What’s up doc - Issue 58 - Magazine | Monocle

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Nancy Snyderman

New York City

Otolaryngology surgeon Dr Nancy Snyderman has moved from operating room to the TV studio and now explains medical issues to around 15 million Americans a day on NBC shows, including TODAY and Nightly News with Brian Williams.

“When I had my first paper on sleep apnea published in an otolaryngology medical journal at the age of 30, I was very proud of myself. Then my professor pulled me aside and said, ‘You’ve really arrived when you’re in the Ladies’ Home Journal.’ That’s when I learnt that when you reach the lay public with a health message you change the world, and I had to be on tv.

I was a paediatrician early on because my father was a surgeon and I wanted a different identity. But I realised that I had a surgical brain: I can envision the body in three dimensions and I’m ambidextrous, even in the operating room, so I moved into ear, nose and throat surgery. It was the 1960s and I was a woman in a man’s field, so I worked harder and was rewarded with great cases. I was filmed doing a tonsillectomy for the local evening news in Pittsburgh in 1981, which led to more tv, and eventually abc’s Good Morning America [GMA] invited me to New York for segments. They hired me as a medical correspondent and I stayed for 17 years before moving to nbc in 2006.

There are similarities between surgery and live television. Both require an ability to deal with the unforeseen – mistakes are made in both when the adrenalin runs too freely. I cover lots of different issues on nbc. There’s the meat and potatoes stuff where I put on my Armani suit, sit down and talk about things like swine flu and Yosemite’s hantavirus; then there’s the stuff that feeds my soul, such as trips to Haiti and watching a famous scientist carrying out a procedure for the first time.

I leave my home in Princeton, New Jersey, at 05.00 and I’m in hair and make-up for the TODAY show by 06.15. I have a cup of coffee, read the newspapers and scour my iPad for breaking news and I’m on set between 07.00 and 09.00: hot news is earlier, softer stories later on. The Professionals, a new TODAY segment in which advertising exec Donny Deutsch, lawyer Star Jones and I weigh in on the headlines of the day – everything from privacy to politics – is always at 08.09.

I have my first nbc Nightly News with Brian Williams meeting at 09.30; at 14.30 the team meets again to see if what we’d planned to cover that night still makes sense, then I check in with TODAY, and I’m on the set with Brian from 18.30 until 19.00. I have a phenomenal support team at nbc: three producers and a crackerjack associate producer. I pitch about 50 per cent of stories and the rest come to me. One of my most important jobs is to be a filter, to tell the team when something’s not worth covering.

When I joined TODAY we were the number one morning show; we’ve slipped behind GMA recently and it’s a lot more fun being number one. We need to find our voice again and to get out into people’s lives. Medical stories, in particular, are best told when there’s a face attached – you have to humanise the science.

As for my position on healthcare, I believe it’s a right and a responsibility but there’s only so much money in the bank. Putting a 98-year-old on a ventilator is not a good use of healthcare dollars. Do I think Obamacare is going to stay? As a matter of fact, I do. The White House did a lousy job explaining Obama’s healthcare message and the Republicans were very irresponsible in ripping it apart and scaring people.

Patients want access to affordable, quality medicine and doctors want the freedom to counsel patients the best way they know how and to be compensated fairly. It’s as simple as that. And if it comes with a government stamp I’m OK with it.”

Sandra de Castro Buffington

Los Angeles

Sandra de Castro Buffington is director of Hollywood, Health & Society, a Beverly Hills-based programme that provides resources to leading scriptwriters and producers on top TV programmes and films, aiming to improve the accuracy of health-related storylines. They reason? They recognise the profound impact that entertainment media has on public knowledge and behaviour.

“Where there are stories about human beings, there are stories about health – it’s such a big subject in entertainment that in the past two years, we’ve consulted on 384 storylines on 74 tv shows. Just think about the shows whose protagonists are suffering a health condition – Breaking Bad (lung cancer), The Big C (melanoma) – not to mention shows about the medical industry itself, such as Grey’s Anatomy, ER, Private Practice and House. We’ve consulted on all of them. We also work with shows that aren’t medical per se – for instance, the makers of Mad Men contacted us to ask how a 1960s obstetrician would talk to a pregnant, unwed mother.

On a typical day, a writer might call us to ask, ‘if a serial killer uses this kind of poison, what will happen?’ and we’ll connect them with the right toxicologist. Sometimes we’re involved in more complex brainstorming – let’s say one of the principal characters on a show suffers from bi-polar disorder, as was the case in the six-week storyline on 90210 that we consulted on. We visited the writers on the studio lot, accompanied by a psychiatrist and the writers were able to get the real facts. In Hollywood, screenwriters are exceptionally bright and well-informed… master storytellers. So if we give them something factual, like a case study, they will take it and run with it.

In the five years I’ve been working here, there are certain narratives that keep coming up. Organ transplantation is popular – the dramatic potential there is huge. Mental health and addiction are always in, as are violent deaths. Also, cancer treatment – ‘What would a doctor say to a patient who has a stage four cancer diagnosis?’ is a question we often hear. In the US, access to healthcare is a big one – we consulted on cbs’s A Gifted Man on that subject. It’s harder to grab and hold attention around hiv these days, in part because there’s treatment, so it’s less of a life-and-death issue than before – but we recently consulted on an episode of Army Wives where a little hiv positive boy has to deal with the stigma of his condition. These storylines are very helpful because they expel a lot of myths and rumours and provide a public service, all through entertainment.

In the future, we’re expecting to see writers asking us about climate change – tropical diseases such as West Nile Virus are starting to move north, as are strange worms and exotic parasites that were virtually unknown in the US until temperatures started to edge up. There was a real-life story recently about an eight-year-old boy who went for a swim in a lake in Minnesota and was dead three days later because of a parasite that had proliferated due to the warming effects of climate change. For writers working on tv shows, these real-life case studies can be the spark of a very dramatic storyline. And drama, of course, is the key ingredient of any good story.

Luis Gutiérrez & Ana Bellón


Over a million viewers tune in to the national broadcaster’s daily morning programme La Mañana of which Saber Vivir (Knowing How to Live) is an hour-long show-within-a-show, heading into its 15th year. Gutiérrez and Bellón are a point of reference for Spaniards in need of a trustworthy source of information about their health.

“We must stress that we do not diagnose or treat patients from afar,” says Luis Gutiérrez, the veteran doctor who helms Saber Vivir. “Our duty is to provide preventative medicine.”

Gutiérrez, a trained gp and licensed surgeon became Spain’s most recognised doctor almost by accident. “Right before we went to air, the original doctor fell ill. I was on set doing a segment about Zarzuela music and they asked me to fill in. The ratings prognosis was great and the rest is history,” he proclaims with a beaming smile. He is an affable chap, willing to share a laugh, yet serious and methodical when it counts. Perhaps this is the key to his longevity on the small screen and his incredibly popular local radio show.

“Emitting charisma is what works on tv. You don’t have to have the most attractive face but the camera has to love you. By knowing how to speak to your audience, you help them to understand and this builds trust.” Ana Bellón, the team’s resident nutritionist agrees. “There are serious repercussions to the things we say on air.” Still practising what she preaches, the tall, vivacious medico hurries off to her practice after each broadcast. “I love both jobs but there is a potency to television that allows you to spread a message much more effectively.”

This sense of gratification is a driving force for the doctors, both of whom 
reply to a daily stream of letters. “In my practice I am advising one person at a time. On tv I’m talking to over a million people,” says Bellón. They admit that televised medicine is sometimes threatened by commercial forces and meddling journalists. “There is an expression in Spain: don’t let reality get in the way of a good news story,” says Luis, shaking his head, “but when it comes to health, one must never fall into the trap of sensationalism.”

While Saber Vivir is on Spain’s national public broadcaster, the age of austerity has meant that ratings are as important as ever. “When people stop me on the street, they treat me as though I’m their lifelong family doctor. With higher unemployment we have more viewers and I don’t want to break this trust.”

Heba Kotb


In a region where open discussion about sex is still taboo, Heba Kotb’s ‘The Big Talk’ is a bit of an oddity. Broadcast across the Middle East via the Egyptian Al-Mehwar satellite channel, the landmark show began its run in 2006 and has garnered a strong audience.

Its Egyptian host, a trained surgeon and American-educated sexologist, often perplexes international observers. To outsiders, the hijab-wearing Dr Kotb seems to cut a conservative figure but to her audience she’s a revolutionary of sorts, openly challenging disinformation.

“Well, it’s not just me; a lot of people are now talking about sexuality on a scientific basis, putting an end to these myths everywhere,” she says.

While only advocating sex within the confines of marriage and what is acceptable in the Koran, she spends much of her airtime trying to counter the folkloric teachings that permeate society. “TV is magic. It reaches you whoever, wherever, and whatever your underlying religious differences are. It speaks to everyone, especially in our region, where there are lots of people who don’t have access to the right information. So in this sense it’s a really good tool, a sort of home-delivered medicine.”

The Big Talk mixes up its format with guests, experts and psychologists in the studio, while viewers are encouraged to call in and seek advice. Her new show (the name is a closely guarded secret), begins filming this November and will go a step further with patients and couples treated in the studio. “Television reveals body language, which is important as it shows more emotion. People need to put a face on these issues and see that they are normal.” So strongly does she believe in the visual medium that she once rejected a contract because it included a radio syndication clause.

While a few Muslim clerics have accused her of encouraging promiscuity and some in the West may not agree with all she has to say, Kotb’s show has certainly started a big conversation, where facts remedy fiction.

Nancy Snyderman’s CV 

1952 Born in St Louis, Missouri
1977 Graduates from University of Nebraska Medical Center with Doctor of Medicine degree; residencies in paediatrics and ear, nose and throat surgery at the University of Pittsburgh
1997 Joins ABC as medical correspondent, appears on ‘20/20’, ‘Primetime’, and ‘Good Morning America’
2006 Finishes practising surgery; joins NBC as chief medical editor, appears on ‘TODAY’, ‘NBC Nightly News with Brian Williams’, ‘Rock Center with Brian Williams’, ‘Dateline NBC’, MSNBC, and MSNBC .com

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