But Pirraglia and other doctors say what makes Scrubs resonate isn't the specific scenarios so much as the broader themes. The show tracks the tensions between surgical and internal medicine residents—the jocks vs. the chess club, as J.D. puts it in the pilot. It captures the allure of private practice—in Season 6, Elliot takes that route and enjoys the fruits of an inflated salary. It explores the risks and rewards of intra-hospital romance, through the on-again, off-again relationship between Elliot and J.D.—which is currently quite on. It dramatizes the ways hospitals struggle to allocate resources—Dr. Kelso, Sacred Heart's chief of medicine, has more than once ordered a patient without insurance to go untreated. And it pokes fun at the way residents jockey to get plum assignments—in one episode, residents race down a hallway like Pamplona bulls for the right to treat a member of the hospital board, trampling one another and several patients in the process.
Even these fantasy sequences can be seen as an element of the show's verisimilitude, suggesting a sort of survival tactic, a way to endure the grueling rhythms of life on 36-hour shifts. Scrubs captures the agony of hunger and fatigue those shifts force doctors to endure, says Dr. Svetlana Krasnokutsky, another attending rheumatologist at NYU and Samuels' fiancee. (Hospital romance does happen in real life; there's hope for J.D. and Elliot yet.) She recalls watching a Scrubs doctor eat food off a comatose patient's tray. Krasnokutsky says she's never gone that far, but she's thought about it.
Krasnokutsky says she, too, identifies with J.D.'s constant self-reflection and self-doubt. In the pilot, J.D. declares, "I don't know jack," and the show in many ways has been an ongoing exposition of that point. Residents often feel like they know nothing, Pirraglia says, yet they're suddenly invested with huge amounts of responsibility, expected to give orders to much-more-experienced nurses, required to make quick decisions with life-or-death consequences.
"Being a resident is a strange place between officially being a doctor, which you are, but also really not knowing it all," he says. "You get this level of authority that you don't think you deserve. All of a sudden you're the doctor and people are going to listen to you."
What helps—and also comes through on Scrubs, he says—is the support of fellow doctors. A seminal moment in his own residency came when he was called to a patient with a serious gastrointestinal bleed. Blood poured over the table. Time was running out. And suddenly, the room was filled with fellow residents, offering unsolicited help. Over and over again, even when they're mired in hospital politics or a relationship squabble, Elliot and J.D. do the same for each other. In the Season 4 episode "My Office," they snipe at each other relentlessly after being named co-chief residents. But when a patient codes, they work together without a second thought. "The best thing about this place," J.D. says in his voice-over, "is that when somebody's really in trouble, all the pettiness melts away."
Despite the dogged efforts of the medical staff, however, the patients on the show sometimes die anyway—sometimes because the Scrubs doctors have made fatal mistakes. Scrubs isn't a procedural built around dramatic recoveries, and many of the episodes, as goofy as they are, end on notes that are wistful or just plain sad. "You never promise a patient they're gonna be fine," the abrasive Dr. Cox growls to J.D. in the Season 4 episode "My Best Moment." "God hates doctors. He truly does. …"
That case had a happy outcome—it was a Christmas episode, after all. Unflinching as it often is, Scrubs also maintains an unabashedly sentimental perspective on medicine. That could well be something else that doctors love about the show and a reason Lawrence is asked to speak at medical school graduations. J.D and his colleagues may be by turns blustery and mired in secret self-doubt, but they're also uniformly human and well-meaning; even the supposedly hard-hearted, penny-pinching Dr. Kelso has turned out to be a softie in the end. God might hate doctors, but Scrubs loves them, and the feeling is mutual.