Surgical accuracy

Can a hospital drama revive the image of Chinese doctors?

Bai Baihe-w

Bai Baihe: plays a thoracic specialist in Surgeons

In China, doctors don’t have the stellar reputations they enjoy in countries like the US and the UK. The majority of physicians are poorly paid and overworked. In fact, one survey in 2015 revealed that only 6% of the country’s doctors made more than Rmb10,000 ($1,600) a month. In many public hospitals doctors take kickbacks from pharmaceutical firms to supplement their incomes. Some even solicit bribes, or “red envelopes”, from patients or their families.

This widespread malpractice further tarnishes the image of Chinese physicians. Small wonder then, violence against doctors has also become commonplace. In 2012, a teenager was sentenced to life in prison after killing a medical intern and stabbing three other workers at a hospital after a doctor refused to treat his spinal condition (for more example, see WiC252).

Some doctors admit to feeling demoralised about entering what is supposedly a noble profession. “I regret very much having chosen to study medicine,” wrote a Chinese medical student in the English medical journal the Lancet.

Hopefully, the latest TV show Surgeons will change some of the public perception about doctors. The series, which is available on Beijing Satellite TV and Zhejiang Satellite TV, has been one of the highest trending topics on weibo since its premiere last month.

Surgeons follows the career of Lu Chenxi, a ferociously ambitious but hard-edged thoracic surgeon (played by Bai Baihe), who offends as many people as she saves. In contrast, the other main character is a mysterious surgeon (Jin Dong), who returns from the US to find out the cause of his mother’s death.

Even though medical dramas have long been a staple of primetime television in the US – since ER, there has been Grey’s Anatomy and House just to name a few – the genre is virtually nonexistent in China.

To begin with, producing a medial drama is more of a challenge than most other TV genres, and even more so in China. “It is difficult to write the screenplay; difficult to film; difficult to pass censorship,” says Beijing Youth Daily. In fact, most so-called medical dramas use the hospital as a backdrop while the characters spend little time actually practicing medicine.

Finding a writer that is familiar with medical procedures is not an easy task either. “You can’t solely rely on your imagination when you write for a medical drama,” says writer Liu Liu, who spent over two years in a hospital before he wrote the medical novel Xin Shu in 2012. “It’s not just about the medicine. But how the hospital is structured; how the different departments work together. So even if you are a good writer, if you don’t know medicine and don’t know how the hospital works, the end result is not going to be right.”

Media watchdogs are also very strict about how scenes involving surgery are filmed: anything that shows too much blood and is too graphic is ruled out. Producers in the past have also complained the state censors often demand that they “glorify” doctors, presenting them as morally upright demigods.

To make the drama closer to reality, the producers of Surgeons tapped scriptwriter Zhu Zhu, a graduate from the Peking University Health Science Centre, to write the screenplay. Director Li Xue spent almost six months studying medical procedures and making sure everything from the props to the costumes were accurate. All the surgery scenes were also filmed in an actual operating theatre.

Surgeons has still attracted a fair share of negative reviews. Like most medical shows, most of the complaints appear to come from real physicians, who have called the show “unprofessional” and “defying common sense”.

In one episode, Jin’s character puts on a sterile surgical coat incorrectly (“a mistake that would give an operating room nurse a heart attack,” one wrote). In another, without even finding out the reason why an operation has gone wrong, the surgeon orders a transfusion of red blood cells, which many professional physicians were incredulous about. Similarly, Bai’s character dismisses other more senior figures during a patient round so she can lecture an intern. Real doctors say that is the quickest way to get fired.

Zhu, the screenwriter is unfazed by the criticism, admitting that Surgeons isn’t just about accuracy. “I’m sure there are flaws. But I’d also like to point out that given the amount of medical cases the show tackles, the percentage of us getting something wrong is small. At least, not enough for audiences to say that this is a show that completely disregards the spirit of medicine,” she told Shantou Evening Post.

Most viewers have been forgiving too. “The drama gives viewers an opportunity to understand the medical profession. When I am watching I am also more concerned about the doctors and the conflicts they confront. Minor errors are not going to affect my overall judgment about the series,” one netizen wrote.

Surgeons is also outspoken about the problems within China’s medical system. In one episode, one doctor complains that the most senior cardiothoracic surgeon only performed four operations in a month. Of these, two were high profile cases that would generate media coverage and the other two were related to research for pharmaceutical firms.

Indeed, as the series progresses, more and more viewers say they are more sympathetic to the dilemmas that doctors face. For instance, in one episode, Lu tries but fails to convince a couple to put their premature baby through surgery even though the chance of it succeeding is high. The same day, the daughter of an old woman insists on submitting her mother to surgery, even though it will only add to her misery.

For the viewing public, the show introduces a human element that could improve the perception of hospital workers. “In medicine, nothing is ever going to be perfect, we just strive to do our best,” Jin says in the initial episode. That sense of upbeat realism dovetails nicely with the wide range of healthcare reforms the government has been undertaking to improve patient coverage and combat corruption in the sector.

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