the gaping absence left by collins and now samira's impending absence has been well litigated within fandom discourse at this point, but i would like to return to the first season, where i felt the narrative's treatment of samira's ''slow-mo'' approach was at its most effective.
it is clear even from the show's initial scenes that robby is incessantly met with the terms by which the ER's care is appraised, namely, a regime in which the dehumanisation of patients into metrics is conjoined with a concurrent burdening of staff of high patient satisfaction amid conditions of systemic overcrowding and chronic underfunding. robby continuously stresses the contradictions inherent in such expectations and resists them in his own fashion, though he has internalised certain aspects of its logic in order to endure within the system. we observe, in turn, the externalising of these very logics of a broken apparatus onto residents such as samira.
having previously suffered the consequences of this reifying system in relation to her father's misdiagnosis and passing, samira acts in direct opposition to it through her sustained humanisation of patients, a practice also informed by her study of racial disparities. this is most clearly evidenced in her treatment of joyce st. claire, a black woman in the throes of a sickle cell crisis who was assaulted and subsequently dismissed as a drug-seeker upon seeking aid. samira's approach to joyce centres upon a restoration of comfort and safety in the wake of that assault, affirming both the reality of her pain and the injustice of her mistreatment, while cultivating rapport and trust through reference to her studies and to her father's passing. she explicitly draws upon her work on racial disparity to attend to the aspects most excluded from the care of black women within medical practice. alongside correcting whitaker's initial minimisation of her pain severity, by any humane measure samira's care would warrant commendation for its depth and attentiveness. however, once robby becomes aware of the extent of time samira is devoting to joyce's case, she is subjected to reprimand, as within a resource-depleted system that privileges metrics, each moment samira spends humanising joyce is a moment another patient is left unattended.
a line i find particularly germane here is robby's insistance that samira conduct herself not as a ''friend'' to joyce, but as a ''doctor'', for the division between such designations encapsulates the very principles samira, and in a more conflicted manner, robby as well, seek to resist. robby is attempting to enforce a framework of detached concern, wherein one neither lapses into total dispassion nor succumbs to a corrosive empathy. yet the structures within which they are forced to operate do not permit a salutary apportioning of empathy, and such approaches therefore tend to lean toward one extreme or the other. the consequence is a devaluation of the forms of care that are often indispensable to those disproportionately subject to abuse, such as black women. within a system already replete with those such as whitaker, or others whose ill-informed assumptions regarding black people's biology precipitate mistreatment, the reprimanding of figures like samira only serves to deepen the disparity. moreover, there is a note of trivialisation in construing samira's conduct as an attempt to be a friend of joyce; what might be mistakenly dismissed as a luxury of care often proves a diagnostic necessity and should be better understood as an effort to meet disproportionate harm with a commensurate measure of attentiveness. the cultivation of trust also increases the likelihood of securing an accurate patient history, as well as a willingness to consent to invasive procedures such as intubation without incurring the risk of further traumatisation. as such, robby's characterisation of samira's care as existing beyond the parameters of medicine mirrors the real-world undermining, and subsequent denial of funding, afforded to such frameworks. and the insistence that samira conform to a narrowly prescribed, often unattainable division of empathy sustains the logic that any ensuing burnout is to be read as a failure of individual discipline, rather than as a symptom of a perpetually failing structure.
the counter to robby's argument is offered in the form of collins; later in the same episode, samira is apologetic for the length of time she had devoted to joyce, but colins interrupts noting that her standard of care is ''what this is all about''. the phrasing is especially significant, as it fundamentally rejects robby's division between ''friend'' and doctor''. collin's ''this'' instead seeks to define the medical apparatus through the moments of connection and safety samira cultivates. the creation of conditions under which a marginalised patient feels secure enough to offer consent carries just as much, if not greater, value than the routinely coercive mechanisms through which consent is extracted from black women in clinical settings, even if both ultimately amount to ink on paper. the indeterminacy of the word ''this'' further anchors the concept in that which denies quantification, and thus evades corruption, while simultaneously reworking prevailing notions of efficiency. where a figure such as gloria might construe efficiency as the rapid turnover of patients, samira reorients it toward a thorough treatment of a single patient, whereby the cycle of a frequent flyer engendered by the former model might be averted. that collins is positioned as the one to articulate this principle grounds its legitimacy in the recognition of a specific, often unacknowledged labour required to care adequately for a patient such as joyce. navigating the institution of healthcare as both a black doctor and a patient, collins is uniquely equipped to recognise the necessity of samira's approach. additionally, it is all the more imperetive that she refuse robby's definition of the doctor, insofar as his metric frequently depends upon the delegitimisation of patients such as herself.
the framing of both scenes aids in this reorienting of perspective. when robby seeks to define the role of the doctor as something divorced from samira's mode of care, he is positioned as the dominant focus of the shot, while samira remains visible yet withheld from focal primacy. this visual arrangement underscores robby, and the white male dimension of medicine as the dominant and defining institutional identity, while those such as samira, though present within the system, are frequently obscured and effaced. the shot is also composed over samira's shoulder, further defining the asymmetry of power between the two. the absence of joyce from the shot is likewise telling; while it is standard practice to conduct such discussions beyond the patient's presence, her visual omission reflects the dehuminisation inherent to the ''slow-mo'' condlict, wherein joyce remains the subject of discourse yet is reduced to an object of concern. however, in the exchange between collins and samira, the camera adopts a similar over-the-shoulder angle, yet frames them at equal height, thereby introducing a compositional parity suggesting a mentorship marked by power asymmetry but aligned in values. and while joyce remains absent in this scene as well, the visual focal point is afforded to collins, a black woman, as the arbiter of the role of the doctor, and in this way joyce is afforded a form of ''presence'' through her framework.
“everything I’ve done in my career is an effort to improve the system. just because you know it’s broken doesn’t mean you stop trying.”
this is a sentiment shared by baran al-hashimi during the second season, and one i find mirrored in the earlier exchange between collins and samira. samira recognised the institution of medicine as replete with disparities in the provision of adequate care, and utilised that recognition in order to study and effect change within her own practice. she likewise acknowledged the incentive structures favouring expedited workflows, yet remained committed to her ''slow-mo'' approach. establishing a prior history between baran and samira within the VA further reinforces the notion that samira did not cultivate her methodology in isolation; she benefited from mentorship grounded in the belief that one may operate within a dehumanising structure while still resisting its most pernicious impulses. the presence of such a figure, who both holds these values and stands as a peer to robby, holds the promise of durability for the kind of unorthodox care samira champions, and yet it is within this very season that my and many others' grievances with samira's narrative begin.
already having removed one of the few people willing to explicitly affirm the value of samira's work, the narrative introduces her early on as having made plans to depart for jersey with the intention of supporting her mother, though his plan is made redundant by her mother's cruise. in this respect, samira's prospective estrangement from the pitt mirrors robby's own, wherein his proposed sabbatical is repeatedly deferred or placed in jeopardy. however, samira remains amenable to a fellowship, and we learn that the funding for her research into racial disparities has since been withdrawn. while samira's drift away from the pitt can be understood as a familiar byproduct of the system within which she operates, beyond that register of realism, i find myself questioning the narrative impetus behind her removal, particularly in the wake of collins.
supriya ganesh has noted in an interview that samira accrued a great degree of confidence over the course of the first season, only for this to be ''chipped away'' by the close of the second, a trajectory which presumably culminates in her departure. the presence of a character who operates according to a logic distinct from the metricts and commodification of medicine, who encounters impediments yet ultimately comes to understand the value of her position within the system, constituted a satisfying narrative arc. that the subsequent season should instead depict an erosion of this position, until her eventual exit, proves less as an organic development than as the successful excision of an outlier by an oppressive apparatus. even if samira is not expelled from the practice of medicine altogether, she is nonetheless divorced from the specific institutional context in which patients such as joyce, and doctors such as collins, found such demonstrable value.
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