Thursday, January 31, 2013

Why I don’t watch medical TV shows


A new dramatic television show called “Do No Harm” debuted last night on NBC. It is touted as a modern version of Dr. Jekyll and Mr. Hyde. Its surgeon-hero is described in the network’s public relations material as “He’s twice the man you think he is.”

The pilot apparently aired a couple of weeks ago, and NBC posted it on line as a sample of what the series will be like. Against my better judgment, I decided to see what it was all about.

If the opening scene of the pilot is representative of the rest of the episodes, viewers are not only in for some drama, they might get a few laughs too.

In first three minutes, which was all I could take, the following events occurred:

Two doctors were scrubbing for surgery with their masks off.

When they entered the operating room, the masks had magically appeared in their correct positions.

The surgeon, who apparently had never met the patient, asked another doctor what the patient’s problem was.

The other doctor said the patient had a massive brain hemorrhage and had an ICP (intracranial pressure) of 40. Normal is less than 20. The blood pressure was 160/100 and dropping, which is the opposite of what usually occurs; with elevations of ICP, the blood pressure goes up.

The surgeon ordered a unit of blood to be transfused and two more to be typed and cross-matched. Patients don’t bleed out from cerebral aneurysms. They die from brain damage due to the fact that blood fills the closed space of the skull which compresses the brain tissue. They rarely if ever need a transfusion.

The surgeon introduced himself to the patient who expressed concern that he was about to die. Not only was the patient perfectly lucid (an impossibility with an ICP of 40), but there was no sign of the ICP monitor.

After gowning and gloving, the surgeon walked over to a small machine and ran a blood sugar on himself by pressing a button WITH HIS STERILELY GLOVED HAND. It's not clear what would have happened to the patient in the OR if the surgeon's blood sugar had prevented him from starting the case. He did not don a new glove.

During the surgery, which was clipping of a cerebral arterio-venous malformation, the blood pressure falls to alarming low levels, presumably due to bleeding. However, the fake surgical field showed only some dribbling blood. This was about the only realistic part of the entire scene.

There were some tense moments and some sardonic wisecracks but the heroic surgeon managed to get a clip on the vessel just in time. The blood pressure shot up immediately.

All of this happened within the first three minutes of the show. See for yourself here.

As far as I can tell, there was no informed consent discussion and even worse, there was NO “TIME OUT.”

It turns out that the surgeon has 12-hour blackouts or something every night starting at 8:25 which can only be controlled by a powerful new sedative that a colleague gives him. People in administration know about this but still the guy is allowed to operate. There is no mention of who covers for him if a patient has a complication while the doctor is "out."

Here’s what the San Francisco Chronicle had to say: “NBC has had some problems launching new comedies, but at last it has a show guaranteed to have you falling on the floor in hysterics. Unfortunately, ‘Do No Harm’ purports to be a dramatic series.”

And that review doesn’t even mention all of the medical faux pas.

Here are my thoughts from two years ago about Grey’s Anatomy.

Note: This post was updated on February 1, 2013.

21 comments:

Tonja Treece said...

Ugh I watched more than 3 minutes & that was awful! And not just in a medical sense.

Skeptical Scalpel said...

Thanks for affirming my decision to quit after three minutes.

Moose said...

I am always torn between the idea that these shows don't even try to do research or that they do, or maybe even have an adviser, and then throw out anything that is logical for "dramatic license!"

I work with computers. Some of the stupid stuff I've seen on a screen just makes me want to cry.

My favorite example is an episode of NCIS (a show which, in itself, probably makes anyone in law enforcement or military law cry) where a desktop model computer is allegedly being broken into ("hacked") from another location. Now, with few exceptions, me trying to remotely break into a desktop machine, even at a place of business, would be like me trying to drive your car from my living room.

When one person is unable to stop the "break in" via frantic typing, a second person comes to help -- by typing on the same keyboard. I still can't believe not one person thought, "What happens if two people type on the same typewriter?" You don't even need to be a technology expert to see the problem here.

I sometimes wish I could find these writers and smack their heads together.


Anonymous said...

But these shows are the reason why Im now in the medical field ....... Lol no really though.

Skeptical Scalpel said...

Thanks for the comments. I'm told that many cops can't watch police shows on TV either.

Marc said...

And as a retired paramedic/firefighter, I can't watch Chicago Fire, either. The biggest thing that used to get me was that they always were bringing in these patients in cardiac arrest or unresponsive from trauma unintubated . . . and then the surgeons would intubate without really even looking. Yeah, very realistic.

As bad as the portrayal of physicians is on those shows, the portrayal of nurses is even worse - like almost non-existent. Or to be yelled at by the physicians for screwing up. Oh, wait, that is the only realistic part . . ..

Skeptical Scalpel said...

Marc,

Thanks for commenting. The nurses are there for the love interest only. Realism be damned.

Anonymous said...

I saw an episode of the British show "Doc Martin" recently where he got a patient out of DKA with enough insulin to kill an elephant.

My father is an engineer for Sikorsky. He says he has seen several movies where they have dubbed the sound of Sikorsky helicopters with that of a Huey (not Sikorsky-made). The Huey is that "Apocalypse Now"/Vietnam-era helicopter that makes the distinctive "Whoop, whoop, whoop" noise and apparently many directors feel that is what a REAL helicopter ought to sound like. The kicker, of course, is that my dad specifically works in the vibration/acoustics group and has spent and entire career trying to prevent Sikorsky helicopters from going "whoop, whoop, whoop."

Maybe film/TV producers get all bent out of shape by they way they are portrayed in books?

Skeptical Scalpel said...

That information about helicopters is very interesting. Now that you mention it, I have noticed that they all sound like Hueys.

Justin said...

I love the magical surgical masks in TV shows too.

Being a surgery resident and having seen parts of Scrubs and Gray's Anatomy, I get most annoyed that the residents walk into the hospital after the sun is up with coffee in hand, go out everynight and have time to do lots of stuff other than work while in the hospital.

Skeptical Scalpel said...

Justin, I am so disappointed to hear that you don't arrive after the sun is up and don't go out every night. What has happened to surgery residencies? :-)

Anonymous said...

There's another medical show starting tomorrow (Feb 4) called "Monday Mornings" which promises to take the viewers inside the "secret world of M&M conferences". Will be very interested to hear your reaction as to authenticity.

(on TNT at 10pm)

Emily

Skeptical Scalpel said...

I know. There's a 5-minute preview on the TNT website. I've already written a review. The link will be posted in the mid-morning on Monday.

Anonymous said...

Outstanding! Another media outlet painting doctors as serial killers. Just what we need...

Reader's Digest- TEN THINGS YOUR DOCTOR DOESN'T WANT YOU TO KNOW!

and on and on and on...

Skeptical Scalpel said...

The next new show, Monday Mornings, paints us as a bunch of raging a--holes, at least in the 5-minute preview posted on line.

See my review of it here: http://is.gd/59Tt9Y

Ashley said...

Haha I can imagine it would be frustrating for medical professionals to watch med TV shows because they are soooo unrealistic and can adversely impact public opinion of a field. But I can also imagine that these shows would be so much more amusing with the context of why they are so off the mark. That would make a great web series, actually. Two docs on a couch picking out the implausible parts.

Skeptical Scalpel said...

What a great idea for a show. Of course, it will never happen.

artiger said...

Who says it will never happen? Scalpel, you put together this blog. Go on, take the next step up!

I share your disdain for medical shows, but I was pretty entertained by "Scrubs". Although unrealistic, it was quite humorous. Didn't most of us have a senior/chief resident like Dr. Cox at some point?

Skeptical Scalpel said...

artiger,

Thanks for the encouragement. I'll have my agent get right on it. :-) I can't comment on Dr. Cox, because I could not get through 5 minutes of Scrubs.

Anonymous said...

I used to watch the show Trauma in the ER. I thought it was a good show but far from the reality of what I have experienced in the ER.

I would like to see shows that educate the public. I wonder why if you go into an ER a doctor cannot tell a bacterial infection from a Viral infection.
Why is it if you go into an ER with a stiff neck, legs, chest tightness and more they are clueless you have Meningitis. Should that not be obvious?? Imagine being in that condition and having to find your own drive from a rural ER to a city ER because someone is clueless to call an ambulance to transfer you you can only image what would result in being made to sit for 40 minutes. Or when you are returned back to an ER shortly after having a spinal tap you are denied medical help and are being yelled at you need to see a psychiatrist. What university gave that doctor a degree?? And Cuba is said to have the best health care. I have never come across so many incompetents in all my life. That is exactly what i needed within 3 hours of having a spinal tap to see a psychiatrist.What could he have done.LOL I am sure some of this stuff i could say would make competent doctors shake their heads. What was i doing being sent home from an ER only 2 1/2 hours after a spinal tap at 5:55 in the morning. What were they going to do call me back in 24 hours to tell me that I did have Meningococcal Meningitis and to come back for the real treatment. You know the treatment they were suppose to give instead of giving me oral Zithromax. Who is training these people and are they doing any kind of practical exams? Oh i got the IV antibiotic at a later date after an extensive cover up. Oh and they all those changed radiology reports to conceal any damage to stop a lawsuit and exposure.As if i could not figure all that out on my own. Is it any wonder they blocked me from getting an MRI of my spine. Do they not think I would not notice the deformation of my own body combined with the extreme pain from head to toe. My liver is clearly damaged and is enlarged as well as my spleen and they give out a fake radiology report and claim its only a fatty liver. Really i wonder how come I am in so much unbearable pain then. I wonder what I am still anemic and have all that other stuff coming back in my blood work. Do doctors think patients cannot read and understand what a flagged blood test is because I can tell you we will research, find out and ask. It did not surprise me to see the extreme falsification in my records. My stiff neck and legs apparently started 4 weeks earlier my records claim. Too bad this never happens when you get the disease. The onset of symptoms hit within minutes and it does not take very long for your brain too long swell within your skull which you can feel every bit of. No try to figure out what the real intent of having me taken home shortly after the spinal tap was. To get rid of any obvious and visible sign I have the disease by removing the fluid. My neurological signs later explained as a mental illness instead. What a sad world we live in today when we cannot own up to our own failures and need to make the patient look crazy to cover up our stupidity.. IMO

Skeptical Scalpel said...

Anon, Thank you for commenting. That is quite a story.

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