NIP/TUCK (Warner Brothers TeleviSIon)
Editor's Note: It is important for the plastic surgery nurse to be familiar with our patients' impressions about plastic surgery because they influence their expectations of the plastic surgical experience. In this journal, there have been many reviews of Internet sites (in the Journal Club Department) and books about plastic surgery. It is important not only to know what our patients are reading (printed and Internet materials) and viewing, but also to have some knowledge of the content of these materials. As we well know, when we meet our patients, they come "armed" with information about surgery and specific procedures. Some of the information is accurate, some is not. It is good practice to ask patients what they have read so that we can address their questions or misconceptions accordingly. However, it is not as easy to address the impressions of the plastic surgery experience that they have gathered through television. The lines of fact and fiction are blurred. How "real is "reality" TV? How fictitious is a drama? With a good story line, the viewer is drawn into the program, and he or she may not even question the validity of the information.
In this issue of Plastic Surgical Nursing, Margo Bloomberg, RN, AEMT/IC, gives the following overview of the television show Nip/Tuck (Warner Brothers Television).
Within the world of reality television and drama, the series NIP/TUCK enters. Unlike the reality plastic surgery shows like Dr. 90210, Extreme Makeover, The Swan, and Miami Slice, NIP/TUCK is fiction. The producer and creator Ryan Murphy states he "wanted to do an in-depth show about superficiality" (interview on NIP/TUCK DVD, 2003 Warner Bros. Entertainment). He wanted to show "the glamorous outside with the festering rot underneath." The show is about making life choices and the consequences of those choices. The operating room scenes are accurate and graphic, to the point that it is difficult to believe that they are not clips of actual surgeries. They are not. Their special effects team of Thomas Burman and Barabara Dreisbach-Burman do a superb job with fake body parts. Although the show's technical advisor is a surgical nurse, the basic premise of preserving the sterility of the surgical field seems to have been overlooked. For example, doctors enter and exit the operating room without their masks once the cases are already opened. This aspect alone was distracting to me.
The show centers around two Miami plastic surgeons: Sean McNamara (played by Dylan Walsh) and Christian Troy (played by Julian McMahon). The doctors have been friends since college, with Sean being the moral, talented, and more complex of the two, whereas Christian is fairly close to what he presents, sometimes harsh, brutal, and totally lacking in sexual discretion, having had sex with a lot of their patients. (Be forewarned, the series is sexually explicit with the actors and actresses naked and appearing to have sex onscreen.) Other primary characters include Sean's wife Julia, who dated both men in college and gave up her chance to attend medical school to become a wife and mother. She is discontent with her life in general and her life with Sean in particular. The three, all in mid-life crises, form a dynamic triangle of complex emotions.
Among the reoccurring characters is the corrupt, untalented, last-in-their-class, Dr. Merill Bobolit, who steals the other surgeons' patients by undercutting the fees and using the images of their patients on his billboards.
There is also an anesthesiologist named Liz, whose portrayal of the profession must have anesthesiologists everywhere cringing. She is portrayed as an employee of the practice, who not only administers anesthesia, but seems to have other duties that include showing patients to rooms, changing dressings, and doing surgical counts of instruments. She becomes involved in situations that she should have walked away from and her credibility is really in question. Her character is a lesbian and she has an affair with a transsexual patient.
NIP/TUCK is now in its third season. Whereas the first season seems to have concentrated on the doctors and their patients, the second season showed more family dynamics and its effect on the partnerships.
In the opening pilot, the doctors become involved with Columbian drug lords. They are asked to perform surgery on a man who wishes to alter his appearance because he was caught with his "boss's girl" and needs to escape. The doctors are offered an outrageous sum of money for the surgery; money they need to complete the expansion of their clinic. This opens the door for the criminal element to weave in and out of the season's plots, as "the boss" seeks retribution and wants his money back. The doctors are forced to perform procedures that they would never do under ordinary circumstances. The season also presents the wide variety of patients that plastic surgeons see and many whom a "real" surgeon would turn down.
In the second season, the criminal element was "the Carver," who goes about cutting people's faces and becomes enraged with the plastic surgeons for operating on these victims.
The portrayal of the doctors and anesthesiologists are certainly enough to make real ones bristle. What about the portrayal of nurses? In NIP/TUCK, plastic surgery nurses are essentially nonexistent, which may be a good thing considering how poorly the other professionals are portrayed. The nursing duties are performed by the female anesthesiologist on this show.
Frankly, I enjoyed watching this series, which was entertaining because it was laughable. I rented the DVDs from Blockbuster and viewed several episodes at a time. If you watch NIP/TUCK, you will find yourself saying, "This is ridiculous," then at other times, it strikes home and the characters are all too familiar. Many of the patients on the show remind me of patients I have cared for: the aging socialite desperate to hang on to her looks and her husband, the male patient improving his looks to keep an edge in the business world; the transsexual patient unhappy with the appearance of her genitalia; or the plastic surgery addict that just can't get enough surgery. We've all encountered challenging patients, and I found myself thinking "What would I do?" with some of the patients and situations. The storyline totally sucked me in.
Margo M. Bloomberg, RN, AEMT/IC
Clinical Nurse II, William Beaumont Hospital, Royal Oak, Michigan