Tracing the history of television as a therapeutic device, Joy V. Fuqua describes how TVs came to make hospitals seem more like home and, later, "medicalized" the modern home. She examines the introduction of television into the private hospital room in the late 1940s and 1950s and then moves forward several decades to consider the direct-to-consumer prescription drug commercials legalized in 1997. Fuqua explains how, as hospital administrators and designers sought ways of making the hospital a more inviting, personalized space, TV sets came to figure in the architecture and layout of health care facilities. Television manufacturers seized on the idea of therapeutic TV, specifying in their promotional materials how TVs should be used in the hospital and positioned in relation to the viewer. With the debut of direct-to-consumer prescription drug advertising in the late 1990s, television assumed a much larger role in the medical marketplace. Taking a case-study approach, Fuqua uses her analysis of an ad campaign promoting Pfizer's Viagra to illustrate how television, and later the Internet, turned the modern home into a clearinghouse for medical information, redefined and redistributed medical expertise and authority, and, in the process, created the contemporary consumer-patient.
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About the Author
Joy V. Fuqua is Assistant Professor of Media Studies at Queens College, City University of New York.
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Prescription TVTHERAPEUTIC DISCOURSE IN THE HOSPITAL AND AT HOME
By Joy V. Fuqua
Duke University PressCopyright © 2012 Duke University Press
All right reserved.
Chapter OneConvalescent Companions HOSPITAL ENTERTAINMENT BEFORE TELEVISION
Motion pictures and radio preceded television's entrance into hospitals in the United States by more than thirty years. In order to more fully account for television in the hospital, as a new technology in an established space, it is important to understand the technological and cultural frameworks that facilitated the incorporation of the new media technology. Indeed, as these forms of new media entered into the established, institutional spaces of hospitals, they helped create what we recognize as the modern hospital. While curing and treating disease, performing surgeries, and delivering babies were and continue to be the main features of a hospital's function, another aspect of patient care involves providing a healing environment that offers therapeutic leisure for the mind and the body. As film, radio, and later television found their places in various viewing and listening contexts, hospitals adapted these entertainment media to the specificities of patient need, comfort, and hygiene. Hospitals also employed media to establish a new way of thinking about the hospital as a clinical space, as well as what it means to be a patient within that space.
As a form of therapeutic distraction, film exhibition in hospitals had its debut during the last two years of the First World War. In military hospitals in the United States and France, wounded soldiers were shown American films for entertainment. Later, as American hospitals began to modernize and revise the institutional, cold, and unpleasant clinical characteristics of hospitals, film and radio were used to signify both modern technology and a homelike environment. By 1920 some hospitals in the United States were showing movies, and in 1923 radio was introduced at Beth Israel Hospital in New York City. Films were shown in both private rooms and wards, just as radio sets were placed so that many patients could listen either in a group setting or, after the introduction of headsets, alone. Film and radio quickly became used as therapeutic and educational devices that simultaneously distracted patients from the experience of being in the hospital, while also reminding them of life elsewhere, beyond the hospital.
This chapter tells the story of how film, and just a few years later, radio, came to be recognized as therapeutic media, helping to provide spectators and listeners with corporeal experiences that were defined, at least potentially, more by pleasure than by pain. As a demonstration of media geography and as a historicization of the place(s) of media technology, this chapter explains how film and radio were introduced into the institutional realm of hospitals in the United States, establishing a framework for television's entrance during the early 1950s. Among other forces that helped institutionalize the therapeutic uses of media in medical settings, such as programs that facilitated the projection of films in military and civilian hospitals, early advertisements for film and radio devices played a key role in establishing the idea that media could be used as therapeutic tools in the hospital. Articulating a discourse that sometimes seemed at odds with popular press and research studies about the presumed harmful effects of film and radio, during the 1920s film production and distribution companies such as the Eastman Kodak Company Medical Division, along with radio and sound reproduction manufacturers like Western Electric, represented their media products as just what the doctor ordered.
Early advertisements for film and radio in hospitals touted the perceived therapeutic benefits of media consumption by repositioning the patient as a mentally active, yet perhaps physically immobile, film spectator or radio listener. These advertisements from the 1920s underscore that, at least from the perspective of film and radio manufacturers and hospital personnel, media consumption is not passive. This is emphasized through the ways the patient is positioned in the advertisements, and how the instructions for media use assume the patient is mentally active and engaged while being, to varying degrees, physically inactive or at least limited in his or her physical movements. Thus these advertisements support contemporary media theorists' and critics' arguments that media consumption is not now and never has been passive. Even while inactive because of illness or accident, patients can, to greater or lesser degrees, respond and engage with media.
By the early 1920s, with motion pictures drawing large crowds to movie palaces, hospitals began to ponder the possibilities of bringing home movies and other entertainment films to inpatients. As we will see with the case of hospital television, the implicit assumption that structured the promotion of film spectatorship and radio listening in the hospital was that, at least within the confines of that space, film and media could be their own form of therapeutic entertainment. Patients, through in-hospital media consumption, could feel connected to the outside world and their ordinary lives. Film projection programs and advertisements for hospital film and radio not only promised to keep patients in a therapeutic frame of mind, but to create a different experience of the hospital as a clinical space, and a different way to be a patient within that space. Articles in trade publications like The Modern Hospital, directed to hospital administrators, specifically addressed the issue of how to make hospitals more hospitable for their middle-class patients. These types of historical documents demonstrate how the introduction of motion pictures into hospitals went hand in hand with the transformation of modern hospitals from places of last resort to places that represented the powers of scientific medicine.? Watching films and listening to radio in hospitals naturalized their role in these contexts, while the presence of media entertainment facilitated the deinstitutionalization of clinical space.
Among the historical materials I analyze here are advertisements for film and radio. They are rich historical texts, not only for the information they provide about the ideal consumers of the featured commodities, but also for how they represent certain cultural and economic assumptions about media. As prescriptions for ideal uses and functions within particular spaces, advertisements can offer clues as to the ways that manufacturers of portable film projectors and radios assumed that their products could be incorporated into hospital and home settings. Indeed, advertisements appearing in professional and trade publications related to medical care and health tell us as much about the place of film, radio, and television within hospitals and clinical sites as they do about the ideal spectators, listeners, and viewers. Moreover, the specificity of the marketing discourse directed toward hospitals constructs a vision of healthy mass media that is at odds with critical debates about their role in society. These particular examples also underscore how film, radio, and television advertisers were responding to a new market—hospitals. Therefore, this chapter focuses on advertisements and attendant articles as key discursive frames for the analysis of media's assumed role within hospitals, about the hopes and hesitations that accompanied their use in these spaces, and the relief they may have provided.
The documents used in this chapter include advertisements and articles from a range of trade, professional, and consumer publications spanning the years 1918 to 1932. I examine advertisements and articles from The Moving Picture World and Radio Retailing, two trade publications; The Modern Hospital, a publication addressed to medical professionals like hospital administrators; and Hygeia, the consumer magazine published by the American Medical Association. These publications make clear the ways that, from administrative, industrial, and consumer perspectives, pre-television media such as film and radio were incorporated into hospital routines and spaces, and the attendant assumptions that guided their reception. The Modern Hospital, The Moving Picture World, and Radio Retailing represent concerns with media and health care from an inside perspective that allows us to understand how and under which administrative, economic, and spatial circumstances such media entered hospitals.
MOVIES AS MEDICINE
As the First World War unfolded, ideas regarding the function and purpose of American hospitals began changing. In short, hospitals needed to create a certain perception of indispensability and accessibility on the part of non-medical personnel. A variety of factors worked together to transform hospitals in the United States. Some of these factors included "hospital budgets, physician's practice patterns, attitudes toward science, charity, and the prerogatives of class—as well as the X-ray, antiseptic surgery, and clinical laboratories." Moreover, "From the 1870s on, hospitals had sought to present an inviting and increasingly scientific image to the public. In annual reports and planted newspaper stories, they underlined two themes: first, that their private rooms offered the comfort and convenience of a hotel with the ambience of a home; and second, that professional care and a newly effective technology could only be provided in a hospital." In addition to gleaming medical equipment, the display of modern communication technologies and interior design signified a hospital's legitimacy, capability, and care. Through the production of a homelike atmosphere, modern hospitals represented themselves as familiar places devoted to the "care of strangers." Other hospitals tried to produce, through interior design, the atmosphere of modern hotels. Hospitals engaged in a variety of practices to show that they could provide levels of care and comfort that were better than those in all but the wealthiest of private homes. One of these practices involved introducing film projection in the hospital.
An early example of films shown for patient entertainment occurred during the First World War. Films were shown on transport and battleships, as well as at the front lines of conflict in Red Cross and YMCA recreation huts and hospitals. Under the guidance of Mrs. Dunham Foster, of the New York City-based Community Motion Picture Bureau, and her staff, extra care was taken to match film genres to particular aspects of military operations. Films that would not "work too much on their feelings" were shown to soldiers at embarkation points, while lighthearted comedies or romances were shown at battlefronts and in hospitals. Movies as medicine, however, were not limited to battlefront contexts, but were also beneficial to soldiers in hospitals. Movies shown to recovering soldiers varied from entertainment to educational films, but the context determined which kinds of films were shown to which patients.
Concern for soldiers' morale and morals regarding entertainment extended to the highest levels of military command, with General J. J. Pershing ordering the U.S. Army to provide the troops with uplifting entertainment. As General Pershing, in 1918, said to E. C. Carter, the general secretary of the YMCA in Paris (its European headquarters for the entertainment operation), "Morale is a state of mind upheld by entertainment." Entertainment, in this case, was used as a kind of moralistic prophylactic to discourage soldiers from pursuing foreign pleasures and to encourage their fighting spirits. When soldiers were injured, U.S. Army-approved entertainment was used to heal broken bodies and soothe shell-shocked minds.
Supporting the perceived importance of therapeutic film viewing, new projection techniques were developed in order to adapt to patients needs. As The Modern Hospital noted, patients limited to lying on their backs could not see projected films. So "portable motion-picture machines are stationed so that the projections appear on the ceiling, and all the patient lying on his back need do is to look up." The hospital context, at once private and public, both a site for the care of the ill as well as a place of work and visitation for the well, required certain technological (formal) and cultural (content) adaptations. The earliest documentation of the exhibition of film in hospitals for the designated purpose of patient entertainment comes from September 1918. Indeed, many of the ideas about the restorative, therapeutic qualities of film, and later radio and television, in hospitals and other institutional health care facilities can be traced to the use of motion pictures for military entertainment and for wounded soldiers. During and at the close of the First World War, never had the medical infrastructure of the United States been asked to care for so many sick and wounded individuals.
From the perspective of medical professionals and hospital personnel, movies played a key role in therapeutic practices not only in military hospitals, but in civilian ones as well. Some of the structuring assumptions that brought movies to hospitals were that film spectatorship could be enjoyed by many different kinds of patients and that, if need be, specific films could be shown to specific patients. Film, silent during the early years of hospital projection, was also, compared to other entertainment activities such as reading, an experience that could accommodate a group or be shown to an individual patient. If patients were dealing with diminished or restricted physical capacities, then the movies could provide entertaining mental distraction with minimal physical effort. What is interesting from a medical perspective is how doctors, nurses, and hospital staff recognized that the movies were highly adaptable to the hospital routine, and that there was something specific to the medium with therapeutic potential. For one thing, film spectatorship in the hospital, like theatrical film spectatorship, facilitated discussion among the spectators. It allowed people who may not have anything else to say to one another the opportunity to share an experience and to talk about it afterward. It also allowed the spectators to laugh together and discuss topics other than their immediate personal discomfort or pain. In order for films to enter the hospital context, medical personnel had to recognize this capacity of film to facilitate conversation and to give patients a respite from their personal discomfort through the narrative pleasures of the movies.
As a test of the hospital as a site for film exhibition and patient pleasure, George Eastman started the "Hospital Happiness Movement" in 1920 in Rochester, New York. This movement facilitated film exhibition for patients at all the hospitals in Rochester on a weekly schedule. This therapeutic and marketing experiment proved successful, and in just a few years, the Eastman Kodak Company Medical Division began targeting hospital administrators across the United States as potential markets for its films, projectors, and screens. The Hospital Happiness Movement was "supported by the contributions of moving picture patrons, deposited in the boxes in the lobbies of motion picture houses throughout Rochester." In this way, conventional theatrical exhibition actually supported and facilitated non-theatrical film spectatorship. The Modern Hospital endorsed the Hospital Happiness Movement and understood film spectatorship to be a suitable form of entertainment that could "be enjoyed without exertion by all who are in a condition to enjoy anything." Film spectatorship, from a clinical perspective, was therapeutic because it did not require physical exertion, though it did require that a patient be able to see.
Even if the patient was blind, however, it could be possible for other patients to narrate the story. The idea that film spectatorship was therapeutic, partly because it did not require physical movement, structured the use of film in hospitals. Perhaps because film spectatorship does not require the viewer to turn pages in a book, lift one's head, or otherwise move the body, this form of entertainment was understood as especially adaptable for patients. In this case, the film industry, as represented by Eastman, stresses the inactive physical state of the patient—but only temporarily so—as a form of spectator therapy. If the patient is incapable of moving, or at least is diminished physically, then film as a form of therapy facilitates the return of normative health through mental activity.
Excerpted from Prescription TV by Joy V. Fuqua Copyright © 2012 by Duke University Press. Excerpted by permission of Duke University Press. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of ContentsAcknowledgments ix
Introduction. Television, Hospital, Home 1
1. Convalescent Companions: Hospital Entertainment before Television 23
2. Television Goes to the Modern Hospital 49
3. Positioning the Patient: The Spatial Therapeutics of Hospital Television 71
4. Television in and out of the Hospital: Broadcasting Directly to the Consumer-Patient 93
5. Mediated Agency: Consumer-Patients and Pfizer's Viagra Commercials 115
Conclusion. Our Bodies, Our (TV) Selves 141
Selected Bibliography 187