Amednews

(August 23-30)
Amednews.com

The scene: In dramatic fashion, the federal government's crack team of disease detectives sets off to solve yet another medical mystery threatening the public health.

The team's leader, Stephen Connor, MD, boards a National Institutes of Health helicopter that sets down beside a Little League field in Bethesda, Md., where he had been watching his son play baseball. Summoned by an urgent cell phone call, he's off to New York City where blue patients have started arriving at a hospital.
Hold on a minute. This sounds a bit like the Centers for Disease Control and Prevention's Epidemic Intelligence Service.

In a sense, it is -- with a little touch of small-screen ingenuity. A new television series called "Medical Investigation" is to begin airing next month on NBC, based on the work of this elite CDC corps of investigators.

If "Medical Investigation" catches on, it could greatly elevate public health and the profile of the typical EIS epidemiologist, despite the fact that in TV-land, these medical investigators work as part of the NIH based in Bethesda, rather than the CDC in Atlanta. Still, EIS investigators could suddenly take on some of the gutsy glamour of the show's stars.

"If the general sense they give of what EIS is all about is reasonably accurate, I suppose it can't hurt. And it certainly could make the public more aware of public health," said Neal Nathanson, MD, associate dean of the University of Pennsylvania's global health programs. Dr. Nathanson spent two years in the EIS program, which inspired his lifelong interest in virus research.

Donald A. Henderson, MD, MPH, who spent several years as director of EIS and is now senior adviser at the Center for Biosecurity at the University of Pittsburgh Medical Center, is also intrigued at the prospect of a television series based on the real thing. He thinks it could be an idea whose time has finally arrived.

After all, the story concept isn't new. "When I was down there [at EIS in Atlanta] from 1960 to 1966 we must have gone through several instances where there were trials and story ideas put together," he said. "And a number of times during the '80s people said, 'Wouldn't this be a good thing to do?' "

Part of the inspiration for dramatizing the exploits of the EIS officers sprang from the stories of Berton Roueche, who wrote "Annals of Medicine" articles for The New Yorker for four decades.

Among them was "Eleven Blue Men," an account of a real-life event that occurred in 1944 and is now the basis for the new series' pilot program. It was also at one time required reading for the physicians and others who embark on the two-year EIS training program, said Dr. Henderson, who was featured in another Roueche article, "In the Bughouse."

In the television version of "Blue Men," however, there are at least 12 men and women who are felled by a mysterious malady that leaves them the color of dusky indigo and in very bad shape. Plus, instead of being down-on-their-luck alcoholics who collapsed in a seedy section of the city, as was the case in the original outbreak, the updated version begins with an equally ill-fated, but well-dressed man using a cell phone -- the outbreak's index case.

Regardless, the medical mystery is no less intriguing.

Laurence Andries, the show's producer, emphasizes that the series is intended as fiction, and the hybrid NIH and CDC agency will work well with a plot line that includes a participant in a clinical trial, which is an NIH specialty.

But the stories will be either based on or inspired by true events, he said. "We aren't making up any superbugs that we are going to eradicate. It will all be based on identifiable medical science."

To ensure that the scripts are medically accurate, the producers have enlisted the aid of Donald Francis, MD, DSc, who spent 21 years at the CDC before retiring to work on vaccine development, first with Genentech Inc., and then with VaxGen, which he founded with colleagues. He is now working to establish a nonprofit company called Global Solutions for Infectious Diseases to continue his work on vaccines.

"He keeps us honest," said Andries of Dr. Francis.

The role of adviser requires a level of control that doesn't always surpass that of the producers, said Dr. Francis, who started his Hollywood career with the movie, "And the Band Played On." That film was based on the book of the same name and featured Dr. Francis's early work investigating AIDS as it was first recognized as a lethal scourge.

"But I was sucked in big time with the movie 'Outbreak,' " he said. This film starred Dustin Hoffman as a medical investigator on the track of an Ebola-like disease that was carried by a monkey.

The movie taught Dr. Francis some lessons on how not to do things. The slam-bam shoot-em-up aspect of "Outbreak" was distressing to him.

"I would hope that the excitement of the unknown and the intrigue of taking the layers off of the unknown would affect the audience instead of action," he said. "That's where we lost in 'Outbreak.' "

Although the pilot for "Medical Investigation" has a lot of action, "I hope it will center around the intellectual intrigue," said Dr. Francis. "The audience can be held with that -- that's what holds us epidemiologists."