Recently, I decided to watch Where Danger Lives again.  It’s only a minor film noir, but nevertheless entertaining.  This time through, however, I noticed an attitude often found in the movies toward doctors that choose to go into private practice, especially as it regards their relationship with female patients.  But first things first.

Where Danger Lives begins in a hospital where Jeff Cameron (Robert Mitchum) works as a doctor. He is dedicated to his profession, and so much so that a nurse reprimands him for working too hard (fifteen hours a day). To underscore what a good man Jeff is, his patients are children, with whom he has a terrific bedside manner. He tells a story about Elmer the Elephant to a girl in an iron lung to help her fall asleep, which she does before the story is finished.

Then he chats with a boy, promising that they will have more baseball discussions in the future.  The boy mentions that he knows Jeff will be going away.  The nurse says, in an apologetic tone, that she told him that Jeff will be going into private practice.

We get the sense that there is something wrong with Jeff’s going into private practice, that it means that he values making money more than caring for people. This seems to be what those who produced this movie wanted us to think, for they clearly put in the scene about Jeff’s intention to go into private practice for a reason, even though we never see it come to fruition. Remove that one brief scene with the boy, and the rest of the movie could have been exactly the same, without anyone thinking there was something missing. The point is that Jeff is guilty of shirking his duty to serve the public good for the sake of private greed.

Julie Dorn (Maureen O’Sullivan), a nurse, is Jeff’s fiancée. We know that their relationship is wholesome because he regularly gives her a white rose. But that is about to change.  As he is leaving the hospital for the night, he is delayed by an emergency.  A woman has attempted suicide, presumably by taking sleeping pills, since she is unconscious.  The woman is Margo Lannington (Faith Domergue), and when she wakes up, she sees Julie’s white rose and thinks it is for her, saying she likes red roses instead. When Margo grabs Jeff’s hand to thank him for pulling her through, Julie senses something, raising her eyebrows and glancing at Jeff.

As it turns out, Julie’s doubts and suspicions are justified. Just as Jeff is abandoning the children in the hospital, so too does he abandon Julie, breaking a date with her one night so he can be with Margo.  On another night, as he is leaving the hospital, Julie tells him the girl in the iron lung wants him to finish the story about Elmer the Elephant.  He says he doesn’t have time for that girl, and that he hates Elmer the Elephant.  He tells Julie that she should just make up something to end it, like Elephant gets Elephant.  He doesn’t have time for the girl because he has another date with Margo, bringing her a red rose, red being an obvious symbol for lust, the new sin added to the previous one of avarice.

Jeff doesn’t know it, but Margo is married.  He only finds out about this later because Margo has lied to him, telling him that her husband, Frederick Lannington (Claude Rains), who has been away fishing, is her father.  This lie leads to a confrontation between the two men when Jeff shows up one night unexpected. Frederick says, “Margo married me for my money.  I married her for her youth. We both got what we wanted, after a fashion.”  This eventually leads to blows and ultimately to Frederick’s death.

Jeff, who was hit with a fire iron during the fight, believes he accidentally killed Frederick, and he is now suffering from a concussion.  Unable to think straight, he lets Margo talk him into fleeing with her. From that point on, everyone they come into contact with wants money from them. By the time they get to the border, they are broke. But then Margo reveals that for years she has been squirreling her husband’s money away in a Mexican bank in her maiden name. Jeff realizes that it was Margo who murdered her husband, smothering him with a pillow while Jeff was out of the room. She then tries to smother Jeff. Later she shoots him. Then the police shoot her.

Her dying confession exonerates Jeff, who wakes up in a hospital.  It is clear that he and Julie are going to get back together, white rose and all. While nothing is said one way or the other, we can’t help but believe that once he recovers and is no longer a patient in this hospital, he will return to the hospital where he works as a resident much in the way he is returning to Julie. He has presumably learned his lesson about wanting to go into private practice.

As a general rule, movies tend to look favorably on doctors that work in hospitals. That is why we feel good about Dr. McKenna (James Stewart) in The Man Who Knew Too Much (1956) when we find out that he practices at the Good Samaritan Hospital back in Indianapolis.  This is reinforced when we are informed that he and his family traveled to Paris so he could attend a medical convention, definitely a sign of dedication.  After that, they traveled to Morocco for reasons of nostalgia, for he served at an army field hospital during the war and is proud of the contribution he made there.  There are exceptions, of course.  For example, even though Dr. George Harris (Richard Widmark) works in a hospital in Coma (1978), he turns out to be a villain.

With some movies, it is not a matter of working in a hospital as opposed to having a private practice; it is working in the public sector rather than the private sector. In Panic in the Streets (1950), for example, Dr. Clinton Reed (Richard Widmark) is an officer in the U.S. Public Health Service.  Like Jeff in Where Danger Lives, he works hard.  In the first day he’s had off in six weeks, he gets a call from someone at his office.  It seems that a man who was murdered had the pneumonic plague. Needless to say, this is a serious matter.  The killer needs to be tracked down before he spreads the disease.

However, Reed’s family is struggling financially, owing money at the grocery store, and he is tempted to take a job with an oil company as a medical advisor.  His wife Nancy (Barbara Bel Geddes) admonishes him for thinking about such things, telling him how important his job is right now, that he is doing exactly what he planned on doing when he was still in school.  We know he will do the right thing, continuing to work as a dedicated public servant rather than take a job in the private sector, even though his family can barely make ends meet, which isn’t going to get any easier since Nancy is going to have another baby.

In some cases, a doctor gives up a lucrative private practice so he can do medical research, which is what Dr. Steele (George Brent) does in Dark Victory (1939), after performing one last (unsuccessful) brain surgery on Judith Traherne (Bette Davis). It will be less remunerative than his private practice, but he believes his research will be of greater benefit to humanity.

So, what is it about private practice that is so rewarding financially? According to the movies, it is rich women who are hypochondriacs.  And it is always women, mind you, never men.  There is the occasional movie, of course, where a man is a hypochondriac, but I have never seen a movie where a doctor makes a good living by regularly treating rich men who are hypochondriacs.  It is the women that are as foolish as they are wealthy that provide the doctor with a rewarding practice, the reason being that they enjoy the attention of the male doctor with whom they are infatuated.

This is played for laughs in A Day at the Races (1937), where Dr. Hugo Z. Hackenbush (Groucho Marx) manages to make the wealthy Mrs. Emily Upjohn (Margaret Dumont) dependent on him by convincing her that she is suffering from obscure illnesses and in need of his care.

This is such a cliché that if a doctor is in private practice, the movie will sometimes make it clear that he is nevertheless more interested in contributing to the public good than in making money off such women. In Dr. Jekyll and Mr. Hyde (1931), for example, we learn early in the movie that Dr. Jekyll (Frederic March) has chosen to forgo catering to the Duchess of Densmore, who is a hypochondriac, so he can attend to his charity cases in the free wards.  In the next scene, we see a little girl struggling with her crutches. Thanks to Jekyll’s treatment of her, however, she has been cured, and with a little coaxing, he gets her to give up her crutches and start walking on her own, much to her delight.  This is to show us that Dr. Jekyll is a good man in his role as a doctor before the evil Mr. Hyde shows up.

In Arrowsmith (1931), the title doctor, played by Ronald Colman, wants to be a research scientist like Dr. Gottleib.  When Dr. Gottleib offers to take Arrowsmith with him to the McGurk Institute, Arrowsmith has to turn him down.  He is getting married to Leora (Helen Hayes), and he needs to go into private practice to support the two of them.  Dr. Gottleib is disgusted, saying, “Practice! To give pills to ladies, to hold their hands for them, to make their diets for them.”  Eventually Arrowsmith is able to do the medical research he always wanted to, but only after Leora loses her baby and learns that she can never have children.  Had the baby lived, one suspects that Arrowsmith would have had to continue in private practice.  Later, when Leora dies, this really frees him up to do the research he has always wanted to do, all for the greater good of mankind.

Green for Danger (1946) takes place in a British hospital that treats casualties during WWII.  A nurse reminds the surgeon, played by Leo Genn, how nice he had it in private practice before the war: “Rolls-Royce, lovely ladies.”  She notes that the ladies were happy to be in his consulting room on account of his “wounded stag look that no woman can resist.”  Later she refers to the women “who used to dither in and out of your consulting room in a flutter of checks and eyelashes.”  He says he misses the checks.

In Bad for Each Other (1953), Dr. Tom Owen (Charlton Heston) is pushed by Helen (Lizabeth Scott) to give up public service as a full colonel in the army to become an associate in a health clinic in Pittsburg that treats wealthy women.  As an indication of their strong sexual desires, all the rich women in this movie seem to be having adulterous affairs on a regular basis.  Having gotten a look at what a hunk Tom is, they can’t wait to make an appointment, get naked, and be examined by him.

After examining Lucille, one of his patients, she asks him if she will see him at a social function on Friday.  He says she will, and she says, “I hope you’ll recognize me with my clothes on.”  There is nothing wrong with her, of course, but to play along with the charade, he says he is prescribing “something to quiet your nerves.”  Tom’s nurse, Joan, gives Lucille a knowing look.  She is idealistic and doesn’t approve of Tom’s clientele of wealthy women who have nothing wrong with them.

Part of this movie is set in a coal-mining town, Coalville, to be exact.  Tom’s father and grandfather worked as coal miners.  In some movies about coal miners, like How Green Was My Valley (1941), one gets the sense that there is something honorable about continuing to work in the mines, even when there is a way to get out, so it’s no wonder that Tom’s mother disapproves of the way Tom’s older brother didn’t want to work in the coal mines too.  She doesn’t expect that of Tom, but she believes that, at the very least, he should live in Coalville and be a doctor for the coal miners.  One night there is a big accident in one of the coal mines. After working to save lives, Tom sees the error of his ways, breaks off his engagement with Helen and opens up an office in Coalville.  It is still private practice, but since he intends to treat poor coal miners rather than rich women, that makes it all right.  Joan approves of this change and continues to be his nurse.  We gather they will eventually marry.

In The Citadel (1938), on the other hand, coal mining is depicted quite differently. Dr. Andrew Manson (Robert Donat) starts out with noble aspirations about helping Welsh coal miners with lung conditions, but these miners are an ignorant, ungrateful lot.  They don’t mind having him for a doctor, but they don’t like the medical research he tries to do on the side, so they destroy all his notes and laboratory equipment.  He and his wife Christine (Rosalind Russell) give up and move to London.  He has a hard time making it, but one day he is called upon when a woman’s regular doctor is away.  He is brought to a room where Miss Toppy LeRoy, a rich, beautiful woman, is lying on the floor screaming.  He immediately diagnoses her problem as willful hysteria and slaps her until she stops.  His prescription for her is to get a husband and have children.

As he leaves, he runs into an acquaintance from medical school, Dr. Frederick Lawford (Rex Harrison), who invites him to come with him while he visits Lady Raebank, a rich hypochondriac at the most expensive, snob nursing home in London.  It isn’t long before Andrew himself starts making a lot of money by also treating rich women who have nothing wrong with them.  Another doctor who is in on the scam, Dr. Charles Every (Cecil Parker), points out while he and other doctors are playing golf that whenever Lawford speaks in general terms about patients, he always uses the feminine gender.

In addition to all the money that can be made off rich women, doctors that treat them have plenty of leisure time, and nothing says that better than a game of golf.  Unlike Jeff in Where Danger Lives, who works fifteen hours a day, or Dr. Reed in Panic in the Streets, who gets one day off every six weeks, these doctors in The Citadel don’t have to put in the long and hard.

Christine does not approve of Andrew’s unethical behavior, billing patients for doing nothing, prescribing treatments that don’t cure ailments that don’t exist.  It doesn’t help when she reads in the society page about Andrew being entertained by Miss Toppy LeRoy on a night when he said he would be home late on account of business.  Christine eventually tells Andrew that his work isn’t supposed to be about making money, but about helping his fellow man.  He tells her he doesn’t want to discuss it.

When Andrew’s best friend is hit by a car and needs surgery, Dr. Every, who only knows how to cater to rich women, botches the operation, and the friend dies. Andrew has a revelation.  Christine was right.  He is not supposed to make lots of money.  He is supposed to serve mankind.

There is a famous quotation from Adam Smith’s The Wealth of Nations recognizing the social good of the free market, where people seeking after their own interests end up providing benefits for others:

It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest. We address ourselves, not to their humanity but to their self-love, and never talk to them of our own necessities but of their advantages.

Well, this may be true of butchers, brewers, and bakers, but not of doctors, if the movies are any indication.  Those movies do indeed address the humanity of doctors, expecting them to act from benevolence rather than from self-love, and working long, hard hours when they do so.  And that means they must leave those silly, rich women alone with their imaginary ailments.