Heroism, Celebrity and Therapy in Nurse Jackie

Christopher Pullen

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781315297477
• Edition: 1
• Topic: Medios de comunicación y artes escénicas
• Subtopic: Televisión

This book presents an examination of the television series Nurse Jackie, making connections between the representational processes and the audience consumption of the series. A key point of reference is the political and performative potential of Nurse Jackie with regards to its progressive representation of prescription drug addiction and its relationship to the concept of quality television. It deconstructs Nurse Jackie 's discursive potential, involving intersections with contemporary notions of genre, heroism, celebrity, therapy and feminism. At the same time this book foregrounds the self-refl exive educational potential of the series, largely enabled by the scriptwriters and the leading actor Edie Falco.

1
Female Work and Hospital Drama

Introduction

In the closing episode of season 6 of Nurse Jackie, Jackie Peyton is represented as on the run, travelling on the motorway to the airport, likely to be found out for illegally using a doctor’s identity to obtain drugs and falsifying a patient’s personal security card to cover her tracks. However her escape is held up en route when she administers life-saving support to a dying patient who is the victim of a car crash, later accidentally crashing her own car and is alerted to the police.

All the while her journey of escape had not been to find an easier and safer life, but it had been to follow “a cause”, to offer her services as a nurse to the victims of a local flood disaster in Florida. Jackie Peyton is represented as committed to her work ethic even in times of flight and likely incarceration. The notion of work informs her “life blood” and identity, where she seemingly cannot exist unless she performs her function as a nurse.

This chapter consequently places into context the narrative drive of Nurse Jackie, which I argue frames the significance of labour and workplace identity. At the same time I discuss audience identification with female characters in soap opera, considering the significance of irony and ambivalence in assessing the narrative potential. As part of this, I argue that the generic constitution of Nurse Jackie is both medical drama and “heroine television”.

Medical Drama and Heroism Television

Jason Jacobs (2003) tells us in his ground-breaking book Body Trauma TV: The New Hospital Dramas:

Hospital dramas of the 1970s, included frequent explicitness in the discussion of medical and social “problems”: abortion, homosexuality, rape, drug addiction, artificial insemination, venereal disease, issues that had been more or less excluded from the earlier shows on the grounds of taste and audience sensitivity.

(p. 7)

Revealing a new kind of realism and a shift towards cultural liberation, Jacobs highlights the significance of hospital drama for its ability to focus on minority identity issues and the situation of the other in society.

At the same time Charlotte Brunsdon (1997) considers the notion of “heroine television” as occurring in a range of television dramas including sitcom and crime drama, featuring exemplars as I Love Lucy (1951–57), The Mary Tyler Moore Show (1970–77), The Golden Girls (1985–92), Cagney and Lacey (1981–88) and Prime Suspect (1991–2006). Brunsdon tells us:

“Heroine Television” is centrally about female characters living their lives, usually working both inside and outside the home, usually not in permanent relationships with men, sometimes with children, and trying to cope.… [T]hese shows are all in some fundamental way, addressing feminism, or addressing their gender that feminism has made public about the contradictory demands on women.

(p. 34)

Brunsdon reflects the significance of television programming that features females as central characters and lead storytellers, seeming to offer a sense of political activism, and identification for audiences.

In this sense both the notion of hospital drama as a genre, and the significance of female-focused television dramas within diverse genres, informs our reading of Nurse Jackie. Jacobs highlights hospital drama for its ability to map “societal anxieties on to the body… as a site for the application of benevolent medical science [framing] [i]llness and injury [as] the catalysts for the exploration of human relationships, emotions, desires and morals” (p. 7). Brunsdon highlights the importance of positive role models for female audiences, framing the significance of “feminist textual analysis” and its focus on two types of programmes, “those addressed to women and those centrally about women characters” (p. 34). Nurse Jackie is situated as part of the genre of hospital drama, and independently may be considered as an exemplar of “heroine television”.

Although the constitution of “heroism” may be complex in Nurse Jackie, as in many ways she is an “anti-heroine” (see Buonnanno [2017] and Chapter 3) and consequently could be seen as counter productive in advancing a positive sense of feminism, it is this balance between the generic progression of hospital drama and its relationship to female identity that is central. In many ways it is possible to argue that although hospital drama has for many years focused on women, including representations of many female characters, largely it has (to paraphrase Brunsdon) “addressed women” audiences, rather than necessarily “been about women characters”.

Within hospital drama, there is a dominance of the male lead character evident in the identity of the doctor, and this is counterpointed with the role of the nurse, who normally takes a subordinate role. Despite this, a female audience could be addressed not only in representing the nurses as able and inspirational supporters of the diagnosis of the doctor, but also in framing the notion of the domestic narrative, including romance narratives. While there may be a the tension between the role of the nurse and the doctor evident in series such as The Nurses (1962–65), Marcus Welby MD (1967–75), M*A*S*H (1972–83), St. Elsewhere (1982–88), ER (1994–2009), Scrubs (2001–10), Grey’s Anatomy (2005–) and House MD (2004–12), often nurses are represented as central storytellers, who not only care for the patients in an environment away from home, but also replicate the traditional domestic and romance narrative that centres on male and female dynamics.

As Luke Hockley and Leslie Gardner (2011) tell us discussing the context of House MD and its precursors within the genre, “These programs were often headed by a patrician figure such as the senior doctor in Marcus Welby MD…. The subversion of this particular trope is one of the familiar views of House, whose central character had a bedside manner that is somewhat different to that of the kindly Dr Welby” (pp. 1–2). While the male lead in House subverts the traditional relationship between male professionals within the medical world, the doctor is nevertheless considered as the leading authority, and primarily the hero, who potentially subordinates females. For example in House, although the lead doctor (played by Hugh Laurie) is unconventional, his interactions with female members of staff (and patients) reference the regular “masculine-active” and “feminine-passive” dynamic. For example, when House initially assesses his new medical team (in season 1), which includes a strong willed and talented female doctor, Dr Allison Cameron, he openly admits that he recruited her as she is good-looking. However he states that his would be a trial for her to advance within the medical profession, because she would have been stereotyped for her good looks. Hence he hires her, as she must be a great doctor, because she has advanced despite herself. Hence even in House, a hospital drama that is progressive in terms of defining the doctor as “wounded” (he is disabled, evident in a leg injury) and consequently must be “human”, the masculine order is maintained, or at least referenced.

Nurse Jackie offers a complex prospect in this dynamic. Although Jackie Peyton performs the role of the nurse as subordinate to the doctor, in effect she challenges this hierarchy. For example, in the pilot episode of the series Jackie Peyton and junior Dr “Coop” care for a bike messenger who arrives at the emergency department and has received head trauma. After Jackie Peyton raises medical procedural concerns, which are ignored (or devalued) by Coop, the patient dies. In a scene where both characters stand in the presence of the now deceased young man, Jackie acts more like a doctor than a nurse, admonishing Coop, that:

I had to sit there and look that kid’s mother in the eye and tell her that we did everything that we could. You dumb shit—that was my patient! I told you he was slipping and he was. If I tell you to order a scan you order a Goddamn scan, because if you don’t I will go to the next doctor and the next doctor after that. In the meantime that kid died, and it is all on you.

Seeming more like a doctor rather than a nurse, the doctor/nurse dynamic is inverted. The fictional female character of Jackie Peyton takes the lead in what might be termed as having insight in the best “procedural practice” within the medical profession. In this sense Jackie, as a female and not even a doctor, challenges the primacy of the male doctor in following best practice. Such a focus on mortality in relation to practice is central in highlighting the significance of audience engagement.

As Jason Jacobs (2003) discusses in relation to the drama ER:

The death of a patient is the pretext for discussion about procedure so that ethical issues are framed within the specific context of working practices. Viewer proximity is distributed between our sympathy for the dead patient and [the health professional’s] experienced emotional response to it.

(p. 3)

In this sense our understanding of the medical treatment of the patient, in context with the professional and the emotional universe of the characters, offers a framework of identification for the audience. Jackie Peyton’s commentary that the doctor did not follow her best practice recommendations, evident in the death of the bike messenger, challenges the patriarchal narrative conventions of hospital drama, through framing the authoritative voice of the nurse rather than the doctor.

As Jacobs tells us, historically

[r]eassurance as personified in the figure of the infallible, capable doctor and in the early shows [such as Medic (1954–55) and Dr Kildare (1961–66) prioritise] the individual doctor’s central role in healing people; typically the doctors were white males at the centre of authority in the hospital or practice.

(p. 5)

Contemporary hospital dramas featuring ensemble casts with doctors and nurses such as in St. Elsewhere (1982–88), ER and Grey’s Anatomy, often frame incidences where nurses save the lives of patients presenting superior knowledge to doctors. However in Nurse Jackie, it is the focus on the emotional as much as the procedural that prioritises a heroic female identity.

I argue that Nurse Jackie complicates historical notions of hospital drama, not only seeming as part of “heroism television” (Brunsdon 1997), but also in doing so presents new scope within the procedural and the pathological, through framing the female nurse as authority. As Jason Jacobs advises us, hospital dramas or “body trauma TV” may defined within these contexts/eras:

• Paternal (mid 1950s–late 1960s)—where male doctors were central storytellers, and there is a reverence for best practice.
• Conflict (late 1960s–early 1990s)—where challenges to order were presented in following the youth and liberation movements.
• Apocalypse (early 1990s–early 2000s)—where teams of medical staff work within oppressed social conditions, and there is new realism that accepts mortality.

While it is not simple to map a range of programmes that fit easily within these contexts/eras, it is possible to argue that Nurse Jackie is an extension of Jacobs’s “Apocalypse” context/era. However rather than a team focus on “rawness, explicitness, pace, cynicism and despair that was effectively normalised in their narratives” (p. 11), the individual personal struggle of the health professional becomes a central narrative trope.

Viewed in this way, Nurse Jackie could be considered as a progression of House. Both Gregory House, MD (played by Hugh Laurie) and Jackie Peyton (played by Edie Falco), are wounded themselves and are addicted to opioid narcotic medications: House struggles with a leg injury, and openly takes the painkiller Vicodin, and Peyton responded to psychological stress surrounding her identification with her daughter as a child, and became covertly addicted to Percocet/OxyContin (Season 4, Ep. 2). The interrelation of the shows may be evident where both series involve a focus on the procedural and the pathological, albeit in entirely different ways.

Although House is the central medical practitioner, the narrative is less about his personal struggle with addiction (although as the series develops we discover detail of his injury and wider life story), and more about his struggle to diagnose, involving a challenge to the norms of medical practice. For example in the pilot episode of House, the narrative of pathology involves his need to solve the case of a woman who seems to exhibit the signs of a brain tumour, but later is revealed to be caused by a parasite. The mystery and cause of this illness is resolved, revealing unconventional medical practice, including House encouraging his medical team to break into the home of the patient, to try and find evidence as to what could be the case of the illness. When pork is found in the refrigerator, a seemingly tenuous link is discovered which leads House to consider that the patient may have consumed pork in South America, where a rare parasite may be found in the meat. While we are not provided with a wider reason why House is in pain, or why he is addicted to painkillers, we witness his excellent skills in deduction and knowledge of medical practice.

In contrast, within the pilot episode of Nurse Jackie, we are immediately given access to the imagined psyche of Jackie Peyton. Our first glimpse of Jackie is one of an imaginary death. The camera focuses on a close up of a blurred eye seeming like the moment of death, or the moment when you lose consciousness or experience the effects of drugs. The camera later pans across an empty hospital bathroom floor, revealing Jackie Peyton on the floor flat on her back as if just tripped up, coded by the chewing gum viewed on her shoe.

The music that accompanies this is k.d. lang singing the theme tune to The Valley of the Dolls. The use of this song originally composed in 1967 (and sung by Diane Warwick), a tale of female struggle in the entertainment industry and the lure of recreational drugs to aid your career, eventually leading to relationship breakdown and self-effacement, is significant. The lyrics not only frame the impossibility of leaving, or changing direction, but also the mise en scène a 1960s-style hospital room with Peyton herself dressed in white nurse’s uniform represent a sense of past. Such a representation suggests that she is living in an imaginary past, that the audience will have little access to, as the series is set in the present day. This is also apparent...