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Before beginning arguments into critically exploring the fascination with body trauma in television medical melodrama, it is first essential to define melodrama, its aesthetics and its relevance within television. By definition, melodrama is ‘a drama, such as a play, film, or television program, characterized by exaggerated emotions, stereotypical characters, and interpersonal conflicts' . It is therefore apparent melodrama shifts between forms of media and thus over time between cultures and decades. It is a form of genre that was crucial to genres development and ‘understanding [of] shifting borders between high and mass culture' . Although it must be noted that what constitutes a melodrama in terms of aesthetics is shared between these sections.

In terms of the general characteristics and aesthetics of melodrama, often primarily related to film, it can be said it produces recognition for a range of audiences from different classes, localities, and national groupings. Gledhill states that it draws upon ‘social, popular, and high-art cultures and discourses into its orbit, packaging them in different combinations through its cluster of genres for consumption by a newly emerging mass audience, whose social and cultural differentiations can be appealed to and exploited within a broad generic system' . Melodrama searches for the truth and authentic experience in the world of everyday reality. Gledhill states that ‘the drive of realism is to possess the world by understanding it' . Melodrama looks for post-enlightenment reason and rationality in order to understand the world. Melodrama socially externalises ideas of moral conflicts, ethical concerns, the private and the unseen, often providing the idea of hysteria to the spectator. Typically, melodrama polarises moral issues, relating to ideas of characters embodying the roles of good and evil. The characters internalise social problems as they are trapped within a ‘small space in time'. It also refers to issues and dramatic plots that, within the social context of when the melodrama arises, may be seen as ‘taboo' by dealing with ideas such as incest, domestic abuse and trauma to the human body. Melodrama also typically deals with ideas of failure, fate and love, personifying social forces, often referring to pessimistic world, if not utopian worlds. It relates to ideas of heightened emotions and emotional extremes being delivered to the audience by the actions of the characters, giving rise to emotions in the spectator. This can done by musically categorising these emotions, awkestraighting ups and downs and referring to patterns helping the rhythm of the story and pressurising these emotions to the surface. Expression is also imperative into demonstrating emotions especially to that of silent film.

Talking in simplistic terms, melodrama has its origins in 19th Century French theatre, becoming the most popular and dominant form narrative with plays by 1940. Typically theatre favoured domestic, romantic, and society melodrama. Then in the 1900's, silent film developed. Melodramas aesthetic changed slightly as the use of sound was not available. Brooks states that ‘Silent cinema in general…… reaches out to melodrama for the stylistic features that allow meanings to be conveyed without words' . This meant that the use of facial expression was imperative in conveying ideas of heightened emotion. Melodrama, as a form of developing genre, then crossed borders into television and broadened its appeal to the general audience. Television melodrama employs many of the characteristics and aesthetics used within film, for example music. Joyrich states that ‘the use of music to convey emotional effects defines the basic attribute of melodrama in all its forms' . Music helps illustrate the emotional ups and downs, and highlights a rhythm of experience which Joyrich argues marks the discontinuities ‘of emotional experience as the plot slowly build, amidst much delay, to dramatic moments of outbreak and collision before sudden reversals of fortune begin the movement again' . Dramatics intensification can also be heightened by visual metaphors. There is more attention to dramatic setting, interior, décor and costume in order to visually communicate with the spectator. Television melodrama relies on non verbal communication often by the aforementioned visual metaphors to externalise emotion acting as ‘stand ins for human contact'. It can also be done by means of editing and facial expressions, for example and close up of a characters facial expression of sadness. There is also intensification of the mundane and the everyday happenings of everyday people by means of everyday action and ordinary gesture. Television melodrama also expresses emotions in terms of ideological and social conflicts to convey uncertainty and daily life. Although unlike film, television issues are developed differently. This has to occur due to serialising, as the plot needs to carry on to the next weeks programme arousing the interest of the spectator to want to watch the next episode. Joyrich believes that television melodrama has an enduring popular appeal, from cop shows to soaps. She states that it shows everyday life with significance.

This study will aim to identify these and other characteristics of melodrama used within the context of medical television melodrama. By identifying these issues, the fascination with body trauma can be discussed, exploring how hospital fiction uses body trauma and medical treatment as its source of drama. The study will closely relate to ideas brought forward by that of Jason Jacobs in Body Trauma TV – New Hospital Dramas (2003). To illustrate these arguments it is imperative to relate them to a number of case studies. This study will use a variety of examples from both the UK and United States that helped the distinctive development of the medical drama genre. Typically these dramas follow the private and working lives of doctors, patients, nurses and others who all attend a division i.e. the emergency room, within a hospital. The examples that will be used are Casualty (1986 – present), Holby City (1999 – present), Bodies (2004 – present), Cardiac Arrest (1994 – 1996) and lastly ER (1994 – present).

Medical melodrama began to arise in the mid 1990s, with the introduction of shows like Cardiac Arrest, Chicago Hope and ER. By identifying the melodramatic style of medical dramas, the fascination with body trauma will be identified bringing forward ideas of voyeurism and fear.

In terms of the proliferation of medical melodrama on television, Jacobs identifies three historical stages in the development of hospital drama. The first is paternal reassurance. This occurred during the 1950s to the mid 1960s and concern dramas such as Dr Kildare and Emergency Ward 10. The shows sought to help public trust in the medical profession as well as providing drama. Jacobs states that ‘according to Dr Meyrick Emrys-Roberts, medical advisor for Emergency – Ward 10, the important thing was, ‘to make sure that the doctors were shown in the best light possible so that public wouldn't lose faith in medicine' . The hospital doctor was shown as part of a working team, depicting the paternal relationship between young doctors and their experienced teacher . Dr Kildare showed character development, in terms of narrative, through the treatment of patients with acute medical problems. The characters are seen as caring, fatherly figures and spectators ‘fall in love' with them. It also had the tendency to juxtapose glamour with morbidity. Medical dramas of this period gave a reassuring view of the world and how modernising medical science cares for its patients.

The second stage is conflict. Conflict in medical dramas arose in the 1960s and 1970s. They began to introduce ideas of cultural liberalisation with explicit ‘social' contents such as abortion, rape, drugs addiction and homosexuality. They tried to illustrate the conflict between dominant values, different generations, race and gender. M*A*S*H (1972 – 1983) exemplifies this to some degree. M*A*S*H is concerned with the medical treatment of the war zone set in the Korean War. It is slightly ironic in its content, visible in the title song ‘Suicide is Painless'. The doctors were not fighting with accidental injuries, but with wounded patients and their environment. In this show the medical staffs face the negative impact of a hostile environment. In Britain

WAR ZONE 50

The final stage is apocalypse 100

NHS 50

Doctors as God 50

Medical melodrama dramatises the contemporary world's melodramatic feelings and sensibilities through dealing with life and death issues. Jacobs states ‘melodramatic issues are articulated within a dramatic setting where issues of responsibility for the body and it mortality are routinely fore grounded' . This concerns emotions of illness and health, with illnesses acting as a social force metaphor. It also deals with beliefs and values that might be expresses as ‘healthy' or ‘unhealthy'. Medical dramas tapped into the fear centre to the body and the fascination with age. Melodramatic themes are usually associated with personal sphere of relationships and the tension within the workplace i.e. practices, relationships and romances, but this will be discussed in further detail later.

The term patient means to suffer, and they are reflectors of issues medical teams face within procedures, ethics and morality. Drawing upon the characteristics of melodramatic devices, medical dramas depict body trauma in visual and narrative terms. Medical melodramas also borrow and modify visual styles from other genres i.e. horror, action and reality television. Action films influences highlights the conflicts channelled through the body. Joyrich states that ‘Peter Brooks remarks that melodrama has been such an enduring popular form because it is both ‘frightening and enlivening' as it exists on the brink of abyss' allowing us the comfort of belief in the importance of our lives as well as the challenge that this entails' . Television melodrama in medical context also concerns medical discourses whereby certain individuals don't conform like obese people, highlighting hopes and fear. This illustrates the increasing medicalisation of everyday life within the self, society and the body. The body becomes the projector of anxieties of these hopes and fears. Currently, society appears to be obsessed with health and to ways in which the health care service is coping with organisation and delivery. This is shown by a growing number of health programmes presented by health gurus. There are also a number of keep fit programme currently on television, aiding people to lose wait and ‘keep healthy'. Hallam states,

‘An on-going public concern and interest with the state of the nations health is

demonstrated not only in the coverage of formerly marginalised

complimentary therapies but in the number of programmes that focus on

showing how the national health services is coping (or not) with changes in

the organisation of health care delivery' .

There is a sense of the heightened significance given to the affective landscape of the body. Body functions are used as dramatic device of the mise-en-scene. For example, bags, tubes, ventilators and heart monitors.

Social problems can be pathologised in medical melodrama, as mentioned above in medical discourses. It can show the hyperactive or the phobic thus showing a somatic society. Michel Foucault's work on the body sees medical intervention as a means of disciplining and controlling the body. He also discusses the idea of the ‘circus of the body' with the introduction of real life medical autopsy on television. It can be said that the human body is a signifier of the social body. This relates to non-verbal communication and Freud 19th century ideas of hysteria. Hysteria has been created with the introduction of epidemics and proliferation of health cares from AIDS in the 1980's to Bird Flu in 2006. Medical dramas are not a vision of science as a reassurance. Melodramatic worlds encompass unseen and uncontrollable forces, depicting a world out of control thus reinforcing the sense of powerlessness and failure.

With regards to specific examples, it is apparent by comparing Bodies to ER and Cardiac Arrest that a few key elements of melodramatic forms are evident. In an episode of Bodies Rob Lake (Max Beesley) prepares to work his last days at the hospital. But without him there, questions arises as whether Roger Hurley be left unopposed to continue endangering and maybe even killing patients. This can relate to previous ideas in ‘doctors playing God'. Bodies is a gritty, hard hitting medical drama that deals with taboo material. It is also apparent that it has a very negative tone, especially that of relationships between the doctors. It often visually depicts images of the body that could be seen as graphic and ‘hard viewing', showing dying and bodies in distress. The opening sequence shows a baby in womb, signifying the beginning of a life and the body in its purest form. Within this episode, aired in the UK on BBC2 in 2005, it illustrates the relationship between doctors and nurses, and the hierarchy and corruption within the medical profession and the NHS. It brings forward ideas of power, lying and deceit.

In terms of power, the relationships between doctors seem to be one of getting one up on one another rather than looking after the patients. It appears to be about career progression which is illustrated with the Spanish registrar, Consuela, who claimed sexual harassment against another character Tony Whitman played by Keith Allen. She thought sleeping with him would help her career development but this was not the intention of Whitman and was done purely for enjoyment. In terms of lying and deceit, characters lied that a drug wouldn't be commercially viable when it could of, just to keep the status of the hospital. Cardiac Arrest is also somewhat critical of the health practice system. It is critical of the training of junior doctors, illustrating that they over worked and under paid. Conflict is evident in Bodies, with doctors going against the manager of the hospital Paul Tennant (Nicholas Palliser), trying to make them all appear on good behaviour in order for the hospital to receive a ‘3 star' rating. Money is thus being poured into the accident and emergency department leaving other areas in the hospital to cut back on cost, by in this case having to ask permission for blood transfusions. It appears anything will be done to make themselves, doctors and the hospital, to look better just so they get what they want. It appears to be a business rather than a hospital. This clearly highlights how the NHS is depicted within medical melodrama, being shown as a hostile environment.

The issue of covering for the failures of one colleague by another and relationships of doctors is also discussed. Donna Rix (Neve McIntosh) did not want to place the death of a patient primarily on Rob Lake and refuses to sign a statement stating this. Beesley's character also hides the real reason for a patient's death from her children in order to save his job. This also relates to the idea of doctors playing God. It can also be looked at in terms of melodramatic worlds encompassing unseen and uncontrollable forces, reinforcing the sense of powerlessness and failure. Covering for fellow colleagues is also true of Holby City. In an episode aired on BBC 1 on 16th May 2006, Diane Lloyd played by Patricia Potter believes she is appropriately covering a surgical mistake, a patient's urethra being cut during surgery, made by Michael French's character Nick Jordan but instead gets into trouble for it by not putting it in her surgical notes. The character Nick Jordan is also typical of the villain used within early presentations of melodrama. Roger Hurley (Patrick Baladi) can also be seen as a villain within Bodies.

Taboo issues are dealt with both within Bodies and ER, intertwining ideas of realism. Bodies deals with issues of still birth, sexual harassment, and in one episode accident death and the idea of playing God. In an episode of ER, which is set in a hostile environment, abortion is dealt with. Dr Luka Kovac (Goran Visnjic) and Abby Lockhart (Maura Tierney) struggle with the decision of aborting their baby. When it is decided to keep the baby, the emotions of the scene are highlighted with music conveying to spectator ideas of both sadness and hope. In season 12 episode 19 – No Place to hide, D. Gregory Pratt (Mekhi Phifer) Pratt heads to Africa to help Carter and quickly realises how difficult life will be. This episode depicts society of refugees and the violence that occurs there. There are a series of occurrence of violence, from being held and gun point, seeing victims of rape and watching a man getting beaten to death. This illustrates relationships between the spectacle of traumatised and dying bodies. It acts as despairing rather than reassuring.

Again despairing images of morbidity is shown with the depiction of the hysterical woman having to give birth to a still born in the Bodies episode that early representations are being recycled. The emotions of this scene are intensified by the close ups and expressions of sadness on the characters faces.

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Source by Paul Kennard