The microscope has turned on the researcher. The Johns Hopkins Medical Institutions will be the subject of a six-part documentary set to air this spring on the ABC television network. The series is intended to provide a comprehensive portrait of an academic medical institution and to offer an intimate glimpse inside Hopkins' own world of teaching, clinical care and research, according to series producers.
A team of eight ABC production crews armed with digital cameras has been granted almost unlimited access to each facility on the East Baltimore campus for a three-month period that began Sept. 29. In addition to filming at the schools of Medicine and Nursing and at The Johns Hopkins Hospital and Bayview Medical Center, production crews will follow Hopkins caregivers and students at work in the field.
The documentary will focus on nearly every aspect of the institutions, from the mail room to the operating room and from a first-year medical student to Edward Miller, CEO of Johns Hopkins Medicine and dean of the medical faculty at the School of Medicine.
Miller said this comprehensive look at a medical campus by a major network not only will shed light on Hopkins' role in the world of health care but will likely alter perceptions about academic medical institutions in general.
"Most people do not know what academic medical centers do," Miller said. "Some believe we care for only the most ill. Most do not have any idea of how much research is done, how a medical student becomes a doctor or what house officers do."
Miller said the documentary also will illustrate the daily behind-the-scenes stories that take place in a medical center--stories, he added, that at times portray the fragility of life.
"The viewers will be exposed to some real-life situations that are filled with emotions," he said. "And they are not always pretty."
Hopkins was one of seven academic medical institutions in the country that ABC News considered for this project.
Severn Sandt, coordinating producer of the series and a field producer for ABC News, said the decision to film in East Baltimore ultimately was made not just because of Hopkins' prestigious ranking among its peer institutions but also because of its role as a community institution engaged in urban health issues and because of the "unprecedented access" the news organization was offered.
For this project, ABC News has assembled a full-time crew of about 20 producers, reporters and videographers and has been given a production control room in the Billings Administration Building. Sandt said the ability to move into Hopkins and immerse themselves for three months enables ABC to document the three missions of an academic medical center in full context.
"More typically, television takes a small subject and comes in for a couple of days and then cuts it into a 10-minute piece," Sandt said. "That is not what we are doing here. We are rolling incredible amounts of tape every day in every corner of the institution with an eye to creating this very comprehensive portrait."
Peter Bull, one of the series' senior producers, said the documentary will show human stories that will both engage viewers and bring them inside a medical center "with an immediacy and an intensity of focus they haven't seen before."
"You will not be ushered by a correspondent or reporter through what appears on the screen," Bull said. "There will likely be minimal narration so that there is less of a filter from the viewer to the experience."
The documentary series, which will be shown in one-hour installments for six consecutive weeks beginning sometime between April and June, will be hosted by a top ABC News correspondent, according to ABC.
The producers said that for this project they are experimenting with new lightweight equipment to avoid the obtrusiveness typical of documentary production. Instead of bulky lights and sound equipment, each team is using a digital camera the size of a standard camcorder, equipped with its own microphone, which allows the producer operating the camera to be a "fly on the wall."
Eight teams of two producers were assigned "beats" to cover major facets of the medical campus. Members of each team spent time prior to filming acquainting themselves with various Hopkins faculty and staff to build trust, negotiate procedures and approvals, and to become familiar with the workings of their departments.
Crews will be shadowing individuals and conducting one-on-one interviews as well. There are, however, no on-camera reporters, which Bull said is very unusual for this type of network program.
The documentary will focus in part on several individual cases, which ABC producers hope will have some level of resolution. For instance, within the three-month production span, a crew will follow a patient who comes in for treatment at the hospital and may find out if the treatment works or fails. The camera will take the viewer into the operating room, listen in on a doctor's consultation and stay inside the patient's room after the nurses and doctors have left.
Production crews also will spotlight support staff, medical students and how all facets of the medical institutions are integrated.
Bull said this type of full-scale documentary is unique for network television.
"It is very unusual for anybody to do a long-form series shot in one place," Bull said. "Normally if you are doing a series, say on medical students, you would probably get a whole bunch of schools and it would end up as one hour [of television]. We are devoting a full six hours to just one institution."
Hopkins personnel and students are encouraged to participate in the documentary but are not obliged to do so.
"No one will be forced to participate in this project," Sandt said. "If our cameras are around and they don't feel comfortable, they should feel free to say to our camera crew, but it has been rare that they do, that 'I would rather not be on camera.' We can then just shoot around that person."
Janet Berg, instructor in Professional Education Programs and Practice at the School of Nursing, said the ABC crew that recently paid a visit to her Death and Dying course spoke with her students before they began filming and explained what they were doing.
That day they were shadowing Michael Carducci, assistant professor in the Oncology Department at the School of Medicine, who would be speaking to Berg's class. Berg said the cameras were obvious due to the small class size, but the disruption was minimal.
"They were very low-key," Berg said of the ABC crew, adding that some of her students were excited about the prospect of being on television. "But my students told me that if what they filmed looks good, they will be proud. And if it's not good, we are probably never going to see it."
ABC is not required to obtain written consent from faculty, staff or students during normal work and class hours. The crews are, however, required to get written consent from patients and visitors to Hopkins who appear in discernible focus. And they are not permitted to film those who cannot give informed consent, such as psychiatric patients who might not be able to evaluate what participation would mean.
Miller said that protecting the privacy and rights of both personnel and patients was a major issue in terms of Hopkins' agreeing to participate in the documentary.
"We were assured by them and our legal advisers that we could trust them in this arena. I said something like, 'I trust that what would be shown would be treated as though it were a member of your own family with all the sensitivity that brings with it,'" Miller said. "In the long run, we trusted ABC, and we thought that we had a compelling story to tell about academic health care centers and what they do for America. Basically, when you get to the bottom line, I believe in the people who work here and what they are here to do--namely, take care of patients, teach and make new discoveries that will alleviate suffering and prevent disease."
Judy Reitz, senior vice president for operations at The Johns Hopkins Hospital, said what viewers will ultimately watch will be the day-to-day workings of a hospital, both the good and the bad.
"We have warts. We have warts 24 hours a day, seven days a week. They will be seen," Reitz said. "But that is reality. And the excellence of what we do so far outshines the problems that we became convinced that the truth would prevail. And we also developed trust in the people from ABC News, who have proven to be true professionals."
Reitz added that she has the utmost confidence in her staff to deal with any unanticipated event that could very well occur during the three months of filming.
"I really know how great we are, and to be able to demonstrate that to the world is really important because we see ourselves as stewards of academic medicine. And if we are going to play that advocacy role, what better opportunity than this to show it?" Reitz said.