A note on structure: I'm going episode by episode as a way to begin slowly digging through the many layers of Grey's Anatomy. There's a lot here, though, so this essay is in two parts. You can find pt 1 here.
All of the doctors on Grey’s Anatomy are so beautiful that it’s a running joke, a bit of meta-cinematic humor about the inherent fictionality of doctors who are too good to be true. It’s strange, though - sometimes the show seems to forget that the outrageous beauty of the ensemble was carefully curated.
Horton again:
“[Ellen Pompeo has] that ‘every girl’ beauty. She’s not model-y, she’s not overtly gorgeous, she’s just beautiful. That’s exactly what Meredith needed to have.”1
I find this confusing, because Ellen Pompeo was a model. So were Katherine Heigl and Justin Chambers, two more of the five actors who play the main group of surgical interns. Heigl was a child model, and Pompeo and Chambers were both approached by talent scouts as adults.
Another quote from Horton, referencing Heigl, who - unlike the other models - plays a model on the show as well:
“Trying to find someone that beautiful who really can act is really hard.”2
Why is it, exactly, that actors have to be that beautiful in addition to being able to act? Might it not be enough for an actor simply to inhabit a body, and to use it? Why is it so important that the people we see onscreen look a certain way?
Beauty - and beauty standards, which often exist as a way of violently enforcing social norms - affect casting, which means they affect jobs. Jobs, like games, tend to be win-or-lose; one person getting a job means another person can’t have that job, or the money or resources connected to it.
Pompeo was bartending in New York City when a casting agent asked if she was an actress. She said yes; she’d moved to the city as an aspiring actor. He sent her to three commercial auditions that day, including one for L’Oreal, and she booked all of them.3 Fast forward about twenty-five years, and Pompeo is one of the highest-paid actresses on television.4
“To come from where I come from, no entertainment background, not even having the slightest idea how to get into show business?” she said in 2021. “I just felt so blessed to be making a living this way.”5
Pompeo could still have been an actor if she hadn’t been spotted, of course. But her path, like those of the other models, was eased by something totally outside of her control. She was invited into the television business because she, as a slender young white woman with light eyes and hair, was instantly recognizable as desirable.
When Grey’s Anatomy began airing, much was made of the racial diversity in the main ensemble. Many reviews praised the show’s ‘colorblind’ casting, as Rhimes famously chose not to specify the characters’ race or ethnicity in the pilot script.6 She said,
“[The show] isn’t diverse by some design. I’m an African-American woman, and I assumed when we cast the show it would be diverse. I said, ‘Let’s bring everybody in to read.’ When the cards fell, these were all the actors we picked.”7
What seems to have made a difference, though, wasn’t that each and every part was open to the best actor, regardless of race. It was that Rhimes insisted on actors of color being considered for each and every part, which naturally led to more actors of color being cast. “They sent me all these white actors,” Rhimes said in 2005, “and I was like, ‘Are you kidding?’”8
Several reviews also praised Sandra Oh’s standout performance as Dr. Cristina Yang, who is the only nonwhite surgical intern in our main group of five. One critic wrote that Oh was so “darkly alive” that he wanted the show to be about her, not Meredith.9
Another critic titled his review “Grey’s Anatomy Features Oh, Little Else,” and quoted actor Paul Giamatti, who had worked with Oh on the 2004 movie Sideways, as saying, “She really is one of the best actresses alive, that woman.”
In the same review, however, he also wrote that Oh “doesn’t possess the looks of a leading lady,” but that her face is “appealing in its own way.”10 He failed to elaborate on what a leading lady looks like, or why this might be relevant to her acting.
Oh did not begin her entertainment career as a model. Instead, she began acting in school plays at the age of ten. “My parents were not the ones who brought me to acting,” she said. “I brought myself, and when I found it, I could never go back.”
In 1994, at the age of 23, she was starring in her first films. The director of one of those films, Sturla Gunnarsson, said, “She put herself on the map. She stood out from the beginning. She had then what she has now, a tremendous emotional accessibility and a steely inner core…She could do it all.”11
In a 2018 interview, Oh explained that she was confused when she first received the script for Killing Eve - a show in which she plays the titular role, and for which she has received Critics’ Choice and Golden Globe Awards and been nominated for Emmys and BAFTAs - because she wasn’t sure which part she was being offered:
“I was quickly scrolling down the script, and I can’t really tell you what I was looking for…I did not assume the offer was for Eve. I think about that moment a lot. Of just going, how deep have I internalized this? [So] many years of being seen [a certain way], it deeply, deeply, deeply affects us. It’s like, how does racism define your work? Oh my goodness, I didn’t even assume when being offered something that I would be one of the central storytellers.”
The problem was never that Sandra Oh didn’t look like a leading lady. It was that people didn’t see one when they looked at her. And that the people looking were the ones telling the stories - and so they got to decide what everyone else saw, too.
Meredith’s first patient is a teenager named Katie Bryce (Skyler Shaye) who has a set of mysterious symptoms, including repeated seizures. Bailey assigns Meredith to look after Katie - apparently randomly, though no other interns get their own patient. Later, as Katie’s tests come back inconclusive, Derek issues the diagnostic challenge to all of the interns to maximize Katie’s odds of survival, along with the promise that the diagnostician will scrub in on the surgery (since she presumably needs surgery of some sort).
Meredith and Cristina decide to work together, and Meredith tells Cristina both that she slept with Derek the night before and that she doesn’t want the surgery: if either of them figures it out, Cristina will scrub in. Later, Meredith comes up with the thought that Katie might have a ruptured aneurysm, and Cristina presents the idea to Derek, Meredith behind her but not speaking.
Katie gets a scan, the diagnosis proves correct, and - Derek invites Meredith, not Cristina, to scrub in.
Later, when Meredith asks if he picked her because they slept together, he says, “You’re Katie’s doctor. And on your first day, with very little training, you helped save her life. You earned the right to follow her case through to the finish.” Then he leans in and adds, “You shouldn’t let the fact that we had sex get in the way of you taking your shot.”
But the fact is that there’s no way to know if the two of them sleeping together affected Derek’s decision, since he’s already indicated that his sense of appropriate workplace behavior is questionable. Meredith being Katie’s doctor was random (apparently), and Cristina told Derek about the aneurysm, not Meredith - which should mean Derek doesn’t know that Meredith made the diagnosis.
If he believed that Cristina made the diagnosis, did he also believe that Meredith’s contribution to Katie’s case outweighed Cristina’s anyway? Why did he assume that Meredith had earned it more than Cristina had earned it, without carefully parsing what they did to earn it?
Meredith has many advantages in life, including some advantages that are specific to her position at the hospital, and it’s impossible to know if she’d be as successful (or successful at all, in this highly competitive field) without them. Consider that when she successfully makes a treatment plan after another intern fails to do so correctly, Webber says to her, “I’d know you anywhere. You’re the spitting image of your mother. Welcome to the game.”
Resemblance, inheritance, legacy - they aren’t listed requirements, but they sure help, and you can’t resemble a famous ancestor if your ancestors weren’t famous. When that critic wrote that Sandra Oh didn’t possess the looks of a leading lady, which leading ladies was he thinking of, exactly?
Cristina confronts Meredith about Derek’s decision, and there will be times in upcoming episodes where characters similarly blame Meredith for any problems connected to her and Derek’s relationship - even though there are two people in that relationship, and Meredith is the one with significantly less power.
I’m not saying Meredith is blameless. Often she’s far from it. She could’ve said no to scrubbing in on the surgery, said instead, “No, it was Cristina’s idea, I don’t think it’s right to take this from her” - whether that was true or not. Instead, Derek telling her that she deserves the surgery is enough for her to disregard her deal with Cristina.
But the show rarely holds Derek responsible for the decisions he makes, or the way they impact other people. And in this case, Derek’s refusal to meaningfully consider the power he has over Meredith and Cristina - or the bias he holds towards them - prevents Cristina from accessing an opportunity that she also deserved.
Much of the time, as we move through a complicated and frightening world, it’s easiest for us to dismiss ethically tenuous behavior - even when it harms us - as unimportant, or not really the person’s fault. It is often easier to deliberately forget about a painful incident, for example, than to confront that a powerful person hurt you, and that they might not believe that they did anything wrong at all.
George begins his solo surgery, an appendectomy, confidently. He manages to successfully remove the patient’s appendix. But he also rips the cecum, the area of the large intestine to which the appendix was attached. When he does, he panics, freezing again, his hands fluttering over the open abdomen. Burke offers brief instructions on how to repair the tear. Then, as the patient’s pressure drops and George continues to stare helplessly, he says, “Come on, George. Today. Pull your balls out of your back pocket. Let’s go. What are you waiting for?”
George doesn’t move. The scrub nurses warn Burke, urgently, that the patient’s blood pressure is dropping too low.
“Get out of the way,” Burke says, pushing George away from the patient. “Pansy-ass idiot.”
Terrorizing complete. For the rest of the episode, George is frantic over the knowledge that the entire surgical intern class is calling him ‘007’ - meaning he’s licensed to kill, not heal.
Later, after George makes the mistake of promising a patient’s wife that he will survive his surgery, Burke punishes him by making him tell the unsuspecting woman that her husband is dead. With no guidance from Burke or anyone else, George delivers the news in a crowded waiting room, clumsily, stumbling over his words. It’s deeply painful for them all. After he manages to deliver the news, she has to ask him to go away.
Clearly there are problems with this version of education. This isn’t teaching so much as letting people fail. In both of these cases, the patient/visitor experience would have improved had Burke been able to offer support to George instead of belittling him. George isn’t learning from this: being shamed for making mistakes and having incomplete knowledge results in panic, not focus. And the shaming doesn’t shy away from personal territory - Burke comments on George’s gender and genitalia - which means that it’s actually sexual harassment.
We often imagine, when doling it out to others, that shame is motivating. Because embarrassment is so painful to experience, we think that a dose will incentivize people to work harder, give more, be better. And we believe that if people work harder, they will not make mistakes, and it will in this way be possible to avoid pain.
But the truth is that mistakes are inevitable, and so is failure, and so is ignorance, and it is impossible to avoid them by working harder, because they are not symptoms of inadequacy but facts of existence. So shame doesn’t motivate us to grow. It just makes it more frightening to fail, which makes it harder to try, to take risks, to ask for help, and to admit that you’re wrong when you’re wrong, as we are all wrong sometimes.
Professionally speaking, Burke has the same relationship with George as Derek has with Meredith. Both attendings cross boundaries wielding power over their students in this episode, albeit in very different ways and with different goals. Neither intern can do much to respond, or to enforce their response. In the end, Meredith’s only way to make herself heard when talking to Derek was to leave.
Derek acts as though he is unaware of this. Of how much he could hurt her, and how little she would be able to do to protect herself.
Humans have learned many ways to model the behavior we want to teach. Storytelling is one important way. Game-playing is another.
In the late 1890s, Elizabeth Magie decided to take action against the injustice of property law, and she sat down to “work out a demonstration of how the landlord gets his money and keeps it.” What emerged was a game that “prove[d] one of amusement as well as of instruction.” She called it The Landlord’s Game. These days, it’s better known as Monopoly.
In 1902, Magie described the game:
“It is a practical demonstration of the present system of land-grabbing with all its usual outcomes and consequences. It might well have been called the ‘Game of Life,’ as it contains all the elements of success and failure in the real world, and the object is the same as the human race in general seem to have, i.e., the accumulation of wealth.”12
Magie knew, though, that the accumulation of wealth was not the only goal humans could be motivated to accomplish. She wanted to demonstrate socially and culturally what she understood to be true politically: that the game of life is unfair, but that its rules are set by players, and we can play by different rules if we choose to.
That is why The Landlord’s Game - unlike Monopoly, which is essentially a rip-off - has two sets of rules. One is the set we’ve played with, where one person gradually takes all of the land deeds, cash and houses. The other set is more egalitarian. Later dubbed Prosperity, that game ends when all players have doubled their resources.13 In this way, Magie hoped, children would “see clearly the gross injustice of our present land system,” and build something better when they grew up.14
How might we design the rules of healthcare to motivate doctors to work collaboratively, rather than competitively? To provide the best quality care to the most people by sharing resources and maximizing education? And how might collaborating more effectively enable healthcare professionals to better care for themselves and their peers, too?
Because any separation of the audience from the players, or the players from the outcome, is artificial: doctors cannot protect themselves from the vulnerability of having a human body any more than the rest of us. We are all patients at one time or another, many if not most of us are caregivers as well, and we can’t isolate ourselves from either role, especially when they’re rarely chosen freely. If surgery is a game, we are all players: but those whose bodies are most on the line are least in control of the final outcome.
Under capitalism, we have become accustomed to the idea that need motivates us - that if we are not threatened with the loss of shelter, food, health, etc. that joblessness implies, we will not work, and society will fall apart.
But the idea that society inhibits our true nature of idleness by forcing us into service ignores the fact that we ourselves build society. And we don’t build society with one another to avoid being alone in the dark.
We work together to create structures that support our lives, our capacity for life. And if our societal structures are not helping us, it’s time to try building them differently.
Rice, Lynette. How to Save a Life: The Inside Story of Grey’s Anatomy. St Martin’s Press, Sept. 2021.
Rice.
Hiltbrand, David. “‘Anatomy’ of a winner: Young, spirited females.” The Chicago Tribune, May 6, 2005.
Chen, Joyce. “Ellen Pompeo, TV’s Highest-Paid Woman: ‘I’ve Chosen to Financially Empower Myself.’” Rolling Stone, Jan. 17, 2018.
Rice.
Fogel, Matthew. “‘Grey’s Anatomy’ Goes Colorblind: With a black creator and chief resident, the surprise ABC hit is the most quietly diverse show on TV.” The New York Times, May 8, 2005.
Brennan, Patricia. “The Colorful World of ‘Grey’s Anatomy.’” The Washington Post, May 22, 2005.
McNamara, Mary. “She’s Chief of Staff Here.” The Los Angeles Times, May 21, 2005.
Brownfield, Paul. “Lessons in the OR and via voice-over.” The Los Angeles Times, Mar. 25, 2005.
Johnston, George Toshio. “Grey’s Anatomy Features Oh, Little Else.” North American Post, Mar. 30, 2005.
Posner, Michael. “Sandra Oh’s doing just fine.” The Globe and Mail, May 12, 2007.
“THE LANDLORD’S GAME.” The Single Tax Review, Autumn 1902.
Adgame Co., Inc. The Landlord’s Game and Prosperity, 1932.
“THE LANDLORD’S GAME.”