The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Sunday, October 09, 2005

My Dirty Little Secret:

I love Grey's Anatomy. Like many other medical professionals, I spent the first few episodes yelling at the TV. I tuned into the first episode out of curiosity, then watched the next few to see what new medical inaccuracies and ridiculous stereotypes they could come up with. Now it's season two... and I'm still watching. Sigh.

Today I came across a great article written by two residents in the states about the more damaging errors portrayed in the show. I'd just link to it, but I'm afraid since I found it on MSN it would disappear after a few days. So here's the article, credited where credit is due.

Paging Dr. Welby: The medical sins of Grey's Anatomy.
By Ingrid Katz and Alexi Wright

This patient has an acute case of incredulitis. Perhaps if I kiss her..."

On the season's first episode of Grey's Anatomy, surgical intern Meredith Grey was drafted to help a pediatric surgeon, who happens to be her boyfriend's wife, operate on a pregnant woman, who happens to have lost her husband to an affair. Genius. As doctors, though, we haven't been dreading the show's reappearance because of its silly plot twists. We have a professional beef with Grey's Anatomy: Along with House, the other hospital show on the air at the moment, it is medically far-fetched and misleading. Most of all, we dislike the show because it loses sight of the point of any medical enterprise—the patients.


In last season's premiere, blond and attractive Meredith Grey oversleeps on the first day of her surgical residency after a one-night stand with a stranger—who later turns out to be her boss. As the show unfolds throughout the season, the two struggle to stay apart, soap-opera style. Meanwhile, Grey and her fellow interns suffer through the humiliations of residency, from an abusive chief nicknamed "the Nazi" to a hospital-wide syphilis epidemic started by a surgical intern.

Many moments would make the old-time AMA vetters cringe. Instead of asexual father figures, the doctors on cast are hyper-hormonal. Attendings sleep with residents. Interns bed nurses. Even patients are fair game. On one episode, Grey kisses an injured biker brought in to the hospital after an accident involving spokes sticking out of his abdomen. Normally, any of these infractions would be grounds for dismissal. At Grey's hospital, they're all in a day's work. These breaches, however, are minor. What matters are the glaring inaccuracies in complicated and delicate areas of medicine. In one egregious episode, the character played by Sandra Oh, Cristina Yang, asks a woman to donate her husband's organs after he dies unexpectedly. Yang botches the job, dispassionately asking for the husband's eyes and skin as if they were no more than items on a grocery list. Then she runs out of the room as the wife begins to cry.

The scene is rife with errors that could damage public perception of organ donation, starting with the premise: Yang is angling for the husband's organs because another patient (who also happens to be a close friend of the chief of surgery) is dying from liver failure and will be saved if the wife agrees. In real life, hospitals go to great lengths to prevent exactly these types of conflicts of interest, barring doctors from approaching patients directly and designating statewide organizations instead of individual hospitals to distribute organs. Maybe we're just two overeducated doctors who take television too seriously, but we worry that this plot line could have done real harm by discouraging people from donating.

In another episode, two of the characters experiment on a patient, performing an illegal autopsy against a family's wishes. On the show, the characters are forgiven, instead of arrested, because they discover the patient had a rare genetic disease (which Oh blithely mispronounces). But as doctors, we could not forgive the producers for their superficial all's-well ending. Since the Tuskegee tragedy, doctors have instilled institutional checks to ensure that clinical research is ethical. Still, many patients avoid doctors because they are afraid of being experimented on. The autopsy on Grey's Anatomy's casually corroborated their worst fears.

Watching these episodes makes us long, in spite of ourselves, for the days when the AMA had television producers on a tight leash. Don't get us wrong: We don't miss Dr. Welby's starched white coat. But we are afraid that TV's worst inaccuracies may compromise what trust remains between doctors and patients.

A few months ago, one of our patients left the hospital emergency room before getting treated because he did not want to miss a Grey's Anatomy episode. As he signed out against his doctors' advice, he reminded us that medical shows are sometimes better than patient realities. Maybe so. But the patients are what real doctoring is all about.

Ingrid Katz and Alexi Wright are medical residents at Brigham and Women's
Hospital in Boston and clinical fellows in medicine at Harvard Medical School.

Seriously. This show has been driving me crazy since the outset. From the first episode, where all of the surgical interns are on call the same night (wha?) to this week's episode, where there were so many ridiculous aspects to Sandra Oh's 'ectopic pregnancy' I couldn't concentrate on the plot, this show is so inaccurate it makes my teeth itch. Granted, I'm a stickler... it drove me crazy when they said she was in danger of losing her RIGHT ovary when the surgical board (where doctor I-have-a-large-stick-up-my-ass first learned of her pregnancy) clearly stated LEFT salpingo-oophrectomy.

Sigh. I am such a geek it hurts.


Blogger doctor T said...

Do you mean watching the show won't qualify me to operate on myself if I ever have an ectopic pregnancy? Damn it!

Have you ever watched Scrubs? It's less about medicine and more about people. They don't try to convince you that they are crazy-smart doctors. They're just crazy.

6:40 PM


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