Pathology, televised

Sometimes people die of their diseases.

Sometimes the drugs don’t work.  Sometimes no amount of treatment can overcome the illness that ravages the body.  Sometimes the best efforts of the best providers with the best training and the best expertise cannot turn the tide of infirmity, and the patient dies.

Sometimes people die of their diseases.

This grim thought occurred to me the other night when the Better Half and I were watching television.  Indeed, so pervasive was that notion that at one point I turned to him and actually said of the woman on screen “She’s going to die of her disease.”  And I am entirely confident that I am right in that prediction.

What show could we possibly have been watching to have evoked this morbid commentary?  What were we viewing such that I was moved to remark on the almost certain demise of the program’s subject?  What entertainment provoked my bleak review?


Neither of us had ever seen the program before.  We’d heard of it, of course.  But the closest we’d come to actually watching it were jokes made in some Kathy Griffin special.  (She is, it seems, an avid watcher.)  The show airs on “Lifetime,” and since the channel was already turned to it after our having watched the latest episode of “Project Runway” a few nights before, it was the first thing that came on when we turned on the television.

And we were curious.  So we watched the episode that was just beginning.

My friends, I am terribly confused by the appeal of this show.  Perhaps I caught a particularly horrifying installment, featuring especially miserable people, but I don’t quite understand what would draw people to watch it more than once.  It is entirely possible that other episodes are more hopeful, and my conclusion about the show is unfairly premised on seeing merely one.  But based on that one, I could never imagine watching another.

The show in question featured two people (one of whom had a desperately unhappy wife) who each hoarded animals (among other things).  One was a woman who hoarded livestock and poultry, and the other was a man who hoarded rabbits.  To say that both lived in squalor and filth would be to indulge in understatement.  And while both were deeply immersed in pathology, the former was so obviously broken-down and devoid of insight into her mental illness that absolutely nothing was accomplished during the segment I saw that in any way improved her chances of making a better life for herself.  Since her illness had forced her to move into an unheated trailer and winter was approaching as the episode filmed, the ostensible goal was to get her back into her home where there was, at least, heat.  This didn’t happen.  (At very least, a few particularly desperate animals were rescued from the hellish conditions in which she had them suffering.)  I wouldn’t be in the least surprised if that woman is dead by now, if not from exposure to cold then to some other ramification of her shockingly unhealthy life.

I have no doubt that, in writing this, I am coming across as an utter scold.  I actually toyed with making this a Millicent Tuesday Question, but then decided against it.  Doing so would smack of glibness, and my question is really quite sincere and serious.

Why are people filming deeply sick and miserable human beings such as these?  Would we tune in to watch the painful final days of a patient riddled with cancer?  If we restrict ourselves to the mentally ill, would we rouse random individuals from park benches and subway grates and try to capture the ramblings of the most obviously unbalanced among them?  What would be the ratings of watching a diabetic slip into a coma?

I realize that in the case of the people featured on this program, there is an element of what seems like volition in their plight.  But I defy anyone to look at a home overrun with rabbits and covered with the resulting layers of pestilential debris and ordure and not conclude that the people living there are deeply, deeply unwell.  I am reminded of a bit Jon Stewart did years ago during the run of the immoral and tragic “The Anna Nicole [Smith] Show” in which he, clearly not joking, addressed the producers of the program with the imperative to put down their cameras and help her.

I also realize that the show supposedly exists to help the people who have become hoarders.  I know there are several other shows, “Intervention” being one, that purport to have similar goals.  Not having seen them, and having seen only one episode of “Hoarders,” maybe I’m missing the real good that is sometimes done.  Maybe some people really are helped.  Lord knows I’d love to think so.

But the woman who kept chickens and ducks in her house in grossly inhumane conditions was pretty clearly past helping.  And I cannot understand why anyone would want to peer into so incredibly dark and deep a hole as that person’s sickness.  It seems indecent to me to gawk at people like her.  If she’s going to suffer, must we watch her?  Are there no pockets of the human experience that don’t lend themselves to packaging for prime time?  Are we so lacking in mercy that, should we encounter people mired in a hell of their own creation, we can’t grant them the small grace of doing so without an audience?

So has anyone seen more of this show than I have to offer some reassurance?  Does it actually do more good than I’m giving it credit for?  Please tell me it isn’t always limited to watching people slowly suffocate under the accumulated evidence of their own illness,

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. So you’re under the impression that reality TV is actually real?

    • Well, not really. I consume very little of it, actually, and what little I do consume I understand to be pretty heavily edited to produce a certain impression. “Project Runway” is among my favorite shows (though I’m starting to enjoy it less these days), but I am under no illusion that it is not heavily manipulated and massaged.

      But I am reasonably certain that we were treated to a real person’s very real illness and suffering in that episode. Indeed, unless the whole thing was an outright lie, then staging it meant subjecting dozens of animals to grossly inhumane conditions, beyond that which any even notionally ethical producer would ever devise.

  2. I think there’s one simple explanation: the desire to say, “Well, my life might be bad, but it’s not THAT bad.”

    • Well, yes. I did feel better about the clutter in my own home after having seen those. That being said, if I need to watch people trying to make their way through ankle-deep rabbit feces to feel better about my lot in life on a regular basis, I’d appreciate any of you sneaking up behind me and bashing in the back of my head with a shovel.

  3. I can make the argument that while it may be too late to help some of the people on the show, WATCHING the show may spur people who either have the same problem, or know someone else who does, to get help and make changes before their own situation becomes so dire.

    Because at some point, early on, presumably they just thought this was a “quirk”. The exact place where “collecting” or “hobby” or “messy/quirky” turns into “pathology” varies by person, and some undoubtedly will never cross the line into needing help.

    But it seems like graphically seeing the end of that road, might help some turn off that road, before it’s too late.

    • I guess? Maybe? But given how lack of insight into one’s condition is a hallmark of said condition, I suspect many people who are in early stages of the illness can simply look at the end-stage cases and focus on the daylight between them.

      • Is lack of insight a common problem with hoarders? My understanding was that hoarding was somewhat akin to OCD, and I thought many OCD sufferers are aware of their condition and wish for it to change.

        So when I see hoarders that seem to have no insight, my take was that (at least in many cases) they DO know something is wrong, but admitting it out loud to others, or allowing their “things” to be taken away, is just too frightening for them to say out loud.

        • I will admit to knowing little about hoarding per se. My understanding was that it is more like an addictive illness than an OCD-spectrum one (though mental illnesses seldom present in tidy, discrete packets), cases of which typically include lack of insight into one’s own condition.

          • And of course the whole “illness/addiction” dichotomy (or spectrum, depending) is a tricky one for me too. I think treating “addiction” as “illness” has certain conceptual benefits, but also certain drawbacks.

            Certainly better than treating “addiction” as “criminal behavior” though.

          • Quite frankly, I have an easier time describing behaviors such as hoarding as an illness than addiction to pleasure-inducing substances. But that’s probably a ball of wax best left alone for now.

      • My anecdotal impression is that many hoarders know they have a problem of some kind. What a lot of them don’t realize is that there’s a psychiatric component to their behavior, that what’s ailing them goes beyond acquisitiveness, laziness, or messiness.

        I know one person whose apartment is so cluttered they can’t have anybody over, ever. We’ve been close for years and I’ve never seen the place. I don’t think zie has crossed into hoarding territory yet, but it’s something zie’s keenly aware of. My great uncle was a full-blown hoarder. It took us the better part of a year to clean up his apartment after he died.

        I hate the show, but I can see some value in spreading the idea that severe hoarding is a potentially life-threatening illness, not just an eccentricity or a character defect.

  4. By inviting you the viewer (not necessarily you personally, Dr. Saunders, although like me you are not immune to this, given that your brain like mine has a functioning hypothalamus) to point and laugh at the subject of the show, you are promised and likely will leave the show feeling good about yourself. Allow me to elaborate:

    Having seen the pathology in action, you the viewer will compare yourself to the subject of the show, if only subconsciously. The verdict is inevitable — “I am not like that,” you the viewer will say to yourself, “so this terrible set of conditions will never happen to me. Ah! My life is better than I fear it is.” A danger is exposed and we viewers are made to fear it. But as we are made to fear it, we are also given a safe place in which we can assure ourselves that we need not fear it, as the cause of the danger is something we are immune from.

    If you judge and morally condemn the subject of the show, so much the better; you are thus given outlet for that facet of your personality that imposes judgment, either the “J” side of your Myers-Briggs or your superego if you subscribe to the Freudian tripartite. However you wish to classify it, this portion of your personality is flattered and given vent.

    “I am smarter than this,” the viewer says, or “healthier” or “wiser” or “better educated” or “more worldly” or, at the core of the show’s message, “better morally.” When you boil down to the very root, the viewer is “stronger” than the subject of the show. The subject of the show is weak because of her lack of sophistication or control over her own actions or whatever dimension of herself it might be at which the producers and editors of show invite we the viewers to point at and laugh.

    To be unkindly honest, I see this same thing in a recent post of my own in which readers evidenced pointed dissympathy for those who “made bad decisions” and find themselves in financially undesirable situations with respect to their homes. The subjects of the post ought to be more like the readers, who were smarter than the author and others similarly-situated, and so they can confidently proclaim that their superior intelligence, judgment, and prudence will protect them from harm.

    Safety! Self-esteem! These are now yours, viewer. Tune in next week for more!

    And it’s uncomfortable to read this because it points out a degree of cruelty and sadism within the human personality which superficially appear incompatible with the superior moral construct to which we flatter ourselves that we adhere. In truth, the cruelty and sadism are ways in which aggression is expressed, and aggression is what makes us go out into the world and do things, so we need it. Hopefully we can place this kind of thing in check, and use the fear and hollowness of ego and aggression it embodies in a manner to motivate ourselves to achieve and do good. Learning how to channel this aggression is part of the process of becoming a mature person. Each of us will fail in that respect from time to time, and some more often than others. The issue is not aggression, and it is not that we fail sometimes to channel the aggression appropriately. The issue is if we do not try at all.

    • While I am slowly shedding much of the religious baggage of my youth (more on that tomorrow!), I am grateful for some of those valuable lessons that were taught to me at a young age, the virtue of which I have tried to retain. (NB. I am not saying these lessons cannot or are not taught equally well or better in other contexts, merely that I was taught them in a religious setting and that they had and have value to me.) Reading your comment, I am reminded of Jesus’ parable of the pharisee and the tax collector.

      As I wrote above, if I ever find myself in such straits that I must view the abject misery and degradation of another person in order to feel good about myself, I will have become a more broken-down soul than I ever wish to be. For my part, I am grateful that no camera is trained on me in my own worst moments, which are appalling enough and sadly frequent enough that I know all too well how human beings can fail themselves.

      • The big moral qualm that I have about the show is informed consent. I’ve watched about 5 episodes, and a lot of the time, the characters participate because they’re about to be evicted, or lose custody of their kids, or something truly dire. I can’t imagine being in a situation where I had to choose between the public humiliation of being profiled as a hoarder on TLC vs. losing my kids or becoming homeless. Of course, the counter-argument is that it’s better to give people the option of getting help rather than simply leaving them alone to face their horrible fates.

  5. “Perhaps I caught a particularly horrifying installment, featuring especially miserable people”

    nah, that’s pretty much their thing on that show.

    they do get folks cleaned out, in touch with therapists, etc, but whether it does any actual lasting good, i dunno. maybe it provides a shock to those viewers who are borderline hoardsy in their habits?

    i do know that intervention (the show) has been a boon to inpatient and outpatient drug treatment centers – i wouldn’t be terribly surprised if the junk hauling and organizational therapist types saw a similar dramatic bump.

  6. I’ve caught parts of a few episodes here and there. I will say that the episodes involving animals are uniquely horrifying, because the harm caused by the individual’s pathology is transplanted to other living creatures.

    Part of the reason I’ve seen any of it (and part of the reason I haven’t seen more) is because Zazzy struggles with her own inability to declutter her life. She is not even close to the people on the show, but I know she worries sometimes that she might be headed down that road which led to a personal interest in the show. Realizing that she did not compare to the individuals ended this motivation and the intense sadness she felt watching it (in part motivated by the extent to which she could identify with the participants) made it a show we simply don’t have on any more.

    Compared to other voyeuristic reality shows, I think it is one of the’ better’ ones. I don’t get the sense that the producers are out to humiliate their subjects, a la “Honey Boo Boo”. I do get the sense that they do intend to help them AND to inform the viewers who might be struggling with their own pathology or (more likely) know someone who is suffering in silence. The extent to which the show makes anyone say, “Oh my! That reminds me of me/Uncle Bob/my sister,” is a good thing. Whether that makes it on the whole a positive good is something I can’t answer. But I don’t think it is wholly horrible, like “The Jersey Shore”; there is something worth redeeming there from an education standpoint.

    I do think our willingness to create shows like this and the Dr. Drew shows about rehab or even “Catfish” but not similar shows dealing with physical ailments tells us all we need to know about the different ways we view physical illness and mental illness. The TLC shows on little people might be the lone shows I can think of dealing with folks who are atypical physically, but even that shows the difference in how we perceive little people and the like.

    • I will grant that I did get a sense that the people directly involved in interacting with the people on the show seemed sincerely interested in trying to help them, and I’m willing to grant that there may be a sincere desire on the part of the producers to make people’s lives better. And maybe the only way to get the resources necessary to help people is to have viewers tag along.

      I will certainly grant that the show is much better, in its way, than the vast majority of so-called “reality” television, which comprises little more than a showcase for utterly awful people to behave in as outlandishly awful a way possible, all for their own greater fame and income.

      But man, what an absolutely unpleasant show to watch.

      • Yes. Indeed. I see a show like that as more of a documentary series featuring the realities of a very unpleasant way to live. So often, we choose to ignore or marginalize the unpleasant aspects of life. None of us are hoarders so why should we be burdened by all their unpleasantness? Well, because there are people who are hoarders out there, whose lives are unpleasant because of their struggles with their disease, a disease we are woefully ignorant of or even actively hostile towards. I assume the unpleasantness is deliberate, to avoid sugar coating what is a very real and very difficult disease.

        Of course, we have not yet reached the stage where any television is mandated viewing. If it is too unpleasant to watch, simply click it off, as we have done in our household (and it sounds as if you have made the same choice).

        I’m more curious about the folks who DO find the show pleasurable to watch in some morbid way.

  7. Why are people filming deeply sick and miserable human beings such as these? Would we tune in to watch the painful final days of a patient riddled with cancer?

    I’m convinced that there would be an audience to watch such things, if there were terminal patients willing to sign on to be filmed, for the reasons Burt laid out so well in his post. There seems to no longer be a line drawn regarding what aspects of their personal lives some people are willing to have aired on TV. There also doesn’t seem to be a line regarding others’ willingness to see people abase themselves. Part of this may well be human nature combined with the technology capable of bringing us into other people’s private lives.

    I have seen a few episodes of the program, and what you describe is pretty par for the course. It’s sad and I’m not sure how much they’re helping these people by filming them.

    • I’m not sure I could stand to be part of a television show, if I had a terminal illness.

      I could be part of a documentary, though.

  8. I think Burt is largely spot-on.

    These shows (along with other reality TV shows) are the 21st century equivalent of the old carnival freak show. It seems like every culture and age needs to have their own version of both the freak show and gladatorial combat. For the freak show, we have reality TV shows like Hoarders. For Gladatorial combat, we have football and MMA.

    Also people are inherently curious about subcultures and different lives but we want to explore them safely and at a distance. Reality TV allows us to do this. So do things like Dan Savage’s Savage Love Podcast, blogs, reedit AMAs (especially for people in taboo occupations or pasts), etc.

  9. Burt may be correct about why some people watch the show, but there are other motivations. I definitely have a tendency toward hoarding, and I have been close to people who really were/are hoarders. When I watched Hoarders (only about 3 or 4 times, about 3 years ago), I felt the “at least I’m not that bad” response approximately as often as the “that really reminds me of my desk” response. There was a similar show I saw more of on BBC America called “Clean My House,” that I liked better, because it wasn’t quite as bleak. You always saw a beautifully clean and decorated house at the end of each episode, and it made me want to clean things (which is not a natural impulse in my psyche).

    When a person is really far gone into hoarding, it can often seem to them and their loved ones that there’s no way back to normal. By bringing professionals with resources to bear to the problem, and by demonstrating that yes, there is always a way back to at least a physical normal, the show teaches viewers not to give up too easily.

  10. I am convinced that within the next ten years there will be a cable reality show that features updated gladiatorial combats where one of the participants dies or is badly hurt on camera every week. Viewers are being desensitized to outrageous spectacles, and the time is fast approaching when only weekly displays of blood and gore will do. (See also: decline and fall of the roman empire)

      • In fact, the gladiatorial games were vital to the cohesion of the empire. They demonstrated the equality of men of all races and creeds by showing that deep down they were made of the same stuff.

        • By the time of the empire’s decline, though, most people only watched for the commercials.

        • They demonstrated the equality of men of all races and creeds by showing that deep down they were made of the same stuff.

          One large intestine is, indeed, very like another.

          • Pointy-headed boss: Why do you programmers use so many colons?
            Dilbert: They remind us of you.

  11. From the title, (and the fact that someone mentioned it at work today as a parallel to ‘lessons learned’ processes), I thought this post was going to be about this new TV show

    • Having now read that review, I will add “Monday Mornings” to my list of shows to skip. Which is a shame, since I actually found its premise promising.

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