"Under Control" - Is Carter's situation plausible?

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While I thought "Under Control" was well done in many respects, there are a few points that I'm not quite buying. Maybe some of you can provide an explanation, or at least help me suspend my disbelief. And please correct me if I'm wrong.

First, why is Carter back at work, considering the shape he's in? When my husband missed several weeks of work due to a back injury, he had to have clearance from his doctor before he was allowed to return. Why should it be any different for Carter? Like anyone in any job, he's an employee subject to the rules and procedures of the human resources department, insurance coverage, etc. You'd think a hospital would be especially picky about fitness to return to work.

Carter would have to be under some doctor's care (not his own), right? And I'm assuming it's not Benton. The way Benton casually told Carter "I read your MRI," just in passing, wouldn't make sense if he were. I take it that Benton is keeping an eye on Carter's recovery, but isn't heavily involved in his treatment at this stage.

So, if Carter is under the care of some unnamed, not-in-the-ER-department physician, doesn't it seem like this person doing a lousy job? "Let's see...my patient walks with difficulty, is in pain whenever he's bumped or bends over or reaches for something, and wants to go back to his physically demanding job. Sure, why not?"

And wouldn't Carter's physician pursue pain management strategies such as the ones Kerry mentioned? Or maybe he or she tried to, and Carter wasn't interested...but then why the hell not? I know Carter must feel guilty, but why would he choose to suffer that much -- especially since it affects his ability to do his job? Maybe the most plausible explanation is that several options have been tried and weren't successful -- but then why not just tell Kerry that?

Also, didn't it seem strange that Mark would let Carter take a trauma case right away, without observing him for awhile to see how he's doing? Isn't inadequate supervision of residents one of the factors that led to the stabbing in the first place? (Whether *you* think it was a factor or not, the issue is sure to have been raised by someone during the internal investigation.)

The obvious answer is that Mark was too busy to supervise Carter. Which brings us to: Who did such a lousy job of scheduling the ER staff that day? I might be wrong, but I don't remember anyone saying that other doctors had called in sick, been in car accidents, etc. -- it was just their day off.

I don't mean to sound so critical of the episode, which had many good aspects. But if we're being set up for some future Carter crisis (and I'm trying to avoid details about rumors and spoilers, but it should be obvious to most everyone by now that *something* is being set up) --if that's the case, I need someone to help talk me in

-- Kathy Carter (keefcart@ix.netcom.com), March 26, 2000

Answers

(my question, continued):

to help talk me into believing this scenario.

-- Kathy Carter (keefcart@ix.netcom.com), March 26, 2000.


It is a little farfetched, but not jarringly so IMHO. There is no magic tool doctors have to measure pain. If Carter is hell bent on returning to work, for whatever psychological reason he has, and says he isn't feeling pain, any doctor would have to take him at his word. I am assuming that his doctors expect him to be in some pain for a while, but that the pain will go away when the hematoma resolves as expected. (?)

What still needs to be explained in my opinion is WHY Carter would be so needing to return to work and look normal. The angle the writers seem to be taking is not the Lucy-guilt angle but rather, Carter feels he has to keep up at work to the point of masking pain (perhaps with self medication as rumored). Is there anything from what we've previously seen from Carter that would hint that he is SO wrapped up in his work and career that he would do such a reckless thing?

Crisis has a way of bringing out new wrinkles in people as well as fictional characters, so I don't have a huge problem with it. And as far as Carter being closed off - that does make psychological sense based on what we know of his remote relationships with his family and the fact he can't seem to keep a steady girlfriend for more than 8 episodes.

-- debbie (riccardoiii@aol.com), March 26, 2000.


I agree with Kathy on most aspects of her comments, but then I've worked with people who come in with raging fevers and spread germs to everyone in the office. As a supervisor, I've told people to GO HOME! Before the entire staff is at home sick. That wouldn't of course been the case here, but still I'd think someone would have said GO HOME! I did think he tried to hide his pain, and was pretty good at doing so. Kerry saw him at the end of the day when the exhaustion of the pain and facade had caught up with him. Mark was too busy and also worried about his own father in ER and Elizabeth's hard head (re: the patient whose organs she wanted to harvest). Wasn't that what got this mess started though in the first place? Everyone in charge the night of the stabbing was too busy to see what was going on: Carter helping Abby let Mrs. Connelly die, Mark going out to dinner with his father and Elizabeth, Luka and the party? I'd have thought there would have been an internal investigation regarding that and better supervision would have been the main factor to come out of it. Mark did some supervision of Carter in this episode but not as much as I'd have expected...like Kathy said above.

-- Diana (dilynne@juno.com), March 26, 2000.

It is a little strange, but since Carter is a doctor, whoever is caring for him probably assumes he will be wise in his decision. I'm sure the only reason he returned so fast was to create problems for him...how interesting would it be to have him recover for a few months and return perfectly fine? Although I do hope others realize his difficulties soon, not just Kerry. When Carol was catching up to Mark in the hallway I kind of expected her to say something like 'Maybe you should keep an eye on Carter', or 'Carter's not doing too good'. A lot was going on, but she saw him in pain several times, I just hope concern over him develops soon.

-- Elaine (mrsclooney78@hotmail.com), March 26, 2000.

I don't really know if someone could go back to work so quickly after going through something so major, but I was thinking that perhaps he is allowing himself to be in pain, because he feels that he deserves it. The reason he doesn't look for pain treatment is because he feels that he should be in pain. Does that make sense?

-- Emma (webbef@hotmail.com), March 26, 2000.


Yes, that does make sense. That would be pretty interesting, if others realized that's how he feels and why he's working with so much pain. Do you think ER would get that psychological?

-- Elaine (mrsclooney78@hotmail.com), March 26, 2000.

A clue to how Carter is feeling was in the scene where the suicide jumper was brought in and he was relegated to the sidelines. When the scene was ending and Carol was singing on the phone, they panned around the table and Carter was sort of standing by looking very out of sorts and helpless and basically miserable.

I don't think the writers are going toward guilt about Lucy. I think they are heading more toward the angle of, "Can Carter handle depending on other people and admitting weakness?" You could get into some very good psychological twists re this and guilt over Lucy but I do not expect the ER writers to go into this much depth (too bad). I think Lucy is gone, gone, gone. The storyline will focus on Carter's own reactions to his own experience of being weak and powerless.

Still, this is a psychologically sound explanation, as far as it goes, for Carter trying to hide his pain. Because when you are stabbed in the back you are going to feel very helpless and powerless, having "power over pain" is a way of taking charge of your life away from your attacker.

As for why nobody in the ER is noticing... well, if people in the ER had been on the ball then Carter's attack would never have happened in the first place.

-- debbie (riccardoiii@aol.com), March 26, 2000.


Y'all are cracking me up. The "reason" Carter is in the ER is because he's party of the cast, and it would be really boring to show him at home by himself, or in rehab, not interacting with other people. Him coming back to work keeps him on the payroll (he's quite popular), and the story line of his physical aches is supposed to interest us.

The "reason" his doctors are allowing him to go back to work is because there ARE no doctors. It's make-believe. There's some writers in a room trying to make an interesting, loosely accurate show. Give 'em a break.

-- Susan Someon (soozremove@texas.net), March 27, 2000.


Thanks for clearing that up, Susan! In case you missed the point, we're discussing whether or not the writers have done their job well by creating a storyline that makes sense to us. You don't have to play if you don't want to! :)

-- Kathy Carter (keefcart@ix.netcom.com), March 27, 2000.

I agree with you Kathy! This discussion forum is for discussion! We all know that the T.V. Drama ER is just that, a T.V. Drama and it is not real!! It is for letting our imaginations run wild if we want.

-- Paula (pbranden@dwave.net), March 27, 2000.


I think that Carter's feelings of powerlessness and his guilt over Lucy's death are not easily seperated. It is just that no matter how guilty you may feel, fear for your own mortality will come first. I really like the way they have Carter reacting. I don't know if it is accurate but I also know that there is no way to tell what someone in that situation would feel unless it has happened to you.

I think that the horror that he has both witnessed and taken part in has scarred him psychologically and the physical pain is a constant reminder of it.

I also think that a plausible reason for coming to work early is to try and find something to keep his mind occupied. I think if he doesn't then he might find he can not shake that last vision of Lucy from his brain.

-- Rusty Priske (rusty.priske@hrdc-drhc.gc.ca), March 28, 2000.


I really appreciate all the thoughtful responses that have been contributed here. I can certainly believe that Carter would want to get back to work as soon as he can, and many of the other explanations that have been suggested.

I guess what still bothers me is the feeling that the writers might be force-fitting certain elements of the situation to set up later plot developments. I'm all for setting up storylines that will pay off later (love it in fact), as long as it's not contrived. I'm not saying for sure that's the case here, just that I get the feeling it might be. Even if that's not the case, I guess I feel that the writers aren't giving us enough insight into exactly what's going on -- and that may make it more difficult for me to empathize with Carter later. And believe me, I do want to empathize with him.

I may be doing the writers a disservice (and if any of them are reading this, sorry -- by profession I'm an editor, the natural enemy of writers; can you tell?) But I can envision their thought process as going something like this: "We want Carter to have a big crisis in which he [fill in your rumor of choice]. In order for that to happen, let's have him be in a lot of pain long after the attack. In order for him to be in pain, let's have him pretend to be okay, so that nobody's treating him for the pain. And the reason he would do that is -- well, let's not bother to explain that; it doesn't matter."

If the writers (of any fiction) provide enough clues as to what's going on inside characters' heads, as well as the external circumstances that are affecting them, I'll be completely caught up in whatever results. But if I can't relate to the characters' actions -- if I feel that whatever crisis they're going through is a result of their own foolish decisions that I can't understand, because I haven't been made to understand -- then I'll feel frustrated and cheated.

Having said that, I'll admit that I'm probably jumping the gun by worrying about future developments that we don't even know for sure will happen. When I watch this episode for a second time, I'll try to do so with an open mind and some new

-- Kathy Carter (keefcart@ix.netcom.com), March 28, 2000.


(OK, from now on, whenever I add a posting there's going to be a contest to see who can guess the last few words that always seem to get cut off no matter how many extra returns I put at the end of my message!)

-- Kathy Carter (keefcart@ix.netcom.com), March 28, 2000.

Kathy, I agree with your most recent comments, especially about setting up the story but not using contrived means to do so. By the way, I'm a writer and ENJOYED getting into the mind of an editor! :)

-- Diana (dilynne@juno.com), March 28, 2000.

I think some interesting points have been brought up about this topic. There's something I've noticed about doctors being patients in their own hospitals; the doctors who are taking care of them are usually "easier" or lenient on overtaking their care. I don't mean that the other doctors don't care about their colleagues when they are admitted into the hospital. But, I remember one time when my aunt, who's also an ER doctor, was admitted in the hospital for something related to asthma... anyway, her colleagues basically treated her well, but during her recovery, she was allowed to leave the hospital at least five or six days before a normal patient would, and she didn't have to be put under observation if she didn't want to. The thing was, her doctors didn't press her to stay, didn't force her to take additional tests, the main reason being that she was a doctor, and she knew what she was doing. Where as, were it another patient who wasn't a doctor, she or he would definately have been admitted into the hospital for a longer time. So I think this is the case with Carter-- I think the other doctors assume he knows what he's doing, and that he's doing everything with the best interest because he's a doctor himself and he knows what the risks are. So obviously they assume that if he comes back to work, he's probably alright, and if he wasn't, he wouldn't be back-- because he's a doctor. I think the rest of the staff, in light of this, probably think he's not sufferring too much, which is why Mark allowed him to do trauma and see to patients. Ok, so we'll see how wrong they are in assuming this, I hope.

Secondly-- doctors on crutches. I remember when I was admitted into the hospital for an allergic reaction, my ER doc was on two crutches. Broke a leg or something. So it's not too unrealistic for Carter to be seeing patients with crutches, although perhaps something which requires a lot of mobility like Trauma may not have been such a good idea.

My other comment has to do with a post above me stating that she hoped that the writers would give some insight into what Carter is thinking. Couldn't agree more. I think "Under Control" set the foundation that Carter is definately not back to normal, and that he's sufferring from a combination of physical and emotional pain. However, it did very little to convey what exactly Carter was thinking, what his motivation for coming back to work are. I agree that the writers are probably setting the scene for some larger plot. But it would help to know what Carter's going through, and why he decided to come back so soon: if he's "bored" staying at home, or in bed rest, and he developes complications because of his hasty decision, when he should've known better, the result of which he has to steal pain killers, may risk his job etc.etc. I wouldn't feel sorry for him.

If the writers develop feelings of survivor's guilt, or that Carter feels that he deserves to feel pain, or that he's tired of sitting at home by himself and replaying that fateful day's events-- now those could explain better why he decided to come back to work so soon, reconsidering the better option of recovering some more. They could also set the scenes for some heart to heart talk with Kerry (which is what I'm hopin')Those aftermath feelings after violent incidents can cloud a person's ability to make good judgements. You must have heard of people who's loved ones have recently died and who immerse themselves in work 24/7. It's possible that Carter's feelings of acute guilt could lead him to work just to take his mind off it. It's very hard to stay at home all day, all by yourself, just thinking.

As for the idea that perhaps he's in the hospital to take some of those pain killers the rumours hinted about-- I think the medication his doctor must have, should have prescribed still aren't over. At least they shouldn't be-- most medications last for perhaps six weeks.



-- samira (matb_west@chickmail.com), March 29, 2000.



Samira brought up some interesting points, particularly that Carter's (premature) return to work was precipitated by a need to put the whole incident behind him. I agree with this assessment; it's the best explanation yet. I have said on another thread somewhere that this guy doesn't appear to have anyone to go home to and work, even if it causes physical pain, might be preferable to sitting around thinking about his own sorry situation. I know, I've been there. (If you don't believe me, look on other thread for spoilers to see what too much time with guilt, grief, and pain can lead to.) Also, in spite of what Mark said, he does have "something to prove" if only to himself. I think that's what he was getting at during the coversation at his grandmother's house.

-- Sam (trelles@ix.netcom.com), March 29, 2000.

Samira, great comments! Re your note about painkillers -- the odd thing about the self-medication rumor is that Carter has so many options for obtaining pain relief legitimately. Now if it's established that he's tried everything and it's not working...maybe then it would make more sense, IMHO.

Going back a little farther, Debbie's insightful comment about Carter being relegated to the sidelines helped me realize something. Did anyone else notice the parallel between Carter and Abby in this epi? They both were asked to step aside because they couldn't do the job fast or well enough. Yes, Carter must have felt weak and powerless, ineffective, in the way. Kind of like he felt during his first weeks in the ER as a med student. Makes you wonder if this experience will help him be more understanding with Abby (or whoever he supervises next) than he was with a certain other med student of the short, blonde variety.

And finally, here's another possible interpretation of Carter's first day: maybe he isn't deliberately trying to hide his pain. Maybe he honestly did think he was ready to come back to work (and somehow was allowed to), not realizing how difficult it would be. Once he was there, seeing how shorthanded the department was and how overloaded Mark became, he felt obligated to stick it out. As for why he didn't seem to want to discuss his difficulties with Kerry, there could be other reasons for that too (he was exhausted just then; she's his boss, not his buddy; he's not used to opening up to people; he's had too much well-meaning advice during the last month; etc.) Just another po

-- Kathy Carter (keefcart@ix.netcom.com), March 29, 2000.


Part of the problem with ER I think is that the show has a philosophy of "less is more." Read an interview once with Anthony Edwards where he said that everyone on the cast more or less feels the same way about it - they don't want extended emotional scenes for their characters, I think because nobody wants to be accused of overacting or hogging the spotlight. Unfortunately sometimes "less is less" and glossing over the characters' inner lives through more "meaningful" scenes (outside of the ER) is necessary for the drama to be satisfying and believable.

-- debbie (riccardoiii@aol.com), March 30, 2000.

for whatever reasons carter came back to work, boredom or whatever, he still should be told by someone, that he is not ready. he is putting the patients at risk by coming to work, when he cannot possibly perform the job. if he is scheduled to be there, that means they need an able bodied person to be there, to work!! he cant do it. but, really folks, it is a tv show, and if he is not at the hospital, where would they film him? at home watching the price is right?? Boring!! LOL. if it was for real, he would not be there, but he has to be there, cuz lexi would miss that cutie pie way too much!!!

-- Alexis (lexicat1@webtv.net), March 31, 2000.

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