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Mind, body, and spirit

Switched at Birth has strong NP character but still assumes smart people pursue medicine

 
Daphne, Campbell and Jorge August 2014 -- The third season of the ABC Family drama Switched at Birth included a plotline in which talented high school senior Daphne works at a Kansas City health clinic. While there, she meets and has flings with both a nurse practitioner (NP) and a medical student. The NP character Jorge displays health care skill, strength, and good judgment. After he explains that he chose nursing for its holistic features, we see him provide expert, autonomous care to clinic patients ranging from a boy with asthma to a young heroin addict in withdrawal. But even though Jorge has a bigger and more impressive clinic role than the medical student, Daphne appears to be heading for a career in medicine. In fact, there is no suggestion, in the many episodes touching on Daphne's future in health care, that she might consider becoming a nurse. Of course, that is the modern entertainment media's default mode for a smart character from a disempowered group (Daphne is deaf) who shows interest in and aptitude for health care. But it's more striking than usual here because of the Jorge character. And it's not just a senior physician who offers Daphne the standard Hollywood endorsement that she will be a great physician some day. Jorge himself tells her that. We do thank the show producers for including Jorge, a skilled and strong Latino man in nursing. And if they can't have Daphne even consider nursing, we urge them to at least be open to more good portrayals of nursing and to avoid suggesting that medicine is the only health profession for able career seekers. The show was created by Lizzy Weiss.

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Community service

A great physician?

 
Community service

Daphne, Campbell and JorgeJanuary 2014 episodes introduce the health clinic plotline. Daphne is working there as part of her community service sentence, the result of her role in an earlier blackmail scheme that brought down a venal local politician. In the January 13 season premiere, she meets the attractive, friendly nurse practitioner Jorge, who will be her direct supervisor at the clinic; the initially gruff senior physician Elroy Jackson, who seems to direct the clinic; and medical student Campbell, who impresses by giving her a ride home in his hand-controlled sports car (his legs are paralyzed). In the February 3 episode, Jorge asks Daphne--who is also a progressive chef--for a recipe for vegan sweets for a party being held for his sister, who will be getting married. Daphne offers to make them herself and he invites her to the party. There, Jorge explains to her that he got into nursing after his mother died of cancer. During her illness, he felt that physicians had "put her through hell, trying to fix her," but that the nurses had "treated her like a person," taking care of her mind, body, and spirit. Daphne says Jorge has "the same gift" with patients, but she does not express interest in nursing herself. Also at the party, Jorge's sister berates Daphne for her role in the prior political scandal--evidently the sister liked the venal politician, who was also Latino. Jorge later apologizes for not defending Daphne, and they kiss. They begin dating.

But this being Switched at Birth, Daphne also has feelings for medical student Campbell, and there will be ongoing romantic ambivalence. In the February 17 episode, Campbell realizes that Daphne and Jorge are sort of together, and there is tension at the clinic. That does not prevent Daphne from throwing Campbell a surprise 21st birthday party, which includes his old Colorado snowboarding friends and his ex-girlfriend. Daphne and Jorge talk Campbell out of traveling back to Colorado with his old pals to snowboard using a new board they got him. But Jorge sees that Daphne has a thing for Campbell and he asks what he's supposed to do with that. Daphne says she doesn't know. There is no real sense that Jorge is getting less respect because he is a nurse; it seems like a pretty standard TV love triangle.

Events in the next few episodes spark Daphne's interest in medicine. In the February 24 one, Daphne brings a friend's mentally ill mother to see the senior clinic physician Jackson after hours, when Jackson has persuaded a psychologist friend to join them. But the mother loses control and stabs Jackson. Badly injured, the physician asks Daphne if Jorge or any of the other nurses are around. However, since it's after hours, no one is there. So Jackson talks Daphne through the process of decompressing his tension pneumothorax, saving his life. By the March 3 episode, Daphne is considering premed programs. She asks Jorge if she can take on more work at the clinic. At first, Jorge is annoyed, but not because she is ignoring nursing. It's because, he says, her big save of Jackson should never should have had to happen, since she should not have brought a dangerous patient to the clinic after hours. Jorge soon seems to regret his harshness and he tries to make it up to Daphne by getting her involved in the case of a boy who has asthma. Jorge seems expert in responding to this patient's needs, and there is no suggestion that he needs to consult with physicians. But when Jorge steps out of the room, the patient begins having seizures, and Daphne does not see or (of course) hear them. The patient seems to be OK in the end, but the patient's angry mother calls Daphne a "deaf idiot." Jorge is supportive of the patient; it's unclear from the scene what he thinks about Daphne's hearing issues. Daphne flees and reconsiders medicine as a career path. But when she visits Jackson in the hospital, he encourages her to persevere, citing his own obstacles as an African-American physician.

These scenes do highlight the prevailing Hollywood bias in a curious way. The show has Daphne follow a skilled NP in his practice, yet she never considers anything but becoming a physician. And although Jorge is the one actually treating the asthma patient, it is the physician Jackson who later reassures Daphne. Of course, she did fare much better in the clinical interaction Jackson saw--saving his life. Indeed, his enthusiasm for Daphne's medical future is now strong and persistent. In the March 10 episode, he tries to set up a meeting for her with a physician who runs a premed camp, although in the end the logistics don't work out.

Meanwhile, Campbell and Jorge vie for Daphne, although it soon seems that Campbell is likely to prevail. And in the March 24 episode, Jorge discovers Daphne and Campbell kissing at work. After his initial surprise, Jorge simply excuses himself and departs with no fuss. But then a young man who previously attacked Daphne to rob the food truck she was running seeks care at the clinic. Daphne is very upset to see him, and Campbell later claims he's going to beat the guy up if he returns. Jorge basically tells Campbell he will handle it. Jorge is sympathetic to Daphne and says they will watch the attacker carefully, but they have to treat everyone. She claims Jorge is just getting back at her because she chose Campbell. But Jorge calmly says no, the job is to treat everyone, and if she can't handle that part, she should not go into medicine. Later, the attacker does return--in heroin withdrawal because he is trying to quit. Daphne freaks out, but she manages to help find an open clinic room so Jorge can treat him. And she even, at Jorge's urging, manages to calm the attacker while Jorge treats him (the attacker does not seem to recognize her). Impressed, Jorge tells Daphne that she'll make a great physician. Yes, great.

Daphne does not seem destined to be with Campbell either. In the June 23 episode, she gets a paying position at the clinic--which appears to involve supervising volunteers like Campbell. Soon, she has a dispute with Campbell about his role in preparing for an inspection of the clinic which did not go perfectly. Campbell lets Daphne know that he would not have minded a paying position himself. Daphne tells him that he should have asked the clinic director for such a job, as she did. So he does that, and he gets one--but at a different clinic across town. So Campbell will be leaving and that also seems to mean breaking up with Daphne. She seems sad, but it's done pretty casually and she doesn't really try to persuade him to stay.

As the season ends in August 2014, the clinic is no longer a focus and neither Jorge nor Campbell seems likely to play a role in the show's immediate future. But Daphne appears to remain premed. She has been identified as having committed further crimes by destroying construction equipment in protest of her mother's participation in an arguably exploitive development project in their old neighborhood. But her sister-by-other-parents Bay gallantly takes the rap, allowing Daphne to go on to college despite her troubles with the law.
 

A great physician?

There were many good elements in the season's presentation of nursing. The Jorge character was a Hollywood rarity--a male Latino nurse practitioner who displayed skills and autonomy in a clinical setting. He was Daphne's clinic supervisor, and he appeared to provide expert care to patients on his own, as with the asthma patient. His explanation of why he chose nursing was persuasive and highlighted nursing's holistic focus, although we can't endorse Daphne's description of his skill with patients as a "gift," as if it was innate rather than a result of education and experience. There was no hint that Jorge was on the show as a feminist toy for female physicians, as in many such plotlines. Indeed, there were only occasional mild suggestions that he reported in a general sense to the senior physician who directed the clinic. No one seemed to direct Jorge's clinical practice. And although Campbell did prevail in the romantic competition for Daphne, it was never explicitly about his status as a future physician or Jorge's as a nurse. Daphne simply seemed to identify more with Campbell or to find him more appealing, for whatever reason; even apart from their shared experience of disability, maybe Daphne connected with Campbell more because neither one of them was very mature.

So the main problem was the unstated but inescapable message, throughout the season, that only medicine was worthy of Daphne. No character ever said that; it was simply assumed that this was an unquestionable path for her, or anyone. Even though the season conveyed positive things about a strong, attractive nurse practitioner character and about nursing generally--Jorge was actually Daphne's main mentor at the clinic--she never considered nursing and no one, including Jorge, suggested that she do so. In fact, he encouraged her medical plans.

Even so, Jorge was such a strong character that the season might be considered a net gain for nursing. We do worry, though, about how things will go in the future, as Daphne confronts the rigors of a premed program, which will offer plenty of opportunities for the show to fall back into the entertainment media's standard physician-centrism. Still, we hope for the best.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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