On Grey’s Anatomy, only a few handmaidens can hope to reach battle-axe status
Nurses in the show’s 13th season were mostly meek servants taking physician orders, when they appeared at all. One episode did portray a nurse managing a primary care clinic. But he was a quasi-battle-axe, a petty bureaucrat obsessed with protecting his turf and resenting physicians, not helping patients.
May 2017 — In the 13th season of ABC’s Grey’s Anatomy, a dozen brilliant surgeon characters handled everything in the hospital, including many dramatic tasks that nurses would likely do in real life. Those ranged from interventions like defibrillation to psychosocial care for patients and families. Meanwhile, nurse characters rarely appeared. When they did, it was to absorb commands and hand things to the physicians. The nurses almost never got names, and almost never spoke to patients; indeed, they rarely spoke at all. A nurse did emerge from the background in one episode. Nurse Tamir displayed some basic health knowledge and clinical authority. But he was a quasi-battle-axe, a petty bureaucrat who abused his authority in running the hospital’s free clinic, torturing surgeon Alex Karev. Alex had been banished to do what surgeon Meredith Grey called “scut” work at the clinic while a well-founded assault charge was pending against him. (Evidently violent criminals should not be doing surgery, but they’re fine for primary care.) Tamir was not a full-on battle-axe because he wasn’t female and wasn’t trying to hurt patients. His attitude was closer to indifference, or aggravation when the patients complicated his life. Like several Grey’s nurse characters before him, Tamir was disagreeable, sniping, and resentful of the surgeons, with his main dramatic function being to present a temporary obstacle to one of them (in this case Alex) at a low point in his professional life. But once Alex had gotten his life lesson, he returned to Olympus and the show forgot all about Tamir. Creator Shonda Rhimes is responsible for Grey’s Anatomy.
The vast majority of the show simply ignores nurses, even though it is mostly about hospital care. Once in a while nurses do appear, perhaps in the background performing what seem to be custodial or administrative tasks, or else absorbing physician commands. Episode 6, for example, includes most of the usual features: nurses handing things to physicians, silently helping out, pushing gurneys in their patterned scrubs, doing something undefined. Sometimes, during a code, nurses may look panicked until a surgeon tells them what to do. Although that approach to nursing doesn’t call for a lot of new analysis every year, or many detailed examples, it is close to 100% of the show’s portrayal, and that should not be obscured by our more detailed examination of the few exceptions, like the fleeting portrayals discussed below or the Tamir character.
Episode 8 is mostly about one long, complex operation, a good example of the show’s romanticizing of excessive surgical hours, but it also has a few telling details about nursing. An early scene appears to feature perhaps a dozen faceless nurses setting up an OR. They never speak, but when the surgeons enter, the show becomes very interested in what the surgeons say. After the long surgical ordeal is over, Meredith is alone in the scrub room when an apparent nurse enters, perhaps for some kind of cleanup or restocking. The nurse actually apologizes, as if she has entered restricted surgeon airspace: “I’m sorry. I didn’t think anyone was in here.” Meredith, beneficently: “Whatever you need.” Thus blessed, the nurse continues with whatever it is those people do.
Physician nursing is especially common in the show’s depiction of interactions with patients and families. But sometimes the show has physician characters undertake physical interventions that nurses generally do in real life.
The season also seems to have an appearance by a nurse manager other than Tamir. In episode 9, as the hospital confronts one of its frequent mass casualty events, we see chief of surgery Miranda Bailey getting updates from several managerial subordinates (the show has always appeared to believe that the chief of surgery is automatically the chief of medicine and hospital CEO). Nearby, an African-American man in scrubs, possibly a charge nurse, takes notes on a clipboard.
Charge nurse: Already recalled my nurses. I’ve got the ER covered, Klein is manning the OR floor, who do you have up there on–
The rest is difficult to discern. (Incidentally, “Klein” is also the name of the show’s “supervising producer,” a real nurse who has spent years showing the actors playing physicians how to do things nurses do in real life.) But this is an extremely rare, albeit fleeting, appearance by a nurse with some management authority. Of course, it’s clear Bailey is in charge, and the nurse character does not seem to re-appear.
Another rare nursing event occurs in episode 15. We see Alex Karev, who is a pediatric surgeon, with a newborn baby. An apparent nurse (she wears pink scrubs) actually tells Karev that she “noticed a systolic murmur” and that “it’s probably nothing but I thought I’d call just in case.” Karev: “I’ll check it out.” Later, Karev tells the parents that they baby has a heart murmur, but they will need to run tests to know more. A more senior physician eventually diagnoses Hypoplastic left heart syndrome. Nurses play no other role beyond the usual background work, and the nurse comment above is such a blip that few viewers are likely even to note that the diagnosis started with a nurse engaged in patient surveillance. Still, it is a tiny hint of reality.
Orders from a nurse
Nurse character Tamir appears in episode 4. Attending surgeon Alex has been banished to the hospital’s walk-in clinic because he assaulted a resident physician who Alex thought was having sex with Alex’s girlfriend Jo. That assault, which caused serious injuries, has led to criminal prosecution and some apparent limitation of Alex’s ability to practice. Evidently he is allowed to handle clinic patients in some hazily defined medical capacity. But at the clinic, Alex is under the thumb of a white-coated nurse that online sources say is named Tamir Dahr, although we did not catch his surname in the actual episode. We see Alex stocking supplies at the clinic. He got there early, he tells his visiting friend Meredith, because he had to open it up, and apparently his lawyer told him this work looks good, because it shows he is a valuable member of the community. Meredith sympathizes, but observing his work at the clinic, she delivers the show’s verdict: ‘This is scut.’ Only surgery, it seems, has real worth. Then Tamir appears.
Nurse Tamir: Don’t think for one second you’re getting points for arriving before me. Things you didn’t do yesterday: refill the glove dispenser, check the auxiliary thermometer battery, stock oral swabs… [Meredith leaves] Oh, wait, you think this is a place to hang out with your friends? You do realize we open in 20, so do you wanna sit there and admire me or do you wanna get to work?
Later, Alex apologetically asks Tamir for a “favor”: he needs to leave for an hour that afternoon.
Tamir: I know you consider this grunt work, Dr. Karev, it’s a far cry from the hallowed halls of the surgical floor. And I’m sure you’re not used to taking orders from a nurse.
Alec says it’s fine.
Tamir: Oh, is it…”fine”? Thank you. This is second Thursday — vaccination day. We’re about to get flooded with hundreds of patients needing shots, on top of everyone else.
Alex says he would not ask if it wasn’t important.
Tamir: What’s important is our patients, they can’t be rescheduled like elective surgeries. They need you here and so do I. The answer is no, you figure out your life on your own schedule. The clinic’s open [throwing keys on the counter in front of Karev], get the doors.
Later, Alex encounters a man with a very infected abscess. Tamir swoops in to ask what he’s doing. Alex says he can handle it, but Tamir tells him to page surgery. Alex says he is surgery.
Tamir: Not in here, you’re not. You do not lance, you do not drain, you do not cut. You are not authorized to use a scalpel on anyone. Page surgery.
Later, the clinic becomes crowded. One patient is scared he’s really sick, but Alex tells him that eating beets has produced “a natural reaction called beeturia.” Tamir interrupts.
Tamir: Which means you’re fine [handing the patient some paper], give this to the desk on your way out. (To Alex.) This is a clinic, not a hotel. Bed 6, binge drinker, name’s Emma, frequent flyer, in here once a month. (Handing Alex the chart.) Good luck.
Karev: What’s the protocol for underage alcoholics?
Tamir: Like an adult. Hydrate her, give her the pamphlet, then get her out, we need the bed.
Even so, Alex, who unlike Tamir is a real health professional, takes Emma’s case seriously–she seems to be a working college student–and he investigates her symptoms. But she presents as a savvy, impatient clinic veteran, and all she wants is to get hydrated so she can leave.
Emma: Oh, ew, you’re new. Put the IV in the left arm, that’s where the good veins are, start with a liter of saline and push it hard, I’m dehydrated. And do me a favor? If you’re an intern, or like, dumb, get help because last time I was poked about 100 times, my arm was purple for weeks.
Later, Karev confides to Meredith, who has stopped by again, that he is trying to get out for a meeting with his lawyer that afternoon, if he can ‘get past Tamir the gatekeeper.’ Other surgeon friends stop by, having lunch in a clinic room, hiding. Alex consults them about Emma. Surgeon Amelia, herself recovering from addiction, is contemptuous of pamphlets. She says the patient needs an ally, someone who has been there, speaks the language. Then Tamir discovers them.
Tamir: Really? This is not the cafeteria, Karev. We’ve got two cases of strep, your alcoholic, your foot guy still needs his foot done.
Alex snaps that he paged surgery about the foot guy. Tamir notes that they’re in a room full of surgeons, and Alex asks if any of them will lance the abscess for him. They are eating and all decline. Alex returns to Emma, but she needs to get to work. Alex sheepishly offers her a pamphlet; she denies being an alcoholic. He tells Emma that she’s headed for the street. The senior attending surgeon Richard Webber, who is there for some reason, has to intervene and tell Alex to ‘back away from that young woman.’ But it turns out to be an act Webber and Alex have pre-arranged, to give Webber and Emma a common enemy, so Webber can play good cop. And Webber himself has experience with addiction. Then Emma has an extreme reaction to just a slight touch from Webber to her shoulder. Clearly she has some issue beyond alcohol.
Webber, Tamir, and Bailey have a meeting. Bailey asks who is at fault for Emma’s injured shoulder. Tamir says it is Alex, not the clinic, because Alex should have discharged her earlier. Bailey is annoyed because the hospital is liable (presumably this reflects the show’s idea that she is in charge of everything). Webber says Emma seems fine, but needs X-rays to rule out fracture.
Afterwards, Tamir confronts Alex. Not only did he get his clinic dumped on, Tamir says, but Alex made him look incompetent “in front of the Chief.” Tamir also claims, inaccurately, that Alex pulling the patient’s arm out of socket. Alex, who is at least more rational than Tamir, points out that was Webber. Emma overhears this and says she put the arm back herself like always, asking when can she leave. Alex says they still need X-rays. Tamir says Alex upset her, and he is why she tried to leave. Emma says she has to go because her boss is a jerk. Alex mutters that he can relate. Tamir follows up with Alex privately.
Tamir: All it takes is her filing one complaint. I know that you don’t care because you have a cushy job to go back to, but this is my cushy job. I don’t need you causing trouble.
Alex’s girlfriend Jo, now somewhat estranged from him in light of the assault, shows up for the surgical consult on the abscess. Jo was not aware of Alex’s banishment to the lowly clinic, and she also can’t believe Karev has paged her to do scut work. He confesses he is not allowed to do it himself. Tamir says that’s right. Alex loses it, and tells Tamir to screw it, there are his charts, there is his surgical consult, but Alex has someplace to be. He leaves for his lawyer meeting. But on the bus, he realizes something and dashes back to see Webber. Clever Alex has realized that Emma’s not an alcoholic. He and Webber work through the unexplained symptoms, including the chronic arm issue as well as bruising and fainting. They settle on the rare Ehlers-Danlos syndrome. Webber says Alex may have saved her life. But Alex wants Webber to take the lead in pursuing the tentative diagnosis, so as not to undermine Tamir’s authority. So Webber and Tamir break the news to Emma. Tamir seems abashed. Emma is grateful: ‘Thank you, Dr. Webber. There’s no way that other asshat doctor would have figured this out.” Karev overhears but smiles.
Tamir: That’s why the clinic’s here, Emma. We’re just happy to help.
And the portrait of Tamir basically concludes with those comments, which viewers know to be bogus, in light of Tamir’s actual indifference to anything but preserving his little fiefdom.
Tamir does have to show some authority and familiarity with health care in order for the plotline to work at all. But most of what he says is pretty basic. He doesn’t display any technical knowledge that will impress viewers, and what actually ails Emma seems a thousand miles out of his league. And he is a quasi-battle-axe. Of course, most nurse battles-axes are female, and the stereotype has a lot to do with misogyny, with the resentment of female power and the inclination to present it as unnatural and dangerous. But a man in nursing can also be a battle-axe if the portrayal suggests that the nurse can’t handle power, that he is abusing it. Tamir is only a partial battle-axe because is not trying to hurt patients. But he also has no genuine concern about them. Instead, he is irritably obsessed with patient flow, keeping order, protecting his turf–a standard bureaucrat. He is quick to blame underlings like Alex rather than accept responsibility. Tamir is also deeply insecure about his nursing status relative to physicians. Note how he repeatedly brings up his authority over a surgeon, even though Alex has done nothing to challenge him. And Tamir is way too impressed with Bailey, “the Chief.”
On the rare occasions when Grey’s nurses have been more than silent helpers, their function has often been to present an obstacle to the surgeons, and that is Tamir’s main function here. This is not the first time the show has had a male nurse in that role. Consider the appearances over the years by the disagreeable Nurse Tyler, who is always telling junior surgeons what they can’t do. Nurse Eli, a 2011 romantic dalliance of Bailey’s, initially played a similar role, although he was later revealed to be a skilled nurse worth paying attention to, even if he did not necessarily seem to understand exactly why his care was good. The one thing we did enjoy about this plotline was the idea that an attending surgeon (Alex) would have to inject diagnostic ideas indirectly so as not to undermine the authority of a nurse (Tamir), a striking reversal of a common real-world event, since it is nurses who have traditionally felt the need to do that so as not to challenge fragile physician egos.
As always, we urge Grey’s Anatomy to improve its awful misportrayal of nursing, and we ask for your help in encouraging them to do so.