “Dr. Cox let me tell a woman her husband is dying.”
I remember studying it in psychology class in college, something akin to the Stockholm Syndrome. The abused actually believe that they deserve to be abused and are somehow grateful to the abuser. We’ve all pulled more than a few Elliots during medical school; practically begging to put in a naso-gastric tube fully knowing the patient would most likely puke all over me – and he did.
That’s medicine.
Truth #4: The Nurses are Actually Running the Show
This is absolutely true in the hospital, and it’s true on Scrubs. In one of the very first episodes, Elliot finds that one of the nurses has made a mistake on one of her patients. She points this out to the nurse in a somewhat stern manner, only to find later that none of her tests or blood draws are getting done. Care for her patients grinds to a halt. It’s true that if you piss off one nurse (and, it’s not hard to do), you quickly gain a rep among the nursing staff, and each one will fight you tooth and nail over the simplest orders. A patient is suddenly spiking a fever and you need a blood culture. Someone else has had diarrhea for two days, and you need stool samples. What you need is the nurses because they do all of that. The doctors may come up with the plan, but the nurses carry it out.
The nurse’s power is all-pervading; you often find that they have the ear and the respect of your superiors, often more so than you – at least until you prove your usefulness. On Scrubs, while the interns can barely get their superiors to use their real names, Carla has the ear of both Dr. Cox and Dr. Kelso. They respect her, ask her for advice, even yield to her demands. In one episode, Dr. Kelso (the Chief of Medicine, mind you) approaches the nurses with a sugary-sweet “How are my girls?” only to be shut down by Carla. “If you’re about to start one of your ‘how are my girls? and this is what you can all do for me,’ stop, because I am in a mood.” She walks away unscathed, while a pre-emptive rant from any one of the interns would have certainly been followed by fierce and well-deserved retribution from on high. In another episode, Dr. Cox even sneaks back into the hospital on his night off to ask Carla for relationship advice. In medicine it’s often true that attendings reward nurses for hard work by showing their human side.