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{{about|the film|the phrase|Primum non nocere}}
{{More citations needed|date=July 2020}}
{{Use mdy dates|date=April 2025}}
{{Use American English|date=January 2025}}
{{Infobox television
| image = ...first do no harm.jpg
| caption = DVD cover
| based_on =
| writer = Ann Beckett
| director = [[Jim Abrahams]]
| starring = {{Plainlist|
* [[Meryl Streep]]
* [[Fred Ward]]
* [[Seth Adkins]]
* [[Allison Janney]]
* [[Margo Martindale]]
* [[Leo Burmester]]
* [[Tom Butler (actor)|Tom Butler]]
}}
| music = [[Hummie Mann]]
| country = United States
| language = English
| executive_producer = {{Plainlist|
* [[Michael Jaffe]]
* Howard Braunstein
* Jim Abrahams
* [[Meryl Streep]]
}}
| producer = Jim Abrahams
| editor = Terry Stokes
| cinematography = Pierre Letarte
| runtime = 94 minutes
| company = {{Plainlist|
* Pebblehut Productions
* Jaffe/Braunstein Films
}}
| budget =
| network = [[American Broadcasting Company|ABC]]
| released = {{Start date|1997|2|16}}
}}
'''''...First Do No Harm''''' is a 1997 American [[drama (film and television)|drama]] [[television film]] produced and directed by [[Jim Abrahams]], written by Ann Beckett, and starring [[Meryl Streep]], [[Fred Ward]], and [[Seth Adkins]]. It is about a boy whose severe [[epilepsy]], unresponsive to [[anticonvulsant|medications]] with terrible side effects, is controlled by the [[ketogenic diet]]. Aspects of the story mirror Abrahams' own experience with his son Charlie.

The film aired on [[American Broadcasting Company|ABC]] on February 16, 1997. Streep's performance was nominated for an [[Primetime Emmy Award for Outstanding Lead Actress in a Limited or Anthology Series or Movie]], a [[Golden Globe Award for Best Actress – Miniseries or Television Film]] and in the [[2nd Golden Satellite Awards|Satellite Award for Best Actress – Miniseries or TV Film]].<ref>{{cite web|title=The 55th Annual Golden Globe Awards (1998)|url=http://www.goldenglobes.com/winners-nominees/1998/all#category-35|publisher=GoldenGlobes.com. [[Hollywood Foreign Press Association]] (HFPA)|access-date=2 May 2015}}</ref> Beckett was nominated for the [[Humanitas Prize]] (90 minute category). Adkins won a [[Young Artist Award]] for his performance.

==Plot==
The film tells a story in the life of a Midwestern family, the Reimullers. Lori is the mother of three children, and the wife of Dave, a truck driver. The family is presented as happy, normal, and comfortable financially: they have just bought a horse and are planning a holiday to Hawaii. Then the youngest son, Robbie, has a sudden unexplained fall at school. A short while later, he has another unprovoked fall while playing with his brother, and is seen having a convulsive seizure. Robbie is taken to the hospital where several procedures are performed: a [[Computed tomography|CT scan]], a [[lumbar puncture]], an [[electroencephalogram]] (EEG) and blood tests. No cause is found but the two falls are regarded as [[seizure|epileptic seizures]] and the child is diagnosed with [[epilepsy]].

Robbie is started on [[phenobarbital]], an old [[anticonvulsant]] drug with well-known side effects including cognitive impairment and behavior problems. The latter causes the child to run berserk through the house, leading to injury. Lori urgently phones the physician to request a change of medication. It is changed to [[phenytoin]] (Dilantin) but the dose of phenobarbital must be tapered slowly, causing frustration. Later, the drug [[carbamazepine]] (Tegretol) is added.

Meanwhile, the Reimullers discover that their [[health insurance]] is invalid and their treatment is transferred from private to county hospital. In an attempt to pay the medical bills, Dave takes on more dangerous truckloads and works long hours. Family tensions reach a head when the children realize the holiday is not going to happen and a [[foreclosure]] notice is posted on the house.

Robbie's epilepsy gets worse, and he develops a serious rash known as [[Stevens–Johnson syndrome]] as a side effect of the medication. He is admitted to the hospital where his padded cot is designed to prevent him escaping. The parents fear he may become a "vegetable" and are losing hope. At one point, Robbie goes into [[status epilepticus]] (a continuous convulsive seizure that must be stopped as a medical emergency). Increasing doses of [[diazepam]] (Valium) are given [[Intravenous therapy|intravenously]] to no effect. Eventually, [[paraldehyde]] is given [[rectum|rectally]]. This drug is described as having possibly fatal side effects and is seen dramatically melting a plastic cup (a glass syringe is required).

The neurologist in charge of Robbie's care, Dr. Melanie Abbasac, has a poor bedside manner and paints a bleak picture. Abbasac wants the Reimullers to consider surgery and start the necessary investigative procedures to see if this is an option. These involve removing the top of the skull and inserting electrodes on the surface of the brain to achieve a more accurate location of any seizure focus than normal scalp EEG electrodes. The Reimullers see surgery as a dangerous last resort and want to know if anything else can be done.

Lori begins to research epilepsy at the library. After many hours, she comes across the [[ketogenic diet]] in a well-regarded textbook on epilepsy. However, their doctor dismisses the diet as having only [[anecdotal evidence]] of its effectiveness. After initially refusing to consider the diet, she appears to relent but sets impossible hurdles in the way: the Reimullers must find a way to transport their son to [[Johns Hopkins Hospital]] in [[Baltimore, Maryland]] with continual medical support—something they cannot afford.

That evening, Lori attempts to abduct her son from the hospital and, despite the risk, flies with him to an appointment she has made with a doctor at Johns Hopkins. However, she is stopped by hospital security at the exit to the hospital. A sympathetic nurse warns Lori that she could lose custody of her son if a court decides she is putting her son's health at risk.

Dave makes contact with an old family friend who once practiced as a physician and is still licensed. This doctor and the sympathetic nurse agree to accompany Lori and Robbie on the trip to Baltimore. During the flight, Robbie has a prolonged convulsive seizure, which causes some concern to the pilot and crew.

When they arrive at Johns Hopkins, it becomes apparent that Lori has deceived her friends as her appointment (for the previous week) was not rescheduled and there are no places on the ketogenic diet program. After much pleading, Dr. Freeman agrees to take Robbie on as an [[outpatient]]. Lori and Robbie stay at a [[convent]] in Baltimore.

The diet is briefly explained by Millicent Kelly, a [[dietitian]] who has helped run the ketogenic diet program since the 1940s. Robbie's seizures begin to improve during the initial [[fasting|fast]] that is used to kick-start the diet. Despite the very high-fat nature of the diet, Robbie accepts the food and rapidly improves. His seizures are eliminated and his mental faculties are restored. The film ends with Robbie riding the family horse at a parade through town. Closing credits claim Robbie continued the diet for a couple of years and has remained seizure- and drug-free ever since.

==Cast==
*[[Meryl Streep]] as Lori Reimuller
*[[Fred Ward]] as Dave Reimuller
*[[Seth Adkins]] as Robbie Reimuller
*[[Allison Janney]] as Dr. Melanie Abbasac
*[[Margo Martindale]] as Marjean
*[[Leo Burmester]] as Bob Purdue
*[[Tom Butler (actor)|Tom Butler]] as Dr. Jim Peterson
*Mairon Bennett as Lynne Reimuller
*[[Michael Yarmush]] as Mark Reimuller
* Millicent Kelly as herself

==See also==
*[[Never event]]
*''[[Primum non nocere]]''

==References==
{{reflist}}

==Further reading==
* {{cite web
| url = http://www.charliefoundation.org/noframes/whoweare/essay.php
| title = Things I Wish They Had Told Us: A Parent's Perspective on Childhood Epilepsy
| access-date = 2008-03-30
| author =Jim Abrahams
| year = 2003
| publisher = The Charlie Foundation
|archive-url = https://web.archive.org/web/20080213122107/http://www.charliefoundation.org/noframes/whoweare/essay.php |archive-date = 2008-02-13}}
* {{cite journal
| url = http://www.hopkinsneuro.org/epilepsy/research.cfm?research=A_Talk_with_John_Freeman.htm
| title = Talk with John Freeman: Tending the Flame
| access-date = 2008-03-30
| volume = 16
| issue = 2
| year = 2003
| author = John Freeman
| journal = Brainwaves
| archive-url= https://web.archive.org/web/20080507111717/http://www.hopkinsneuro.org/epilepsy/research.cfm?research=A_Talk_with_John_Freeman.htm| archive-date= 7 May 2008}}
* {{cite news
| title = Movie First Do No Harm Boosts Popularity of Diet for Epileptic Children
| date = 2000-07-06
| author =Denise Mann
| publisher = WebMD Medical News
}}
* {{cite web
|url = http://www.epilepsyontario.org/client/EO/EOWeb.nsf/web/First+Do+No+Harm+(Movie)
|title = ...first do no harm
|author = Venita Jay
|access-date = 2008-03-30
|date = April 1997
|publisher = Epilepsy Ontario 'Sharing' News
|archive-url = https://web.archive.org/web/20071215081457/http://www.epilepsyontario.org/client/EO/EOWeb.nsf/web/First+Do+No+Harm+(Movie)
|archive-date = 2007-12-15
|url-status = dead
}}
* {{cite news
|url = http://www.charliefoundation.org/articles/usa-today-reports-%E2%80%98miracle%E2%80%99-diet-treat-children-epilepsy%E2%80%93-11999
|title = Recognizing a 'miracle' The high-fat ketogenic diet can ease seizures in epileptic children
|author = Kathleen Fackelmann
|access-date = 2010-07-23
|date = 1999-01-12
|publisher = USA Today
|archive-url = https://web.archive.org/web/20091113115846/http://www.charliefoundation.org/articles/usa-today-reports-%E2%80%98miracle%E2%80%99-diet-treat-children-epilepsy%E2%80%93-11999
|archive-date = 2009-11-13
|url-status = dead
}}
* {{cite journal
|vauthors=Freeman JM, Kossoff EH, Hartman AL | url = http://pediatrics.aappublications.org/cgi/content/full/119/3/535
| title = The ketogenic diet: one decade later
| journal = Pediatrics
|date=March 2007
| volume = 119
| issue = 3
| pages = 535–43
| pmid = 17332207
| doi = 10.1542/peds.2006-2447
| s2cid = 26629499
| url-access = subscription
}}

==External links==
*{{IMDb title|0118526|...First Do No Harm}}

{{Zucker, Abrahams and Zucker}}

{{DEFAULTSORT:First Do No Harm}}
[[Category:1997 television films]]
[[Category:1997 films]]
[[Category:1997 drama films]]
[[Category:1990s American films]]
[[Category:1990s English-language films]]
[[Category:American Broadcasting Company original films]]
[[Category:American drama television films]]
[[Category:American films based on actual events]]
[[Category:Drama films based on actual events]]
[[Category:English-language drama films]]
[[Category:Films about families]]
[[Category:Films directed by Jim Abrahams]]
[[Category:Films scored by Hummie Mann]]
[[Category:Films set in Baltimore]]
[[Category:Johns Hopkins Hospital in fiction]]
[[Category:Low-carbohydrate diets]]
[[Category:Medical-themed films]]
[[Category:Television films based on actual events]]
[[Category:Works about epilepsy]]

...First Do No Harm - Revision history

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