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The Medium and the Message

A Friday Story
By Professor Shlomo Mor-Yosef

Dear Friends,

It's interesting to ponder whether the world we see in the movies reflects reality or if what is portrayed becomes part of our perceptions. For those of us who practice medicine, we have to wonder if the doctors who appear on the screen bear any resemblance to the doctors we know; if their ethical and professional dilemmas mirror ours. Watching movies about our world, we are aware of how much information – true and false – is being presented and how much medicine has changed since the movies were first released.

This is especially true for the complex world of psychiatry. Viewing The Snake Pit a 1948 movie about a mentally ill woman in a 1940s psychiatric institution, for example, we are both horrified and awed by how significantly treatment has changed over the years. Thinking about what we have seen makes us wonder about practices of the past and how the way we treat patients today might change in the future – and based on what they have seen, what the public believes in contrast to what we as physicians know.

Four years ago, Prof. Yoel Donchin, Head of Hadassah's Patient Safety Unit, Dr. Michael Beigel, Ph.D., Head of Multimedia Assisted Learning at the Hebrew University-Hadassah Medical School, and Prof. Arieh Shalev, recently retired Head of the Department of Psychiatry, created Hadassah's Medical Cinemateque for medical students, staff and others interested in analyzing these issues. Through this ongoing project – unique in Israel – they have already screened and discussed 18 films, with more in the planning stage.

Prof. Shalev, who spent two years at the Sorbonne studying cinema, introduces the screening with a 30-minute lecture. "After his inspiring talk before our first film, David and Lisa, it was clear he is a superstar," said Prof. Donchin, who is also fascinated by the film world.

I wonder if any of us realize how much the media influences our perception of the world or changes our beliefs. Surveys show that most people are highly skeptical of the communications media – radio, television and newspapers – evaluating what they see and hear, measuring it against their own experience and their own opinions.

Yet, I am not sure we apply the same critical thinking to television shows, theater and movies. Doctors and nurses may shake their heads in awe at the many maladies that are cured in the span of a television episode of a popular medical series or emerge from a movie asking themselves who practices medicine "that way." After all, we are professionals, but what about the general public?

Some years ago, The New England Journal of Medicine printed an article on American television series about doctors. Did you know that on television the success rate for CPR, cardiopulmonary resuscitation, is 75 percent? On television, thanks to this intervention, three-quarters of the people who go into cardiac arrest survive. The actual survival rate is seven percent. Yet the public thinks this – and many other medical procedures – can work miracles. If the public's expectations are very high and unreasonably unrealistic when it comes to medical procedures, they are even more unfounded when dealing with mental illness.

According to researchers, "films can offer realistic depictions of character styles and psychopathologic disorders, as well as personal and family dynamics, with subtexts alluding to the prevailing social norms … Characters experience their symptoms in the context of their lives, not in an isolated clinical encounter." Yet, unrealistic portrayals can leave the public with distorted images of psychiatric patients and the profession of psychiatry.

This is why Prof. Shalev's presentation is critical. Medical students have to deal with their patients' complex problems, as well as the patients' families and friends, understand their expectations and make sure that their diagnoses and prognoses are based on the real world, not the celluloid one.

If you happened to be at Hadassah on June 12th, you would have seen Whose Life is it Anyway? that presents complex moral and ethical issues about patients' rights, specifically a patient's right to die. Next up is Red Beard, a 1965 Japanese film directed by Akira Kurosawa, about the relationship between a town doctor and his new trainee. "And," says Prof. Donchin, "since it's very long, [185 minutes] we've already announced we'll break for sushi."

****

While officially retired after many years of dedicated service, Prof. Donchin, Prof. Shalev – and many other retired department heads – continue to be actively involved in the work of the Hadassah Medical Organization, committed to sharing their experience and knowledge with the next generation. We are proud that these elder statesmen and women have chosen to remain part of the Hadassah family, proud of their dedication to their profession and to all we serve.

Shabbat shalom,

Shlomo

Prof. Shlomo Mor-Yosef

Director General

As I write this, here at Hadassah-Ein Kerem, we are busy preparing to host Sarah Drew and Kevin Mckidd from Grey's Anatomy, which is very popular here. They will be joined by Lucas Neff and Shannon Woodward from Raising Hope and Gregory Smith and Travis Milne from Rookie Blue, which are not shown in Israel. The next time we watch an episode of Grey's Anatomy, we will be particularly alert to see what they learned from Prof. Dan Engelhard in the Dept. of Pediatrics, which he heads, Endovascular Neurosurgeon Prof. Jose Cohen in the Neuroradiology Center and Prof. Avi Rivkind, Head of Surgery and Trauma in the Shock Trauma Unit.

Date: 6/17/2011 12:00:00 AM

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