Doctor skills needed to play one on TV

Actors go through rigorous preparation to maintain realism.

When Lee Strasberg directed the Group Theatre's premiere of Sidney Kingsley's "Crisis" (better known as "Men in White"), he took the cast to a hospital to talk to doctors and nurses and rehearsed the operating-room choreography more than 100 times in three months. The actors practiced their operating-room moves on their own every morning in pantomime, and those playing doctors kept stethoscopes in their pockets.

Today's TV doctors and nurses are even more rigorous: They have to know lots of procedures and terminology -- and make the fake look real for the camera. It's not just an acting challenge; it may also change your mindset about the medical profession.

On the set, medical advisers are always present, and on some shows real nurses work as extras. Actors also get training after they're hired. For example, when Yvette Freeman was cast as a nurse on "ER," she shadowed some nurses at a Los Angeles hospital. They taught her how to use the various machines and do basic things like wrap bandages and put on surgical gloves quickly. "In real life you have time, but on TV you have to do it in seconds," Freeman says. Now she can fake taking blood pressure faster than it's taken in real life.

Parminder Nagra, who plays "ER's" Dr. Rasgotra, initially followed an attending physician around the UCLA Medical Center for a day. "Observing the different mentalities, the different temperaments, was fascinating," she says.

Like Nagra, who practiced drawing blood at home with a banana and a tourniquet, many actors do their own research. Kal Penn, who plays Dr. Kutner on "House," went to UCLA's library and bookstore, studied anatomy and pharmacology manuals and watched online footage of surgery and other medical procedures. Ellen Crawford, who played a nurse on "ER" for nine years, ultimately became friends with a real nurse.

The technical elements of playing medical personnel are one thing, the character elements another. Jennifer Morrison, who plays Dr. Cameron on "House," read several books by doctors in order to understand their feelings. They wrote about how scary their first surgery was or their frustration with being human and sometimes making mistakes. "Dr. Cameron cares so much for her patients, is potentially too involved," Morrison said, "and this was the key I needed to find that place in her: the need to be perfect and not being perfect."

Several actors compared learning the necessary medical vocabulary to learning lines of Shakespeare: You have to understand what you're saying -- and know exactly how to pronounce the words -- for the audience to understand.

The hardest part for Morrison is doing fussy physical stuff while saying lines in what feels like a foreign language. "If we were actually intubating someone, it might be easier," she says. "But we're faking it, and you're doing eight things with your hands, and you don't want to hurt the patient or stab them. You're almost doing a sleight of hand while you're saying things like, 'He's going into cardiac arrest!' "

Just a few of the things TV docs have to fake realistically, expertly, while cheating for the camera: spinal taps, palpation, echocardiograms, drawing blood, inserting an I.V., intubation, injections, scrutinizing an ultrasound screen, hand sutures and coping with copious quantities of blood. In surgery scenes, of course, a prosthesis is placed on top of the patient's actual body part and the blood is fake, but intestines, for example, might be actual pig intestines. Nagra says she didn't mind working with the porker's innards and even found their texture fascinating, but she got queasy at the sight of blood pumping out of a prosthetic arm stump -- the fake blood grossed her out more than real organs.