UNIVERSAL CITY, Calif. – Two AIDS doctors made a house call last month to the set of TV's "Law & Order: Special Victims Unit."
The plot line was the suggestion that HIV doesn't cause AIDS -- a fringe theory promoted on the Internet and by certain African leaders. But the two physicians weren't there to doctor the script.
They just wanted to make sure the TV show followed some standard doctor advice: First, do no harm.
Surveys show that most people believe the medical information they see on television dramas and soap operas. With fictional TV shows playing such a powerful role in public health education, the government is dedicated to keeping an eye on what Hollywood says. That's why the CDC is one of four government health agencies that fund the "Hollywood, Health & Society" program at the University of Southern California. The program has an annual budget of nearly $564,000.
It's run by a former CDC employee, Vicki Beck, but the real "talent" are government health officials and other medical experts the program sets up with writers of daytime soap operas, nighttime dramas and other shows.
To be sure, many TV shows consult with doctors, lawyers and others professionals on plot details. Some even hire physicians to be writers. The executive producer of "Law & Order: SVU" is an MD.
Still, some TV and movie scripts skirt -- or outright ignore -- the practical limitations of the real world. Some low points:
--"Medical Investigation," an NBC series in 2004-05, made health officials cringe. The show didn't even get the names right: The series' heroes did the out-in-the-field epidemic detective work of the CDC, but were identified as employees of the National Institutes of Health, a federal agency that's more focused on lab science. Worse, the heroes wore leather jackets instead of protective gear when checking for a deadly pathogen.
--"Fatal Contact," an ABC movie last spring about bird flu reaching the United States, was denounced as unrealistic by some prominent flu experts for, among other things, showing an Angolan village strewn with bloody bodies that looked more like a mass suicide than an area hit by flu.
--"Outbreak," a 1995 motion picture starring Dustin Hoffman, involves a government plan to bomb a California town to stop the spread of an Ebola-like contagion. But CDC officials insist that they would not deal with such an outbreak by bombing towns.
Beck's program tries to head off such errors.
The CBS show "Numbers" is one example. "Numbers" writer David Harden called, saying he was pursuing a plotline about black market profiteering in human organs. TV writers like the topic because of it's dramatic potential and persistent hold on the public imagination: Who hasn't heard the urban myth about the man who meets a hot woman in a bar and wakes up in a bathtub full of ice?
Health officials, however, hate it. They say there is no black market in organs in the United States, and dramatizing the idea may dissuade Americans from becoming organ donors.
But the program took Harden's call and convinced some experts to talk to him. One in particular was skeptical of the plot idea at first, Harden recalled, but answered every question.
The resulting show, which aired in January 2006, was about an international black market that provided detailed information on how the national organ matching program works. Health officials deemed it a success: In a subsequent online survey of about 160 people who said they were not organ donors, 10 percent said they had decided to become donors after watching the episode.
Another success occurred a few years ago with the Fox show "24."
The show was interested in this scenario: Terrorists release a biological agent in a hotel air conditioning system, making people sick in a matter of minutes and killing roughly 2,000 people within a few hours. They concocted a genetically engineered "Cordella virus" to do it, and wanted government officials to be able to wave an electronic device that could instantly detect the virus in the air.
They consulted CDC officials, who said there are no such devices. The CDC also suggested that health officials might try to deal with such a situation by isolating the ill from the well, perhaps reducing the contagion's impact, said Dr. Mitchell Cohen, director of CDC's Coordinating Center for Infectious Diseases.
The writers took the tip, and the final death toll fell to under 800. "We saved 1,200 virtual people," said Cohen, who consulted with the "24" writers and did an on-camera interview for the DVD boxed set of the series.
CDC officials make time for Hollywood meetings, because they know what's on screen can be influential. In a 2000 CDC-sponsored survey, more than half of TV viewers said they trust health information on prime-time shows to be accurate, and about one-quarter said prime-time television is one of their top three sources of health information.
Health-focused plots, and sympathetic characters dealing with disease, do seem to stir public reaction. Just one example: A CDC study that chronicled the impact of a 2001 story line on a soap opera, "The Bold and The Beautiful," in which a heterosexual male Hispanic character was diagnosed with HIV. The phone number to a CDC hotline for AIDS and sexually transmitted diseases was televised immediately after the episodes, and calls to the hotline spiked from about 100 calls a day to more than 1,400.
Program officials present themselves as resources, not advocates, so there's been little push to get smoking characters to drop the habit push or eat more fruits and vegetables.
They also do relatively little with the movies. The CDC placed a smoking prevention employee in Hollywood in 2002 as a liaison with the motion picture industry, but stopped funding the effort in 2004. Beck hasn't tried to fill that void.
"Film is too difficult to track and influence because of the many years, writers and stages of change that a film undergoes before it is released," she said.
Health officials acknowledge that it can be tough to work in Hollywood, a town that's driven by relationships. They acknowledge to being cautious about taking steps that might be seen as challenging or critical of entertainment leaders.
That's a failing, said Stanton Glantz, a University of California-San Francisco researcher who leads a campaign to remove smoking from the movies. He's critical of how little success the CDC and others have had in diminishing episodes of cinematic smoking, which he said declined only slightly from 1999 to 2006.
Glantz alluded to recent statistics that show, in the last three years, a leveling off in the decline in both teen and adult smoking.
The CDC's approach "does raise consciousness. It does educate people. But it just hasn't had any effect," he said.
"They should follow the lead of several state and local health departments and start pushing for policy changes -- most notably an R rating for smoking," he said.
Beck's work includes not only arranging consultations but also holding the "Sentinel for Health" awards, which recognizes TV shows that do fact-based story lines with positive public health impact.
A Sentinel for Health may lack the cache an Emmy, but writers said the award is noted and appreciated.
"It reflects that hard work that we put in to accurately portray health issues that affect Americans," said Paul Grellong, a writer for "Law & Order: SVU."
Grellong and four of the show's other writers sat in on the recent meeting at Universal Studios with the two HIV experts, Dr. Joseph Cadden and Dr. Jocelyn Suzette Dee of L.A.'s Rand Schrader Clinic.
The meeting was run by Josh Kotcheff, the writer penning the episode, who sat with the doctors at a conference table. The other writers sat on a nearby couch with notebooks, listening for future-episode fodder.
Kotcheff peppered the two with questions about disease theories and the intricacies of HIV testing. He listened intently to their replies. Later, he said he wanted not only to master the realism-ensuring details, but also to be responsible in how he presents characters that deny HIV causes AIDS.
"There are people who do believe these kinds of myths, and it can have an impact on their lives. If they don't take (HIV-fighting) meds, they're going to die," he said.