PBS begins series with diagnosis of Hopkins Hospital

TELEVISION PREVIEW

April 05, 1993|By David Zurawik | David Zurawik,Television Critic

PBS puts Baltimore's Johns Hopkins Hospital under a microscope tonight and asks some tough questions about the way medical doctors are trained.

"Medicine at the Crossroads," an ambitious eight-part series, begins at 9 o'clock on MPT (Channels 22 and 67) with an hourlong look at Hopkins titled "Temple of Science."

"The teaching hospital, home to the most advanced technology, the most revered doctors and scientists, the most seriously ill patients," begins narrator George Page as the show opens with a montage of Hopkins images. "But are doctors trained in this environment learning to practice the kind of medicine most people really need?"

The show's answer is, ultimately, no. The segment argues that 90 percent of all training is conducted in high-tech teaching hospital, such as Hopkins, where only 1 percent of patients nationwide are actually treated. That 1 percent consists of the most seriously ill patients, the series says, and doctors are thus left unprepared for primary care and prevention.

As a result of the dichotomy between training and the community's needs, "People have lost their faith in doctors," says the Rev. Melvin B. Tuggle of the Garden of Prayer Baptist Church in East Baltimore. His program to involve doctors with the East Baltimore community is featured in the show.

"Temple of Science" is a compelling documentary, full of skillfully edited, powerful images that often evoke emotional responses.

A segment of the show featuring Jo Marie Leslie, a physician's assistant in Hopkins' AIDS unit, juxtaposes scenes of her group's compassionate care for a terminal patient with Leslie's assessment of how residents are trained at Hopkins and elsewhere.

"It's like being in a war," Leslie says. "It's a very brutalizing experience. [Residents] go into the training [as] one kind of person, and they come out very, very different people. They come out . . . much harder. . . . [It's like] having been to war and some of them are still bleeding . . . or they've got pretty nasty scars, and that will show in the way they care for patients from now on."

At another point in the show, Leslie says, "We refer to patients as hits. And an admission is a hit. It's wartime talk. And the patient can become an enemy."

Beyond the specific look at Hopkins, "Temple of Science" has a larger vision. For all the training and new technology, in the end medicine is still human beings trying to help other human beings.

The notion is crystallized in interviews with a first-year resident who is treating an elderly man with multiple ailments. The resident tells an interviewer that the man "looks like he's improving." The man then tells the interviewer that he feels like he's getting better. But then the narrator tells us that the man died the next day.

In a follow-up interview, the resident struggles to articulate her feelings: "You find out . . . that a lot of our so-called therapy is not really based on . . . any well-thought-out study. . . . We don't really know. There is a lot of uncertainty in medicine."

Produced by WETA in Washington, with WNET in New York, the BBC in England and other international partners, "Medicine at the Crossroads" will be telecast on four consecutive Mondays as two-hour specials. Next week "Medicine" looks at the increasing demands an aging population will place on the health-care system. The second half of the program examines the moral and ethical issues raised by medicine's increased awareness and control of genetics.

Subsequent episodes will deal with the amount of unnecessary surgeries and the public expectation that every disease can be cured. The final program examines efforts in other countries to prevent disease and the care and treatment of the mentally ill.

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