Second Look: Scrubs Season 1, Episode 4 – “My Old Lady”

Scrubs Season 1, Episode 4 “My Old Lady”
Written by Matt Tarses
Directed by Marc Buckland
Aired October 16, 2001 on NBC

“My First Lady” is the first Scrubs episode firing on all cylinders, a half hour displaying the comedic and dramatic balance the series would use to great effect throughout its nine-season run. It’s really where the series was often at its best, finding balance between the beauty and tragedy of the doctors and their work at Sacred Heart, aspiring to be something greater, and more unique, than the more straightforward “hospital melodrama + office comedy” combo offered in the first three episodes. All great comedies have their watershed moment; “My Old Lady” is that episode for Scrubs, taking all of its existing elements and arranging them in a near-perfect harmony.

“My Old Lady” disguises itself under two unsuspecting premises, re-introducing conflict between Elliot and Carla in the cold open, followed by J.D.’ announcing that’s voiceover detailing how “one out of every three patients admitted will die here,” as it introduces the three doctors (and the audience) to their patients for the episode. For the first time, Scrubs largely isolates its main characters in their own stories, using some of its already-established character beats – J.D.’s anxiety, Turk’s impersonal approach, and Elliot’s insecurity – as the thematic connective tissue between the patients they treat in the episode.

It does so by pushing these characters into their own corners, their only relief coming from their core friendship; J.D. and Turk in a yin/yang story about being empathetic with patients, while Elliot and Carla struggle to find common ground between self-righteous, privileged doctor and headstrong, confident nurse. It not only allows “My Fair Lady” to play with the conflicting philosophies of both pairs of characters, but it helps the episode maintain its progression, setting itself up perfectly for an unexpected, poignant third act twist.

It explores these ideas in simple, but effective ways; Turk assumes that it’s better he doesn’t know his patients, while J.D. is understanding that being too empathetic with the people in his care can be both dangerous and emasculating. Through each other, “My Old Lady” slowly helps the two unpack these problems -and it happens fairly early in the episode, too; Turk hangs out with his patient David (even using him for some random hallway bowling), and J.D. puts his foot down with Mrs. Tanner’s family a little; taking cues from each other brings them closer to their patients, and makes them feel more in control of the medical situations in front of them – Mrs. Tanner and her renal failure being more serious than the routine hernia procedure awaiting Dave after his 1982 NFC Championship game rewatch session.

Across the hallway, Carla and Elliot’s conflict is catalyzing the same progress, both for each individual character and their friendship as a whole. Elliot can’t talk to her immigrant patient, annoying Carla, admonishing Elliot for being on her private school high horse and too good to learn the primary language of 1/3 of Sacred Heart’s patients (ironic, considering Sarah Chalke can speak about 3,482 languages in real life). Piggybacking off Elliot’s behavior towards her in previous episodes, Carla and Elliot continue to struggle to find a common thread between them, making them the perfect thematic mirrors of besties J.D. and Turk – which, as “My Old Lady” shifts from comedy to drama in its third act, uses to its advantage, observing how young doctors learn how to survive when the realities of working in a hospital are shoved in their face.

“My Old Lady” also uses a bit of smart narrative distraction to lead its audience along; J.D. states early in the episode that one of three patients will die, so when all three take a turn for the worse partway through, the episode lulls the audience into its stated inevitability – until all three patients die for different reasons, and J.D., Turk, and Elliot all find themselves dealing with the first deaths of their medical career. It’s a rather big gamble for a young sitcom, to shift into a much more emotionally raw, dramatic tone – the potential for it to feel mawkish or manipulative (or both) is extremely high, and with the entire episode hinging on its first act mislead, it would be easy for a young comedy to misgauge itself and fumble the landing.

Thankfully, the character work that is constructed underneath that story is so strong, it’s impossible for those climatic moments not to hit hard. Turk’s newfound humanity, J.D.’s blossoming strength as a doctor, and Elliot’s confidence are all at stake when their patients suddenly die on them, and “My Old Lady” gives those developments weight by presenting them in the context of their friendships. As J.D. later says, the only way they’re able to make it through the rest of the day is with the lessons they’ve learned from each other, a night that changed their worldview and how they view their profession.

It’s a strong, resonating idea, a medical show that isn’t afraid to admit doctors can’t cure anything (and as we see through Dr. Kelso, often aren’t really interested if they do or not). As Cox so eloquently points out while dressing down J.D., what doctors do is essentially a stalling act; they’re “just trying to keep the game going” a bit longer with all of their patients, even though they know they’re fighting a losing battle. It sounds melodramatic, but “My Old Lady” expounds on this way in a really powerful way when all three patients die; it’s impossible not to be heartbroken by any of their patients, stark reminders that every patient in the emergency room is a roll of the dice, and the circumstances of a doctor’s job can be a very depressing thing (something Scrubs could always find a way to make funny, doing so here with the image of Death beating J.D. at Connect Four).

Being doctors allows these characters to access parts of their humanity in ways their interactions with friends couldn’t; while Cox remains the decided seer of the show, David and Mrs. Tanner alike serve important purposes in guiding our characters to the next step in their journeys, presences that never share any screen time, yet still find themselves working in perfect harmony in the episode’s climatic moments.

“My Old Lady” is not exactly a flawless episode (there’s a strange lack of Dr. Cox, and Elliot’s patient doesn’t register in the way David and Mrs. Tanner do – it’s by design, but it holds the episode back), but it’s an incredibly strong fourth episode that builds on the three introductory episodes in really fascinating ways. It marks the arrival of Scrubs‘ ambitious streak, which Lawrence and the writers of the show would dub their ‘concept episodes’; the few times a season they would try to deliver one of these powerful stories in some kind of unique, occasionally non-canonical context (which would grow increasingly ambitious, like the musical episode or the medieval Season 7 finale). “My Old Lady” is the first of these – and one of the best of them, a half hour that effortlessly moves from laughs to tears, then back to laughs again without ever being desperate or indulgent. This is the episode that firmly establishes Scrubs‘ true identity and its occasional fascination with death and failure – and most importantly, the power of human connection in helping us all heal after life hands us a loss.

Grade: A-

Other thoughts/observations:

• “What’s his name?” “Hernia Patient – but we’ve gotten closer, so I like to call him Hernia.”
  
• Writer Mike Schwartz makes his first appearance as a delivery guy, a character who would become a member of the B Squad’s B-squad in later seasons.
  
• Elliot: “I like to use sex as an ice breaker.” Carla: “how’s that working out for you?”
  
• Mrs. Tanner: “I think I’m ready to die.” J.D.: “But with dialysis, you could live another 80-90 years.”
  
• “I’m a chunky monkey from Funky Town.” “I’m going to have trouble translating that.”
  
• Elliot’s speech about not picking a soda is nice and all, but it is the one moment where it feels like Scrubs is reaching, the one place where the dialogue feels a bit melodramatic and tinny.
  
• Yeah, “Hallelujah” is probably a bit too on-the-nose as a song choice.
  
• Turk exercising to dance videos is a riot. I miss the early seasons of Scrubs, which spent copious amounts of time hanging out in the employee break room.
  
• Dr. Tanner, to J.D.: “Make ’em know you’re a man, not a boy.”
  
• “Matter of fact – how many times have you sat on the grass and done nothing?”
  
• Death is played in an uncredited role by Randall Keenan Winston, who has been EP on so many shows since, including Ground Floor, Cougar Town, Undatable, and Shrinking.
  
• Todd Hive Five Count: Zero this episode, leaving our season total at 5 1/2.
  
• Up next: J.D. plays some golf in “My Two Dads”.