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What sort of doctor would rather create medical shows for TV than practice medicine?

July 29, 2007|Mary McNamara | Mary McNamara is a Times TV critic

The whiteboard that hangs in David Foster's office on the Fox lot is, in its own way, a window on two worlds. On it, in black and blue marker, he has written a crowded stack of plot points. Or character arcs. Or medical terms. It's actually quite hard to tell, given that the words are written in that classically indecipherable physician's scrawl.

Foster is a co-producer of the medical hit "House." He is also a doctor, one of a handful of physicians and researchers who straddle the worlds of science and imagination to keep some of the top shows grounded in medical reality while exploiting the dramatic possibilities of a pulmonary embolism or Tourette's syndrome. On "ER" alone there are six--two doctors who are full-time writers/producers, two who are part-time consultants and two who are technical advisors. "Grey's Anatomy" on ABC has one MD on staff to make sure the actors talk like doctors, one nurse to show them how to act like surgeons and two full-time medical researchers to help the writers find and flesh out the cases that often mirror each episode's theme. And in addition to Foster, "House" has four more physicians working as consultants.

It's as niche as niche gets, and a golden niche it is. "House" and "Grey's Anatomy" are two of the biggest breakout shows on television, racking up a plethora of awards and nominations for each of their three seasons. Even after 13 years, "ER" remains landmark television.

It's good to be a Doc Hollywood these days.

"It's the best of both worlds," says Lisa Zwerling, a pediatrician who has written for "ER" for four years. "There are days when I cannot believe I get paid to do what I do."

Time was when medical shows were not this complicated. The doctors on shows such as "Marcus Welby, M.D." were gods--whatever they said, went, no matter the vagueness of the terminology; it was all in the authoritarian delivery. Even the soap opera "The Doctors" opened with the earnest intonation "Dedicated to the brotherhood of healing."

Then came NBC's "St. Elsewhere" and "ER" with their brilliant but flawed doctors. Delving into the gore of the emergency room, "ER" especially put medicine, with its miracles and limitations, front and center as specialists consulted with surgeons and everyone bandied about diagnoses and possible solutions. Suddenly, this was not only drama, it was also public service. One famous "ER" episode, in which a pregnant woman with preeclampsia (which is characterized by high blood pressure) died, continues to haunt women 10 years later. "When I told my ob/gyn I wrote for 'ER,' " says Zwerling, "he said, 'Do you know you've made an entire generation of women paranoid about preeclampsia?'"

As Foster will tell you, the best part about being a doctor has always been the stories. The tales about teachers and patients he and other students swapped to shore themselves up against the pressure of med school; the medical histories and personal narratives his patients told him at the inner-city clinic in Boston where he worked for five years; and the cases he continues to discuss with doctors around the country since he moved to Los Angeles.

"The great thing about being a doctor is that you get to hear stories from people whose lives are so different from your own," he says. "It's why I went into medicine. This is a natural extension of my work as a doctor. A chance to tell compelling stories about medicine."

And the really bad handwriting?

"It's my secret weapon," he says. "That way no one has any idea what I'm working on."

Not that legibility would make a difference. At "House," which chronicles a premier diagnostician, much of the drama is the medicine, or at least the symptoms, which always look like something else before turning out to be some obscure syndrome or a malady so simple that no one thought of it. Foster is in charge of writing two episodes per season as well as helping the rest of the writers with the medical portion of their plots.

"It's very tricky because the A story is so complicated," Foster says. "Each writer will come up with a kernel of an idea--it could be a character or a twist in Act 4. A patient that House respects, so he acts even crazier than usual. One writer saw an image of a fetal surgery in which the fetus' hand reached out and touched the doctor, and so that became a story. Sometimes you work backward, sometimes forward. Every story is different."

Like Foster, Zwerling loves stories and wrote her way through high school and college and even into her career as a pediatrician in the Harbor-UCLA emergency room. When a friend told her about a woman working on a medical pilot who was looking for a doctor who could write, Zwerling's hand shot up. The show was "Presidio Med," executive produced by John Wells. When "Presidio" got the boot halfway through the first season, Wells, who also is executive producer of "ER," asked Zwerling if she'd like to join that show. "I jumped at it," she says.

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