Two AIDS doctors
made a house call last month to the set of TV's Law &
Order: Special Victims Unit.
The plot line was
the suggestion that HIV doesn't cause AIDS--a fringe
theory promoted on the Internet and by certain African
leaders. But the two physicians weren't there to
doctor the script.
They just wanted
to make sure the TV show followed some standard doctor
advice: First, do no harm.
Surveys show that
most people believe the medical information they see on
television dramas and soap operas. With fictional TV shows
playing such a powerful role in public health
education, the government is dedicated to keeping an
eye on what Hollywood says. That's why the Centers for
Disease Control and Preventioin is one of four
government health agencies that fund the ''Hollywood,
Health & Society'' program at the University of
Southern California. The program has an annual budget of
nearly $564,000.
It's run by a
former CDC employee, Vicki Beck, but the real ''talent''
are government health officials and other medical experts
the program sets up with writers of daytime soap
operas, nighttime dramas, and other shows.
To be sure, many
TV shows consult with doctors, lawyers, and others
professionals on plot details. Some even hire physicians to
be writers. The executive producer of Law &
Order: SVU is an M.D.
Still, some TV
and movie scripts skirt--or outright ignore--the practical
limitations of the real world. Some low points:
Medical Investigation, an NBC series in
2004-2005, made health officials cringe. The show
didn't even get the names right: The series' heroes
did the out-in-the-field epidemic detective work of
the CDC, but were identified as employees of the
National Institutes of Health, a federal agency that's more
focused on lab science. Worse, the heroes wore leather
jackets instead of protective gear when checking for a
deadly pathogen.
Fatal Contact, an ABC movie last spring about
bird flu reaching the United States, was denounced as
unrealistic by some prominent flu experts for, among
other things, showing an Angolan village strewn with
bloody bodies that looked more like a mass suicide than an
area hit by flu.
Outbreak, a 1995 motion picture starring Dustin
Hoffman, involves a government plan to bomb a California
town to stop the spread of an Ebola-like contagion.
But CDC officials insist that they would not deal with
such an outbreak by bombing towns.
Beck's program
tries to head off such errors.
The CBS show
Numbers is one example. Numbers writer David
Harden called, saying he was pursuing a plotline about
black market profiteering in human organs. TV writers
like the topic because of its dramatic potential and
persistent hold on the public imagination: Who hasn't heard
the urban myth about the man who meets a hot woman in
a bar and wakes up in a bathtub full of ice?
Health officials,
however, hate it. They say there is no black market in
organs in the United States, and dramatizing the idea may
dissuade Americans from becoming organ donors.
But the program
took Harden's call and convinced some experts to talk to
him. One in particular was skeptical of the plot idea at
first, Harden recalled, but answered every question.
The resulting
show, which aired in January 2006, was about an
international black market that provided detailed
information on how the national organ-matching program
works. Health officials deemed it a success: In a
subsequent online survey of about 160 people who said they
were not organ donors, 10% said they had decided to become
donors after watching the episode.
Another success
occurred a few years ago with the Fox show 24.
The show was
interested in this scenario: Terrorists release a biological
agent in a hotel air conditioning system, making people sick
in a matter of minutes and killing roughly 2,000
people within a few hours. They concocted a
genetically engineered ''Cordella virus'' to do it, and
wanted government officials to be able to wave an electronic
device that could instantly detect the virus in the
air.
They consulted
CDC officials, who said there are no such devices. The CDC
also suggested that health officials might try to deal with
such a situation by isolating the ill from the well,
perhaps reducing the contagion's impact, said Dr.
Mitchell Cohen, director of CDC's Coordinating Center
for Infectious Diseases.
The writers took
the tip, and the final death toll fell to under 800.
''We saved 1,200 virtual people,'' said Cohen, who consulted
with the 24 writers and did an on-camera interview
for the DVD boxed set of the series.
CDC officials
make time for Hollywood meetings, because they know what's
on-screen can be influential. In a 2000 CDC-sponsored
survey, more than half of TV viewers said they trust
health information on prime-time shows to be accurate,
and about one quarter said prime-time television is one
of their top three sources of health information.
Health-focused
plots--and sympathetic characters dealing with
disease--do seem to stir public reaction. Just
one example: A CDC study that chronicled the impact of
a 2001 story line on a soap opera, The Bold and The
Beautiful, in which a heterosexual male Hispanic
character was diagnosed with HIV. The phone number to
a CDC hotline for AIDS and sexually transmitted diseases was
televised immediately after the episodes, and calls to the
hotline spiked from about 100 calls a day to more than
1,400.
Program officials
present themselves as resources, not advocates, so
there's been little push to get smoking characters to drop
the habit push or eat more fruits and vegetables.
They also do
relatively little with the movies. The CDC placed a smoking
prevention employee in Hollywood in 2002 as a liaison with
the motion picture industry but stopped funding the
effort in 2004. Beck hasn't tried to fill that void.
''Film is too
difficult to track and influence because of the many years,
writers, and stages of change that a film undergoes before
it is released,'' she said.
Health officials
acknowledge that it can be tough to work in Hollywood, a
town that's driven by relationships. They acknowledge to
being cautious about taking steps that might be seen
as challenging or critical of entertainment leaders.
That's a failing,
said Stanton Glantz, a University of California, San
Francisco researcher who leads a campaign to remove smoking
from the movies. He's critical of how little success
the CDC and others have had in diminishing episodes of
cinematic smoking, which he said declined only
slightly from 1999 to 2006.
Glantz alluded to
recent statistics that in the last three years
show a leveling off in the decline in both teen and
adult smoking.
The CDC's
approach ''does raise consciousness. It does educate people.
But it just hasn't had any effect,'' he said.
''They should
follow the lead of several state and local health
departments and start pushing for policy changes, most
notably an R rating for smoking,'' he said.
Beck's work
includes not only arranging consultations but also holding
the ''Sentinel for Health'' awards, which recognizes TV
shows that do fact-based story lines with positive
public health impact.
A Sentinel for
Health may lack the cache of an Emmy, but writers
said the award is noted and appreciated.
''It reflects
that hard work that we put in to accurately portray health
issues that affect Americans,'' said Paul Grellong, a writer
for Law & Order: SVU.
Grellong and four
of the show's other writers sat in on the recent
meeting at Universal Studios with the two HIV experts, Dr.
Joseph Cadden and Dr. Jocelyn Suzette Dee of L.A.'s
Rand Schrader Clinic.
The meeting was
run by Josh Kotcheff, the writer penning the episode, who
sat with the doctors at a conference table. The other
writers sat on a nearby couch with notebooks,
listening for future-episode fodder.
Kotcheff peppered
the two with questions about disease theories and the
intricacies of HIV testing. He listened intently to their
replies. Later, he said he wanted not only to master
the realism-ensuring details but also to be
responsible about how he presents characters that deny HIV
causes AIDS.
''There are
people who do believe these kinds of myths, and it can have
an impact on their lives. If they don't take (HIV-fighting)
meds, they're going to die,'' he said. (Mike Stobbe,
AP)