A Modern-Day Tragic Hero

Dr. Duntsch, the real-life neurosurgeon who intentionally maimed his patients on the operating table, was not a good person. Walter White was also not exactly an upstanding citizen. Macbeth, the murderous Scottish upstart to the throne—lots of room for improvement.

While the hero’s journey through adversity may be a compelling story, there’s a reason the hit show was called Breaking Bad and not Staying Good. The same holds for Macbeth, chosen rather than Scotland’s actual hero, Macduff. The tragic hero has become one of the most engaging characters in literature, taking on alternative forms as the genre grows. But there is one tragic hero more seductive and insatiable that we as readers can never stop thinking about: the tragic doctor.

What is a tragic hero?

First for clarity, the tragic hero is defined by the subversion of the classic hero’s journey opening the story up to a messy and morally ambiguous arc of self-destruction. The tragic hero is supposed to be virtuous—destined to be the paragon. But somewhere along their journey, the tragic hero makes that one fated mistake that derails their course trajectory from reliable hero to reviled underdog. The classic mustachioed caped villain has undergone a modern transformation into a multi-dimensional character with their own distorted and tangential progression.

Readers once accustomed to cheering for the protagonist, have expanded their tastes to the tragic hero. This is because sometimes virtue appears boring—morality can be a buzzkill. This is why, as readers, we particularly love the medical crime thriller. We stand as spectators, yelling at the pages as the doctor makes one incremental mistake after another, descending into madness of her or his own hubris. Why do we love reading these characters so much? Why do we yearn to watch the fall from grace of healthcare professionals pushed from their pedestal and plunge to the criminal underworld?

Before we explore what makes doctors such compelling tragic heroes, it’s important to explore what exactly makes the tragic hero so page turning in the first place.

Can we become a tragic hero?

A dehumanizing process occurs when a person commits tabloid-worthy acts. When we read about Doctor Death or the Cragslist Killer in the news, they appear dehumanized as we grasp to understand why they commit such repugnant acts. The story of the tragic hero provides a look behind the curtain, exposing universal human frailty. Once we learn the origin story of the tragic hero, we understand the microprocesses that churn within them: the hubris, the white lies, the sins of omission, the rationalizations, and the cognitive dissonance. With understanding comes dreadful insight: they’re more like us than we’d like to believe. It’s revelatory to discover the corrupting processes that can happen within ourselves. We are knocked down from our lofty pedestal as sanctimonious readers, reflecting on our own potential for wrong-doing.

How do we prevent the tragic hero?

The tragic hero is a model of destruction. With morbid fascination, we read about the tragic hero perverting codified morals and crossing ethical barriers. Knowing that most tragic heroes begin their journey in a moral station similar to the reader, we are faced with a question: what safeguards are in place? What is the calculus that ping-ponged the tragic hero from one misstep to the next? How does a person go from a loving father to a drug lord? How does a person begin as an accomplished surgeon to serving a life sentence? We like to believe that they harbor nefarious instincts, and maybe some do. But it’s also worth asking a pertinent question: what are the safeguards that prevent me from turning into Walter White? The tragic hero helps us to not only pinpoint the character flaws but the safeguards in our own lives that prevent our own personal tragedy.

How is the tragic hero made?

Is sociopathy inborn or installed? If you put the tragic hero’s brain into an fMRI is there a specific spot that lights up? Or did the tragic hero lack nurturing parental figures while suffering abuse, neglect, abandonment, and trauma? We know the answer in real life is much more complicated than the false binary of “nature vs nurture.” To reduce human behavior to a sum of their upbringing, trauma and genetic proclivities is likely a gross oversimplification. When we read a deftly written tragic hero, not only do we explore these concepts, but we relish in the complexity of human behavior.  Our empathy expands when we learn about the series of seemingly unrelated events, habits, hopes and horrors that drives individual decision making. Reading the tragic hero helps us to not only see the humanity in them, but serves as a cautionary tale to ourselves and our potential to become our own tragic heroes. The moral of the tragic hero is clear: it doesn’t matter who you are, tomorrow you could be the headline.

Can the tragic hero be redeemed?

The tragic hero forces us into a morbid standoff: we want them to pay for what they have done… but we are also kind of rooting them on. A really well written tragic hero will continuously push the reader’s moral envelope. Just after we believe they cannot sink any lower, their course corrections usually make matters even worse. Whether it’s lying to loved ones or covering up from an employer, the tragic hero becomes more unscrupulous as they seek self-preservation. We enjoy the degeneration because we want to know something: how far can the tragic hero go before our moral standards deem them unworthy of redemption? The more compelling the tragic hero, the more difficult it is to answer this question. While the tragic hero can never restore what they were at the beginning of their downfall, redemption can take on new forms. That is why we keep reading, not because they can restore what they lost but because we want to believe that some form of redemption is always available no matter what someone has done.

When we take everything we love about the tragic hero and mix that with a healthcare professional, we enter a higher echelon of tragedy that has made the medical crime thriller one of the best venues for the tragic hero. What is it specifically about medical crime thrillers that make them so compelling?

The Healthcare Heroes

Healthcare workers are the real-life exemplars of heroism. Nurses, EMS responders, ER docs, surgeons, oncologists—all of these people are the bastion of protecting human health. During the COVID-19 pandemic, how many images have we seen on the news of exhausted healthcare workers, armed with masks and gloves, crumpled in a hallway corner overcome with exhaustion? For how many years have doctors enjoyed a boundless reverence for their practice? There is a built-in narrative of self-sacrifice and compassion that permeates the entire medical field.

And this works out perfectly for the reader because doctors are a fantastic template for the tragic hero. It requires fascinating forces of folly and hubris to make a doctor violate the social contract that they should hold sacred. The American doctor tackles an arduous journey through four years of undergraduate school, four years of medical school and anywhere from three to ten years of residency or fellowship before she or he even begins practice. The staggering amount of professional accomplishment carries an implied social contract: you can trust your doctor. For better or worse, there is implicit trust in doctors since we believe that creating a doctor is a moral vetting process in and of itself. With this trust, doctors exercise vast influence over a person’s mind and body. Just think about what I do for a living (when I’m not writing books) as an anesthesiologist. I give patients the world’s most powerful narcotics, chemically paralyze them while taking over their heart and lungs as a surgeon applies blades, saws and sutures to their unconscious bodies. It takes an astronomical amount of trust for doctors to even do what they do which primes them to be in the elevated position as the destined hero, ready for the plunge into tragedy.

With trust comes vulnerability and with that vulnerability comes the potential for exploitation. The potential for wrong doing is limitless: narcotic diversion, drug abuse, falsifying medical records, insurance fraud, embezzlement and most horrifically, the violation of a patient’s mind or body. A doctor can commit egregious acts with impunity for a very long time because their position of trust confers unwritten immunity. Yet, the scrutiny of employers and patients can and does catch up to a criminal doctor. Imagine what such a doctor would do to prevent from being caught. To what extent would a doctor go to cover up their crimes? When a person has as much social capital as a doctor, they will go to extreme measures to maintain that status, often more so than someone who is not a doctor.

The Tragic Doctor

Enter the literary tragic hero doctor. A doctor meets the criteria of the would-be paragon of justice, destined for greatness and an agent of equanimity. And just like any other tragic hero, the tragic doctor starts that gradual decline from a place of high esteem. A departure from the classic tragic hero is that the white lies and rationalizations of the tragic doctor can have devastating impacts. The mistakes and course correction of a tragic doctor can ripple far into a community in the form of data breaches, privacy violations, drug trafficking and emotional and bodily harm. The dehumanization of the tragic doctor is particularly jarring because of the contrast with their elevated position in our non-fictional society.

Considering the position that doctors are in, the tragic doctor offers the reader a cornucopia of new motivations. Compared to the typical tragic hero, a tragic doctor likely has enormous tectonic forces, both personal and professional, that force their dissent. And if indeed the tragic doctor has sociopathic tendencies, we consider the startling realization that the process of creating one of society’s most trusted positions might be flawed. We can vet all we like but there is a certain unassailable fact about human nature: people can easily hide who they truly are. The merits of education, professionalism and career accomplishments are limited as social safeguards. In fact, the more esteem and positions of power one attains, the easier they can break bad and become a tragic hero. The tragic doctor is a prime example of the corruption of power and the erosion of social safeguards. To learn about the forces that lead a doctor from trusted healer to criminal is an incredible spectacle which serves as a repudiation about social trust and responsibility.

As we watch the safeguards around the tragic doctor erode, we ask: what created this monster? Are there undue moral forces on a doctor that tipped them beyond their safeguards and onto the highway of rationalization? It’s true that doctors can experience extreme stressors: end of life care, high pressure emergencies, performance anxiety with a person’s life in the balance. Given that the tragic doctor may have more external pressures than the average individual, does this make their tragic actions any more understandable? This is what makes the tragic doctor so compelling: they push the moral envelope way beyond the conventional tragic hero. With the tragic doctor we’re forced to answer deeper questions: How far can the tragic doctor go until they are beyond redemption? Do they deserve a smidgen more of redemption? Are they even allowed redemption?

Unfortunately, the tragic doctor will never give us the answers we want. The motivation and redemption of the tragic doctor remain just out of our grasp, as they should. This is because the tragic doctor, just like the tragic hero, does not exist to give us exact answers. The tragic doctor only serves as a clarifying lens, amplified by the chaos of medicine, showing us just how much more complicated life can get. The answers to the moral conundrum presented by the tragic doctor remains with the reader, revealing our own moral compass and with that revelation perhaps more empathy for others and ourselves.