'Nurse Jackie' Will Make You Feel Better

Edie Falco’s pill-popping, sarcastic nurse is just what the doctor ordered for summer TV. Still, Caryn James says, when it comes to medical care and dramedy, she’s no House.

06.07.09 11:41 PM ET

Let’s get the Carmela Soprano issue out of the way. In her new Showtime series Nurse Jackie, Edie Falco morphs from taloned Mafia wife to crop-haired working-class mom, a nurse so inventive and righteous she tosses a hooker-stabbing diplomat’s severed ear (ready for reattachment) down a toilet, so troubled she’s addicted to painkillers and cheats on her husband with the hospital pharmacist. ( Sopranos trivia: The pharmacist is played by Paul Schulze, who also played the priest Carmela flirted with, so she and Father Phil finally get their moment.) Falco is piercingly good, enough to make you wish the writing was as sharp as her performance; Jackie’s character is a walking emotional landmine, roaming through too many hackneyed medical-show dilemmas.

Here’s a more timely, non- Sopranos issue: Why is Jackie a nurse, not a doctor? (Maybe that’s an elitist question, maybe just conditioned by typical television heroes, but there it is.) We get an answer when she has lunch with her best friend, the glam doctor Eleanor O’Hara (played by superb British actress Eve Best), who tells her, “Healing, helping, fixing—fantastic, that’s why you’re a nurse. When I was a little girl, I took a butter knife and opened up a dead bunny to see how it worked; that’s why I’m a doctor.”

We get it. Doctors are typically cold-blooded, self-absorbed monsters. Nurses are warm, caring creatures, with a tendency to scream at slipshod docs—the way Jackie berates a smartass who ignored her advice and caused an injured bike messenger’s death.

And in case we don’t get the good nurse/bad doc scheme, a glut of new nurse-y shows is coming along to bash us over the head some more. In real life, there is a nursing shortage, but the alternate universe of television addresses reality more symbolically. The heroic working-class nurses speak to the economic downturn. The bozo doctors become lightning rods for our massive frustration at an out-of-control health-care system; they’re overeducated, callous embodiments of everything that’s wrong.

You can spot this appealing but bogus message even in brief clips from Mercy, NBC’s nurse-centric fall series. “I treat the disease,” a doctor tells an interfering nurse, who snaps back, “Yeah, well, I treat the patient!” Does this nurse, a heroine just back from Iraq, know best? “I’m a nurse who knows more than all of your residents combined!” she yells at a doctor whose inept resident has killed a patient.

And Jada Pinkett Smith plays a chief nursing officer in TNT’s watchable but lame HawthoRNe, (beginning June 16). She’s presumably named Christine Hawthorne so they can capitalize the RN. Does a nurse spot a doctor’s life-threatening mistake here? Check. Does Hawthorne yell at the doctor? Check. In this clonelike TV world, could Hawthorne, a widow with an unruly adolescent daughter, be anything other than an emotional wreck of a lifesaver?

There is something satisfying and cathartic in watching these simplistically defined nurses and doctors echo what we love and hate about the medical profession. In the derivative but entertaining Fox doctor series Mental, the hero is a psychiatrist who resorts to outlandish treatments; he’s as brilliant as Hugh Laurie’s character on House, but kind-hearted. His great moment is reminding his staff that M.D. stands for “medical doctor, not medical deities,” a line guaranteed to please anyone who has ever bristled at a doctor with a God complex.

And anyone who has ever felt cowed by a doctor, intimidated by his or her superior knowledge and attitude, can experience an antiauthoritarian thrill when the lowly nurses tell off the lordly doctors. But it’s a cheap, unrealistic thrill that ignores basic elements like doctors’ training and the medical hierarchy.

HawthoRNe has none of Nurse Jackie’s ambition, but at least it acknowledges those professional class distinctions and the resentment they breed. A nurse who has noticed that a careless doctor’s prescription order might overdose the patient says, referring to himself in the third person, (and suddenly the Jackie writing seems so much better), “Nurse wants to find doctor in a mistake because nurse could have gone to med school—in Paraguay.” As a colleague reminds him, “In the real world, you’re a nurse,” who has to follow orders. The nurse may be more scrupulous than the doctor, but think about it: Would you choose a doc who trained in Paraguay? And if you don’t have that choice, the problem points toward a health-care profession whose costs for providers and patients are raging out of control.

Bozo doctors become lightning rods for our massive frustration at the health care system; they’re over-educated, callous embodiments of everything that’s wrong.

The formulaic HawthoRNe seems to have stumbled across that insight. Nurse Jackie simply washes away hierarchical distinctions by making the brilliant, cold-hearted O’Hara Jackie’s extremely unlikely doctor friend. Whether this is meant as a tribute to Jackie’s smarts or the doctor’s lack of snobbery, it’s as unconvincing as O’Hara’s character. She complains that a child who hugs her legs has ruined her $80 pantyhose, but no one believes that a doctor in a city hospital emergency room wears $80 pantyhose.

The extremely good reason to watch Nurse Jackie is a cast that makes us overlook the contrived, tired plots. (Just when you thought the devoted elderly couple, with a special guest star appearance, had vanished with E.R., Jackie trots out Eli Wallach as a dying man who wants to be treated with his wife’s chicken soup.) Merritt Wever is adorable and believable as Zoey, a nervous first-year nursing student so callow she has bunnies on her smock. And Falco’s every move reveals that Jackie is at war with herself, torn between a blissfully ignorant husband and a boyfriend who doesn’t even know she’s married, giving prescription advice to patients and stashing her day’s supply of Percocet in a packet of artificial sweetener. No wonder she says her motto paraphrases St. Augustine: “Make me good, God, but not yet.” Falco single-handedly makes her pill-popping, flawed medical heroine more than a House wannabe.

Not one of the current medical shows comes close to House, though, and that’s not because of the medical plots. Hugh Laurie’s witty, tortured genius is so individualized, so truly unique, that other shows should just stop trying to copycat.

And more than any other show, House reveals how inane it is to value a nurse’s emotional generosity above a doctor’s cool reason. Because even if House himself were utterly humorless and looked like Quasimodo instead of Laurie, you’d still want him as your doctor. No disrespect to nurses; in real life they do heroic, valuable work. And these series play off a false nice nurse/mean doctor dichotomy. But if you had to choose between having your hand held by a warm and fuzzy nurse or being treated by a heartless diagnostician? Take the diagnosis; live to have your hand held another day.

Caryn James is a cultural critic for The Daily Beast. She also contributes to Marie Claire and The New York Times Book Review. She was a film critic, chief television critic and critic-at-large for The New York Times, and an editor at the Times Book Review. She is the author of the novels Glorie and What Caroline Knew.