This article examines contemporary American medical television dramas and their intersections with 19th century literary realism asking how technical language and sentimental speech are connected in these cultural representations of illness and medical discourse. I argue that they share a common effort of medical realism: Questions of medical knowledge, diagnosis and the delimitations of the normal and the pathological not only inform the thematic content of these genres, but also mark the narrative techniques of description, characterization and imagery. Because the rational professionalism, since the founding of modern medical science, carries with it a specific truth privilege, it presents itself not only as the possibility for medical treatment, but also as an answer to our existential troubles. I consider this double authority of medical practice and social therapy a model for the medical realism at play in modern hospital dramas. They borrow the scientific authority of medicine in order to present characters who are first and foremost bodies and who are therefore potentially pathological. Furthermore they borrow the interpretive authority of medicine to develop a diagnostics, which can determine the normal and the pathological on a social scale.