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Scrubs, "How To Save A Life

When it starts with that song by The Fray and just keeps getting worse.

It’s widely agreed that the Scrubs episode “My Lunch” contains the best and possibly only positive use of “How To Save A Life” by The Fray. For those who need a reminder, it underscores a famous sequence in season five’s “My Lunch”; the plot of the episode is that a beloved recurring patient Jill has passed away, and Dr Cox used her organs for four separate transplants. At the end of the episode, he discovers to his horror that the patient was suffering from rabies, and “How To Save A Life” underscores his futile attempt to fix the situation that only leads to four more dead patients.

The song is deeply sincere, and I wonder how much that works against it as a pop song; all art is manipulative, and the line between ‘gently nudging’ and ‘openly hectoring’ is a difficult one. There’s two reasons it works in Scrubs; the first is simply that being repurposed as a song in a montage draws a lot of attention away from it specifically, as the vague idea of the song sticks in your head rather than all the gory, potentially cringe-inducing details. More importantly, it’s hooked into a very good, compelling, heartrending story beat.

The interesting thing about this moment in the show is that it’s a rare case of the show chasing melodrama over medical reality; there’s no way Dr Cox would get to choose or even know where the organs are going, and it’s even less likely they’d all go to the same hospital. However, if you choose to buy into the reality of the story, you get the most intense attack on Cox’s very identity. The funny thing is that I don’t think I’ve ever seen a single audience member argue that Cox was actually at any serious fault here; his mistake is so small and simple as to be completely understandable, because the signs of Jill’s illness were so subtle that you’d have to be a machine to have spotted it.

Unfortunately, Cox fully wants to be a perfect machine of diagnosis and treatment. His strengths and weaknesses as a character are rooted in an ultra-disciplined mindset and complete control of his environment; his love/hate relationship with JD comes largely from his both appreciating and resenting his near-complete devotion and respect, and so much of his rage comes from his inability to really control everything around him. His dedication to doctorin’ is exactly – exactly – as much him playing God as it is him wanting to help people. In a way, the latter justifies the former.

In the middle of it all, JD tries appealing to Cox’s reason; he points out that every single decision he made was, at the time, the exact correct one. I had forgotten until rewatch that he observes that testing for rabies would have been the irresponsible medical decision because they would have had no time. Of course, human emotion is not driven by reason; I’ve always welled up with tears when Cox immediately gets another beeper message and finds, to paraphrase beloved Magpie Lauren James, the bottom of this shitty situation is even further down than he could conceive. When Cox is grieving or hurt, John McGinley generally plays him completely still, as if he’s keeping out all the bad information and processing internally; when his beeper goes off, he quietly cries out “Oh God! Come on!”, and at that point any mask comes off.

The ‘emotional person violently tearing up a room’ is a cliche to the point that one wonders how many young men act it out because they think that’s how you’re supposed to act out loss of control, but it works here because it just keeps building and building; Cox doesn’t want to lose control, he doesn’t want to throw around expensive medical equipment that they’ll probably need in five minutes, but by that point, he’s so overwhelmed his humiliation and grief that he’s not thinking straight. As he points out to JD, the last dead patient had no reasonable justification for being killed by Cox’s decision.

This is where Cox faces a description of himself he doesn’t want: it was now entirely about his ego and rashness, not medicine (“Wasn’t about the timing. Could have waited another month for a kidney.”). There’s no greater assault on Cox’s identity; this was, from his perspective, a moment of unforgivable incompetence with catastrophic results. He cannot in any good conscience justify himself being in a hospital, calling himself a doctor. The thing that gets me about him turning around to face JD at the end is that he’s completely clear-eyed: he must leave this hospital in shame.