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Friday, August 10, 2018

Korean medical TV dramas III

Life

Korean TV darma - Life

There are now many Korean dramas on Netflix. Dramafever or Viki carries many and we have found they often appear there first then end up on Netflix if they are popular. Just because they are on Netflix doesn't necessarily mean they are great or anything but indeed some are very good. The most recent medical drama is called Life.  This follows several very good Netflix posted Korean dramas that were non-medical, but are equally as enthralling. I am thinking of  Mr. Sunshine, Live, Prison Playbook, and Hyeori's Bread and Breakfast.

TV dramas about hospitals probably started out as soap operas. As a kid the soap opera General Hospital appalled us for it's lack of general intelligence and fake acting. Korean epic medical dramas, to my mind starting with Hur Jun in 1999 are extremely interesting to watch - and now that I think about it - better than reading novels. Or, maybe that is an excuse for how much time I have sunk into watching Korean dramas. In fact, I mostly read these dramas anyway because without the sub-titles I am lost. I do hear and know a lot of Korean spoken language and I understand a lot about Korean culture, but it is not a language I am fluent in. For example, sometimes, I can watch a French movie and for the most part can understand what is going on, even without sub-titles. With just French sub-titles I would have an even better understanding.

Life has a well recognizable cast of excellent actors, as they - "star studded cast". I would say it is a powerful cast which would most surely ensure the success of the drama. In fact, the Wikipedia article on Life says for a cable TV drama, the ratings are very high. Anything over 10% is high, and that is very high for cable TV. The most prominent actor is the lead, Lee, Dong Work, who we saw not too long ago in Doekebi ( 도깨비 or English translation - Guardian: The Lonely and Great God ).  He is as good looking as a model, and as the secretary to the Hospital CEO, who has a crush on him in the drama says; "Looks like a Greek God", which in a sly way is referring back to his role as "The Grim Reaper" in Doekebi (도깨비).  Followers of Korean dramas often see these kinds of comical references of actors back to previous roles in famous dramas. One scene we saw recently watching Yi San again were two palace maid friends who said "I think we have met before in a past life somewhere". "Yes, I get that feeling too", which is an obvious reference for the audience who knew those two as not so friendly adversaries in the superb medical drama Dae Jang Geum. Speaking of 'having crushes", any Korean drama would not be worth it's salt without a romance plot or twist and turn, and now into episode number 5, something appears to be developing. Though I also heard that many people were enjoying this medical drama because it lacked a romantic focus.

There is an eHealth reference in Life which startled me for several reasons. The CEO needs to find a way to generate revenue in the hospital, which is a non-profit teaching hospital so that is kind of hard to do. He decides to create a subsidiary non-profit pharmacy that would sell nutritional supplements and all his physicians under this command would be asked to help sell and promote them - a kind sole sourcing monopoly. He finds a supplement company willing to sign on as partners but only in exchange for them funding a technology that the hospital needs.  We later see a scene where the nurses start using RFID bar code readers to interrogate signals and bar codes on patient wrists, medical bottles, inventories, and charts. It is the perfect way to reduce medical error. In early scenes there was a lot of drama over physicians in cancer wards covering up for medication errors that killed a patient. The CEO asked for a solution for reducing the errors but the physicians did not think of the RFID solution. It was the brilliant young CEO who was parachuted in from a subsidiary company that efficiently ran warehouse and product shipping to discover the idea of using RFID and getting his new pharmacy partner to foot the bill. All seems really good with RFID technology until the staff learn that in exchange for the benefit of the technology they now have to be salespeople for the nutritional supplements like whale oil, shark oil, etc, substances most scientifically trained specialists don't give the light of day to. From my own studies of RFID technology, the CEO is right. They do reduce medical errors and improve efficiency.  The technology, as I understand it, is also a bit expensive to implement, and maintain securely. The other thing that startled me is that RFID technology like this is at least a decade old, but really looks new and revolutionary in this drama.

There is another eHealth component in episode 7 or 8 where the CEO of the University Hospital meets a high powered CEO of an electronics company and they talk about starting a health app. They joke that the more people follow their blood pressure on the app, the more worried they will be about their health conditions and thus more prone to book appointments at the hospital and thus more money in the coffers. Thus are the benefits of private healthcare.

The main plot of this drama is how business intelligence pits its wits against medical staff in a top level (big 5) university teaching hospital by applying an all business efficiency and revenue generating model to public healthcare. I don't know all the reality of healthcare in Korea but the trend appears to be towards more privatizations. This drama explores that idea in the extreme. It always makes me think of the journal article written by the McMaster University physician and one of the founders of evidence-based medicine, Dr. Gordon Guyatt, in which he wrote that for profit healthcare is hazardous to your health. That was not just his opinion, but the results of the meta-analysis and evidence-based literature research. In Life, the CEO is played by Cho Seung Woo, who was brilliant in the 2017 drama Stranger (which was written by the same writer as Life - Ms. Lee, Soo-Yeon). Indeed the context for the drama, though not based on reality but is fiction as stated in the intro - has a basis in reality - rural Korean public hospitals being shut down by greedy profit seeking interests.

The focus of interest in the drama is whether or not the CEO of the hospital, who is just following the orders of the Chairman of some huge conglomerate to generate revenue in the hospital after it was bought out ( and don't ask me how a non-profit university teaching hospital can be bought out), is the most unethical, cold hearted greedy capitalist to ever walk the face of the earth, or whether he has inside a human heart capable of compassion and actually being able to listen to the over worked, over stressed and over resourced medical staff, who are just about to go out on strike as a protest to the CEO decision to cut and move out  to the rural areas outside Seoul 3 departments that are losing money. As an audience we start out believing he is a "malicious jerk" to quote the sub-title translation (and I think I even know how that is said in Korean) but through the sympathetic understanding of some of the medical staff and our own inner doubts, we start to believe that the CEO is a human being, who will eventually "pivot" and be able to harmonize solutions for all concerned.

What you have to do with this drama is hinge your mind on every spoken word (or sub-title) because the nuance and intrigue comes fast. You also have to pay attention and learn a lot about business, life insurance, and medical diagnosis, all at the same time. That the drama is packed with dense intelligence is all that I can say, which is why it reminds me more of reading a novel than watching a drama. It is not a "vacuum land" where you can passively watch in an empty state on the hope of being entertained. You actually believe that you can learn about how business and healthcare can operate together. These are also universal and extremely important ideas for society, such as should MDs also have MBAs, or is that some kind of oxymoron?

There have been some other medical dramas that have appeared on Dramafever and Viki but I don't think I will go into them in this Korean Medical TV Drama III post. You can discover those on your own. They are not entirely without merit. This drama called Life, however, I think will be well worth your time watching, and we eagerly look forward to see how this one will evolve past Episode 5.