The Truth in Scrubs
Truth #5a The Sharks Versus the Jets
It’s true that there is a divide in medicine between medical doctors, who use medicine and behavior to treat disease, and surgeons, who use surgery to treat disease. The two groups have been compared as “thinkers” vs. “doers,” “incompetent” vs. “saviors,” “compassionate” vs. “assholes.” The comparisons run the gamut, but one of the most apt characterizations of the relationship between the medicine and surgery worlds is a clip in which JD describes the relationship: “You see, the surgical and medical interns are kind of like two rival gangs.” The surgical interns round the corner at the other end of the hall. “Not real gangs; more like those cheesy gangs you see in Broadway musicals.” The medical interns gather in the middle of the hallway. The two groups step into formation, and the camera gives you a glimpse of one and then the other snapping their fingers and pirouetting toward one another while the surgeons chant. It is the perfect caricature of the medicine vs. surgery rivalry in that it captures the mindless dogma, unabashed nerdiness, and pretentious self-involvement of the two camps. The utter obscurity of details often argued over would baffle anyone not in medicine.
Scrubs - West Side Story
Truth #5b Surgeons Think They are God
Turk, holding up his hands: See these?!?! I can do whatever I want because of these!
This truth is only partially true. Some surgeons think they are God. And you can kind of see why. To save a patient’s life, they sometimes have to take patients to the utter brink of death, and it’s their personal responsibility not to let the patient fall off that cliff. They often have to perform what I’ve considered amazing feats when I’ve had the privilege to see them – for instance, repairing a crucial artery – tiny on a physical scale, but huge on a survival scale. Surgeons are also particularly amazing because in a crisis situation or unforeseen circumstances, they have to be able to single-handedly lead the entire surgical team out of the wilderness.
One Scrubs clip captures the admiration and praise for surgeons that is sometimes almost tangible. Turk has just successfully repaired an artery without an attending present (I’m not sure how realistic that is, but we’ll let that one go for now). Anyway, before the surgery, Turk is sheepish and afraid that he’s not going to be able to handle calling all the shots. After the surgery is a success, there is a pendulum effect, and Turk’s cockiness is priceless. The scene captures the surgeon machismo perfectly, with Turk strutting in with Carla on his arm, singing a rendition of “Shaft,” only it’s “Turk,” and all of the back-up singers are female nurses, medical residents, and patients.
Truth #6 Absurdity is Sanity
The show’s humor hinges on the strange reveries JD slips into throughout the day in an attempt to deal with his surroundings. One of the great defense mechanisms in the hospital is creating humor where none exists, be it through fantasy, exaggeration, or gallows humor (“Oh, that is so awful!”). In one scene, JD is attempting to communicate with a patient who speaks exclusively German. The patient has pancreatic cancer, and JD is charged with the task of telling him that he will likely die soon. “I just wish there was some way we could connect…” While grappling with how to overcome the language barrier to have one of the most dismal conversations in medicine, JD imagines himself and the patient dancing in the hospital room to Nena’s “99 Luftballoons” while red balloons fall from the ceiling.
First, the obscurity of the reference is classic nerdy medical humor; leave it to a doctor to come up with and appreciate the convoluted connection between an elderly German man and Nena’s 99 Luftballoons. Second, the absurdity of dancing with a patient in the middle of a balloon-filled hospital room is not only funny, but is secretly the hope of anyone taking care of a terminal patient. Who among us hasn’t fantasized about a dying patient miraculously getting up and dancing out of the hospital to re-join their families and go on with life? Not to mention the dancing symbolizes a vicarious indulgence of our need to connect with patients on a more human level.
I understand why people are so surprised when I say that Scrubs is the most accurate medical show. If I’d never worked in the hospital taking care of patients, I would never have believed it either. From the official NBC website, you can’t tell if they were really going for the accuracy angle. As they describe it, “’Scrubs’ focuses on the strange experiences of J.D. (Zach Braff, “Last Kiss,” “Garden State”), a medical resident, as he continues on his healing career in a surreal hospital, crammed full of unpredictable staffers and patients -- where humor and tragedy can collide at any time.”
DVDVerdict.com writes, “Series creator Bill Lawrence set out to create a series that was more honest about the realities of being a medical intern than any of the myriad other medical TV shows on the air, past and present, and what he came up with was a weird but irresistible mixture of hyperrealism, sentiment, realistic drama, and downright goofiness.” Lawrence was apparently inspired by war stories from old-college-friends-turned-doctors, which might explain why the show’s underpinnings are so true to life.
If you’re lucky enough not to have spent much of your life surrounded by medicine, most of what you know about doctors and hospitals probably comes straight from Hollywood. Scrubs presents stereotypes that are more true to life than many of the TV and movie-perpetuated clichés that have come to be accepted as truth about doctors, nurses, and hospitals. But more importantly, it goes beyond these truisms, using tongue-in-cheek humor and hyperrealism to explore what stereotypes do not capture: the personality and vulnerability of every person working in the hospital. Its most important lesson is to reveal that while a hospital might be a place where “miracles” happen and life-and-death matters arise hourly, it is still a workplace. Like Office Space before it and the Office after it, Scrubs takes the nitty-gritty details of the daily grind, and amplifies them to a roaring hilarity, accurately paralleling the roar of the blood pumping through an intern’s racing heart the first day on the job.
Appendix I: Timeline and Glossary of the Medical Hierarchy
Medical School: Four years of training after your bachelor’s degree. When you graduate, you’re technically a doctor, and you get an “MD” after your name.
Internship: The first year of residency. At this level, you are an “intern.”
Residency: Three to six years of more training in the hospital after medical school. You must choose a specialty: general internal medicine (like JD and Elliot), general surgery (like Turk), obstetrics and gynecology, psychiatry, etc.
Fellowship: An optional two to four years of more-specialized training in a subspecialty within your residency specialty. For internal medicine, options include cardiology, gastroenterology, endocrinology, etc. Every field has its own subspecialties.
Attending: A person who has completed residency and sometimes fellowship. JD and Elliot become internal medicine attendings in season 4 after completing their residencies. More specialized attendings, like those in cardiology for example, also complete a fellowship.
Note: A medical or surgical team taking care of any one patient in a hospital includes an attending, sometimes a fellow, a resident, an intern, and a medical student.
Chief Resident: An outstanding resident asked to stay an extra year or use part of their last year of residency to help run the residency program.
Chief of Internal Medicine: Prestigious position as leader of internal medicine department. Only older, accomplished doctors are appointed to this position by the president of the associated medical school or corporation.
Appendix II: Cast of Characters
Dr. John Michael Dorian, aka “JD” (Zach Braff): JD begins his internal medicine internship, becomes a resident in season 2, Chief Resident in season 4, and an attending in season 5.
Dr. Elliot Reid, aka “Barbie” and “Sweetheart” (Sarah Chalke): Elliot also begins her internal medicine internship. Her professional path is identical to JD’s.
Dr. Chris Turk, aka “Turk” (Donald Faison): Turk begins his surgical internship, finishes his residency in season 4, and becomes a surgical attending (I think—they’re not as explicit about his professional promotions).
Carla Espinoza, aka Carla (Judy Reyes): Carla is a Registered Nurse at Sacred Heart Hospital who is already a veteran when the above three arrive on the scene.
Dr. Bob Kelso (Ken Jenkins): Chief of Internal Medicine
Dr. Perry Cox (John C. McGinley): Internal medicine attending