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Subverting Authority: The Cultural Work of Medical Romance

Por: | 04 de abril de 2013



A blinking light. We hear the blaring siren of an ambulance, the beep of an ECG monitor, agitated voices coming over the radio and the thud of a car door banged shut—abruptly followed by silence. Then the opening credits of "Bitter Pills" begin to roll, the first sequence of the US TV show Nurse Jackie, accompanied by a slow number by Jane Riberry. Still bathed in harsh white light, we seem to float, looking down from above, to finally zoom in on a motionless body lying on the floor: supine, arms outstretched, eyes open. A woman’s voice-over begins, in a solemn tone, and we take in the scene as a visual code for an out-of-body experience: somebody is dying. And then the body, that of a woman, shows signs of life. She has in her hand, and is shaking, what turns out to be a pill organiser. The voice-over asks: "What do you call a nurse with bad back?” and immediately provides the answer: "Unemployed." The woman, in fact a nurse, realises that there is only one pill left in the box she is holding. "That sucks," she says, and the show begins.

Nurse Jackie, premiering in 2009 on Showtime, an American TV channel, opened to its fourth season in April 2012. The series is a recent addition to medical romance, one of the most popular modern genres today, which first emerged in the nineteenth century. In the context of Western societies increasingly and rapidly dominated by modern medicine and its growing authority, popular narratives increasingly focused on the physician and the nurse as exemplary, outstanding, and above all authoritative central characters. In my project, I take a close look at American medical romances of the second half of the nineteenth century to discuss the cultural underpinnings of those texts during a period of rapid social transformation. Given my agenda of cultural studies, I look for the functions beneath the surface plot of this genre and its recurring codes, which, as in the example above, it uses or subverts: Does the genre popularise scientific and medical knowledge? Does it promote understanding and empathy for the ill and the suffering patient? Does it portray a realistic picture of the state of health care at a given point in time?

Many well-known nineteenth-century American writers—Nathaniel Hawthorne and William Dean Howells, Frances Ellen Watkin Harper and Charles W. Chesnutt, Louisa May Alcott and Rebecca Harding Davis—have used the emerging format of medical romance, its conventions reinforced equally in popular fiction carried by periodicals and dime novels. Yet, as in the contemporary show Nurse Jackie, we will mostly search in vain for accurate depiction of medical realities. Although readers of those medical romances then, as much as TV audiences today, believe that the texts and the shows are closely based the day-to-day work of doctors and nurses, in reality these narratives are only superficially concerned with medical practice, with treating disease, and with helping individual patients. Instead, this genre focuses on the health worker, appropriating his—and increasingly her—authority in support of a variety of arguments. By turning a doctor or a nurse into a story's hero or heroine, medicine and the modern society, in which modern medicine has such a pervasive role, are deeply romanticised—subverting realism and questioning and undermining its claim to be the truth.

To return to Nurse Jackie: Jackie, the woman we encountered in the opening sequences of the series, is not (yet) unemployed, but she suffers from chronic back pain, which she chooses to treat herself with drugs handed out by the hospital’s pharmacist, who is her lover. In this, Jackie’s situation is similar to that of another contemporary (in)famous health worker on TV, Doctor House, who takes heavy doses of a painkiller without a prescription. Yet Jackie and House differ in important ways: whereas House has no fear of losing his job, the threat of being unemployed looms large in Jackie's life. Jackie is a woman, and only a nurse at that, even if—as the opening sequence indicates—she knows more than many of her male superiors. To highlight gender imbalance and to renegotiate gender roles are, in fact, two of the core and often hidden functions of medical romance; these functions were in place right from the beginning of the genre in the nineteenth century. At the time, medical romances provided a way to question the status quo of American society, to put forward claims for equal opportunity and to explore the possibility of participation on equal footing. In the form of these functions, medical romances often have a partly subversive agenda in that at the same time they reinforce the dominant scripts of social propriety and naturalise the concepts of race. Medical romance attempts to forge, in symbolic terms, a nation divided on multiple planes, obviously only with modest success so far. In considering medical romance today, it can be illuminating to examine the ways in which the genre renegotiates the terms of belonging to contemporary society and the roles gender and race play in contemporary Western society.


Antje Dallmann
Humboldt-Universität zu Berlin

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