NEW BRUNSWICK —It's 9 a.m. on a Tuesday morning at Robert Wood Johnson University Hospital and 10 medical students sit around a conference table covered by coffee cups and clipboards.
Preparing to start their morning rounds, the students chat about what they watched on television the night before.
“Jerry’s girlfriend doesn’t like George,” third-year student Marlene Wang says, referring to the iconic 1990s sitcom "Seinfeld." “And he just couldn’t live with the idea of this person not liking him.”
This isn’t a discussion about nothing. More than 15 years after the final episode, "Seinfeld" is the basis for “Psy-feld,” a teaching tool designed to help medical students identify and discuss psychiatric disorders.
Every Monday and Thursday, third- and fourth-year medical students in the hospital’s psychiatric rotation are assigned to watch the 6 p.m. episode of "Seinfeld" on TBS. They begin rounds the following morning by discussing what psychopathology was demonstrated on the episode.
Wang says George demonstrates signs of narcissism as he neglects his own girlfriend to focus on Jerry’s. But fellow third-year student Ryan Townsend isn’t convinced.
“I wouldn’t say he is completely narcissistic because he actually starts to enjoy the idea that she doesn’t like him,” Townsend says from the other end of the table. “Narcissists can’t stand the idea that people don’t like them.”
The discussion is exactly what Anthony Tobia said he had in mind when he created what he calls Psy-feld in 2009. Although not a course, it is required part of the training Tobia provides.
"You have a very diverse group of personality traits that are maladaptive on the individual level," said Tobia, an associate professor of psychiatry at Rutgers-Robert Wood Johnson Medical School. "When you get these friends together the dynamic is such that it literally creates a plot: Jerry's obsessive compulsive traits combined with Kramer's schizoid traits, with Elaine's inability to forge meaningful relationships and with George being egocentric."
Database of shows
Yes, for those who remember, there is a "Seinfeld" episode with a subplot about Kramer acting out diseases for medical students. But, no, that’s not where Tobia got the idea for Psy-feld.
The concept stems from a discussion with students about the final episodes of TV shows. That connected "Seinfeld" to an idea a student had for making a teaching tool about the characters in "Lost."
While it’s not unusual for medical school instructors to make reference to a television show or movie, requiring about 150 students a year to watch "Seinfeld" twice a week is, Tobia said.
“You cannot possibly pitch this idea to administration at Robert Wood Johnson Medical School without getting buy in from your chairman, and that’s not easy,” Tobia said. “Which is why most courses will start with what is traditional and allow course directors and teachers to reference film.”
Tobia is so sold on the concept he’s created a database of every "Seinfeld" episode and its teaching points. All 180 episodes and nearly every character in the series can be used for Psy-feld, he said.
For instance, five of Elaine's boyfriends are the topic of an academic paper Tobia penned explaining how the men display core character traits that match the themes of delusional disorder.
Other characters, like Jerry’s foil, Newman, are “very sick,” Tobia said.
“Newman’s sense of self, his meaning in life, is to ensure that he frustrates Jerry,” Tobia said. “We actually have talked about Newman in that context and related him to Erik in 'The Phantom of the Opera.' The Phantom, while he starts out as being the tutor to the Prima Donna, actually has his life change and he is bent on revenge and that becomes who he is… and that’s Newman.”
The 'aha' moment
Fourth-year medical student Jason Breig struggled at first to see past the show’s humor.
Elaine’s difficulties with men seemed like bad luck, and George was just funny, he said. But after a few episodes, he said he began watching with a different perspective.
"You start watching and you're like, 'What is going on with George?' Breig said.
Wang, who identified George’s egocentrism, said watching "Seinfeld" gives her more practical and relatable examples than any textbook could.
“In this way, it just gives you a more solid picture of the pathology rather than just giving you words,” Wang said.
The hope is that students have an “aha” moment, the kind that doesn’t come from a PowerPoint presentation, said Tom Draschil, one of the psychiatric department’s chief residents.
Nothing in medicine can fully be learned without experiencing it real life, Draschil said. But watching it on television helps, and the funnier a program is, the more teaching points it has for psychiatry, he added.
Tobia uses a similar approach in a monthly elective for medical students. In a lecture hall, students watch a full-length film, like "Fargo," and live-tweet their thoughts about characters' potential disorders at the bottom of the screen.
He’s also pitching a course that would involve real-time Twitter discussion as students watch TV’s most can’t-miss shows live in their own home.
“In order for a surgeon to teach from a movie or TV show, there has to be surgery,” Tobia said. “In order for an internist to teach from a movie or TV show, there has to be the portrayal of an illness. Well, every movie, every TV show has human behavior, so a psychiatrist should be able to teach.”
Adam Clark may be reached at adam_clark@njadvancemedia.com. Follow him on twitter at @realAdamClark. Find NJ.com on Facebook.