Friday, February 18, 2011

I categorically refuse to watch medical shows on television. Here's why.

Thanks to Karyn Traphagen who posted a link to the Grey’s Anatomy episode in which a surgeon tweeted while operating. Having just watched the 8 minute clip, my reservations about medical television shows are reinforced.[Updated on 1/31/13: I'm sorry to say the video has been taken down. Maybe it's available on Hulu.]

A surgeon is doing a Toupe procedure, an operation to prevent esophageal reflux, and [I guess] damages the colon and pancreas. A medical student is tweeting the progress of the surgery and taking questions from surgeons all over the country. The chief of surgery finds out about this because students who are ostensibly watching a case he is doing are following the tweeting case on their phones. During the surgery, the Twitter surgeon takes a break to have a milkshake and runs into the chief of surgery in the cafeteria. He tells her to stop tweeting during the procedure because he is worried about the medicolegal ramifications. She goes back to the OR and finds a leaking pseudoaneurysm of the splenic artery which necessitates a total pancreatectomy. She disobeys the order not to tweet and gets a number of helpful suggestions and insightful questions from the Twitterverse of surgeons. She realizes that removal of the entire pancreas will create a diabetes problem. To address that, she helicopters over to Tacoma Methodist to pick up the equipment to extract islet cells from the removed pancreas for injection into the portal vein. The chief of surgery receives a shout-out from a former resident via Twitter and is now converted to an avid Twitter supporter.

How the audience of Twitter surgeons found out that this case was ongoing was not stated.
I have never in my 40 years of surgery seen a surgeon take a milkshake break during a case.
Disobeying the chief of surgery’s orders is a good way to see what the job market is like.
In the world of fantasy which is television, there are surgeons at Mayo Clinic, Johns Hopkins and Emory who apparently have nothing else to do that day and are glued to their computers/smartphones breathlessly anticipating every twist and turn of the procedure.
Total pancreatectomy is rarely indicated even for gunshot wounds. She must have really screwed up the surgery to end up needing to do that.
It is not clear how the staff at Seattle Grace [the hospital of Grey’s Anatomy] is to be inserviced on islet cell extraction and transplantation.
Oh by the way, is there going to be a morbidity and mortality conference to discuss the colon and pancreas injuries during a simple procedure for esophageal reflux?

Other than those few issues, the episode was pretty realistic.

20 comments:

ktraphagen said...

I have to watch it again, but I thought it was two different surgeries. I did not think she returned to the same surgery. Thanks for your comments! Interesting to hear your perspective.

Skeptical Scalpel said...

It could have been two different cases but the clip didn't make it seem that way. Still, most of what I said is true.

Anonymous said...

Doc, did you also know that "House" is an idiot?! See, I'm saving you from all sorts of stress.

-SCRN

Skeptical Scalpel said...

Thanks, but I've seen 5 minutes of "House" so I already knew that. I think he may be the worst. It's always an autoimmune disease and it always takes only 45 minutes to arrive at even the most exotic diagnosis.

Mrs. Legris said...

Some student told my husband the most realistic medical show on the tube was Scrubs.....hum

Skeptical Scalpel said...

I've never seen "Scrubs." Maybe I'll take a look at it. It might make good fodder for another blog post.

I stopped watching medical TV shows many years ago when on the show "ER" an ED MD called up to maternity for forceps to deliver a baby and then cracked another patient's chest on the same show.

Mrs. Legris said...

It's actually really funny to watch my husband now watch those shows. He is only in his first year of medical school but he already laughs or comments on what's happening or said :)

Skeptical Scalpel said...

Based on your comment, I tried to sit through an episode of "Scrubs." Couldn't do it. It is unwatchable from both a medical and an artistic standpoint. The doctors are portrayed as fools. The episode I tried to watch depicted the black chief of surgery as a buffoon. It offended me and I am not black. BTW, the black female surgeon in the Grey's Anatomy clip was also an offensive stereotype. She spoke "ghetto" and had quite an edge.

Unknown said...

Me thinks Scrubs is to Medicine what MASH was to war

Anonymous said...

I'm only a medical assisting student and I see errors on House (the only medical show I watch), the most obvious being he uses his cane on the incorrect side of his body. I like the show even though it is often ridiculous fantasy, I just like Hugh Laurie. I do recognize much more of what they are talking about now that I've studied a of diseases and anatomy, but I'm sure a lot of is is bs!

EmD28 said...

I remember I almost cried watching that episode. I think the worst medical TV show is "House". Did you know that House's team (who are internists) perform all sorts of surgeries as well?

Skeptical Scalpel said...

Thanks for the three new comments. I didn't know that House's team of internists perform surgery. I think many internists think they could because they assume it's easy. A commenter on another post of mine said surgeons don't have to think when they're in the OR.

Unknown said...

I used to watch House but the "I am an ass but a brilliant one" thing got old.

Michael Katz said...

Respectfully, I think you should give House MD another try.

The most important step is to embrace "willing suspension of disbelief" and simply accept that the medicine practiced by House and his Department of Diagnostic Medicine is the least important part of the show.

Personally, I consider House MD to be an example of art trying to imitate life. It is an extreme satire of the state of American medicine.

American's want their health care like they want their TVs: high-tech, high-cost, and OnDemand. The kind of medicine practiced at Princeton-Plainsboro is a parody of this, with rapid-fire procedures conducted without any basis in evidence by a self-absorbed, arrogant team of drug-abusing physicians in a ratio of 6 MDs to each patient.

Interestingly, the patients don't escape criticism either... usually they're depicted as selfish and entitled to the kind of health care described above. They always lie or withhold essential details regarding sex, drugs, or money. (House says, "patients always lie" and this is the reason his team is usually dispatched to the patient's home to gather more collateral information.)

I mean, common, doesn't that sound like must-see TV?

Pam said...

I haven't seen House lately but in the first few seasons, the only person on his team to perform surgery was a surgeon. See: http://en.wikipedia.org/wiki/Robert_Chase

As to the '45 minutes' issue, the show itself is 45 minutes but frequently spans many days or even weeks.

I agree with Michael Katz, it's a very entertaining show.

Skeptical Scalpel said...

Thanks for the comments, Unknown, Michael and Pam.

I forgot to mention that I haven't watched a sitcom of any kind since MASH. (Google it.) I identified with Hawkeye. I will consider giving House a chance, but it's unlikely I'll watch it. But Scrubs, no way.

Anonymous said...

Once on Grey's Bailey was doing a procedure but the family kept staring in the huge window so she took a blue towel over so she could press a button to talk to the family, then when she was done she threw the blue towel on the mayo! I was laughing on that one!

Skeptical Scalpel said...

That's a good catch. One wonders why they don't hire doctors to at least make sure they avoid obvious mistakes like that.

Anonymous said...

MASH was the best. We still do surgery like that here in the third world ;)

Skeptical Scalpel said...

That was a great movie and a decent TV show.

Post a Comment