Tuesday, July 15, 2014

More bizarre tales from "The Night Shift" ED

Much to my surprise, a medical TV show called "The Night Shift" is still on the air. It's about an emergency department the likes of which you or I have never seen. When it debuted back in May, I wrote a scathing review.

An emergency medicine physician, Nick Genes, has been blogging about the show, and his post about last week's episode caught my eye. So many outlandish things happened that I had to see it for myself. [link here]

Nick's review was so comprehensive and on the money that I won't try to top it. I'll leave out the flashbacks to one ED doc's time in Afghanistan, the chemical plant explosion, and the stripper who gave an intern a lap dance in an ED storage room and focus on the surgical cases.

A 16-year-old girl was brought in because of shortness of breath which turned out to be due to a fork lodged in her larynx. It was removed by the emergency physician who also made the diagnosis of bulimia. The parents refused to let the girl be admitted, so she swallowed a scalpel and vomited a large amount of blood.

At this point, most ED docs would ask for a surgery consult, but not those who work on television. Here the head ED doc and the intern performed a laparotomy in the ED, opened the stomach, and retrieved the scalpel.


As you can see, the rules are a bit more relaxed in the ED. No one is wearing a cap or mask, but at least they've all donned gloves and protective eyewear.

Another crisis arose, and the ED chief had to leave. On her way out she said, "Close her up. Run in another two units. And move her up to the OR." We are left to wonder whether the injury that caused the massive bleeding was dealt with and why she was being taken to the OR after the procedure was over? The ED docs on the show never seem to do any charting or paperwork so maybe they needed a surgeon to write the postoperative orders.

Not to be outdone, two other ED doctors diagnosed internal bleeding in a plane crash victim whom they had rescued after they were lowered from a helicopter. As they were taking him to the operating room [I'm not sure why since there are apparently no surgeons in this hospital and major surgery is done in the ED every day], they decided to stop for a CT scan. They were accosted by a man claiming to be a DEA agent, but who really was a drug dealer.

He wanted to talk to the patient who had been carrying a large amount of drugs. When he was rebuffed, he killed the CT tech and took the doctors hostage. In an effort to keep the patient alive, they intubated the patient without a laryngoscope by jury-rigging some IV tubing to a handy light source and performed a laparotomy without retractors and instruments in the CT suite. The patient died. The bad guy was subdued by a SWAT team, but not before he shot one of the docs in the abdomen.

Whether a surgeon will be consulted and how the wounded doc fares will be revealed during the exciting season finale tonight.

I can't wait.








26 comments:

artiger said...

This sounds so bad, it's almost tempting to watch out of sheer amazement and humor. Kind of like a 25 car pile up; you know it's going to be incredibly bad but you can't help but look at it out of fascination.

Skeptical Scalpel said...

Don't do it. I had to because it's my job.

George Gasman said...

When "ER" first came on the air in, what, 1991 or so, there was an episode in which a patient with a ruptured AAA presented to the ER. Of course, they repaired it right there, in the ER. That's when I stopped watching.

Best medical show?

St. Elsewhere.

hope said...

Haha! Our ED can't even diagnose someone with a pneumothorax before running them through the scanner as they desaturate! This show sounds hilarious.

JEN said...

the best medical show was E/R with a young George Clooney and Elliot Gould.

George Gasman said...

Jen, that's true. Many people don't remember that show. It was based on a now-defucnt hospital (terrible place) on the near North Side of Chicago - on LaSalle Street. The head nurse was based on a real ER nurse who worked in a teaching hospital nearby. She was the archetypal no BS, "don't mess with me", "do as I say, you stupid little intern" ER nurse. She was an excellent nurse.

Skeptical Scalpel said...

Thanks for commenting. Revealing my age, I'll take MASH as the best medical movie/TV show ever.

George Gasman said...

Movie? Yes. TV show? Nah. Too smarmy for my taste. The edginess of Gould and Sutherland was perfect, unmatched by the likes of Alda and the others. "Now, get me a gas passer and a scrub nurse that can keep her tits out of my way, and we'll fix this kids tracheo-esophageal fistula." You'll never hear a line like that in any TV show.

I suppose I was fond of the original ER because the unnamed hospital was not far from where I lived/trained. And Elliot Gould, of course.

Skeptical Scalpel said...

Yes, the movie was far better than the TV show. But he mispronounced "tracheo-esophageal" which always made me cringe when I heard it.

George Gasman said...

LOL. At least he didn't talk about Ahno-Rectal disorders like the TV commercial.

Anonymous said...

This post and the prior one about this medical show make me laugh. Question for you medical professionals: if you know that most medical shows are grossly inaccurate representations of what life in a hospital is really like, then why do you assume the firefighter, cop and lawyer shows are any more accurate? I love how my docs and nurses ask for my opinion about shows about lawyers and cops to me and then express shock when I tell them that none of them are even remotely realistic...... :)

Skeptical Scalpel said...

I never said I thought cop, firefighter and lawyer shows were realistic. I know what they do. Those shows are no more true to reality than medical shows. I must say that Night Shift is particularly bad. Even the ED MD think it's stupid.

Anonymous said...

You guys watch medical shows? Seriously?

I quit watching TV a long time ago. Why should I pay for crap when included with internet payment is Skep and other docs & databases who I can figure out are decent educational sources, and they're not there to make me stupid or entertain me.

I work for the government. I don't need TV. I highly suggest doctors not work for the government either.

Skeptical Scalpel said...

Anon, thanks for the compliment.

I haven't watched any TV shows for many years. I watch selected sports, mostly soccer, Pittsburgh Steelers and hockey, and an occasional movie. I only watch an episode or two of new medical shows as fodder for my blog.

I've worked for various governments too. I agree, don't do it.

Anonymous said...

LOL You are welcome but that is less of a compliment than a statement of fact. :)

Hockey and FIFA.

I can't understand for the life of me why docs would want to watch medical shows on TV. Lets face it: they allow the Kardashians to be stars, so do you think they'd do anything but pimp up doctor, lawyer, cop/detective shows?

Besides, don't you all get sick of that? 12 hours or more a day of medicine. You all really need to enjoy your family and have a life outside of medicine. Its ok. Be human. Join us. LOL.

Skeptical Scalpel said...

I've joined you more than you think. I'm retired. No more 12 hour days. No more call.

artiger said...

Scalpel, I don't want to alarm you, but I checked this show out on IMDB.com, just to see what viewers thought of it...it appears that about half of the posters really like this piece of crap.

On the other hand, an apparent physician posted this sensible assessment:

"Certainly a cut above most medical shows.

I'm an M.D., and I've been a professor of clinical medicine, and taught at 3 university hospitals. None of them, were anything like any of the medical shows, ever shown on network tv.

My brother is a lawyer and he hates all legal shows. I think theres something to the fact that, once you've lived it, the trivialization of it on tv, seems banal and insipid. I've knowns docs that have functioned as technical experts, so I know these programs don't start out to get it wrong. But there must be a central conflict between reality and cost effective tv.

I wish them good luck, but I have my doubts.

Lets bring back St. Elsewhere with a young Mark Harmon, denzel washington, ed flanders, ed begley jr., and a young howie mandel, w/ a full head of hair. That still seems to be the top medical show, it and the young professionals."


When we get down to it, when we turn on the boob tube (called that for a reason, I guess), we want to be entertained, and escape reality. Unless we're watching the news, and even that can be suspect, depending on the source.

I'm still not going to watch "The Night Shift" though.

Skeptical Scalpel said...

I agree. I wouldn't watch it. I'm told on the season finale an ED doc did an arterial bypass in the ED. Yikes.

Libby said...

Ah, bring back Dr. Kildare when TV medicine was blatenly unlike real life and we could buy (or in my case, my parents) a "Dr. Kildare" doctor shirt. Loved that shirt. Wore it with my beloved jodpurs. Yes, quite the fashion plate I was at 5! (not). I can't recall ever seeing a real life MD wearing one, though I think one of my childhood dentists may've.

I'm still mourning the loss of MASH TV. Though it really was coughing up hairballs the last couple of seasons.

St. Elsewhere: the first time I heard about autism.

E/R: they didn't do CPR correctly but I forgave young George Clooney.

As soon as you point a camera at anyone you change the dynamics of the place.

NY Med on showing now. (Dr. Oz isn't on often). Comments about it? Would you have participated?

Skeptical Scalpel said...

Libby, I watched part of an episode of NY Med last year. There was a young woman with a mysterious mass in her small bowel mesentery. It had been picked up on a CT which was done for something unrelated (I think).

After some dramatic footage of her being examined and worried docs talking, they cut away to another vignette. She finally went to the OR. The audience was never told what the mass was or how the patient did. My reaction was "Meh."

I found it interesting that a NYP nurse was recently fired for posting an "insensitive" photo of an empty resuscitation room after a patient who had been hit by a train had left the ED. Yet it's OK for NYP to show all sorts of intimate details of patients on the show.

Libby said...

Yeah, I watched that and it certainly confused me since there wasn't anyone in it. Must've been a witch hunt or a pecking order fall out that had nothing to do with the photo. Office politics. I agree with you about the double standards they obviously have.

Skeptical Scalpel said...

I heard another hospital in New York City has already hired that nurse.

Anonymous said...

Are there any medical dramas you *would* recommend? I'm a former lawyer -- starting medical school this fall -- and about the only legal drama with the faintest whiff of verisimilitude I ever came across was the Canadian show "This is Wonderland," a tragicomic depiction of the intersections of poverty, mental illness, and criminal law -- as well as the legal system's baffling inadequacy in coping with same. It did not last long.

Skeptical Scalpel said...

Anon, I have not seen most of the medical dramas or comedies on TV. A reader told me about a show from England called "The Midwife." I watched a few episodes of that. It is excellent.

Everyone raves about "Nurse Jackie," which is on Showtime. I've never seen it. Maybe I should give it a try.

Sorry I can't be of more help.

Emily said...

A new doctor show for your viewing pleasure, Dr. S. "The Knick" (on Cinemax Aug 9)

Set in 1900, at the Knickerbocker Hospital in New York, ambulance drivers get kickbacks for delivering patients, women regularly die from routine pregnancy complications and the chief of surgery's a strung-out cocaine addict who refuses to allow his black deputy to operate on patients. Did we mention there's no electricity or antibiotics?"

"In the pilot's opening minutes, Dr. John Thackery awakens from a stupor in a Chinatown opium den, hops in a horse-drawn cab and injects cocaine in his toes as he winds through the teeming slums of the Lower East Side. Arriving at the Knick, Thackery scrubs in and in a spectacularly gruesome sequence few viewers are likely to forget, attempts to save a pregnant woman with placenta previa. Let's just say it doesn't go well."

"The show was inspired by William Stewart Halsted, a famed New York surgeon and educator who also happened to be a cocaine addict."

Will await your review.




Skeptical Scalpel said...

Thanks for the tip. This sounds like a real uplifting show. I can't wait to see it.

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