The Marvelous Messrs. Mayo

Ken Burns’ Mayo Clinic documentary reinforces vision of nurses as low-skilled angels

The 2018 PBS film The Mayo Clinic:  Faith – Hope – Science makes a strong case for Mayo physician achievements, highlighting their innovative treatments and progressive financing structure. But it mainly portrays nurses as good-hearted assistants who couldn’t hope to do as much for patients as the nuns who co-founded the Clinic.

September 25, 2018 – Today PBS aired The Mayo Clinic: Faith – Hope – Science, a two-hour Ken Burns documentary on the history of the renowned Minnesota hospital. The focus is on the Clinic’s founders and early leaders, three physicians and a Franciscan nun. The hospital began in the late 19^th Century in the town of Rochester, Minnesota, as an unusual partnership between physician W.W. Mayo and Mother Alfred Moes. It later became world famous largely through the exploits of Mayo’s surgeon sons Will and Charlie. The film argues that the physicians brought the institution to world class status with relentless innovation, collaboration, spiritual awareness, and progressive financing models (including salaried physicians). Despite a few critical notes, the film mainly functions as a long advertisement for the Clinic. It is overwhelmingly physician-centric, with many current physician talking heads and medical historians extolling the Mayos and their successors, including through some current patient stories. The film does touch on nursing several times, but almost all of these bits strongly reinforce the angel image and the “faith” and “hope” parts of the title – the “science” seems to be the province of the physicians. There is almost nothing to suggest that Mayo nurses have saved lives. Sadly, the few comments the filmmakers include from nurses do little to help. The current CNO says that the nuns were well suited to the nursing work because of their empathy and humility. A staff nurse suggests that the nurses can only aim to do a fraction of what the devoted nuns have done. There is a brief description of the hospital’s nursing school, which opened in the early 1900s and offered courses in anatomy, physiology, and bacteriology. But the film does not directly link those subjects to clinical expertise or discuss what nurses do for patients in any detail. The film does briefly describe the formidable early nun and nurse Sister Mary Joseph Dempsey, who served as “head of the hospital” and as the main surgical “assistant” to Will Mayo for 25 years. The narrator says Dempsey was so expert that she would continue operations while Dr. Will would turn to explain things to visitors! But this is the exception in a small group of angel-oriented nursing mentions, which are themselves dwarfed by a long series of salutes to physician skill. The film was written by Ken Burns and David Blistine, and directed by Burns, Christopher Loren Ewers, and Erik Ewers. 

Make a way out of no way

Relying heavily on narration read by actor Peter Coyote, the documentary alternates descriptions of the early decades of the Clinic with talking-head accounts of its cutting-edge modern care, mainly by physicians and patients, who include celebrities like John McCain and the Dalai Lama. The Clinic grew out of St. Mary’s Hospital, founded in the late 19^th Century by W.W. Mayo and the Franciscan nun Mother Alfred, who had a vision after a devastating cyclone that she and the physician should start a hospital with an egalitarian mission. 

The nursing elements are closely linked to discussion of the nuns who provided much of the care in the early years, although the nuns had been trained initially as teachers, not nurses. The film notes that the Mayo son Charlie married a nurse named Edith Wharton, who joined the Mayo practice and mostly worked at the hospital, where she shared her knowledge with the sisters. Nurse Edith was “feisty, outgoing, and an integral part of the Mayos’ practice.”

Another key early nurse was Sister Mary Joseph Dempsey. Nurse Edith persuaded Sister Mary Joseph to stay at the hospital despite some distress about seeing her first naked male patient, and in less than three years she became “head of the hospital.” We hear that Sister Mary Joseph was the second in “a long line of formidable women who would lead St. Mary’s Hospital, working closely with the Mayos, but also maintaining the sisters’ independence and their values.” Sister Mary Joseph “served” as Dr. Will’s main “surgical assistant for 25 years, and became so skilled that she would continue with an operation when he turned away to explain something to visiting doctors or students.” That indicates that nurses can be expert, although it’s not exactly nursing, and the narration does not explain how being head of the hospital lined up with being a “surgical assistant.” 

The Mayos became world famous, the Clinic grew quickly, and “more surgeries meant more nurses.” It sounds like nursing is a function of surgery. In any case, in 1906 the St. Mary’s Hospital Training School for Nurses opened. The narrator: “The curriculum combined lectures on anatomy, physiology, and bacteriology along with classes in practical nursing and hygiene.” A current-day neurosurgeon appears to relate that one of the nuns told him soon after he started at the Clinic that “when she went through the nursing school, everyone was taught to look at every patient like Jesus Christ.” We get it, professionals should hold the lives of each of their patients in the highest regard, but this way to express that idea suggests that nursing is a spiritual calling rather than a modern profession. 

Even the few appearances of current Mayo nurses reinforce the link with the sisters and their devotion, empathy, humility, and hard work, leaving the impression that nurses are pale secular versions of nuns, with little indication that nurses have unique scientific health knowledge or skills or how patients might benefit from that. We understand that it was the filmmakers, not the nurses, who chose what clips would be included. The nurses might have also gone on at length about nursing skill, but viewers of the documentary will never know what lies on the cutting room floor. In any case, the first nurse we see is Quiana DeBrill, identified as “LPN, Mayo Clinic Nurse, Jacksonville, FL.” She says:

I have no idea how the sisters took care of patients with so little, but they made a way. And that’s one thing about being a nurse, you make a way out of no way.

Pamela Johnson, identified as “RN, Chief Nursing Officer,” adds:

I think there are several things that really qualified the sisters to be nurses. I think it was their empathetic approach to patient care, it’s the humility that they brought to their work, and how they worked with each other. It was their Franciscan values which we really carry into the work that we do today. 

The comments we see from Kate Welp, “RN, Cardiac Surgery Care Unit,” do provide slightly more detail about what nurses do, but not a lot, and it’s not long till her comments become an extended tribute to the nuns and their spiritual merit.  

Nursing would definitely be the front line of medicine. We are with the patients 24/7, we are monitoring them 24/7, and we’re going to be the first to try to make things better. I know that the sisters started it, and I think there’s a sense of pride with that. There’d be many nights when I would be leaving working at 8, 9 o’clock at night, and Sister Generose would be rolling up her sleeves. I remember Sister Vera walking the halls when she was 101, 102, something like that. Let’s face it, we can’t compete with the sisters, but if we could do that little fraction of what they’ve been able to do, wow, that would be an honor. I would like to think that tradition can carry on.

The parts about nurses being on the front line, doing 24/7 monitoring, and responding first are a good start, but they are too vague to register much without more concrete detail about what nurses do. Instead of that, viewers get a lengthy tribute to the inspirational devotion of the sisters, who evidently put the nurses to shame.

We don’t begrudge the Mayo physicians their due, but the film’s overall presentation of nurses as low-skilled nun adjuncts is grossly inadequate. It reinforces the enduring stereotype that nurses are basically virtuous angels, rather than modern health professionals. And that is a missed opportunity, because we understand that the Mayo Clinic has been the site of life-saving, valuable research, and clinical innovation by nurses for decades.

See The Mayo Clinic documentary.

Directed by Ken Burns, Christopher Loren Ewers, Erik Ewers

Written by David Blistein and Ken Burns

Executive producer Ken Burns

2-hour documentary narrated by Peter Coyote, with additional voices by Kevin Conway, Tom Hanks, and Sam Waterston.