Somewhat of a ramble I'm afraid - my brain is shredded at the moment.
Another TV medical series, another missed opportunity. I'm yet to see the first episode of NBC's 'Trauma', mostly because I'm not American, but I have read some of the responses to the first episode, from the short 'Funniest damned EMS show since Mother, Juggs and Speed. Wait, you mean it's not a comedy?' to the longer review on JEMS
'I also realize that it's 2009, and writers and producers like to inject sex into every episode, and have characters with cocky, rebellious 90210ish cast members who bring a host of personal problems to work, but this series bubbles over with a cast that should be stationed on Wisteria Lane, not the streets of San Francisco. The premiere of Trauma doesn't begin with a well-dressed crew checking their drugs and equipment before their first run. It starts with the sights and sounds of the boyfriend/girlfriend crew having sex in the patient compartment of their rig. Then, before you can get the words "I can't believe it" out of your lips, you hear the dispatcher (who obviously knows the way the crew starts their shift), tell "Naughty Nancy" Carnahan to button her blouse and respond to an emergency call.'
Even the NAEMT has penned a rather strong letter to the producers,
Why is it so hard to write a decent, realistic TV drama about emergency or pre-hospital care?
I think that there are two reasons, first that TV producers think that viewers are stupid, secondly that the writers carry paintbrushes.
I remember, as a child, watching Rolf Harris on a Saturday afternoon creating works of art using 4" paintbrushes. Big sheet of paper, slopping the paint everywhere and then, as if by magic, a painting would appear.
Big tools, used well to create wonderfully subtle works of art.
Writers today also use those 4" brushes, but they use them not for portraits, but to paint walls. Huge strokes slabbered on with no finesse. Before I visited NBC's character biographies I could guess the characters 'personalities'. You'd have the maverick, the womaniser, the hard as nails female, the unsure rookie, the heartless administrator, the drinker/gambler/philanderer. The list goes on. Oh, and we must not forget the racially diverse cast of good looking people.
Look at those character types, you can see them appearing in pretty much every show.
For another non-medical example of how characters need to be drawn in these wide strokes look at the new TV series 'Flash forward', based off a book by Robert J. Sawyer - in the book the protagonist is a physicist. In the TV series, an FBI agent. I'm guessing that it's easier to create an interesting FBI agent (with an alcoholic past natch) than it is a sympathetic physicist.
Writers seem to be using these shorthand clichés so that they don't confuse people, and because they are so easy to write for.
It's the same with the 'plots' that they find themselves in - after watching one TV programme too many I have come up with a variation on Chekhov's gun. 'Chekhov's pregnancy' - 'If there is a heavily pregnant woman in the first act, she will get trapped in a lift/locked building/under rubble and will then give birth'.
(Needless to say, on TV pregnant women race through the stages of labour in fifteen minutes, not the more normal twelve hours or so)
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So that's the writers, but why do they write such rubbish? Well I sincerely think that it is down to the TV production companies wanting to keep things simple. A writer once told me about his great script that got cut to shreds because the producers wanted 'people in tower blocks to understand it'.
It's that talking down to people that really gets on my nerves - that we can't have TV that is well written, that shows that not all politicians are corrupt, that all doctors are worthy, that all journalists are sleazy and will stab anyone in the back to get a story, that the police have a heart of gold, that nurses are sex maniacs or that all married men desire extra-marital sex.
Does TV really have to be all broad strokes and dumbed down? Can we not use TV to show people the subtleties of life rather than a Daily Mail diet of 'X is Good, Y is Bad'.
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And yes, 'Casualty' does still make me grind my teeth - 'blonde sexbomb'. 'joker', 'socially awkward nerd in glasses' who, in the their second episode tell us what their personalities are by talking to a psychiatrist. Next series I think they'll stop giving the characters names and instead they will instead walk around carrying placards with their character traits written on them.
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What you need is an ambulance worker who likes little old ladies, not because he cares for his elderly grandmother, but just because he finds them sweet. Who dislikes drunks, but secretly enjoys picking them up because they are an easy job that he doesn't need to talk to them while they sleep on his stretcher. Who sees that the ambulance targets are crap but is powerless to do anything about it, and who isn't a 'joker' and 'maverick' a 'bad-ass with a heart' but is just a normal person doing an unusual job.

