I'm a sucker for doctor-related shows, but I'm usually severely turned off by the ones which start diving into soap-opera territory or are used to probe the lives of filthy rich doctors and the many women they sleep with and the many things they drink and their big houses. There were a few shows which started to break with that trend early on in this decade, most notably House, which showcases doctors performing medicine as opposed to a show all about the doctors and not about the patients. That may have changed, but my point remains that it was the original premise of the show.
Royal Pains is a sort of hybrid. The plot revolves around a doctor, Hank Lawson, who, after performing emergency heart surgery on a wealthy donor to the hospital who dies due to complications, is fired from the hospital after he checks upon another patient who was crashing fast due to a heart attack. Despite the fact that Lawson probably did the right thing, and the man's death was likely not his fault, under financial pressure and legal threats from the family of the dead man, the hospital uses him as a scapegoat. Having been blackballed from essentially ever performing emergency medicine in a hospital again, his life descends into chaos, his fiancée leaves him, and he loses pretty much all of his possessions. His brother Evan picks him up for a weekend of partying in the Hamptons - yes, THE Hamptons - and end up inside of a party where Hank performs an emergency procedure to save a person's life.
I'm willing to accept the implausibility of the whole situation, that a guy who has just lost his job and all of his assets liquidated, would go and party in a rich neighborhood for a weekend. For now. With that out of the way, he goes back to his motel, and gets a call from someone else who got into a car crash with his girlfriend. He performs another emergency procedure that saves his life, and word travels even faster when another woman calls upon him to... do a boob job.
Two minor characters are introduced here. Divya, a young Indian woman, believes Hank is trying to set up in the Hamptons as a "concierge doctor", a traveling physician who goes to the patients' houses and gets paid directly for his services. Hank is initially disgusted by the idea and believes it's reminiscent of a system where the rich treat doctors like servants (despite the considerable profit). The other is Jill, the hospital administrator to whom Hank develops a certain attraction, who believes that his actions which got him fired were kind and that he could have done nothing to help.
In this sense, the show seems to revolve a great deal around Hank's personal life as much as it does around the medicine. The show isn't immune to breaking the fourth wall, either, as Hank makes quips about learning emergency techniques from Macgyver and remarks that he "saw something on House". He remains a fairly likable character throughout, with a disdain for the over-opulent lifestyles of the filthy rich. When confronting the kid who was driving in the car crash, he is appalled to hear that the kid would rather just buy a new car for his dad (this car being a rare, million dollar commodity) than go and get it fixed. Instead of the rich and handsome doctor, you have the... well, still handsome doctor who values his ethics over money.
That being said, the show isn't without its flaws, since I find the medicine to be unreliable in its depiction, and the Hamptons are rather caricatured - only about 15 percent of its residents are of the filthy rich type and the rest are anything from boaters to fishermen to commuters who work in New York City. As long as the show doesn't devolve into trying to flaunt too much of the lifestyles of the rich I think it'll be successful.
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