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The Poetry of Nursing by Natalie Safir
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Film Review: The Doctor (1991)
Dr. MacKee as Ivan Ilych
Coincidentally, after publishing Natalie Safir’s review of The Poetry of Nursing, I watched the film, “The Doctor” (1991) with William Hurt, based on a true story. Hurt plays the role of Dr. Jack MacKee, a heart surgeon who achieved the “good life” by materialistic standards: wealth, prestige, a beautiful home with a lovely view. And although MacKee has it all, and his family appears to be happy, beneath the surface, they seem to be living separate lives in separate worlds. In a way, Dr. MacKee reminds me of Tolstoy’s Ivan Ilych. Both Ivan and Jack experience the anguish of disillusionment. Given MacKee’s demanding work schedule, time with his wife and son is limited. Indeed, his seven-year-old son rarely sees him except for brief greetings. For example, when MacKee came home early one evening, his wife called their son to join his dad and by habit, the boy picked up the phone, assuming that his father was calling from work. As a medical instructor, Dr. MacKee unconsciously passed on his lessons of arrogance to his residents by warning them to “not get emotionally involved with patients. What matters is that you cut straight.” The story begins with Dr. MacKee flipping on his favorite song while performing an open-heart surgery. At first, it’s amusing, but then you become aware that the doctors’ wise cracks, the lyrics “I just wanna get drunk and screw,” seem inappropriate, considering that they’re operating on a human being, not a turkey for holiday cheers. The one person who refuses to participate in the mischief, who kept an attentive eye on the patient’s condition—is the nurse. Dr. MacKee would often joke with her during the procedure, “When are going to run away with me, Nancy? Come on, Nancy, sing! just once for me!” Nancy continues working. By contrast, Dr. MacKee and his colleagues are like school boys who turn the integrity of the surgery room into a doctors’ clubhouse. Although it all looks like fun and games, like Ivan Ilych’s tragic awakening to the knowledge that he had led the wrong kind of life, MacKee’s little pretentious world came tumbling down the day he learned that he had a growth in his throat. The tables have turned, and now MacKee would find out what it’s like to be one of those “patients” that you don’t waste emotional time on. The first thing that MacKee discovered is that being a prestigious surgeon at the hospital he worked at didn’t entitle him to special privileges. To everyone else, he’s just another patient at the doctor’s mercy. It is his first occurrence with the “system” as “patient.” He is subjected to the bureaucratic routine of filling out applications and forms, of feeling humiliated in a see-through gown, of being handled like a guinea pig in a laboratory, of waiting long past the appointment time only to hear his own impersonal words repeated from his doctor, “Sorry I’m late. It’s been a busy day.” He’s finding out that he’s just a cog in the wheel of routine. Before his first chemotherapy treatment, he asks for the lead apron to protect his body from radiation exposure. He is told by the technician, “Oh don’t worry, doc, it only hits the targeted spot.” MacKee nevertheless insists, “Yeah, but can I still have it?” “You don’t need it,” announces the technician, “Just don’t move.” As merely a patient, MacKee is left out of the decision-making process. His chemotherapist tells MacKee that he’ll know what to do after consulting his doctor. “And me,” replies MacKee. But the comment is met with deaf ears. Little by little, MacKee begins to see how he played his role in a system that dehumanizes and objectifies human beings. He begins to see through the eyes of others. And for the first time, as a doctor, he is forced to acknowledge his own mortality. At the chemotherapy center, he meets June Ellis, a young woman who is dying from a massive brain tumor. June opens MacKee’s eyes to what it means to live honestly, to be truthful with others. Doctors are in the habit of not being truthful if they think it’s a risk for them. In The Death of Ivan Ilych, Ivan reaches a final point of exasperation with his doctors: “Oh for Chrissakes! Do you never get tired of lying?!” If something doesn’t go right, doctors will never admit it, nor will they so much as apologize because saying “I’m sorry” may be construed as admittance to wrong doing. In the midst of this confusion, June’s friendship is MacKee’s saving grace. Spiritually speaking, June is MacKee’s angel, the patient who teaches the doctor to be true to himself. In June’s case, her insurance company did not recommend an MRI because it was too expensive. Consequently, June’s diagnosis was not discovered until it was too late. Bottom line: it’s all about money, not saving lives, for the insurance companies. After being treated like an anonymous number, MacKee confronts his doctor as though he were confronting the ghost of his past. When the radiation doesn’t work, his doctor tells him that she can work in the surgery by late afternoon, like she was doing him a big favor. He tells her that she’ll be tired at that time. She snaps back, annoyed that he’d have the nerve to question her authority. Finally, he asks for his file. She rudely pulls it out and tosses it at him. Like Ivan Ilych’s colleagues who could not see the warning signs: This will happen to you someday—she didn’t want to hear his hard-earned wisdom: that one day, she, too, will be a patient and she wouldn’t want to be treated this way. It’s at that point that MacKee turns to the one young surgeon he and his colleagues teased for being the “caring doctor,” who “talks to his patients even when they’re anesthetized during surgery.” They’d jokingly call Dr. Eli Blumfield “the Rabbi” not for being Jewish—it had more to do with his ability to empathize. MacKee turns to Dr. Blumfield for the surgery—because he is the only doctor he trusts. Without hesitation, Blumfield assures MacKee, “I’ll do it tomorrow.” MacKee turns to him with a sense of shame, “I’ve said some things about you…for which I’m ashamed of…” The doctor calmly tells MacKee, “Well, I’ve wanted to slit your throat for a long time, MacKee, and now I’ll get that chance.” MacKee laughs out loud even though laughing is probably physically painful for him. It’s a wonderful moment in this film – because humor, in the right place, at the right time, can be like medicine to the heart. It was one more lesson MacKee had to learn: use humor to lift people up, not to humiliate them as he and his colleagues had often done. Certainly, doctors and nurses can not be saints at all times to all people. Surgeons are under tremendous pressure from all sorts of demands. It’s probably easier to shift into automatic in order to get through the day. After a while, patients all look the same, all the many faces and complaints blend together. Nevertheless, doctors must try to step back and realize that neither they nor their patients are cogs in a bureaucratic wheel. Socrates argued that virtue cannot be taught. Likewise, perhaps empathy cannot be taught. MacKee probably always had the heart to care, but his ego got in the way. It took a life-threatening situation to wake his soul, to get his priorities straight as a husband, father and doctor. In the same way, The Poetry of Nursing, introduces the work of caring nurses who’ve empathized with their patients and who’ve walked away from those experiences with a lasting wisdom that they have beautifully expressed through verse.
—Jacqueline Marcus, Editor of ForPoetry
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