Keep taking the tablets

Since Emergency Ward 10 threw open its doors 40 years ago, hospital dramas have continued to set the nation's pulse racing. James Rampton examines the extent of our addiction

Television drama commissioning editors, desperate to alleviate the terminal condition of haemorrhaging ratings, have long turned to reassuring people with stethoscopes and white coats for a cure. "Trust me, I'm a doctor," the characters seem to be saying to the stressed-out executives, "I can stem the flood of viewers to the other side."

But why have catheters and crash-teams unfailingly been the TV commissioner's little helpers since the doors of Emergency Ward 10 were thrown open to the viewing public 39 years ago? Docs on the Box, a BBC2 theme night on Sunday, aims to provide a diagnosis.

The actor Clive Mantle, who plays A&E consultant Mike Barrett in Casualty and links the programmes in Docs on the Box, puts his finger on the popular pulse. "The plethora of medical dramas are there to reassure the audience that if they were ever in that position, there are people out there who would nurse them back to health. The voyeuristic element is very small. People don't watch for the nasty bits; they turn on because they want to see people getting better."

Phil Hammond, a GP and medical lecturer from Birmingham, begs to differ. "There is always voyeurism about human suffering. People watch in order to think, 'thank God that's not me'."

Nicola Moody, executive producer of Docs on the Box, gives a third opinion. "A hospital is a classic place to set a drama. It has all the necessary elements of populist drama. That's why we're all so addicted to it."

Are we not all in danger, though, of ourselves being rushed into Casualty suffering from a severe case of doctor fatigue? Not content with crash- bang-wallop hospital doctors (Casualty, Cardiac Arrest, ER, Chicago Hope, Medics), schedulers are now intravenously feeding us: cosy country doctors (Peak Practice); helicopter doctors (Red Alert); police doctors (Dangerfield); period doctors (Bramwell); and post-mortem doctors (Silent Witness).

"Of course there are too many hospital dramas," Mantle concedes, "but they wouldn't be there if people didn't like them. If people stopped watching them, then television companies wouldn't make them. It's all about ratings, and the BBC are just as keen as ITV to get audience share. If you don't like it, don't watch it."

The centrepiece of Docs on the Box is Playing Doctor, an entertaining ward-round of medical dramas from Emergency Ward 10 to Cardiac Arrest. In the early days, the doctors were depicted as gods wielding stethoscopes like magic wands. A million hearts fluttered at the divine looks and bedside manner of Richard Chamberlain's Dr Kildare (above, showing at 8.05pm on Sunday) and the telly hospitals were the only ones in the world where no deaths ever occurred. (It was nearly three years before anyone died in Emergency Ward 10, and when he did - of an appendectomy - there was such a storm in the papers, the producers decided from then on only to kill off characters in accidents.)

In 1972, that air was shattered as the choppers from M*A*S*H flew in. "That completely changed our perspective with its irreverence," Moody continues. "It dispensed with the idea of the operating theatre as sacred temple and viewers learnt to accept the reality of more blood, more gore, more humour."

Phil Hammond, however, questions the accuracy of some medical dramas. "If you watch ER, when a cardiac arrest happens, there are two minutes of gobbledegook and it's done. In the NHS, it'd be 46 phone calls and a three-hour wait. In real life, when you bleep the consultant, he's usually in the bath or on the loo. Also, TV hospitals have many more resources. They ought to open the Casualty set as an NHS hospital. It would be the best resourced hospital in the country."

Hammond's typical medic's sense of black humour is reflected in Cardiac Arrest, real-life doctor Ged Mercurio's in-your-face and in-their-guts view of the NHS. Here, medics laugh bitterly about August being the "killing season" because so many newly-qualified doctors are doing the rounds.

"Television made me choose that [being a doctor] as a job," Mercurio avers. "You watch TV and you see these guys having a really good time, and you think, 'Oh wow, I'll be a doctor, that'd be brilliant.' Then you do the job and you realise it's a piece of crap, and you think, 'Right, I'm going to make a TV programme that tells the truth,' so loads of people watch it and go, 'I'm not going to be a doctor'."

Staff interviewed at Bristol Royal Infirmary for Playing Doctor found Cardiac Arrest the most realistic medico-drama around - a view that Hammond confirms. "No doctor has much time for Casualty," he reveals, "it's too patient-centred. If they do watch it, they just sit there and laugh when a needle goes in wrongly. Doctors are tossers. Cardiac Arrest centres on the doctors' world. It's almost written for doctors - and people with a very cynical sense of humour. It's the only one which portrays the bad attitude of doctors. They catheterise patients really roughly, and the nurses are just anti-Christs. Doctors' relatives watch Casualty and say, 'that's what my son's like', while doctors watch Cardiac Arrest and say, 'that's what I'm like'."

So hospital drama has, over the years, reflected society's view of doctors: in the present reality of the Patients' Charter and increasing medical litigation, the omnipotent divinity in a white coat has been revealed to have feet of clay. "We now see doctors as real human beings with fallibilities as well as amazing abilities to treat people," Moody contends.

For all that, we show no signs of wanting to give up our fix of medical dramas. Indeed, Channel 4 is planning its own medical theme night called "Doctor, Doctor". But now that every conceivable conventional setting has been explored, Hammond suggests an alternative future. "With more and more people getting into complementary medicine, we might soon see Crystal Healer - The Series, or Douglas Welby: Acupuncturist. That's the way it'll go."

'Docs on the Box' starts Sun at 8pm on BBC2