Opinion | I Am Caught Between the Two Worlds of the I.C.U. and TV

How I loved that phrase the first time I heard it. That was all I wanted for so many of my patients: to be able to have another chance, to treat the sepsis earlier, to stop the pastor from advising against vaccination. To fix it in post.

During the pandemic, I have found my roles as a critical care doctor and television writer increasingly in conflict. I want to memorialize and honor every tragic death, but I also yearn to tell stories that are hopeful, to immerse myself in a world where there is always the chance for recovery, no matter how dire the diagnosis.

It is a tension I am still learning to navigate. How do we tell stories that feel true while also keeping viewers engaged? What kind of cheats are acceptable, and which are irresponsible? Television characters survive cardiac arrests far more often than people do in real life. But if we showed all codes as they really are, all the ribs breaking and limbs flailing and the nurse left alone to clean up after the death, our viewers would change the channel. I struggle to define the line between my responsibility to reality and to entertainment.

Finding this line matters now more than ever. Here in the intensive care unit, where we meet patients at their sickest, there is so much that we cannot fix. But in the writers’ room, we have a chance to start again, to offer a different ending to the story. And in doing so, we can sneak in potentially lifesaving education — about early warning signs of certain illnesses, the dangers of overtreatment or the impact of inequities in access to care.

For better or worse, people often do believe what they watch on television. With millions of viewers of all political leanings, television dramas have an unparalleled opportunity to educate and even to change behavior. I once thought that my role was to tell the unvarnished truth about medicine. But I have come to believe that it is worth glossing over the facts if we can weave a story that encourages viewers to trust science, to get vaccinated, to look differently at disease. When I find myself fact-checking what I see on the television monitors, I remind myself of this more important goal.

On rounds one recent morning, I stopped in to examine a man with a complex history of congenital heart disease. After I muted his television so that I could listen to his heart and lungs, he asked me if I might be able to step out of the way of the screen. He was watching a medical show; it was an episode he had never seen before, and he was just getting to the good part.