Top 5 Ways Hollywood Medicine Fails

I realize that all of Hollywood is fake. And that creative license exists to further the storyline. But I'm pretty sure the "medical consultants" on all major TV shows and movies are from "The Doctors" and don't actually know what they are doing. Or else everyone ignores them. Here are the biggest offenders.  

1.      The biggest flub no matter who you talk to: We don’t shock asystole.

 Nearly every code depicted on TV involves a patient suddenly flat-lining (that dramatic long beep where there is no heart beat, also known in medical speak as “asystole”) and someone yelling “clear!” just prior to the body dramatically jumping off the bed. So you all know, patients rarely just flat-line. When you start circling the drain, adrenaline kicks in and your heart rate speeds up to try to match the demands of infection, injury, stress, what-have-you. The heart tries its best to keep up, its internal pacemaker keeping things going even when the rest of the body is shutting down. Sometimes it works so hard and fast that it can’t beat in rhythm anymore, a condition known as ventricular fibrillation (or V fib).

This is very scary

If that word sounds familiar, it’s because those infamous paddles belong to a device called a de-FIBRILLATOR. Meaning “to stop fibrillation”. In other words the electricity stops that crazy rhythm and allows the heart to restart its own pacemaker. Guys, the paddles STOP THE HEART. Which makes no sense if the heart is already stopped. So shocking asystole is just bad medicine, and every one who’s ever taken an advanced life-support class knows it. Even the automatic defibrillator machines know that. If there is no heart beat, we instead make the heart beat by doing chest compressions and trying to restart it with epinephrine. Which I guess is just not as dramatic as “CLEAR!” But really, how hard would it be to put V fib on that monitor instead of asystole. Seriously.

2.      Medicine is boring. I realize it wouldn’t make for the most compelling story lines, but can we talk for a second about how much of my shifts are spent typing notes, putting in orders, reviewing results, or waiting on hold for a consultant? They’ve done studies about how much of a doctor’s day is actually spent in patient care, and it’s not much. Besides that, most of the cases are routine things like telling parents that their kid’s cough will go away on its own, or telling that adult patient (again) to take their blood pressure medicine. Fascinating, I know. Believe me, I know. So sure, glam it up, script writers, but at least on cop shows they talk about all the paperwork and leg work leading up to the dramatic show-stealing chase scene/shoot-out. Yes, that one helicopter flight to the ICU is what we talk about all week, but it’s a small percentage of what I actually do, and the paperwork from it takes almost more time than the case itself.

3.      Pen tracheostomies aren’t the norm. Speaking of over-dramatizing, I just want to make sure you all know that when someone drops dead in a restaurant/subway station/playground/their kitchen, doctors (especially medical examiners) do not come out of the woodwork to put in tracheostomies or remove bullets or perform emergency surgery with a bottle of vodka and a pocket knife. 80% of the job is having the right tools, which does not include a ball-point pen ever. We all still call 911, and then start CPR. The end.

Never gonna happen

4.      One doctor doesn’t do everything. “House” made it standard, but every show is guilty of expanding the lead character’s expertise to a convenient, but unrealistic scope. We aren’t usually the ones drawing blood, giving meds, hooking up the ventilator, running the CT scanner, and doing surgery. In fact, most of us don’t do any of those things. Medicine is a team affair, and yes, that would involve paying a lot of extras, or having the docs do the more mundane parts of their job on-screen (see #2), so I understand why Hollywood does it. Just don’t expect your doctor to.

5.      Michelle would like to add an honorable mention regarding TV pharmacists: When asked “Do you know what fentanyl is?” The correct answer is not “oh, synthetic heroin?” Everyone knows what fentanyl is.

Fighting the good fight

Had a dream last night that I lost it on the wiffleball court. Lost. It. My team was short on players, the other team kept finding holes in our defense (in fact, I don’t remember us even batting; the Mercy Rule must not exist in dreams), and I dropped three fly balls. I screamed about the teams being stacked, wiffleball being stupid, and other such nonsense, and then stormed out.

I woke up grateful that I didn’t have to go to confession for such shameful behavior. But not surprised. Because I get that worked up playing recreational sports. Or pretty much anything else. I don’t know if it has to do with being the oldest, or a twin, or Type A, or some mutant combination of the three, but I hate losing.
I could try to dance around it, saying that I’m passionate, or dedicated, or that I see things through. But really I’m just competitive. I want to be the best. I want to win.

It’s almost embarrassing to be honest. Sometimes I’d rather just be the person who didn’t care, who was happy just to play, who laughed off mistakes. And while I know it’s good for me to be humbled, I still hate it. But here’s the good news: God is always victorious, and He’s on my side.

Romans 8 reminds us that we “conquer overwhelmingly” in Christ. “If God is for us, who can be against us?” We are on the winning side. Raise the banners, take a bow. God made me just the way I am, competitiveness and all, because He made me to conquer. So it shouldn’t matter that I drop a pass in football (at least it shouldn’t ruin my day) or get yelled at in the OR during an anesthesia day because I didn’t intubate on the first try (I can’t be the best at everything. Dang it!). Because those are just little battles in a bigger war, which we have already won. So I continue trying to funnel this passion towards greater goals, to humbly accept the losses, and to let the victories be His.