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Hollywood Meets the Press

2007; Wolters Kluwer; Volume: 29; Issue: 20 Linguagem: Inglês

10.1097/01.cot.0000298606.51233.28

1548-4688

Andrew Holtz,

Climate Change Communication and Perception

All the players were there: actors, writers, producers, a researcher and many, many journalists. The scene: a hotel ballroom in the Hollywood Hills. The title: “Hollywood & Health.” At the annual conference of the Association of Health Care Journalists earlier this year, we took a bit of time to peer over the fence at our colleagues on the entertainment side of the media, and the role they play in delivering health messages to the public. On the podium were two actors who play doctors on TV, two real MDs who write for hit primetime shows, a scriptwriter who majored in theater and now finds herself immersed in medical jargon, a researcher who tries to both measure and influence health communication via entertainment programming—and me. As emcee and moderator, it was my job to interrupt the lunch munching of a few hundred journalists and other guests and explain why newshounds chasing the health beat should care about fictional health and medical plot twists. After all, reporters cover real medicine and write about actual health facts, while entertainment shows just make stuff up. So why should journalists pay attention to entertainment shows with medical themes? First, in the media world impact is measured by circulation and ratings. On this score, entertainment shows blow news out of the water. The New York Times sells about a million copies a day. On most days, maybe a million people see CNN's top shows. Seven million to 10 million viewers watch the nightly broadcast TV newscasts. The ratings of the top news shows would be considered merely mediocre for primetime shows. Shows like House and Grey's Anatomy routinely pull in 15 million to 25 million viewers. Second, while journalists write stories, entertainment show writers tell stories. Indeed, many viewers of soaps called the shows their “stories.” Viewers develop an emotional connection with the characters—and while we often get all wrapped up in the technological formats of printing, broadcasting, Web pages, and podcasts, regardless of the medium it is emotional communication through storytelling that is the most powerful form of human communication. Third, the huge popularity of top shows is evidence that the writers understand their viewers, and that's also a skill every journalist needs. After all, our reports can meet every standard of accuracy, balance and thoroughness, yet mean nothing if they aren't read or heard because they failed to engage readers, viewers, or listeners. During my years in TV news I learned to open a story with my best video. And so although every member of the AHCJ panel brought expertise, we began this session with the panelists who, in addition to their professional skills, were no doubt the best-looking: a pair of soap stars: Kimberly McCullough and Jason Thompson, who portray Dr. Robin Scorpio and Dr. Patrick Drake on General Hospital. HIV McCullough first appeared on that show as a young girl two decades ago. As a teenager, her character made a loud health statement. “In 1996, my character was 17 years old and had heterosexual relations with this boy named Stone, who happened have been a street kid,” McCullough told the audience. “Anyway, the point is he had AIDS and didn't know it—and she got it. He died of AIDS. And the reason the story was kind of groundbreaking back then was because it was the first medium anything, television or film, to show a heterosexual couple dealing with AIDS.” McCullough's character moved to Paris for several years. She returned all grown up, playing a physician. Her character continues to refer to aspects of life with HIV, including ongoing drug therapy and careful adherence to safer sex recommendations. Jason Thompson plays her current love interest. “When we first started getting involved in our relationship, I don't know how many times we had to mention spermicidal jelly, condoms—it was mandatory as far as our dialogue, which is part of the reason we're here, just educating people on the health risks, and obviously on HIV,” he said. A video clip showed the beginning of the latest health storyline for his character. He was performing brain surgery on a woman with late-stage AIDS and a very high viral count. During the procedure, something suddenly goes wrong. Thompson as Dr. Patrick Drake: “What the hell was that?!” Technician: “Sorry, doctor. It was mechanical. I have it under control.” Cut to a close-up of McCullough as Dr. Robin Scorpio, who was also in the OR. Although she is masked and gowned, her eyes show alarm. “Dr. Drake, you cut yourself.” Cue the dramatic music. Is Dr. Drake also now infected with HIV? Viewers had to stay tuned to find out…and stay tuned…and stay tuned…as the questions lingered. Unlike a primetime show, where almost all the loose ends are wrapped up within the hour, soap opera storylines go on and on. It was months before viewers were told that Thompson's character appears to have escaped infection. “What's unique about a soap opera is that we can tell these stories in real time,” McCullough said. “We actually took six months to find out. And it's difficult to do that in a film or a night-time story because you just have one show every week, which I think is why soaps are so groundbreaking as far as telling stories about cancer, because you can also see the entire process that that patient has to go through.”Figure: Andrew Holtz, MPH, is a former CNN Medical Correspondent and the author of “The Medical Science of House, M.D.” Send questions to him about how the media treat medical topics or suggestions for future columns to [email protected]Several daytime dramas—soaps—make an effort to connect with experts to shape the course and check the facts of their health and medical storylines. But as I discussed in an earlier column (3/10/07 issue), much of the research on the effects of entertainment TV has focused on primetime shows. Victoria Rideout, Director of the Program for the Study of Entertainment Media and Health at the Kaiser Family Foundation, recapped some central findings. “First, entertainment is a really powerful platform for well-crafted stories about health information to reach people and make a real difference in their lives. And secondly, repetition is key,” she said. “Fortunately, we have repeats.” Neal Baer, MD, writer and producer, first at ER and now at Law & Order: SVU, jumped right in. Although primetime shows usually collapse reality to fit into a single episode, successful shows get more than one shot to reach viewers. “You can watch those ER shows still on TNT and you can watch SVU every night, many times. But the nice thing is that people do continue to see it and new viewers see it,” Baer said, smiling as he referred to the ubiquity of Law & Order reruns. New England Journal Article that Criticized Portrayal of CPR Baer played a pivotal role in the evolution of TV's portrayal of health and medical facts. He recalled for the audience that in 1996 an article in the New England Journal of Medicine chastised ER, Rescue 911, and Chicago Hope for painting too rosy a picture of cardiopulmonary resuscitation. (Diem SJ, Lantos JD, Tulsky JA: Cardiopulmonary resuscitation on television—miracles and misinformation. NEJM 1996;334:1578–1582.) Baer and others at ER quibbled with the study methodology. “We were lumped in with Rescue 911, which always has positive outcome!” But the critique affected him—and the show. “It did give us pause, because people were saying that they thought CPR worked—and it really doesn't work, particularly for elderly people. And so then we did a show with Noah Wiley resuscitating an elderly gentleman and breaking his ribs, puncturing his lung, and doing all the things that truly do happen, to try to atone for our sins,” Baer said. When I asked if their entertainment TV shows are also affecting larger public-policy discussions, he and House writer David Foster, MD, launched into a bit of a fraternal debate. It was clear they'd had this chat before. Indeed, the two doctors who became prominent TV writers have been friends since medical school. It was Baer who introduced Foster to Hollywood. Foster is more skeptical about the weight of their influence than Baer; and later he said the two aren't that far apart. “The question was the degree to which television shows shape public knowledge and opinion. Ultimately, the two of us would agree on a nuanced, well-qualified statement,” Foster says. The research leaves no doubt that these shows, while intended as simple entertainment, actually do affect viewers' knowledge and beliefs. And as Baer remarked to the audience, viewers are learning things without even really being aware they are learning things. The lessons just seep into them. One member of the audience mentioned that point later. She said that during the conference session, as she watched a clip from ER that talked about human papillomavirus and cervical cancer, the dialogue seemed to sound almost like it was from an “after-school special.” You know, kind of preachy. But she had never noticed the instructional tone when she watched the show at home, as a regular viewer, wrapped up in the story. The stories are so engaging that even people who know better can't help but let the characters take on a surprising substance. Panelist Elizabeth Klaviter is the Director of Medical Research for Grey's Anatomy. The bonds that viewers develop with characters hit home to her, she said, when her mother wished for a consult with Addison Montgomery-Shepherd, MD, a surgeon at the fictitious Seattle Grace Hospital (this was before she left for her own spinoff this season). “Klaviter's mother had stage zero, grade one breast cancer and she had gone through her operation and everything was extremely successful,” Klaviter told the audience. “They got it all and she was confronted with whether she was going to take drug A or drug B or C: no drugs afterwards. And she says to me in a conversation, ‘I just really wish I could talk to Addison about this.’” The audience laughed. Klaviter continued, “To which, I thought, ‘Wow, I approve all her dialogue.’” More laughter. In a way, the character had become almost more real than the daughter. That's the power of a well-told tale. To Reach Oncology Times ▪ For Editorial, Permissions, or Publishing Matters: Oncology Times 333 Seventh Ave., 19th Floor New York, NY 10001 646-674-6529, fax 646-674-6500 e-mail: [email protected] ▪ For Circulation Matters: To cancel a subscription, change your address or for other subscription services, please call: 800-430-5450, fax: 800-383-1781, send an e-mail to: [email protected] or send a written request to: Oncology Times, 2340 River Rd., Ste 408, Des Plaines, IL 60019-9883. ▪ For Classified Advertising: Melissa Moody, LWW 351 West Camden Baltimore, MD 21201 800-269-4339, fax 410-528-4452 e-mail: [email protected] ▪ For Information about Reprints: Patrice Culligan Pharmaceutical Media Inc 30 East 33rd St New York, NY 10016 212-904-0369 [email protected] Event Online Video and audio of a portion of the AHCJ “Hollywood & Health” event are available at www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2074