'Grey's,' heal thyself: Focus on medicine

Change is hard, as Meredith Grey has observed more than once in the signature voice-over of Grey's Anatomy. After the show's strange slide into bathos last season, everyone involved acknowledged a certain creative downturn, a gloomy earnestness, that would, they swore, be rectified. "We're bringing the fun back," show runner Shonda Rhimes said. Indeed, the first episode of Season 4 was titled "A Change Is Gonna Come." And millions of fans breathlessly waited ...

And waited. Eight episodes in, things have happened of course. George (T.R. Knight) told new wife Callie (Sara Ramirez) that he cheated on her, so that marriage is over and George is officially in love with best friend Izzie (Katherine Heigl). The suddenly single Callie moved in with the suddenly jilted Cristina (Sandra Oh). Derek (Patrick Dempsey) and Meredith (Ellen Pompeo) continue their dance of longing and leaving.


But the only real change is that Isaiah Washington is gone, and the fabulous Brooke Smith, playing Dr. Erica Hahn, has taken his place. The acerbic Hahn seems to be a carefully considered stand-in for viewers choking on the soapy silt of last season, a way for the writers to move forward without messing with the hugely successful brand.

Changing a big hit television show is a tricky business. It's easier to merely tinker, though often not as effective. And while Grey's remains a big hit, its ratings continue to slide; a few weeks ago, they hit an all-time low.


At Fox, on the other hand, the creators of House have gone with a bolder approach -- bringing in a whole new set of ancillary characters to cure the increasingly myopic focus on the lead (Hugh Laurie) -- with more satisfying results. Likewise Nip/Tuck, on F/X, decided to forgo the Botox and give itself the big midlife lift. But the writers of all three shows have apparently remembered that the only thing people like to talk about more than their love lives is their ailments.

In other words, while viewers like the romance and character development, they need to have their medical shows rooted in, well, medicine.

Doctors, cops and lawyers dominate network TV for a reason. Their jobs, by their very nature, provide the exact ingredients of a successful TV show: smart, professional main characters; a high turnover of interesting ancillary characters (patients, clients, criminals, etc.); and, of course, the life-or-death tension that eludes most of us.

Watching lovely people tango with lust while they perform heart surgery or an odd couple find a friendship while they track down serial killers provides not only emotional "frisson" but audience connection to a rarefied world.

What made Grey's Anatomy so successful in the first place was its creation of prickly yet still sympathetic characters, who were then put into an extraordinary circumstance -- the first year of residency at a high-pressure hospital.

The problems of last season, which have unfortunately trickled into this season, were not about losing sight of the fun, but of the medicine -- the dramatic possibilities of medicine. These are doctors, with all manner of flaws and frailties, yes, but still doctors. Which is why they have their own TV series. (And writers' strike notwithstanding, Grey's, House and Nip/Tuck are good for at least another month of viewing.)

The second season of House was even more successful than the first, but it was clear that the increasingly intense focus on the foibles of Gregory House (Laurie) and his strained relations with his team was limiting the show. So the writers decided to start all over again. Literally. At the end of last season, Drs. Foreman, Cameron and Chase had either quit or been fired. This season opened with House vainly attempting to go it alone. After hilariously turning to a janitor for help, House, rather than weeding through job applicants, accepts them all. Then he eliminates most of them as if he were the medical Heidi Klum of Project Runway.

What seemed like shtick turned out to be a brilliant move. The original team is still around with different duties, but half a dozen new people have brought in new stories.


Likewise, Nip/Tuck dragged itself out of a self-involved rut by hauling Drs. McNamara and Troy from Miami to the City of Angels. This gave the creators a whole new playpen to roll around in, not to mention a legitimate call for main character development.

Consider, for a moment, that ER, which created the modern model of the medical drama, with all its surgical sturm and emotional drang, still marches on, having cycled through several generations of cast members. It may not be the fresh, innovative show it once was, but 300 episodes and 13 years on the air? That, my friends, is the power of a well-tended IV.

Mary McNamara writes for the Los Angeles Times.