Based on a novel inspired by true events, the setup of Bad Medicine is this: in an unnamed country “somewhere in Central America,” Dr. Ramón Madera (Alan Arkin) has established an underfunded medical school that will accept virtually anybody and somehow provides degrees that are good in the United States. Among the Spanish students are a handful of Americans who couldn’t get into any U.S. medical schools. It’s a combination of fish-out-of-water comedy and political satire, but more than that, it’s about how medical school is difficult even when you go to a bad one.

Hilariously self-asborbed, Madera runs the school like a dictatorship, concerned more with meting out harsh punishments and garnering positive publicity than providing a decent education. He rides around campus in a limousine bearing the school flag. Humorless goons (Joe Grifasi and Gilbert Gottfried) issue demerits for wearing “loud” (tan) pants and white shoes. They mark students absent for sitting in the wrong seats. Students have to wait in long lines for a five-minute anatomy session working on the school’s only available cadaver (which has been in use since the school opened five years ago). Classes are taught entirely in Spanish, despite the segment of the student body who doesn’t speak the language. They live in roach-infested hovels, and according to the only American sophomore (Julie Kavner), very few foreigners survive their first year. It’s unclear if this is a result of stress or death.

The story finds its anchor in Jeff Marx (Steve Guttenberg), the black-sheep son of a family of frowning physicians. He’s smart but unmotivated, and he doesn’t have the grades to get into medical school. His insistent father (Bill Macy) registers him at Madera Universidad de Medicina (M.U.M., one of the subtler references to Madera’s hilarious mother issues). Although he has the brains for it, Jeff doesn’t know that he wants to be a doctor. At one point, he gripes that he never had a choice — he asked for a firetruck for Christmas, and his parents bought him an ambulance. This has always been his path, whether he wanted it or not. One of the nice things about Bad Medicine is watching Jeff find a sense of purpose as he starts to embrace medicine.

Jeff quickly meets Liz Parker (Julie Hagerty), a nurse back in the U.S., and they form a social group with the other Americans: Dennis (Curtis Armstrong), a wealthy Southerner obsessed with psychopharmacology; Cookie (Kavner), the seasoned veteran; and Carlos (Robert Romanus), a Puerto Rican New Yorker trying to pass for a native to get a tuition discount. The characters go from a disparate, disjointed group to a cohesive medical team over the course of the film, despite the dubious nature of their studies.

You see, as a PR stunt, Madera assigns them to go to a nearby village where nobody has ever seen a doctor, but he’s too cheap to send them with medicine. When Jeff gets shot in the leg by an irate and confused villager, Madera cancels the program. However, the villagers are in desperate need of medical care. The students realize it means more to them to help the villagers than to remain at Madera, so they forge pharmacy requests and open a clinic in the village. Quickly, the students all realize how desperately they want to learn in order to help those who need it, but they have to resort to stunts like bribing a morgue attendant to get a fresh cadaver for their anatomy studies. (They keep it on ice in Dennis’s bathtub.)

Meanwhile, Madera has become smitten with Liz, who agrees to go out with him in order to cover up their clinic. Madera is the source of the film’s most offbeat comedic moments. Typically, writer/director Harvey Miller mines comedy from the characters and their struggles to self-educate in less-than-desirable conditions, as well as the culture-clash antics of confused Americans adjusting to Central American life. Although Madera’s comedic beats come directly from the characters, he’s quite bizarre, the sort of man who thinks a statement like, “God sent me to you in order to spawn,” is the height of romance. A huge, tacky painting of his elderly mother hangs on one wall of his office; an elaborate gun collection adorns another. Despite the way he runs the school, his heart really is in the right place: He wanted to create a medical school where nobody suffers the discrimination he did while interning at his alma mater, UCLA. Ultimately, that all roots back to his self-absorption and inferiority complex, but even a broken clock is right twice a day. As played by Arkin (in one of his most underrated, criminally forgotten roles), Madera goes from a one-note stereotype to a fully-formed human, a walking contradiction whose ambition is frequently hampered by his ignorance and short temper.

Aside from having deceptively strong, believable characters played by a cast of ringers, Bad Medicine finds another major strength in its portrayal of medical school. Obviously, things at M.U.M. are patently absurd, but Miller gets the finer details right: A small group of students spending the majority of their time together, developing trust and deeper relationships than is typically portrayed in raucous “college” movies. Instead of mining conflict from competition among students, it allows them to work together in conflict against the school and the crumbling city of Valencia. It also, amazingly, emphasizes the rewards of education, and the notion that education comes more from experience and self-motivation than quality schools and competent instructors. This is suspiciously complex for a genre that’s usually more interested in keggers. Ironically, it does a better job of tapping into nerdy ideals than the previous year’s much more well-remembered Revenge of the Nerds (a film whose success is probably the reason Bad Medicine exists at all).

If I have one qualm with the movie, it’s that it employs numerous “native” extras who go to M.U.M., but none of them have anything to do with the American group. I understand that the movie focuses on the foreigners trying to make their way through medical school amid cultural confusion, but it’s a tad dispiriting that none of the native students have any interest in giving their own countrymen needed medical attention. I admit, from a dramatic standpoint, it’d make it way too easy for them to have both a translator and an ally familiar with the country’s cultural customs, but it’s a stark omission in an otherwise enjoyable comedy.

I’ve seen Bad Medicine a half-dozen times over the course of 15 years, and it seems to get better with each viewing. The fact that it doesn’t even have a proper DVD release — in an age where DVDs are on the decline — is criminal. Twentieth Century Fox put The Adventures of Ford Fairlane on DVD, but not Bad Medicine? What a world. On the plus side, if you have Showtime, you can TiVo it and have a nicer copy than my fading, fuzzy VHS tape.

D. B. Bates is a freelance script reader and writer.

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