There is a problem with the way our fictionalized media portrays health conditions. But fiction is fiction, right? Wrong.
In the season 9 finale of Shameless, Lip’s girlfriend, Tami, has a BRCA mutation. Now he faces a dilemma: if she has BRCA 1, her pregnancy lowers her newfound genetic risk of cancer, if she has BRCA 2, the pregnancy increases the risk even more.
I would have put a spoiler alert there, but the plot point isn’t meant to stand on its own; it’s a device being used to move the relationship arc between them along, and, as such, spoiling it doesn’t mean much, because it doesn’t mean much to the show. It’s a structural addition—a means to get somewhere else.
But the BRCA mutation isn’t just a “means to get somewhere else” in the life of women, like me, who carry it. Nor is pregnancy something which can reduce my approximately 87% genetic predisposition towards developing breast cancer.
Which makes Shameless’s careless storytelling about breast cancer as infuriating to people like me as it is dangerous to society. Television and film have a responsibility to represent illnesses, disabilities and health conditions in a researched, realistic way, because if they are not represented correctly, the incorrect definitions find their way to real life and affect perceptions and stereotypes—and eventually, real patients.
Shameless’s careless storytelling about breast cancer is as infuriating to people like me as it is dangerous to society.
Don’t doubt for a second that Hollywood’s cavalier treatment of a condition as a plot point can lead to real-world disinformation. Think about the AIDS epidemic, for example. Fifty percent of people report having discriminated against people living with HIV, according to a recent report by the United Nations. And pop culture, movies and television shows shoulder a lot of the responsibility for this mistreatment. From the mid-1980s onwards, mass media attempted to tell stories around the disease, using it as a plot point to various ends… but as the media reflects the culture at large, the misconceptions ran rampant. Shows like St. Elsewhere and the Golden Girls helped stoke fears about the AIDs crisis, and further stigmatize an already marginalized population.
Throughout the late 80s and early 90s, plotlines involving characters getting AIDS ranged from a woman cutting a man’s face in St. Elsewhere to one of the Golden Girls getting a blood transfusion with possibly tainted blood. These narrative arcs may have been meant well, but they stoked fear about how the disease could be spread, and resulted in further stigmatization of an already marginalized population: gay men. By not dealing with the virus and disease in responsible, realistic ways, our pop culture did a huge disservice to the more than 100,000 people who had HIV/AIDS by the 1990s.
This is why television and film producers have a duty to treat health issues as more than just plot points moving a story along. You may say that Hollywood has every right to inject real-life diseases into their fiction, and I’d agree with that, but you can’t treat real-life diseases as fiction, with details you just make up as you go along.
You may say that Hollywood has every right to inject real-life diseases into their fiction, and I’d agree with that, but you can’t treat real-life diseases as fiction, with details you just make up as you go along.
Misinformation around health conditions is quietly internalized by audiences in ways that other things sensationalized for TV are not. And when people carry around false information about conditions and disabilities, those who have them feel stereotyped and othered. No one watching Dexter thinks it’s an accurate representation of serial killers, or that Ozark is a realistic look at life in Missouri. But we all know that health conditions are different.
Most of us have a strong sense of what is realistic and what is overblown, but representation of illnesses gets lost in the suspension of disbelief, and leeches into real life definitions in ways most other things do not. Just ask yourself: how much of the so-called medical knowledge you have absorbed through cultural osmosis comes from shows like House or ER—shows which are so medically inaccurate, they may as well be science-fiction?
Shows like Shameless can do so much better than this (and Shameless has, with its largely accurate representation of bipolar disorder). But when accurate depictions of real-world conditions are treated as unimportant, there’s a larger harm caused not just to people struggling with illness or disability themselves, but all people who will be touched by a medical condition… which is everyone. We must hold our media producers to higher standards, so our health, whether center-stage or backdrop, is accurately portrayed to the public.