Friday 18 January 2013

Medical shows

I got another request from a reader named Mr. M (not his real name).  I hadn't thought about a post like this, but his question piqued my interest in the subject.

Hi DocBastard,

I have a wish for one of your interesting blog entries: could you give us your perspective as a real practising surgeon on medical tv shows like Grey's Anatomy, Dr. House or ER and tell us how they compare to real life in the hospital? I know they try to incorporate real but very rare medical cases, but what interests me more is how daily life in hospital is portrayed, with the relationships between doctors, the time they seem to have to discuss personal problems in the hospital, nine surgeons in one OR on one case, or all nine of them in a bar together, some living together in the same house...

You'd do a great service to dispell these myths and perceptions about medicine created by these shows, because I personally know people who want to go to medical school to live the life portrayed in these shows...

The thing to remember about TV is that it's meant to be entertainment, not informative.  I can guarantee that no one would actually watch a reality show based on my life.  While my stories may seem mildly interesting or entertaining, they are few and far between (which explains why it's often a week or more between entries).  The vast majority of what I do is mundane and boring.  I hope that doesn't disappoint too many people, but that's reality, folks.

I watched a few episodes of "Grey's Anatomy", and it's nothing more than a glamourised soap opera.  The social interactions that these people have are complete and utter bullshit (to put it mildly).  Sure, there may be an odd affair here and there in real life, but the show makes it seem like everyone in the hospital is having sex with everyone else, and that just isn't the case.  In reality, most of us have boring lives, and at the end of the day we go home in our boring cars to our boring families.

"ER" was interesting and fun to watch, but it's just as exaggerated.  What drove me nuts was how almost every patient who was shocked by the defibrillator "came back" after the third shock.  Um, no.  Most of those people die in real life (real death?).  And whenever anyone got intubated, the person putting the breathing tube in would triumphantly announce "I'M IN!" and the nurses swoon and ovulate.  Sorry, but we don't do that.  Ever.  If anyone ever did that in real life, he'd probably get kicked in the crotch for being corny.

As far as "House" is concerned, I will shamefully admit that I watched almost every episode.  But only because my wife made me!  I swear!  It wasn't because of the interesting cases!  The biggest problem with that show is that drama and the pranks in the hospital just don't happen.  At all.  Worse yet, there's no such thing as a Department of Diagnostic Medicine at any hospital like they have on the show.  The real diagnosticians are internists, surgeons, cardiologists, nephrologists, etc.  We don't farm out our "interesting" cases to smarter doctors because we just can't figure it out.

The way the doctors give IV medicines, do all their own procedures, surgeries, MRIs, ultrasounds, and biopsies, is completely fabricated.   Radiology techs do all of the scans, surgeons do surgery, pathologists look at specimens, lab techs do the bloodwork.  And though the names of the diseases presented on "House" may be real, the presentation and evolution of the disease process that is shown is exaggerated, embellished, accelerated, or some combination thereof.  House's basic premise was to come up with a list of possible diagnoses for the patient's problem, narrow it down to one, and then treat it before confirming it.  Inevitably that treatment wouldn't work ("Well, I guess it isn't lymphoma!"), and another symptom would emerge ("OH MY GOD, I CAN'T FEEL MY LEGS!"), prompting a change of diagnosis and a new treatment which also wouldn't work.  And so on and so on, until House had his "House moment" and figured it all out.  No, it isn't lupus.  It's never lupus.

Social interactions are why people watched the show.  It it were purely medical, it would flop after one episode.  No one wants to see cordial people politely greeting each other as they walk down the hall, making idle conversation in the elevators, and silently watching TV while gobbling a sandwich in the lounge between cases.  But that's reality.  Every now and then I get an interesting case, but inevitably I solve it, fix it, and move on to the next patient with regular, ordinary, run-of-the-mill appendicitis.

But instead, people would rather see the surgeon having wild sex with the nurse in the broom closet.  Now THAT is good television.


  1. This is your best post yet! Thank you for making me laugh this morning :)

  2. I thoroughly enjoyed this post. I'm glad someone finally asked this question. I'm a House fan myself, and as much as I love the show, I have often wondered just how much they exaggerate the show. And as for the fake Department of Diagnostic Medicine, they do mention that they are the only "hospital" that offers that position (and for a good reason; It doesn't exist!) Thanks. :)

  3. Doc,

    I always love reading your stories, and I'm sorry you don't post more often. As boring and mundane as most of your cases may be, I'm sure you could dispel any prospective med students romantic notions of what being a doctor is like.

    For some reason, I never quite got into ER, House, Grey's, or any of those shows. (I'm more of a crime show fan.) But I always suspected that they were greatly exaggerating what goes on in the medical profession (after all, as you said, they make those shows for entertainment, not as a "how things are" sort of show).

    Thanks for posting what you do about the weird and wacky side of the medical field! I would never want your job! :-)

  4. If you want to watch a day in the life of a real doctor, check out NY Med, Boston Med, or Hopkins Medical. I think those shows are as close as it gets.

  5. I read that Scrubs is the most accurate medical show. What say you, Doc?

    1. None of the medical shows are particularly accurate. The interactions on Scrubs are definitely the most amusing.


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