Starring Alan Alda, Loretta Swit, Gary Burghoff, Mike Farrell, Harry Morgan, Larry Linville, David Ogden-Stiers, Wayne Rogers, McLean Stevenson, Jamie Farr, William Christopher
Producers: Larry Gelbart, Gene Reynolds, Burt Metcalfe
20th Century Fox
"M*A*S*H" may be the finest health care-related series in American television history. It is arguably second only to its descendant "The Simpsons" among all situation comedies. "M*A*S*H" focused on a U.S. Army surgical unit near the front lines in the Korean War. It had compelling characters, childish pranks and timeless wit, much of it directed at the Army, interspersed with serious treatment of issues the war raised. Some fans of the unsentimental Robert Altman film "M*A*S*H" (1970), on which the series was based, may find the show too soft around the edges. It did wrap its anti-war views in friendlier liberal clothing, and it was not above hugging, learning or happy endings. But it still presented a harsh, bloody world of unredeemed sin and undeserved suffering. The series was also wittier, more literate, more nuanced and somewhat less misogynist than the film. And it maintained its high standards for most of an 11-year prime time run that went well beyond the Vietnam/Watergate era in which it began. Indeed, although some of its humor is now dated, the series remained so popular in early 2003 that the cable channel FX was still showing more than 50 (fifty) episodes each week.
The series' depiction of nursing was somewhat better than that in the film. Chief Nurse Major Margaret Houlihan (Loretta Swit) is probably the most important nurse character in television history. There was little doubt about Margaret's authority, nursing skills, and commitment to the patients' wellbeing, and as the show went on she grew increasingly sympathetic. However, especially in the early years, Margaret was still a fairly pathetic martinet, desperately seeking to enforce petty discipline--and a man to fill the void in her career-dominated life. The series did make clear that the nurses reported to Margaret, not the physicians, and over its many years, it did show some actual nursing, including assessment, intervention and patient advocacy. The nurses often acted as skilled partners in providing care. But they still seemed to be there primarily as assistants and romantic foils for the surgeons, who received virtually all of the credit or blame for patient outcomes, and it's unlikely that the series did much for the public's image of nursing.
In "M*A*S*H," the characters struggled to cope with the flood of wounded and the pressures of a frontline surgical unit. The series retained many of the major characters from the movie. As in the film, the central figure was surgeon Hawkeye Pierce, though the series replaced Donald Sutherland's muttering with Alan Alda's rapid-fire one-liners, which included witty historical and cultural references. Other major characters included Pierce's sidekick and fellow surgical subversive Trapper John McIntyre (Wayne Rogers); Houilihan; the bumbling unit commander Lt. Col. Henry Blake (McLean Stevenson); the meek company clerk "Radar" O'Reilly (Gary Burghoff), who ran the unit with a mix of bureaucratic savvy and the ability to know what was about to happen; whiny surgeon Frank Burns (Larry Linville), whose marginal skills, gung-ho attitude, and torrid romance with Houlihan were the subject of endless derision; Corporal Max Klinger (Jamie Farr), who tried unsuccessfully to get a mental fitness discharge by wearing women's clothing; and Father Mulcahy (William Christopher), the comically earnest, somewhat naïve chaplain.
The series featured a stream of ranting against the war, the military, and the apparent futility of treating badly wounded young men only to see them die or be sent back to the front. Though the series could not have been more anti-war than the film, it was more explicit about the desperation of most of its characters to get back to the States and away from the bloodbath, which it portrayed as senseless. To survive in an environment they loathed, the characters used booze, sex, practical jokes, and constant one-liners. Some plot elements do not hold up as well as others, notably the handling of Klinger's transvestism, the casual alcohol abuse, and, at times, the treatment of women. Some of the physical humor can seem tired and dated. But thanks to excellent writing and acting, most episodes remain fresh and compelling.
As the years went by and the series became an American institution, several characters moved on. McIntyre was replaced as Hawkeye's sidekick by the more responsible family man B.J. Honeycutt (Mike Farrell), who was still game for non-sexual shenanigans. The no-nonsense, cavalry-trained Col. Sherman Potter (Harry Morgan) took over as company commander. Later, Houlihan found and married the laughably straight-arrow Lt. Col. Donald Penobscot. Frank Burns could not handle this, and he was replaced by Charles Winchester (David Ogden Stiers), a snobby Boston Brahmin with exceptional surgical skills who struggled to adjust to wartime "meatball surgery." The addition of the formidable Winchester meant less snickering and more witty banter. Overall, these new characters signaled a shift to an even softer, more forgiving approach; unlike their predecessors, none could really be described as amoral or idiotic. In the later years, a number of the characters--especially Margaret--became more human and complex. Despite the increase in melodrama, the show remained relatively strong, and the final episode was one of the biggest events in television history.
The series "M*A*S*H" represented some improvement over the depiction of nurses (and women) in the film. Houlihan had more of a chance to display her fearless leadership and nursing skills, and it became clear that she was committed to doing an excellent job for the patients. She also showed a softer side. She was capable of a hard-nosed fairness, and of appreciating some of the other characters' unorthodox qualities; at one point, she even had a brief affair with Pierce. The series also made clear that the nurses reported to Houlihan, not the physicians--which seems simple but is something the supposedly "realistic" "ER" still can't seem to get right three decades later. In addition, the series did show some actual nursing, such as Houlihan and the other nurses assessing their patients and proposing interventions in post-op, discussing care with the surgeons, and at times even catching things the surgeons missed. One episode showed Margaret expertly doing triage in her wedding dress; "ER" has still barely recognized that nurses do triage.
Unfortunately, many of the negative aspects of the film's treatment of nurses persisted in the series. In many episodes Houlihan remained a bitter, mocked figure, obsessed with discipline, at times abusing her authority for selfish or petty ends. She continued her tacky affair with the married Burns through the series' middle years, a relationship that underlined how desperate she was for a man, especially since she was not blind to his many faults. Of course, the depiction of Margaret improved. But the series regularly treated nurses mainly as potential love and sex interests for the surgeons. Often this happened in a relatively respectful way, and sometimes the romances were treated with sensitivity. But there were also nurse jokes. Other than clarifying that there was a separate nursing command structure, the series rarely suggested that nurses were anything but assistants to the physicians in actually providing care. The physicians received virtually all credit or blame for patient outcomes, and there was little sense of nursing as an independent scientific profession. The typical nursing depiction involved providing suction or retraction at a surgeon's request. Even in post-op, the patients' main relationships usually seemed to be with the surgeons. It must be remembered that "M*A*S*H" was a comedy about a front line surgical unit in the early 1950's. But on the whole, it's unlikely that this wartime classic has done much for nursing enlistment.
Reviewed by Harry Jacobs Summers
Nursing Editor: Sandy Summers, MSN, MPH, RN
Reviewed February 2, 2003
The views expressed herein do not necessarily reflect those of the Board Members or Advisory Panel of The Center for Nursing Advocacy.