by Laura Turner
SDN Staff Writer

In 1987, NOVA’s cameras began rolling to chronicle the lives of seven medical students embarking on their years-long journey to become doctors. From their first days at Harvard Medical School to the present day, none of them could have predicted what it would take, personally and professionally, to become a member of the medical community.

The final installment of NOVA’s Doctors’ Diaries is a two-part special premiering Tuesday, April 7 and 14 at 8pm ET/PT on PBS (check local listings).  The longest-running U.S. documentary of its kind, Doctors’ Diaries begins by reuniting the physicians on the steps of Harvard Medical School 17 years after graduation.

The seven physicians profiled in NOVA's "Doctors' Diaries" (photo credit: NOVA - Betsey Cullen)

Footage from the previous four installments in the series offers a rare and candid look at the rewards and personal sacrifices each has made over the last two decades – from the stress of medical school exams, to the first cut into a cadaver, through first wedding ceremonies (and sometimes second or third), internship, residency, and life as a certified M.D.

The seven physicians featured in Doctors’ Diaries have taken divergent paths:

• Tom Tarter, Bloomington, IN – The Bronx-born, long-haired, tattooed ER doctor has constantly grappled with how he is perceived as a physician. After his contract was terminated at the local hospital he became an itinerant M.D., forcing him to look for work in distant locations. Once a bouncer, an Olympic-hopeful weight lifter, and a mechanic, Tom is now on his fourth marriage and struggles to make ends meet.
• Jane Liebschutz, Boston, MA – Currently an internist specializing in underserved populations, domestic violence, and addictions. NOVA was there for the gut-wrenching moment when Jane experiences a patient dying in the operating room for the first time.
• Jay Bonnar, Belmont, MA – This private practice psychiatrist is also involved in outpatient group therapy and teaches at the hospital.
• Elliott Bennett-Guerrero, Durham, NC – A successful anesthesiologist who picked his specialty partly based on the less demanding hours-this now affords him more time to be at home with his second wife and two young sons and pursue his new passion: golf.
• Luanda Grazette, Thousand Oaks, CA – Originally trained as a clinical cardiologist, Luanda now works for a pharmaceutical company to develop drugs that will help heart patients.
• David Friedman, Baltimore, MD – As an ophthalmologist and professor at Johns Hopkins University, David aims to one day establish a hospital to provide eye care to the millions of people worldwide who currently have no way to improve their poor vision.
• Cheryl Dorsey, New York, NY – Although she eventually completed her pediatrics training, she never practiced. Cheryl put her residency on hold to found a program that provides free curbside health services for minority communities; today she is the president of the same nonprofit that funded her Family Van mobile clinic.

Producer and director Michael Barnes recently spoke with The Student Doctor Network about Doctors’ Diaries.

Michael Barnes (photo credit: Jim Murphy)

How have you seen the profession of physician change over the course of the series?

Managed care was well entrenched in 1987 when we started filming at Harvard. A couple of the doctors we followed are the sons of physicians. They describe that it was their fathers who saw the biggest changes in the profession. Under Ronald Reagan’s presidency, Congress encouraged the transition of the insurance industry from a not-for-profit ethos into a for-profit approach as enabled by Health Maintenance Organization Act of 1973. Without exception all seven doctors in the series believe the for-profit approach is flawed and that the healthcare system is broken. But this is the model under which they became doctors. Perhaps the biggest change for them is yet to come if the healthcare system can be reformed.

What do you think you would find if you started this series over in 2009 with a new set of first-year medical students?  Do you think the experiences would be similar?

Over the past two decades most medical schools have improved the curricula for the first two years of training (as Harvard did back in 1987 with the New Pathway). I understand 3rd and 4th year students at Harvard now do their rotations at one hospital rather than switching every month. Since we filmed, legislation has resulted in Interns working less hours with fewer nights on call. Despite these changes I am certain the medical school experience would be almost identical to those we recorded in Doctors’ Diaries. There are no short cuts to the process of becoming a fully initiated member of the medical tribe.

Over half the doctors that were featured in the program were married and divorced during the 21-year span of the program.  Do you feel that medical students, residents and physicians are more likely to have negative incidents in their personal lives due to the stresses of their profession?

In the UK, and I suspect in the United States too, physicians do have a higher risk of divorce (as well as drug abuse and suicide) than other professions. Based on our seven physicians it seems that the most difficult time to sustain intimate personal relations is during medical school and residency. Relationships that began later seem to be faring better, perhaps because a reasonable work life balance has been achieved. A couple of the doctors described how their tendency to treat their spouses “like interns” led to conflict.

One of the students (Cheryl Dorsey) is not currently a practicing physician.  Was her journey the most unexpected, or did another student surprise you more with his or her choices?

Luanda’s choice to stop seeing patients and work fulltime in research at Amgen was a surprise. But I am sure her love for patient care will pull her back in to clinical practice at some point soon. Although she kept to herself any misgivings about going to medical school I did sense that Cheryl was ambivalent. Although Cheryl took a circuitous route to get there it is wonderful to see how completely fulfilled she is in her job leading the Echoing Green foundation (that provides seed money for social entrepreneurs).

At the time that the original series was produced, 1987, the whole “reality TV” concept did not exist.  Today, documentary and “reality” television is common.  Do you think that the numerous medical reality shows give a realistic or unrealistic vision of the life of physicians, based on your experience with Doctors Diaries?

I don’t watch a lot of reality TV about doctors. But shows that trade on reality should respect it. Doctors’ Diaries will influence how these seven doctors are perceived and judged by viewers. Even though we shot around 500 hours over two decades for the NOVA series making a film that is completely true to their lives is impossible. Real life is a muddle and as storytellers we must impose structure by deciding which scenes to keep in and which to leave out. As we edit ever more finely it comes down to choices about individual words and frames. The NOVA series only documents a tiny fragment of their lives. But our guiding principle is always to portray the spirit of their careers. In striving to achieve authenticity I have found a good test is to imagine the doctor watching the scene in question in the same room as myself. If that would be an embarrassing experience I have probably made a bad decision. At a recent preview screening which a couple of the doctors attended Jay remarked, “I recognized myself”. I hope the others can say the same.

The Student Doctor Network targets pre-health professional and health professional students.  What key message or messages should they take away from this series?

As Luanda once said becoming a doctor is only for people who cannot imagine doing anything else. Tom agreed and said that if you have any doubts about giving up a decade of your life there are several careers such physician’s assistant and CRNA, which do not require quite so many years of training.

For more information on Doctors’ Diaries, please see the NOVA website at http://www.pbs.org/wgbh/nova/doctors/.