Most of my dramatic writing is either inspired by true stories or based on historical events.
When I was researching The Man With The Plastic Heart, a drama surrounding the events of the first permanent artificial heart implant, I provided the following critical commentary which evaluates the creative process and ethics of documentary drama.
The Fact of Fiction
When Barney Clark was implanted with the Jarvik-7 in 1982, America watched intently as a grandfather, in pyjamas and dressing gown, spoke lightly in the absence of his own heart. Twenty-five years later, details of what occurred behind the hospital curtains are clearer, providing an opportune moment to dramatically re-present the events that eventually destroyed an ambitious heart surgeon, and transformed a retired dentist into an American hero.
The Same But Different
Documentary drama, or Dramadoc, is an appellation applied to a drama which follows historical events, or conversely, a documentary which employs a dramatic reconstruction re-present events. This hybrid can be problematic in its ambiguity, as exemplified in The Elephant Man (1980). The novelisation of the film script assures:
Based on the life of John Merrick, the Elephant Man, and not upon the Broadway play or any other fictional account.
(Sparks, 1980, p.273)
This insinuates that it is a text ‘based’, grounded, in truth. However, the final script presents a host of technical and dramatic inaccuracies, typified by the glaring error that Merrick’s Christian name was in fact Joseph, not John; a error also evident throughout the novelisation. (Howell, 1980) Perhaps ‘inspired by’ would be a better choice of words in this case, if less enticing. It does, however, present the difficulty of assessing what a dramadoc should be, and which constraints the writer should ethically, artistically and legally operative within.
The Elephant Man is exemplified for good reason. The Man with the Plastic Heart initially had the potential to become a dramadoc featuring reconstructed events, counter-pointed by talking heads giving retrospective anecdotes. Unfortunately, key persons responsible for the implantation of Barney Clark’s artificial heart, such as Dr. William DeVries and Una Farrer (nee Clark), declined an interview on the grounds of sensitivity.
Lacking the means of a budget to provide a monetary reward to the persons for a key witness commentary, the project quickly resorted towards dramatization with a grounding in technical accuracy. Like The Elephant Man, The Man with the Plastic Heart became a drama based on a true story, but with documentary conventions and a rigorous research methodology to affirm its dramatic content as historically reputable. It is the aim of this commentary to relate the functions of these conventions to the creative process and access how it informs a research methodology.
Derek Paget has closely studied the development of the documentary drama, formulating the following criteria as the form’s key objectives:
(a) to re-tell events from national or international histories, either reviewing or celebrating these events;
(b) to re-present the careers of significant national or international figures, for similar purposes as (a).
(c) to portray issues of concern to national or international communities in order to provoke discussion about them.
Increasingly in recent times it has also aimed:
(d) to focus on ‘ordinary citizens’ who have been thrust into the news because of some special experience.
(Paget, 1998, p.61)
Plastic Heart is identifiable with all four criterions. Agenda A concerns itself with the historical events of the Utah Heart Programme, in conjunction with B’s aim of re-presenting the key medical players behind the technology. C addresses the concern of altruism and informed consent within human experimentation, and D is the focus on this group of people, lifted from obscurity into the public eye. It is my belief that objective A is essential if objective D is to be developed to allow the audience to reach objective C; the ethical dilemma and debate. In summary, a solid foundation of historical research and accurate presentation of events should form the socio-historical context from which characters’ behaviour and motivation clearly justifying their journey. This launches the writer into the literary realms of thematics and extended metaphor. The historical events serve as the backdrop, the character interaction forces momentum, as Dineen suggests, portraying “more of life’s inherent complexities and contradictions.” (Dineen, 1996, p. 365)
The research methodology constituted a substantial gathering of socio-historical records and contemporary medical data. Newspaper accounts, press releases, patient records, medical papers, journal articles and consent forms were retrieved. The University of Utah’s Barney Clark Collection was also sourced for biographical data. When scrutinising this material, anecdotal phrases of importance or interest were individually filed and assigned to the relevant person or location. Key events throughout the development of the Jarvik-7 heart were recorded on a spreadsheet, forming a cohesive timeline. The timeline provides an opportunity to cumulatively correlate and buttress evidence with anecdotal material, allowing dates and events to be crosschecked. (See Appendix II) This ever-growing linear mapping of events was essential in providing a complete overview of a complex event, accompanied by an expanding set of character profiles which quickly identified the most important, and dramatically interesting, persons involved.
Whilst a very satisfying process, this research methodology has a disadvantage; when does the researcher stop gathering data? A timeline could feasibly grow indefinitely, presenting an infinite scale of detail. The decision was ultimately determined by the construction of a Gantt Chart (See Appendix IV), which predetermined strict boundary dates for research and development, with a view set firmly on achievable goals.
Development and Structure
Using the character profiles and timeline as the main reference, a synopsis was developed, outlining the structure of the teleplay in three defining acts, over a ninty-minute duration.
Initially, a traditional non-linear docudrama narrative was adopted; an exciting conclusion is used as the ‘hook’ in a pre-titles sequence, followed by an account of the event, then a more detailed dissection of why it occurred. This is a model favoured by a number of dramadocs at the moment, specifically National Geographic’s Air Crash Investigation (2008). A similar technique was used for the purely dramatised life story of Hughie Green, in BBC Four’s Most Sincerely (2008), offering an opening shot of Green being sealed in his coffin.
A similar opener was adopted for Plastic Heart, presenting Clark’s death in a pre-titles montage. Whilst effective as a hook, it ultimately dampened the dramatic impact of Clark’s wild variations in health that were to follow. The audience would be too aware of his oncoming demise. As such an establishing scene with DeVries loosing a patient on the operating table was substituted, establishing the medic’s role as a life-preserving force. This led to the development of a synopsis (See Appendix III) in the established linear format of standard television drama. Whilst very much the norm in terms of story structure, a number of dramadoc conventions were applied to transform the research of the timeline into a cohesively structured plot.
It would have been seductively easy to translate the timeline into a synopsis, with events occurring in the time and space as they happened. This, however, would have been a narrative disaster, with a danger of transcribing the events as listed and using characters as one-dimensional vessels of exposition. Fortunately a number of established docudrama conventions are designed to alleviate this development issue. An essential convention is distilling the collection of research findings:
Material is sometimes excessive in relation to the dynamic of the drama. Editing out is thus a vital feature of the organisation of dramadoc/docudrama, and it is unavoidable when plots are driven naturalistically.
(Paget, 1998, p.78)
After meticulously collecting and referencing research material it seems counterproductive to begin rejecting it; there is an overpowering urge to include every detail. Whilst fascinating to a researcher immersed in the subject, such material may be irrelevant and detrimental to the narrative flow, disrupting the story. An example with Plastic Heart is the use of three very dramatic events during Barney’s treatment: Christmas Day, a birthday and his 39th Anniversary. These celebrations are poignantly sad times for the Clark family as Barney is present, yet debilitated. Celebrations counterpoint his painful struggle amidst a party of healthy relatives. From a narrative perspective these events touch on similar themes and to include them all would be repetitive. As such, Christmas Day is developed whilst the anniversary/birthday gets a worthy mention, but in the alternative context of a news report.
In a hospital environment there are dozens of staff, all essential in their roles. Attempting to depict every technician, nurse and consultant related to Barney Clark’s therapy would have been futile; each thinly represented within the ninety-minute parameter of the script. Here the dramadoc convention of compositing is vital to sustain a narrative pace whilst presenting richness of character.
Dr. Ross Wooley embodies many managerial and administrative persons, using his own bullish charm as a vehicle for many attitudes expressed by an entire board of directors. Similarly, Barney Clark also met a number of physicians regarding his heart condition; in the drama he meets just one consultant, Dr. Anderson, who is a composite of himself, Seattle-based cardiologist Terrance Block and Clark’s own G.P. In all instances, an essential character generally absorbed their lesser interesting peers. Dr. Stephen Clark is the main representative of Barney’s children. His siblings are evident, almost as an entourage, but Stephen’s vocation as a surgeon in his own right places him in an insightful, clinical position to explore and is worthy of development.
A number of journalists, press and photographers are evident throughout the story. The audience see a great number of them, but only three are characterised; a representative for television, radio and the press. There is a distinction between the press-body, which is essentially one single mass, and the single reporter, whose breaking news the audience are privy to. Paget refers to this portrayal en masse as:
A kind of ‘Rent-a-Media-Mob’; they jostle each other, thrusting microphones and camera forward, but the babble of questions always quietens quickly so that the story can be advanced when the audience hears the key question.
(Paget, 1998, p.74)
The ‘key question’ comes from one person, our own Reporter. That characterisation is the single talking head of this large, writhing unit. It is, hopefully, a successful composite of hundreds of media people, broken into three distinguishable bodies.
The third technique which Paget emphasises is the telescoping of events, which points to, ‘the structural nature of drama’s meeting with documentary in the dramadoc/docudrama.’ (Paget, 1998, p.76) Essentially, dramadoc is the keystone that supports the bridge between drama and documentary, and it requires the dramatic structure to uphold the realism of the event, within the confines of the running time.
Events have been telescoped throughout Plastic Heart, notably Barney’s congestive heart failure, which began three years prior to the implant. (DeVries, 1984, p.274) This decline has been accommodated within the first five minutes, by aggregating Barney’s love of outdoor life and golf into a scene featuring him suffering angina on the golf course with his eldest son. (Act I, Scene 4). Similarly, he was a dentist and a ‘selfless, trustworthy, honourable, compassionate’ man. (Cassell, 1984, p.34) These affable characteristics have been amalgamated in Act I, Scene 2 to firmly recognise his medical background, and identify a persona that is tragically eroded at the hands of the Jarvik-7.
Whilst dramadoc conventions are plying the truth to fit neatly into a structured drama, it is essential to identify their use, for the audience, in the form of a disclaimer caption:
"The following dramatization is based on personal interviews, books, medical journals, newspapers and magazine accounts. Some events and characters have been amalgamated for dramatic purposes."
(Payne, 2008. p.1)
Paget suggests telescoping and compositing are permissible in view of a disclaimer which recognises this activity, and that ‘fair comment’ on a public subject in an informed manner, ‘is justified in the wider public interest.’ (Paget, 1998, p.39)
Captions have been used throughout Plastic Heart to distinguish the passage of time and shift of location between Utah and Seattle, Intensive Care and Private Rooms. The intention has been to use them sparingly, occasionally displaying a caption to indicate a specific time of importance, such as in Act III, Scene 99, where it is simply:
(Act III, Scene 98)
The intention here is that at this particular minute, something unique is about to occur. It is then revealed that at 20:02, Dr. William DeVries turned off Barney Clark’s heart.
Much of the dialogue in Plastic Heart is adapted from primary source material, such as transcripts from Barney Clark’s taped interview and minutes from Institutional Review Board meetings. Anecdotal information is dangerous by its purely subjective nature and can be maliciously defamatory. The following required further research to ensure it was not libellous:
Yeah I saved him. (PAUSE) But I’d have pulled out that
artificial heart, thrown it on the floor and said he’s dead
if the press hadn’t have been there.
(Act II, Scene 46)
Fortunately a tape of Barney Clark’s interview, including DeVries’ questioning, still exists which provides useful insight into their patterns of speech, particularly Barney’s disturbing nuances of language after the implant. Adapting the Utahn style was also enriched by referencing their unique cussing system. Phrases such as ‘Dang it’, ‘Shiz’, ‘Fudge’, ‘Cripes’, ‘Heck’, and ‘Gash’ are in common usage today and assisted in emulating the distinctive Western drawl.
Themes and Outcomes
Throughout the research and development phase themes and extended metaphors were showing themselves as promising literary avenues of exploration. Many of these occurred naturally during script redrafts as they descended from genuine events. DeVries’ predilection for The Tin Man, for example, and Barney Clark’s astronaut analogy is imagery drawn directly from piliminary research. (Fox, 1992, p.158) The smallest stitch of these themes was already sewn within the fabric of Plastic Heart and redrafting served to magnify and transform them into stronger extended metaphors.
An essential objective of the piece was to capture both an essence of early Eighties America and the Mormon faith as practiced by Clark, DeVries and Wooley. Reaganomics was weaved through the script, humanised through Robert Jarvik’s capitalist objectives in marketing the Jarvik-7, instead of redeveloping it. His stereotypical love of sports cars, fashionable clothing and particularly media attention, are all born of fact. (Barnette, 1987)
‘The Glory of God is Intelligence’ is a motto of Briton Young University, adopted from Mormon teachings. (Fox, 1992, p.164) To learn more about science was to become closer to God, and perfection. This was clearly a motivating factor for DeVries and Clark, who was an altruistic patient for both his God and the furthering of technology, ‘to help people’. (Shaw, 1986, p.2)
There was no intention to give the drama a religious leaning, indeed, any references were intended to be impartial or, at best, the individual opinions of the characters. A reading of an early draft of the script by two Mormon Elders from Utah, however, concluded that the script was sympathetic towards The Church of Latter Day Saints. Whether this is due to a religious, predetermined reading of the material is yet to be seen.
As a purveyor of true stories, perhaps dramadoc provides a faceted, insightful journey which an audience can draw closer to their own hearts, than a fictionalised drama. In dramatizing this unique event, I attempted to capture an element of humanity which is difficult to express in words; it was a bravery shown through actions and determination, perhaps even blind arrogance. As Grigsby enthuses, docudrama should attempt to ‘gauge emotional resonances and listen to those hidden voices.’ (Grigsby, 1996 p. 371) The hidden voices in docudrama are essentially real ones; re-presenting the unspeakable, the unspoken, the silent, or the dead. It tells tales of unimaginable events which are hard to conceive as fact or recent history. Perhaps that it is that very awe-inducing inconceivability, which makes this dramatic medium so engaging, and so firmly established in our television prescription for years to come.
© Samuel Payne 2008, 2016.
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