Thursday, March 01, 2001

Doctors know best

Interesting times on the TV show "ER" these days for people interested in children with special needs.

I say "times," though of course I mean "60-second bursts," because that's all the time this ADHD show has to devote to issues these days. And I say "interesting," though of course I mean "infuriating," because that hyperactive pace leads to pat answers to questions that are anything but.

Consider, for example, the recent vaccination story line. A boy is rushed from his preschool to the ER with fever, seizures, an odd rash. Could it be ... measles? The doctors are shocked. Who on earth would not vaccinate their child against measles? What parent would be so irresponsible? The mother turns up, and, sure enough, says she has deliberately not vaccinated her children. You can tell by the condemning looks the docs give her that this is not going to lead into a thoughtful discussion of the relative risks and merits of vaccines, and possible ties to autism, and how a parent goes about weighing those risks and possibilities.

Because, don't you know, there are no risks! There are no possibilities! We have it from good-guy Dr. Carter himself. As the mother of the ailing child tries to explain herself to the haughty medical professional (and boy, haven't we all been there), she says she's researched this on the internet and in magazines and talked to her pediatrician. Carter tells her flat out, vaccines are safe. What about ties to autism? she asks. There are no ties to autism, Carter says dismissively. Well, phew, good to know. One less thing to worry about. Big thanks to the "ER" writers for researching that and delivering such a definitive answer to the show's very large viewing audience.

In better days, I think, the show would have allowed a little ambiguity here. Allowed the mother to shake the doctor at least a little bit with statistics. Had her mention a nephew who had developed autistic behaviors right after getting his MMR. Even had Carter mention that she could have had the vaccinations delivered in individual doses instead of all at once. Some small bone to indicate that this is a very real issue to very many people. But no. Carter cuts her off. The boy dies. The mother killed him by daring to have an opinion. Next case!

The mother in an earlier storyline fared a little better. This was the snippet that had Dr. Benton befriending a young girl hiding out in a hospital closet, because she's scheduled for a medical procedure she does not want to participate in. Benton comes to find out that the procedure is giving something -- bone marrow? blood cells? I'm forgetting; it's been a while -- to her cancer-stricken sister, and that indeed this particular adorable little girl might have been conceived for the purpose of providing that something. Because everything is simple in his moral universe, he is outraged. Tries to keep the girl from having to go back to the procedure. Questions the mother's motives and moral righteousness.

In this case, thankfully, it's the mother doing the cutting off. But again, there was no discussion of the really rather interesting issues here. Since Dr. Benton is one of the "good guys" on the show, and the doctor defending the parents and gathering up the girl for the procedures, Dr. Romano, is about the only unequivocal "bad guy," we are clearly meant to feel that the mother is a monster. But let's see now: The other option here is that the sister would be dead and the adorable little girl would never have been born. Is that really better? Should children never be conceived for less than the most noble reasons? What about Dr. Benton's own son, who was not exactly planned at all. Do the circumstances of his conception affect the doctor's ability to love him now? Can a child who was born to save a sibling never be loved in her own right?

And on another tack, one wonders how Dr. Benton feels about embryo research? Is it okay to create life at that level for the purposes of medical advancement, but not okay to go all the way to having the baby for the purposes of one particular medical rescue? How does he feel about animal testing, generations of innocent creatures born to suffer and die for the health and safety of humans? Furthermore, as a parent, would he give his life to save his child? If so, why is it so wrong to create life to save a child? Is it because the baby has no say in whether he or she will participate in the salvation? Who among us ever gets a chance to comment on the where or when or why of our birth, or the circumstances we find ourselves in?

I'll grant, I'm not sure how those questions should be answered, and the storyline did make me somewhat queasy, with shades of the suspicion Russians are said to have that Americans only adopt their children for their organs. I can't say that what this family did was right. But I sure don't think I'd be able to decide it was wrong in 60 seconds.

A somewhat similar question -- whether and how a child should be saved -- cropped up in another storyline in which a teenager who needed a transplant confessed to Dr. Luka (alright, I know that's not his last name, I just always think of him as Luka) that what he really wanted to do was die. He did not feel his life would be worth living, always sickly and taking medications and looking weird. And since we all know that teens have a rock-solid grasp of what makes life worth living, Luka set about trying to get the boy released from the life-saving surgery he did not want. Once again, the usually loathable Dr. Romano was the voice of reason, a sure sign that we are to think otherwise. But -- geeze! Are we honestly supposed to condemn these parents for the sin of wanting their child to live?

For my money, the most satisfying MWA-related storyline lately was Dr. Chen giving up her baby for adoption. For weeks, I watched in fear that she would change her mind. I ached for the prospective adoptive parents when it looked like she might. But in the end, she did not. And please, I don't know how long a birthmother has in Chicago to reclaim her child, but writers, Do Not Go There. Really.

On the other hand, I imagine that people concerned with adoptee's rights and birthmother's rights and the desirability of keeping babies with their birthparents found the delivery of the child to the cooing adoptive parents disturbing. I imagine they found the affluent, educated, capable birthmother's reasons for giving up her child reprehensible. I imagine they found the whole storyline to be, well, pat.

But I ain't them.

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