Gimme That Star Trek Ep.23: Bedside Manner

Who would you choose as your Doctor if you served in Starfleet? Who has the best bedside manner? Who’s most useful on an away team? Who do you trust most with your health, both physical and mental? Siskoid welcomes Mike Peacock into the fold to evaluate your favorite Chief Medical Officers from the world of Star Trek and discuss health professionals in the 22nd through 24th centuries!

Listen to Episode 23 below!

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Credits:
“Star Trek Theme” by Alexander Courage, with the Irredeemable Shagg on vocals. End theme: “Deep Space Nine Theme” by Dennis McCarthy.

Bonus clips from: Star Trek The Next Generation’s “Déjà Q”, starring Gates MacFadden and John de Lancie, “Ethics”, starring Gates MacFadden, and “The Battle”, starring Diana Muldaur; “The King of Bedside Manor” by the Barenaked Ladies; Star Trek The Animated Series’ “The Pirates of Orion”, starring DeForest Kelley and Leonard Nimoy; Star Trek The Next Generation’s; Star Trek Deep Space Nine’s “Emissary”, starring Siddig el Fadil and Nana Visitor; “Star Trek: Voyager”, starring Robert Picardo; Enterprise’s “The Breach”, starring Henry Stram and John Billingsley.

And thanks for leaving a comment!

19 responses to “Gimme That Star Trek Ep.23: Bedside Manner

  1. I’ll add to the criteria a discussion of ethics, an area where Bashir excelled but the EMH goes above and beyond, forcing Janeway to lobotomize him before becoming an accomplice to the vicious and coldblooded murder of Tuvix. (When are we getting the Symbiogenesis episode mentioned way back at the beginning of this podcast anyhow?), And after the other extreme, there’s Phlox’s glib endorsement of genocide by inaction.

    Anyhow, while I’d pick the EMH, I’d rather assemble a team:
    Emergency: the EMH
    Surgery: Bones
    Medicine: Crusher
    Specialist: Bashir
    Pediatrics: Phlox
    Administration: Pulaski
    Ob/Gyn: Worf

  2. If there are more Trek shows in the works, why not a “Medical Center” type show, but of course these doctors would be facing all sorts of crazy off-world diseases and ethical conflicts we cannot yet imagine. Are bodies different after beaming? Is it against the Hippocratic Oath to euthanize an evil twin made from a transporter malfunction? Are there even chronic diseases anymore? What has that done to planetary populations?

    Mike is always fun to listen to, nice to hear him on the show. And congrats on the new kitty!

    1. Yes! Hospital shows are like weeds on TV, so why not a Star Trek Hospital Show…in space! This was yet another fascinating episode; I really enjoy this show’s freedom to explore Trek from so many different angles.

    2. I attended the Shore Leave science-fiction convention this past weekend and one of the various panelists (Lorenzo Heard—not the pastor) said he had pitched a Medical Center type show to Paramount in the early 2000s.

  3. Okay, I have a lot to say about this. But I’ll start off by saying that I only feel well-versed enough to speak about McCoy, Crusher, Pulaski, and Bashir.

    I’ll also say that I have to split this up into two different categories. Who I would want as my doctor and who I would want to work with me as a doctor. Those are two very different things, the latter in particular because I am coming at it from an ER viewpoint.

    Bones – He is the guy that I would want to work with most as a doctor. The man gets stuff done. There is a passion to him that drives him. He is committed to helping his patients but he isn’t one to mull over a decision. He is able to think on his feet and be instinctive in his medicine (I think of his patching up the Horda with cement). You need that. I also think he has a healthy set of cynicism as well as compassion meaning as an overworked or stressed out co-worker, he could help you with a laugh or an eyeroll.

    I don’t know if I would want him as my doctor for that same emotional cynicism and compassion. He is the guy that would roll his eyes if I was saying I was in agony over something he might think isn’t agony. I think he would call out his patients for anything they did to self-inflict an injury or illness. And I think that compassion might make it hard for him to be clinical if he was emotionally close to someone. I wouldn’t mind seeing him in an ER setting. I’d get the right stuff done. But as a primary provider, I think he might be too blunt.

    Crusher – I would want her as my doctor. I think she is very thoughtful. She seems to be one to very elegantly and pain-stakingly think about every decision about a patient. There is something of a professional wall between her and her patients it seems. She wouldn’t make a decision based on a personal connection. She is very clinical. As a patient, I might feel she is cold but I would see pictures of her dancing, or a stack of playbills on her desk, or other artistic souvenirs that would let me know she has good work/life balance. I know she will have thought about my case from every angle before coming up with a plan.

    As a result of that medical rumination, I wouldn’t want to work with her in the ED. I fear she would take a long time to make critical decisions as she weighed every risk and benefit over and over in her mind. I don’t know if she would see people efficiently in that way. Your sickest patient might be in the waiting room. You need to make quick, measured, medical decisions. I don’t know if the first adjective would fit her.

    Pulaski – she is sort of muted version of the best of Bones and the best of Crusher. I think if I was working with her or seeing her, I’d shrug and say ‘I can deal.’

    Bashir – I would neither want to see him as a patient or work with him as a colleague. As you say, he is probably best suited for research. Sometimes that means they are more used to working in a lab environment than a clinical one. Sometimes it means they don’t interact with others medically so bedside manner is stilted. Often times, they aren’t used to a hectic clinical pace because they are used to the laborious and careful rigors of research medicine. And I think Bashir is someone who would come off as arrogant, a smart guy who knows he is the smartest guy in the room (even medically) but can’t apply that medicine to getting work done efficiently.

    Hope this makes as much sense written as it does in my mind. And more than willing to expound on any part.

    1. I came here to make my argument as to why I feel Crusher is the best all around, but your assessment is awesome. I can see why a health care practitioner would probably want to work with Bones vs. the others. Additionally, through working in medical publishing where I interact with medical research scientists, I can also see why Bashir would be better suited for this area vs. clinical practice. Crusher is the one I’d prefer to see as a patient. So, who’s to say which doctor is best? It seems it depends on why you need a doctor.

    2. Professional Family Doctor here, casual Star Trek fan, so – like Anj – I too have Thoughts!

      As with doctors in real life, all of the Trek medical characters display a range of characteristics, but for TV and storytelling purposes, one side of their nature tends to be exaggerated. Giving the show the title of “Bedside Manner” does skew the discussion away from those characters who are less warm than others, and doctors need a range of skills to perform at their best.

      McCoy is certainly a passionate advocate for his patients, human or otherwise. I agree with Anj that – for all of McCoy’s reminders that he is a Doctor and not a mechanic/engineer/magician/bricklayer/physicist etc – he does have a pragmatic approach – occasionally bordering on the unorthodox – to treating his patients. It feels strange to say about a doctor practicing 350 years in our future, but McCoy’s Olde Worlde folksy way does give me pause to consider if he’s completely up to date in his medicine. If I dropped in on a house call to bring a bottle of booze to a patient, I’d risk getting struck off! I wonder to what extent his Ol’ Country Doctor manner comes out of the “Waggon Train in Space” pitch for the series?

      I think of Beverly as a great Departmental head. She’s certainly not afraid to get her hands dirty with some practical clinical work, but a lot of the time she’s managing a large team in Sick Bay and taking strategic decisions, balancing medical priorities against the ship’s mission. (Obviously these have to conflict, or there’s no story!) With her family and various side hobbies, she’s probably one of the more well rounded of the medical characters, but she does have a worrying tendency to become romantically entangled with ex- and future patients. Fortunately, they always leave or die or evolve into a higher state of consciousness, saving her from some awkward moments in 10 Forward!

      Pulaski is – to me – a consummate scientist. She quickly forms theories, but is prepared to reject her hypothesis when new evidence calls it into question. She’s not afraid of putting herself at risk to conduct experiments to inform her reasoning. She might not be the warmest of the clinicians, but I like her commitment to evidence-based practice.

      Bashir is one of those rare doctors who is an absolute genius. Sadly that comes with a huge ego, sense of infallibility and a lack of insight into his practice. He’s cocky and expects that his talents in one area extend to all areas: eg – Why shouldn’t he be a perfect spy? I think Garrick sees that arrogance and plays him like a cheap fiddle! Whilst Julian might be trying to push back the frontiers of medicine, I fear he might have trouble knowing when he’s at risk of going too far. For all his brilliance, he’s the Doctor I’d be most worried about: his friendship with O’Brien does ground him to an extent, but like Anj, I don’t think I’d like to work with Bashir or be treated by him.

      Voyager’s Doctor is like a Medical Student or Junior Doctor in Training – he has a head stuffed full of facts and information, but little idea on how to implement them in practice on really patients. As a result he comes off as harsh and uncaring. At least, that’s how it appears in the first season – as with real junior doctors, he evolves his style of practice, either by making mistakes, or by downloading a another TerraQuad of data into his programming (if only all learning could be that straightforward!), so that by the end of the show he’s a fully functioning clinician, exceeding all the original parameters & expectations of his program. I like Voyager for taking these bold approaches to long term character development. (And I think you’re too harsh on the show as a whole!)

      Phlox is the Star Trek doctor I think I’d most like to see as a patient. I don’t doubt his knowledge – he’s clearly very well read on both alien and human medicines. He comes across as compassionate, gently humorous and holistic (I can look past the odd menagerie of complementary therapies he maintains!). Weirdly – for the only alien doctor – he comes across as one of the most human, humanitarian and humane.

      So in summary: Phlox as my GP, Beverly as my Hospital Consultant.

      You also mentioned that Trek surgery doesn’t require surgeons to gown up – but that’s only sometimes true. Some procedures can be carried out on the medical bed with no precautions, but seemingly bigger operations demand that the surgical team don what I like to call their “Masque of the Red Death” scrubs. (http://memory-alpha.wikia.com/wiki/Surgeon)

      Did you know that there was a Medical Tricorder X-Prize running? (https://en.wikipedia.org/wiki/Tricorder_X_Prize) A medical tricorder would make my life soooo much easier! I actually bought a Scanadu device off Kickstarter – it was pretty natty – could measure pulse, temperature, and blood pressure by touching the sensor to your forehead. Sadly, it didn’t make the X-Prize cut and support was turned off last year. Maybe something similar will arrive before the end of my career!

      1. Great rundown, Chris! First, Bedside Manner wasn’t just a title, it really was meant to be the principal focus of the episode; we just strayed all over the place in practice, so there you go. But since we’re not medical professionals like yourselves, just slumming it (Mike having studied in the administration side of medicine, and me being a doctor’s son who got a number of related summer jobs), we didn’t dare speak authoritatively on anything but the doctor-patient relationship.

        And I don’t remember us saying there was no proper surgery (I even used clips from an episode that quite notably had the red scrubs), but maybe we suggested it when we said future medicine was non-invasive. It’s MOSTLY non-invasive. Jump ahead a few years and I bet they can just transport organs in and out of you.

        1. Apologies for mis-hearing about the scrubs; I think the visual of the red scrubs is particularly striking: somber and not a little creepy. You know some serious medical problem is being tackled when they get the scarlet robes out!
          The medical uses of transporter technology would be mind blowing. Probably best not to think about all the intricate reconnections of nerves & blood vessels required to take – say – a liver out (or put one in), or the potential consequences of making an error in a single one of those connections! Maybe that’s why McCoy & Pulaski are so jumpy about beaming down anywhere!

  4. Dr. Anj is going to be a tough act to follow on this one, but I’ll go ahead and throw in my two cents as well.

    While I’m not a medical doctor, I am a biologist and spent a lot of time in and out of class with pre-med students as an undergrad. I noticed that, in general, most pre-med students primarily entered the field because they either loved the scientific aspects of medicine, or because they loved helping people. Not to say that a doctor, who loves science, doesn’t want to help people, or that a doctor, who loves helping people, can’t learn the science, but I wonder how much these two general motivations affects a medical students choice to pursue research or a highly specialized field of medicine versus a more generalized practice of medicine? I imagine that Dr. Bashir falls more into the “love of science” camp, whereas Dr. McCoy might fall more into the “love helping people” camp.

    If I had to pick one of the Star Trek doctors to be my GP, it would be Dr. Crusher. She is competent, professional, and courteous. I don’t mind her being a little cold and clinical, because I don’t necessarily want to sit around drinking Romulan ale with my doctor (not to mention that I tend towards the cold and clinical myself). Above all else, I like that she isn’t condescending or patronizing. I have had an experience with a particularly patronizing doctor, where I’ve felt the need to explain that I do hold a Ph.D. in biology, and he/she didn’t need to talk down to me like a child. Though, I said it in more diplomatic terms then that. For the record, that patronizing doctor was not Dr. Anj.

  5. Fun and thought provoking episode! I would pick Bones as a friend and Crusher as my doctor, which actually fits their primary functions on their respective shows.

    My first year in college I got a summer job at the factory my Dad worked at. I went to the clinic in the “big city” to get my physical done, and was very nervous. The doctor who walked in was a very attractive female who looked a LOT like a slightly younger Beverly Crusher/Gates McFadden, and this was when TNG was still on the air. My first real “cough test” (yes, THAT one) was an emotional roller coaster for sure.

    Chris

    1. First, great point Chris! Their function on the show definitely informs how we perceive them.

      Second, I had a similar but weirder experience. In my 20s, I had to go back to the hospital to get dressing removed and checked after the removal of a benign cyst “down there”, and randomly drew a young female doctor. She walks in and says, “you’re X? I’m Dr. X!” She had my exact name (feminized, but you can’t hear that in French). Presumably, she never went by Siskoid. Uncomfortable, but with a twist. But no less uncomfortable than with a male doctor, I can assure you.

  6. Another enjoyable episode! The discussion of the doctors (no, not the “Doctors”) was well done, and the followup here equally interesting. Thank you, Siskoid and Mike!

    I’m definitely jealous of Star Trek medicine: tricorders, instant full body scans, lead shielding not needed, non-invasive procedures. My aging, aching joints could use these. Thankfully, we get more and more into the future every day, so who knows?

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