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Inside the White Tower
Directed by Ahn Pan Suk
Written by Lee Gi Won
Produced by Bae Ik Hyun
Originally aired in Korea, from January 6 to March 11, 2007
Review by Leonard Norwitz
• Kim Myung Min as Dr. Jang Joon Hyuk
• Lee Sun Gyoon as Dr. Choi Do Young
• Lee Jung Gil as Chief of Surgical Residents Dr. Lee Ju Wan
• Song Sun Mi as Lee Yoon-Jin (daughter of Dr. Lee)
• Kim Chang Wan as Assistant Director of Surgery Dr. Wu Yong Gil
• Kim Bo Gyung as Kang Hee Jae (mistress of Dr. Jang)
• Gi Tae Young as Dr. Yum Dong Il (intern)
• Byun Hee Bong as Pathology Professor Dr. Oh Kyung Hwan
Production: Kim Jang Hak
Television: MBC, Korea
DVD Distribution: YA Entertainment (USA)
Aspect ratio: 16x9
Region 1: NTSC
Feature: 480i / anamorphic
Supplements: 480i / 4:3 + letterboxed widescreen
• Interview with Lead Actor Kim Myung Min (10 min.)
• Interviews with other cast members (11 min.)
• Press Conference with cast members, director, writer and medical consultant (7 min.)
• Interviews with Professional Advisors (10 min.)
• Interviews with Writer Lee Gi Won (10 min.)
• Interviews with Director Ahn Pan Suk (9 min.)
• Comments by Viewers (10 min.)
• Critic Bae Gook-Nam discusses White Tower in the Context of K-Dramas (9 min.)
20 episodes, approx. 62 min/episode
Extra features: 80 minutes
Published in 1 box set
Slipcover contains 2 volumes, totaling 7 discs
Release Date: January 8, 2008
Comment ~ A Question of Informed Consent
(see Introduction to Korean Drama HERE)
A particular assumption about a patient's relationship to medicine, and vice-versa, is at the very core of this drama, yet it is never seriously questioned. So, let's start with the basics: How much do you really want to know about the state of your health? If your doctor suspects a certain diagnosis, at what point, if any, do you want to get the "bad news?" Do you believe that your attitude about the diagnosis plays a role in your recovery – either way? If so, how so? Would you want your family to know of a life-threatening illness if you didn't? And what about lingering pain in the face of an untreatable illness: would you rather face a hopeful doctor, even if it means he or she would have to lie to you about what is actually killing you. In short: Do you want to know what hit you when the time comes, or not?
At a time when doctors are still dealing with sutures and needles (much to McCoy's everlasting vexation) Koreans come down on these issues very much on the side of "Doctor Knows Best" and patients are on a need-to-know basis. And they never need to know. In fact, over the course of twenty hour–long episodes, three different patients face the likelihood of death while in the hospital, while the entire hospital colludes in a concerted effort to distract the patient from the truth in the stated belief that knowing a diagnosis of cancer, even before it reaches the terminal stage, is bad for their health. This apparent respect for the integrity and pride of the patient has a long history in medicine, though I harbor a different explanation for its persistence: namely that doctors are often reluctant to face a patient with the truth because it puts them face-to-face with their own impotence and fallibility.
What I find interesting about this conceit about the doctor/patient relationship isn't so much that it differs profoundly with my own views, but that in case of possible legal action in the event of death, culpability is unclear. If patients don't know why they are being treated, then how can they make informed decisions about their recovery? If you are treated for a broken leg, you will certainly know well enough not to go running for some while. In any case, the cast will remind you of your limitations. But what if you have lung cancer, and are told you are being treated for pneumonia? If the doctors don't want to deal with a patient's knowing the truth about their illness, they are less likely to see the pathology when it is staring them in the face; less likely to run certain tests that might confirm the diagnosis; and unlikely to offer chemotherapy or radiation since the patient would almost certainly not be able to rationalize the treatment with a diagnosis of pneumonia. I'm not making this up. This very line of thought is dramatized Inside the White Tower – an apt title if ever there was one.
What I'm speaking of is "informed consent," a cornerstone of Western medical treatment. The difficulty for a Western audience is that in the malpractice suit that occupies a considerable part of the second half of the show, the question of informed consent never comes up. Neither the patient nor his family are not told about the possibility of cancer and therefore are never engaged in the decision making process about treatment. The reason the doctor is sued isn't because the patient dies (not from cancer, as it turns out) but because the family was dismissed at every phase of treatment. From their point of view they were betrayed twice: once by the unexpected death of the relative, and again by a hospital system that refused to acknowledge culpability. By the time it came, the apology was neither accepted nor believed to be sincere. In other words, it was the attitude on the part of the hospital, not the outcome, that drove them to sue. While this is painfully apparent to us in America, it never really enters the discussion, which devolves on details such as "what did you know and when did you know it." Since the writer is married to a doctor/patient philosophy that does not recognize informed consent, he is free to continue with the cover-up, which turns out to be effective grist for the dramatic mill.
All the same, up to about the final three episodes, I was caught up in the drama, the medical and ethical issues and the emotional turmoil.
I confess that the last television hospital series I watched was St. Elsewhere. I've never watched so much as a single episode of ER or Grey's Anatomy. But I have caught more than a season's worth of House, though somehow I don't really see that as a hospital melodrama. Based on the work of Toyoko Yamazaki, the MBC drama series, Inside the White Tower - the Korean title translates more closely as "Great Tower" - is a fairly realistic drama about people and situations that most viewers can readily identify with: the conflict between moral obligation and material gain being the most central. Thus, the audience will likely have floating identification with different characters at different times.
And –what's this! – not a single chance meeting or flashback to a previous scene in the entire first four hours. Has Korea turned a page? Seems so – at least for the time being. Alone in Love and Someday may have laid the groundwork, but Inside the White Tower represents a number of departures from what had become standard K-drama fare. In addition to a lack of flashbacks and chance meetings, there is a relative absence of babes and hunks, no goofy best friends, no love story worth the name, and no major stars – unless we count Byun Hee Bong, the father in the blockbuster film, The Host. The setting is used as a context in which the characters evolve rather than a backdrop for romance and fantasy.
It's a tribute to Ahn Pan Suk's meticulous direction that, despite the fact that half the actors (all but one were unfamiliar to me) walk around in white coats, at times with surgical masks, that I was able to sort them out by the end of the first episode – by role, if not by name. Ahn's approach to direction is different from other K-dramas, even the more realistic ones, though more subtle in its effect. There is considerably more attention to the face, and more frequent cuts to show the same moment from various angles – in both cases, to flesh out character.
Episode 5 demonstrates the new thinking in an inventive, dramatic and compelling fashion. The focus of this episode is Korea's first-ever triple organ transplant. A single organ transplant would be complex enough, so the filmmakers hit upon the idea of cutting away to two groups of people throughout the surgery. The first is a classroom setting in which some of the details of the procedure are explained as they are happening during the actual surgery. The other group consists of interested, but opposing parties in the gallery around the operating theatre. These, together with what we can infer at the operating table and the discussions by the surgeons themselves, not only enhance our understanding of the events and sympathy for the characters involved, but make for dynamic and suspenseful drama. I was reminded of the TV series Shogun, where Yoko Shimada would translate in and out of Japanese for Richard Chamberlain's character. We not only got an introductory primer on Japanese language and traditions, but the device drew the two characters closer together, as it does us to them. Brilliant!
That which has been the hallmark of Korean television drama – emotional honesty and integrity – is developed to a fine pitch in this series. Characters and situations are even more textured, more complicated, less obvious, less morally straightforward. This is especially true for Dr. Lee who engages in some pretty unethical practices in order to ensure the hospital remains in the hands of someone who cares for patients as much as he does after his retirement.
The series makes use of more than the usual number of veteran actors in key roles. The casting is, with one exception, spot-on. In the Special Features, Director Ahn Pan Suk makes a point that his choices were based on acting ability, not obvious physical traits that would immediately lead audiences to a certain feeling about the character. His contention is that good actors can make any role credible. The evidence certainly supports his view. Except for the uncharismatic and, perhaps all too realistic performance of the actor playing the attorney for the plaintiff, there are no weak performances or casting goofs in White Tower.
To single out just a few of the more worthy: Kim Myung Min brings an icy coolness to his role as the ambitious Dr. Jang that could and does incite terror in the hearts of his adversaries. Lee Sun Gyoon as Choi Do Young, Jang's closest friend and eventual adversary, has the most distinctive voice I've yet encountered among Korean actors. It is soft, yet authoritative, an excellent choice for the part of this most sympathetic of doctors. Kim Chang Wan as the Assistant Director of Surgery, Dr. Wu, is the quintessential inscrutable Oriental. His face gives away nothing, yet we are always certain Dr. Wu is as clever as Charlie Chan, more devious than Mr. Moto - the ideal poker player. The young actor Gi Tae Young plays Dr. Yum, the intern whose inaction is at the heart of the case against the hospital. Gi's character is so profoundly affected by controlling, overwhelming forces that I myself felt like jumping off the nearest building to end both our suffering.
The screenplay plays to the needs of a pumped up drama instead of plausible reality to the point of wincing only a couple of times. In Episode 10, a patient of Dr, Yum, the attending intern, is rapidly declining, and has just bought a ticket to ICU. Yum is unable to reach the surgeon by cell phone. The intern, who feels out of his depth and without proper orders from the surgeon, calls in the admitting doctor, Dr. Choi, who rushes out of the hospital in order to convince the surgeon (it appears that the surgeon is in a different town altogether) that he should contact the intern to properly deal with his patient. Even in the face of a dysfunctional chain of command, a doctor wouldn't walk away from a critical patient who is apparently not being properly attended to just to point out that fact to a colleague. That said, the script does speak to nuanced realities that exist even in Western hospitals – not least, the "he's your patient, you deal with him" attitude.
The series picks itself back up immediately and for the most part stays on a believable and compelling course for the duration until the final episodes when a patient, already suspicious that he is not being told the truth about his diagnosis and prognosis, goes to a different hospital for a second opinion. There he engages the services of a friend and colleague from whom he begs the truth. And does he get it? Is the Pope Lutheran?
Inside the White Tower
The Score Card
The Series : 7.5
Chief of Surgical Residents at Myongin University Hospital, Dr. Lee Joo Wan, is about to retire and needs to recommend his successor to the Board of Hospital Chiefs. The obvious choice is young super-surgeon, Dr. Jang Joon Hyuk, a former student of Dr. Lee's. But Dr. Lee is not convinced. Dr. Jang is as arrogant and ambitious as he is confident and brilliant. He is looked up to by his peers – and no wonder, they are his fellow residents and wish for talent and self-assurance such as his. Lee fears that Jang would pursue the limelight instead of the needs of hospital patients. Jang's position is that patients would do better when techniques are up-to-date and skills are honed to match. He would promote such ideals instead of the antiquated ways of his former mentor.
The problem lies within the rules of Korean traditions. Lee cannot really promote another doctor from within the hospital less skilled than Jang. That would be insulting. On the other hand, and for much the same reason, he cannot openly invite nor support a candidate outside the system. Believing strongly that Dr. Jang would not make a good Chief, Lee begins to act in ways not typical of his basic character: among them, moving behind the scenes to bring in another candidate while all the while pretending support for Jang. But this is child's play compared to his feigning a faint while in surgery so that the new candidate can be rushed in to show off his stuff before a packed house. (This plays better than it reads.) What makes the move all the more interesting is that Dr. Jang is on the very surgical team involved in the procedure.
The first half of the series is involved with the search for a new Chief and the alliances formed on both sides of the question. This is corruption on a grand scale that goes all the way up and down the food chain - and I'm afraid it's all too credible – as realistic as it is nuanced. The second half of the drama considers the consequences of the choice of the new chief for doctors and patients alike - among them, a series of post-surgical complications leading to the death of a patient, and the ensuing legal action. Throughout it all, alliances are formed, involving trade-outs, kickbacks and intimidation – it's like The Godfather with all the blood left on the operating table.
Image : 9 (7.5/9)
The score of 9 indicates a relative level of excellence compared to other standard definition DVDs on a 10-point scale. The score in parentheses represents: first, a value for the image on a 10-point scale that accommodates both standard and high-definition DVDs – where any score above 7 for an SD is outstanding, since the large majority of high definition DVDs are 8-9.5. The second number in parentheses indicates how that image compares to what I believe is the current best we can expect in the theatre or, in the case of made-for-TV fare.
Inside the White Tower Is YAE's best looking offering to date. It is their most artifact-free image, beating out Super Rookie on points, and its 16x9 anamorphic picture makes it a joy to watch. Edge-enhancement is pretty much non-existent. Being an interlaced, non-progressive transfer, like other Korean TV dramas I have reviewed, Jpg artifacts are observable only on Pause or if watched using your computer.
A word about contrast is in order. I have mentioned elsewhere, even in the feature film, The Host, that Koreans have a peculiar attitude about exposure and contrast control. Ansel Adams used to talk about a ten-zone palette from black, where no shadow detail is observable, to a point above which washes out any high level information. The Koreans feel there is an eleventh zone where washed out information resides. This eleventh zone has dramatic meaning for them that in Western still and cinematography would count as an error. You can see this in operation during any of White Tower's surgeries, where the light over the subject is completely bathed in a transparent wash. It's quite striking, actually, especially once you tumble to the notion that it is not a mistake.
Audio & Music : 7~4/5
Much to my surprise, the otherwise clear-as-can-be audio track is marred by an arrhythmic appearance of low frequency rumble. So unexpected was this, that for a number of hours I had misinterpreted its appearance as the work of a neighbor's overactive subwooofer. In fact, it may not show up for an entire episode, and then in the following hour it would dominate the bottom end of the audio spectrum for up to 15-20 seconds at a time.
In an otherwise emotionally compelling and honest story, I found the music overcued and, at times, overscored and trivializing. This was particularly the case in all the suspenseful moments where the music suggested an action thriller more than the internalized drama that it is. I consistently had the feeling that I was been being manipulated by undeserving forces. I felt that drama did not call out for such reinforcement, that it was doing just fine all by itself. I recall another scene where a group of lawyers were in conference to sort out strategy, but the music seemed better suited to a romantic montage. In the drama's more reflective scenes, the music is generally tasteful, even inventive. In the later episodes, unexpected and effective use is made of the Christmas carol, O Tannenbaum. The more obnoxious bits do make appearances a couple of times every episode, reminding us that this is just another TV series with predictable ebbs and flows after all. I deducted White Tower's overall score a point for this error in judgment.
Translation & Subtitles : 8/9
With all the medical and legal situations and terminology, there's every chance for the translation to get muddled and for the viewer to be unclear about what is going on. Particularly in light of this challenge, I felt the translators did well here. There were only a few instances where I puzzled about the choice of words. One of my pet peeves in Jumong - the use of "something" as a cop-out when a more precise description of what was going on would have been better - was minimal. It does bug me, however, whenever I see "Did something happen?" instead of "What happened?"
Operations & Box Design : 9/7
Unlike YAE's Super Rookie, the names of the stars do not appear in English over the episode's credits. Not a tragedy, but missed all the same. The menu is uncomplicated and in English. YAE offers a fairly straightforward box design this time out: a sturdy, compact outer sleeve with an open end for two standard DVD cases. One case holds four discs (Episodes 1-12); the other holds three (Episodes 13-20 + the Special Features. I found the discs, though not mounted directly atop each other, were difficult to remove.
Extras : 7
The final disc offers up a whole 80 minutes worth of K-drama fan-targeted extras, the only downside being that each one begins with that familiar obnoxious high-energy promo and hypermusic cue from the series. All the same, these Extras are all worth watching, especially the interviews with the director, writer, professional advisors and the final segment where pop-culture critic Bae Gook-Nam examines Inside the White Tower in the context of the history of Korean television dramas. One amusing note: I am constantly fascinated by how Korean actors talk self-effacingly about themselves and their work. In the latter case, they can be circumspect to the point of distortion. Kim Myung Min says that others describe his character, Dr. Jang Joon Hyuk, as "evil." While not exactly disagreeing, Kim quickly adds that Jang has his "humane" side, too – which is like saying that Mussolini might be considered charitable because he drained the marshes.
Depending on your willingness to consider attitudes possibly very much different from your own, an outstanding dramatic series marred only by an insistent and peculiar musical score and a poltergeist of an audio rumble. Recommended.