BLACK BOX: Do you want to be exceptional or be WATCHED?

That must have been the question Amy Holden Jones, creator of ABC’s newest scripted medical drama, Black Box, asked herself during development.

Unfortunately, the desire for a large viewership usually overwhelms innovative storytelling. As such, I did not exactly watch the pilot with high expectations.

To my surprise, I found Black Box to be far better than expected. I must admit, as the snobbish critic, this did prove to be a bit of a disappointment. When I first heard the premise, it didn’t sound fresh or intriguing. If anything, the plethora of familiar details sounded little more than a regurgitation of various existing “prestige television” ideas: a doctor prodigy with demons who insists on playing by her own rules (House M.D. anyone?); a female protagonist with bipolar disorder, who is brilliant in spite of her infliction (sounds like the twin sister of Homeland’s Carri Mathisen); neurosurgeons in purple scrubs sleeping with one another (Grey’s Anatomy); and so on.

This is not to say that these shows have a monopoly on those topics. On the contrary, favorites like House M.D. are often given too much credit for being completely original. Perhaps it is merely that House M.D. was among the first TV medical drama to incorporate the “anti-hero.” There were other surly TV doctors, of course. In the early 1960s, Ben Casey was famous for being a brilliant but impatient and sometimes quite grouchy surgeon. Go back a little further and Lionel Barrymore, as Dr. Gillespie in the Dr. Kildare film series of the 1930s and 1940s, was a pretty grumpy father figure to young Dr. Kildare – and his patients. Maybe House M.D. stands out because it’s more recent. Or, maybe because they upped the ante by making him drug-dependent.

What Black Box offered, and what I found tantalizing for its possibilities, was that this formula was being applied to a female lead. Look to the most popular, highly regarded prime-time TV shows of our time – The Sopranos, Breaking Bad, Mad Men, etc. – and very few of them had strong females as leads.

Now, don’t worry. I am not going to bore you with a long bleeding-heart argument calling for more, crazy female leads. Quite honestly, the reason for the male dominance of this character type is quite simple: the female demographic already dominates the audience for TV dramas. As such, network executives are less compelled by a need to cater to an audience that already appears content.

As such Black Box’s manic-depressive, bipolar Dr. Catherin Black (Kelly Reilly) was something of a gamble. Black is revered by the outside world for her impossibly brilliant brain, while it is that same tortured brain that proves to be her worst enemy.

At first glance, Black appears to be under control. She sees a therapist (Vanessa Redgrave) for medical care. Yet, despite her regular therapy sessions where she is prescribed medication, we soon learn that Dr. Black has a history of “noncompliance”: she does not always take her medication. Oh, and for just a bit more subtle irony, she also happens to be a neuroscientist, known as “the Marco Polo of the brain.”
I certainly wasn’t expecting Black Box to receive too much critical acclaim, but I was surprised at the industry’s sudden sense of high-minded morality about its irresponsibly inaccurate use of medical facts.

Don’t take this the wrong way. I applaud the basic sentiment of the reaction: we shouldn’t be okay with yet another medical drama showing flagrant disregard for medical accuracy. It just seemed odd that critics have chosen this particular show to make such a point.

Maybe it’s because of this: One can argue that the audacious quality to the character of Black is only possible because she voluntarily, and with rational forethought, goes off her medication, apparently simply because it’s fun!

Who would disagree with such an assessment? After all, Black surely does seem to enjoy herself. There are plenty of scenes where we see her wildly dancing about as divine jazz fills her mind and body.

Normally, I love and support being a “hater,” particularly when it gives me the opportunity to feign superiority. In this case, though, I unfortunately found myself not hating Black Box.

Firstly, how can any review assert that it has the facts of medicine and ethics on their side… all the while failing to note how a desire to relieve oneself from being medicated is textbook behavior for anyone with any degree of bipolar disorder? To base a review on misunderstandings or misrepresentations of medical knowledge is bewildering and infuriating.

I certainly can find my fair share of reservations with Black Box’s medical accuracy. However, I believe that such battles must be chosen properly, particularly considering the plethora of potential battles. (Fortunate for The Hollywood Medical Reporter, I doubt we will ever have a shortage of television shows or films that inaccurately and/or unethically depict the field and facts of medicine.) An example of one such reservation revolves around (SPOILER ALERT, KINDA) Dr. Black’s first medical case. Her young male patient, we are told, has been diagnosed with schizophrenia. Yet, there are a slew of red flags indicating a neurological/organic disorder (as opposed to mental illness) including:

1. A sudden change in behavior – no typical prodrome as seen in schizophrenia.
2. Associated systemic problems such as headache and periods of losing awareness (absence seizures).
3. An ER would NEVER diagnose schizophrenia. Such a diagnosis is generally made by a psychiatrist with at least six months of symptoms meeting specific DSM criteria (DSM is the Diagnostic and Statistical Manual of Mental Disorders, which is essentially the holy book of the psychiatry world, spelling out inclusion and exclusion criteria for all psychiatric disorders.) Therefore, it would be highly bizarre for an ER to prescribe anti-psychotics to a newly diagnosed schizophrenic.

Despite these issues, Dr. Black’s diagnosis that the patient is not in fact mentally ill, but rather has a neurological/organic disorder, is presented as a stroke of genius, simply one-in-a-million genius! The inaccuracies are simply employed to move the plot along; they are not instrumental to the story in any way. If this diagnosis was integral to the plot in some overarching way, then the facts would be emphasized and all the more misleading.

Even the unabashed “shout out” to the drug modafinil is so insignificant (at least at this point) that I almost feel bad pointing it out.

Modafinil, generic for Provigil, is a non-amphetamine psycho-stimulant, wakefulness-promoting drug, that can cause the same central nervous system stimulation affects as the amphetamine based ones (i.e. Ritalin, Adderall). There is recent research that the dopamine and reward pathways are modulated with this drug.

In Black Box, we see Dr. Ian Bickman (Ditch Davey), the new bad boy chief of neurosurgery, pop a couple of modafinil pills right before having office sex with a cheating Dr. Black. This is, of course, not before he has a chance to explain how modafinil is regularly used by surgeons and pilots to help stay awake and focused. I guess they’re dangerous enough to allow the “bad” in his “bad boy” title, without too much cause for alarm.

Overall, I found it surprising just how novel the mere attempt at this show’s concept was for network television. To my own surprise, I give it 3 out of 5 syringes for meeting the formulaic standards for primetime network medical dramas, while also making a valiant effort towards a show driven by both intellect and passion.

We shall see if anything changes with the second episode.

RATING: 3/5 syringes