The Monster, the Mythos and Medicine X

What does the television program Supernatural have in common with Stanford's Medicine X? That will take a bit of explaining…

The world of the televised science fiction/horror serial is not so distant from the world of medicine.  I find one often emulates the other and can often be analyzed using the same tools.  When I am in a call focusing on the message of HIT, I remind folks to remember the Metanarrative.  Technology is not the most important part of our discussion. The overarching patient story must be considered equally significant.

How do you explain story?  I recommend using story itself. 

Back in 1993, The X-Files changed the world of the sci-fi narrative.  Not only did it add valuable catch phrases to our lexicon, such as “The Truth is Out There.”  It set up a contentious dyad in the characters of FBI agents Fox Mulder and Dana Scully. Here belief confronted skepticism on a weekly basis. In each episode, the characters would investigate an X-File: the odd, perhaps paranormal cases that filled the cold case files.  These X-Files were beyond the normal range of FBI investigation and any agent who voluntarily studied them was considered suspect.

Each week the audience would watch Mulder believe and Scully attempt to debunk the cause of the X-file.  They would confront human horrors, monsters and aliens.  This weekly dance of the macabre has a grand history in the televised narrative and is used in classics such as Star Trek to camp favorites like Friday the 13^th the Series. This convention is called “monster of the week” and does not require a continuous narrative.  Often in “monster of the week” programming the shows could be watched in any order without causing the audience distress.

But The X-Files show is about that which is beyond the normal, so this show embraced mythos.  Above and beyond the weekly episode was a master narrative that was at first supported by the “monster of the week” device and then subsumed it.  This show became completely mythos focused towards its end as the characters were entwined within an epic conspiracy that involved covering up the truth.

The X-Files opened the flood gates for a new kind of televised serial and in 1997 Buffy the Vampire Slayer was first aired.  Buffy was the dissertation topic of my late husband Fred Holliday and he often marveled at the beautiful marriage of “monster of the week” and mythos within this program.  It also had a healthy dollop of Metanarrative with characters using lines such as “I can’t believe you, of all people, are trying to Scully me” or “Dawn’s in trouble, must be Tuesday.”  (Tuesday day was the day the program was aired.)    

Buffy aired from 1997 to 2003 and astounded critics and fans alike with its well written dialogue and its mythos that spanned 7 seasons.  During those years characters were allowed to grow and change.  Buffy went from being a high school student, to college student, to college drop-out, to food service employee, all the while spending her nights saving the world.  She was an every woman embracing all economic classes and with the death of her mother became the adoptive parent of her younger sister. Buffy died twice, only to return to deal with grief, addiction, domestic abuse in addition to the trials of leadership. Then in 2003 Buffy left the airwaves, but like The X-Files before her, she inspired other programs. 

In 2005 the BBC the creative team behind the reboot of Doctor Who would successfully pitch the return of this well loved franchise as a “Buffy” for the UK. Also in 2005 Supernatural débuted in the United States, in this program, like The X-Files, “monster of the week” was devoured by mythos.  Supernatural begins with a tale of two brothers, Sam and Dean Winchester, who define themselves as “hunters” and their goal is to find their lost Father avenge the deaths of their loved ones at the hands of a demon.  Along the path towards this goal they encounter various paranormal entities that they must overcome in order to help terrorized civilians. They are mission driven and in the cause of fighting for that which is good, they support themselves through credit card theft and card sharking. Saving the world rarely pays well.

Now the worlds of television and medicine begin to collide.

I painted this painting as I listened to episodes of Supernatural streaming on Netflix.  As I listened, I learned the protagonist Sam was attending Stanford.  He was smart, handsome and empathetic with strangers to the point of endangering his fellow hunters.  He was also somewhat elite, fussy and prone emotional outbursts when things did not go his way.  Dean, the other lead, liked heavy metal, drove a 1967 Chevy Impala, took pride in his blue collar and beer tastes.  In addition, Dean was loyal to the point of self-destruction and refused to accept the concept of fate.   

All of these thoughts swirled in my mind like the spirals in this painting, as I painted “Medicine X.”  

In this painting the tower and quad of Stanford define the piece.  The sky behind roils with inky spiraling clouds.  The time is now and healthcare in the United States is mired policy debates; while, like a beast of burden, the institutions of care limp forward toward an ever elusive goal.  In the center of the painting is an Ivory Tower.  It has entire sections sawed out and begins to resemble an electronic key.  Here is the key to saving lives.  As I am sure Dean Winchester would say to Sam, you must leave the tower to fight the monsters. So when you look at this tower, I want you to think of the silos that must open and the towers that must level so we can all communicate on common ground with provider, academic and patient. Also as Buffy could tell you there is only one Key that opens a portal between worlds.  That key is a life.

In the foreground, two girls stand within rising water.  They are patients in need of rescue from the coming flood.  One girl turns her back to the viewer and holds a smart phone in her hand.  The other girl looks out of the frame and a blue twitter bird perches upon her finger.  Though they look concerned but they are not panicked, because they have the tools of mobile health and social media to help them.

To the left of this piece, a series of people are pushing their rafts upon the rising water.  Our blocks from the tower have become rafts to navigate the deluge.  Here we have doctors, techs, academics, venders, designers and patients trying to find common ground.  Each uses the pole in their hands to move forward in the water.  As the pole crosses before their body each becomes the letter “X.”

We are the X in Medicine X.  We are the unknown part of the equation.  We are the mysterious other that has not been applied to the solution.  We are the files locked in a cabinet and dismissed as other or strange.  We are the ever arching story above and beyond the episode of care.

Currently many institutions are treating their patients like a monster of the week, destroying the one-off disease and forgetting we are a reoccurring character within in our own lives.  Data access and patient portals allows us to enter the land of mythos where a narrative lasts a lifetime.

Some of us will go farther, gentle reader.  We will journey into a world where incentives are not measured in dollars but in lives saved, where stones float and ivory towers work as keys that let people in rather than keep them out.  I look forward to seeing that place.  I know many doors lead there and I think one door will open at Medicine X  and I thank Larry Chu for designing a event that is patient inclusive.  I hope to see some of your there on September 28-30, 2012.