Changing how the world thinks about nursing

Join our Facebook group

A nursemaid scorned

ABC's Black Box presents the nurse as surgeon-worshipping rebound sex toy

Black Box castJuly 2014 -- ABC's neurology drama Black Box, which aired its first and only season from April to July 2014, was a fairly standard Hollywood hospital show. It focused on brilliant physicians, with occasional appearances by nurses as handmaidens, sexual playthings, and the Greek Chorus, observing and commenting on the physicians who really mattered. All of the major characters were physicians, starting with lead character Catherine Black, a superstar neurologist who was also secretly bipolar and a glamorous drug abuser. Minor nurse characters were more present than in some comparable shows, and at times they actually spoke and did things. In particular, a nurse named Tinker showed some independent health knowledge and a lack of reverence for physicians in her few brief clinical interactions. But on the whole, the nurses tended to be passive order-takers in clinical scenes, while masterful physicians called the shots, at times needing to educate low-skilled nurses about what was what, even as to the psychosocial issues involved in neurological care. And the most prominent nurse character, Carlotta, was essentially a surgeon-worshipping rebound sex toy, in thrall to an awesome neurosurgeon who really loved the lead character Black. That plotline reinforced the idea (common on ABC's Grey's Anatomy) that nurses are adequate short-term romantic/sexual objects with whom physicians may dally while waiting to get back with their true peers, other physicians. Carlotta could tell the surgeon was just using her while he could not be with Black, but she still stayed with him--at least until she tattled on Black for illicitly obtaining Oxycodone, ultimately getting Black fired, and showing the resentment of a nursemaid scorned. The show was created by Amy Holden Jones, with Bryan Singer (of Fox's House) as one executive producer.
 

Foosball

Getting her medicine

 
Foosball

Black Box followed the professional and personal adventures of world-famous neurologist Catherine Black ("Black Box," get it?), who directs a cutting-edge New York neurological center called "The Cube." Black is also bipolar, but she seems to have hidden that from all her colleagues except her psychiatrist. Much of the show's drama flows from Black's periodic failure to take her prescribed meds and her decisions to abuse other substances. Still, the show presents Black as an awe-inspiring genius. She has a long-term relationship with a Brooklyn chef, but she also seems to have sex with random others and ultimately falls for the hotshot neurosurgeon Ian Bickman. The other major physician characters are her psychiatrist Helen Hartramph; her fairly indulgent boss, chief of staff Owen Morely; and junior physician Lina Lark. All other major characters are Black's family members.

Since all the major health characters are physicians, it's not surprising that all the clinical action runs through them--their thoughts and actions are what matter. Nurses are noticeable only occasionally, and for the most part, the best they can do is to be reasonably competent assistants, reporting on basic status, taking orders to call social services, pushing wheelchairs. Of course, it can be dramatically helpful for a nurse to flail or do something objectionable, so that a physician character can show expertise or wisdom. For example, on more than one occasion Black has to stop nurses from doing something counterproductive with the neurological patients, like restraining them at the wrong time. That's partly because only Black has special special insights, but also because the nurses often seem like lay people who are baffled by mental disorders, even though those would seem to be, you know, their field. (The show creators may not be aware that nurses actually have subject-matter specialties, just as physicians do.) Another example of nursing education appears in the June 26 episode, when Black indignantly explains to a nurse who seems to be endorsing a "slow code" on a wounded mass shooter that the patient deserves the same care as any other. And if the nurse doesn't like that, Black says, he can find himself another job--also implying that the nurse reports to Black.

TInker Black BoxOne relatively bright spot is Nurse Tinker, who appears in less than half of the show's episodes. In the episode that aired on July 17, 2014, Tinker has what might have been the best scene for nursing on the show--it lasts less than a minute. The swaggering surgeon Bickman, who is generally Black's equal in terms of arrogance and egomania, is having some uncharacteristic doubts after a surgery has not gone as he hoped. Still, he brusquely inquires of Tinker why the post-op patient has not been extubated. Tinker replies evenly that they have been trying, but the patient is not initiating breaths. Bickman tells her to hold sedation. Tinker responds that the patient has been off everything for six hours, and suggests that maybe the patient just needs more time. Bickman, relenting, muses that he was the one who needed more time, a reference to his surgical difficulties. That brief scene portrays the nurse as a skilled health professional capable of independent judgments and even a peer interaction with a powerful surgeon, more or less. Later, Tinker makes an astute observation to a nurse colleague about why Bickman is allowing another surgeon to do a follow-up surgery: "I didn't think that was possible . . . he's scared." The two-episode finale, broadcast on July 24, includes a scene in which Black is hallucinating. As she passes the nurses' station, she imagines that Tinker is telling another nurse that there are plans to name the Cube after Black, evidently because she is awesome. But in reality, Tinker is saying, " . . . so even though the biopsy results were in, the doctor was in his lounge, playing foosball." Of course, while such comments show a fitting lack of reverence, they also suggest that the nurses are more focused on discussing physicians than they are patients.

 
Getting her medicine

The most notable nurse-related plotline is the one involving nurse Carlotta, who worships Bickman and eventually hooks up with him while he pines for Black. We first hear of Bickman in the April 24 premiere, which finds chief of staff Morely telling Black of the surgeon's imminent arrival to enhance their team. Black has heard of Bickman, and she describes him as a "sexual predator." But Morely assures her that Bickman has only willing partners, stressing that the nurses at Boston General had only good things to say about "Dr. Big Man." That comment presents nurses as disposable physician sex toys, right off the bat in the series premiere. Still, Black herself soon becomes one of those willing partners, except that as a social and intellectual peer of Bickman's, she presents the danger of serious emotional attachment.

Nurse Carlotta Black BoxNurse Carlotta does not present that danger. She is more of a Bickman fangirl. In the May 8 episode, we learn that Bickman has saved the life of a famous opera singer outside the clinical setting by cutting into her throat, rather than doing the Heimlich maneuver. Junior physician Lina Lark actually thinks this move, which seems unnecessarily aggressive, shows that Bickman is a psychopath. But Carlotta defends Bickman, stressing that he saved the singer's life and is a "hero." Later, when Bickman is having doubts after the surgical difficulties noted above, Carlotta assures him that he is still the best surgeon. Black, by contrast, does not enjoy adulation from Carlotta, presumably in part because Carlotta knows Black is competition for Bickman's attention. And when, in the July 17 episode, Black asks Carlotta to give some Oxycodone that she has prescribed for an ailing child directly to Black, Carlotta actually resists handing it over, noting correctly that nurses usually give meds! Carlotta relents, which a strong nurse would not do, and later Black takes the drug herself.

By the time of the two-hour finale, Bickman has broken things off with Black, apparently so he can stay sharp in surgery--she was distracting him. He is now having sex with Carlotta, but it's clear that he is not over Black. In one painful scene, Bickman approaches the nurses' station wanting to know where Black is, because he plainly wants to tell her that he has recovered his surgical confidence. Carlotta's seductive manner and expression of interest does not register.

Black finally goes totally off the rails, is picked up by the police, seems to spend weeks at an inpatient facility getting on the right medications, and finally returns to the Cube, with the official explanation that she has been suffering from "exhaustion." Hearing this, Carlotta is skeptical and annoyed, and another nurse privately asks Lark what is bothering Carlotta. Lark confides that Carlotta and Bickman "get busy" once in a while; one time, Lark walked in on them and "she was gettin' her medicine." So, she is implying, Carlotta is jealous.

Later, Carlotta tries to seduce Bickman at work, saying it will only take five minutes and brandishing the key to the pharmaceutical room. He declines, annoyed, saying he has a surgery and now must scrub again. Carlotta: "So Catherine's back and now I'm out, is that it?" Bickman claims that he and Black are just friends. Carlotta: "You're in love with her." Bickman says he is not in love with anyone. Carlotta: "Are you lying to yourself, or just me?" Still, when Black stops by Bickman's home, she finds him with Carlotta. Later, he explains to Black that his time with Carlotta has only been to get Black off his mind. Black observes that that is not very gentlemanly. Bickman says he never has been much of a gentleman and didn't want to be -- till he met Black! It's inconclusive, but it certainly seems possible that they will end up together.

Finally, though, even Carlotta has had enough. She goes to chief of staff Morely, who has just gotten done forgiving Black for her period of "exhaustion." Carlotta tells Morely about the Oxycodone prescription, noting that the patient never got the drug she reluctantly gave Black. And in the last line of the show (the last line ever because of the cancellation) Morely finds Black, who is happily observing a Bickman surgery, and tells her: "You're fired."

Maybe the show gets a point because Carlotta finally had enough guts to turn Black in. But the overall plotline still portrays Carlotta as a casual sex object--good enough for a temporary diversion but not for a physician's serious attention--and ultimately as a vindictive woman scorned, ruining the great Black's hard-won second chance. Those themes embody the variation of the naughty nurse stereotype in which hot young nurses try to seduce powerful physicians, perhaps hoping to advance socially, but certainly awe-struck that they are getting such attention, as nurse Rose was on Grey's Anatomy in her 2008 plotlines, before Derek Shepherd returned to Meredith Grey.

On the whole, while the Carlotta plotline was an unfortunate sideshow, the main problem with the nursing portrayal on Black Box was that the nurses were low-skilled physician handmaidens. That remains the most common and damaging Hollywood nursing stereotype.
 

Send your comments to Executive Producer Bryan Singer at reception@badhatharry.com

 

 

 

 

 

‚Äč