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Looking for Mr. McSteamy

"And yet nowhere in that newspaper article does my name appear. I am the unseen hand to his brilliance."

-- Cristina Yang, having quit surgery for nursing, protesting the media's tendency to credit physicians for the important work of nurses


May 8, 2008 -- Tonight's episode of ABC's "Grey's Anatomy" was a tour de force of physician nursing and portrayed nurses as so desperate for physicians' romantic attention that they would stop work and call in their union if they failed to get it. In the episode, Seattle Grace's surgical nurses boycotted all surgeries of plastic surgeon Mark "McSteamy" Sloane because he had loved and left too many of them. The boycott lasted until resident Miranda Bailey gave the mute ninnies a public lecture on romantic maturity and how their hurt feelings were probably a little less important than the lives that could be saved by, um, actually doing the surgeries. The producers probably thought they could not be accused of promoting the "naughty nurse" because Sloane was, as Bailey stressed, the real "whore." But the plotline suggested that nurses were too dumb to realize what Sloan was all about despite his reputation, and that they were after more of his attention than they could have, underlining the sense that they are slutty serfs grasping at any available hunky physician. Meanwhile, the episode relentlessly showed the surgeons doing important work that nurses actually do: running the surgical board; providing all psychosocial care to distraught patients and families; giving IV medications; doing all patient observation, including monitoring a patient's intracranial pressure; and doing a clinical trial essentially by themselves. Finally, resident Cristina Yang gave a bitter speech about ex-flame Preston Burke winning a prestigious medical award without crediting her help--an astonishing echo of the show's own crediting of physicians for work nurses really do. The episode was Tony Phelan and Joan Rater's "The Becoming"--the title is drawn from a Nine Inch Nails song, because if any TV show is in sync with Trent Reznor's fiercely bleak view of modern life, it's definitely "Grey's." The episode drew 15.6 million U.S. viewers.

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The show does not make clear why a group of adult females would decide that Sloane's private behavior would justify what amounts to a group work stoppage. Normally boycotts have a goal, but it's not clear what the goal of this would be--that Sloane apologize? That he continue having sex with all of them? Presumably they all wanted more than a simple hookup, but McSteamy was moving on--implying that the nurses are so desperate for physician attention that they would make a public issue of it. But the episode does not stop there. The nurses actually complain to their union and a union rep shows up to get chief of surgery Richard Webber to impose a kiss and tell policy, forcing all physicians and nurses to submit the names of their in-hospital sexual contacts--a jaw-droppingly ridiculous plot development, an amazing violation of privacy to which the staff actually acquiesces, and a clear suggestion that the chief of surgery manages nurses. The union rep turns out to be the chief's wife Adele, from whom he is separated. The chief mutters to Sloane that Adele "used to be" a nurse, underlining the common idea that nursing is just a job rather than a profession; if the chief quit, we would not hear that he "used to be" a physician.

Finally, we see the no-nonsense Bailey call about 30 of the nurses together (right) in what appears to be the atrium of the hospital to publicly chastise them and get them back to work. She disparages McSteamy as a "whore" but allows that he's a good surgeon, and stresses that the nurses all knew what his reputation was, so "let us all close our knees and get back to our jobs." Not a single nurse can reply, and normally we might object that this reinforces the sense of nurses as mindless physician servants, but this plotline is so degrading that it's probably just as well they said nothing. Bailey closes by shouting "disperse!", and the idiot sheep amble back to their pastures.

The physician nursing is less obviously offensive, but it's arguably even more damaging because it's more subtle, adding to the torrent of media depictions that suggest physicians provide all important care. Early in the episode, we see Bailey trying to reschedule surgeries of Sloane and orthopedic surgeon Callie because a certain nurse is not available to work with Sloane now. Nurses really do this scheduling. We see cardiac surgeon Hahn providing emotional care for a distraught transplant candidate in isolation; no nurse is present. In real life, nurses would almost certainly be the ones to do this. We see resident Alex Karev providing more of this care as he gives the patient a medication by IV--which nurses actually do. When the patient's lung collapses, Karev alone intervenes to save the patient, issuing a command to the ether to get Hahn; a background nurse-blur responds, "Right away, Dr. Karev!"

Meanwhile, surgical resident Meredith Grey provides all psychosocial care and counseling to a soldier with a brain tumor who will be in the clinical trial she and attending Derek Shepherd are doing. There is tension between this soldier's father and his male lover; Meredith manages all of the above. After the surgery, Meredith monitors the patient's intracranial pressure, which nurses really do. At one point a nurse character actually volunteers to give Meredith a break, but she soldiers on. Later, the patient codes, and a nurse hands Meredith the paddles so she can defibrillate--which nurses generally do. Toward the end, Karev takes the initiative to get the transplant patient's husband and kids into protective gear so they can enter the isolation bubble with her, something a nurse would likely have done long ago. The episode also spends significant time on Derek and Meredith's clinical trial, and no viewer will imagine that nurses play any role, when nurses actually do much of the work on such research.

Finally, there is the astonishing scene in which Yang gives her bitter speech about cardiac surgeon Burke, who left the hospital some time ago but has now won some prestigious international award. Yang is provoked into giving the speech by the enforcement of the "kiss and tell" policy, which requires her to disclose Burke's name. The speech is about how Yang supported Burke and actually secretly performed his surgeries during a period in which he was recovering from an injury. She protests the media's portrayal:

And yet nowhere in that newspaper article does my name appear. I am the unseen hand to his brilliance. ... I know everybody is proud of him, but I am not. And I do not wish him well.

Clearly, the show has a keen sense of the injustice and harm that occurs when someone receives credit in the mass media for work actually done by someone else. We'd like to think this means the show has also gained insight into how its portrayal of nurses might make them feel, and we feel confident that it will take corrective action. We're proud of the show, and we wish it well.

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