Also written while bored on an airplane.
I was a huge fan of the ER tv show from the first episode. A year or three ago we stopped watching. We’d been tapering down and found it less and less essential for years. I can tell you the episode of shark jump for me personally. It was when Carter went to Africa for the first time, and I think it exposed a moral failing of the show’s world view that I had never noticed before.
The storyline at the time involved Carter’s grandmother working to get him involved with the family foundation, ideally taking it over. Think Macarthur Foundation, that’s always what it seemed blatant to me that they were trying to evoke. Carter was ducking out on these responsibilities, refusing to return phone calls, etc. At some point, there was a conversation where he explained why he was going to Africa to treat patients rather than helm the charity. He said something like “I don’t want to spend my time with rich people, I want to help people.”
Now, a doctor wanting to expend the enormous commitment of time, energy and their soul to go to Africa and help is commendable and they should be praised to the rafters and encouraged. However, any doctor that is presenting with the Carter Dilemma and makes that choice is an irresponsible idiot. I daresay few MDs that do this are refusing to head a wealthy charity by their actions. To rephrase slightly the Carter speech, I heard it as “I don’t want to control the allocation of billions of dollars of charitable assets, I want to help people one by one in the Congo.” When you work out the calculus of good that can be done with either path, they differ by orders of magnitude. “I don’t want to help millions when I can help dozens” is the other way to phrase it.
So here’s the world view of ER in a nutshell (simplified a little, but still.) Any rogue maverick always has more value than any system. A doctor or med student who is sure of a fact and willing to risk a patient’s life on it outweighs any body of knowledge and procedures. The person who cares the hardest is always the most technically correct. Playing by the rules is for pussies.
After years of this show and its “medicine by machismo (or machisma)” I am so sick of it that I will never watch another episode again. I believe one person can and should make a positive difference for another person whenever and wherever possible. When you decline a unique and explicit opportunity to make a positive difference for a thousand because you are more comfortable with the one, you are just jacking around with the commonweal and failing big time.