Or alternatively titled: Why I Don’t Watch TV.
Nearly every medical show irritates the piss out of me. That’s why I can’t watch those shows.
Chicago Med doesn’t appear to have any nurses- the doctors do everything.
I saw one show where there was a car accident near the hospital and the doctors ran down the street to the scene, snatched the extrication tools from the firefighters’ hands, and extricated the patient from the car.
This is how it works-
- the patient comes in and is triaged by the nursing triage team.
- The patient is taken to an ED bed. The nurse assigned to that bed conducts the initial assessment and orders some basic tests, and maybe even a few medications.
- The doctor reviews the patient’s chart and orders some additional tests and more medicine.
- Then we wait for the results if testing and imaging
- More medications are ordered and the patient is either admitted or discharged
The doctor may appear to see the patient at any point in this process, or may not. There are times when the patient may not even see the doctor until hours after they arrived. It doesn’t mean that the provider isn’t evaluating you- it means that some maladies don’t require him to physically be in the room for most of it.
Not so on TV. On television, the doctors are waiting outside for the ambulance, then they run into the ED with the patient, frantically shouting orders. People see this, and when they come into the hospital are shocked and angered that it doesn’t work like that.
I get at least one patient each day who asks: “So when is the doctor going to come see me? I’ve been waiting for an hour.” In reality, the doctor and I have been in constant contact, you have an IV, blood has been drawn, a CT scan was ordered and done, you have received three or four medications, and we are awaiting the results of all of that testing. It’s remarkably efficient, fast, and maximizes the wise use of everyone’s time.
Even shows about EMS and firefighters is nothing close to reality. I once watched a show where a paramedic needed to deliver a shock to a patient in cardiac arrest, but the patient was lying in a puddle of water. He then placed the paddles on the patient’s chest (paddles are largely a relic of the past) did a handstand on those paddles to get out of the water, and shocked the patient.
I can’t tell you how many times someone has said to me: “Why aren’t you doing X? It always works on Greys Anatomy/Chicago Fire/Rescue 911.” People watch this stuff and think that it’s a documentary.
The few times that my wife tried to get me to watch shows that cover topics in which I have some knowledge, I spent the entire time rolling my eyes and making comments. She doesn’t watch them while I am around any more.
The only thing that all of those shows get right is that there are tons of people who work together that are having romantic affairs. Every hospital seems to have a doctor or two who enjoys diddling the nursing staff, and there are plenty of young nurses fresh out of school who think that they are going to bag themselves a doctor husband, not realizing that they are the fourth or fifth nurse he has bedded this year.
At this point, I just assume that every show on TV is BS. Then there are the people who Google their symptoms or malady and want to know why we aren’t doing what Google recommends, but that is another topic entirely.
23 Comments
Big Ruckus D · December 2, 2024 at 10:14 am
Well hell. Next thing I know, you’re gonna tell me CHiPs was bullshit too. And thus my childhood memories have been retroactively destroyed.
Yeah, TV is fake and ghey.
Divemedic · December 2, 2024 at 1:07 pm
True, but no one ever used CHiPs as a guide on how to drive a motorcycle.
Steve S6 · December 2, 2024 at 12:10 pm
Well there is the joke:
I Googled my symptoms. Apparently I need to buy a 50 BMG.
That one may be valid.
Bad Dancer · December 2, 2024 at 12:39 pm
With all that said, are there any shows that you feel got closer to the mark than others or did most of them take the medical writers advice and launch it directly into the bin.
I’ve heard Scrubs is one of the closer ones to the mark.
The curse of watching your particular area of experience being written for drama can be amusing the first few times and irksome the half dozenth.
birdog357 · December 2, 2024 at 1:12 pm
I always heard that the old 70s show Emergency! was pretty accurate.
Grumpy51 · December 2, 2024 at 2:34 pm
EMERGENCY (Squad 51) was a PR series designed to educate the public on who and what Paramedics were. My timelines may be a bit off(having to reach WAY back into my memories) but — Illinois had the first EMTs able to do IVs in the field. LA County started using medics to bring the ER to the patient. Direct result of what was seen in Vietnam (VN), not to mention there were a LOT of combat medics with experience in VERY difficult situations. (This is also when Physician Assistants, PAs, came into being, but that’s a different story).
Previous to EMS, “ambulances” (quotes for a reason) were run by funeral homes, which is why they looked like hearses….. with a cherry (rotating red beacon) on top. One of my first ambulances to work on (Beaumont FD) was an old hearse. Standard joke at the time was “which can make more money – taking ’em to the hospital or to the morgue.”
Along comes EMERGENCY and starts educating the public. The first field defibrillation unit I ever used was an MRL – had the coiled wires coming out the top of the handles and the oscilloscope was about 2″ square (IIRC). Our pads were 4×4 gauze with normal saline poured over to conduct the electricity. Conductive gel was a step up. Would occasionally see an arc go flashing across the chest, hence the term “burned ’em.”
Divemedic · December 2, 2024 at 3:19 pm
Ha. You are older than me. My first was a Lifepack 3. It used paddles, but we had gel. When I started, the old Cadillac hearses were not front line units, but we did have them for reserve in case the new ones broke down.
Patients would ask what color the light was- red was for ambulance, purple (IIRC) was for the hearse
Grumpy51 · December 2, 2024 at 4:43 pm
LOL…… wanna know HOW Capt decided WHO would ride the “ambulance” for the shift (we, Beaumont FD, were back-up for the various private ambulances and funeral homes)?? I was an 18-year-old 135 # skinny rookie ….. who could fit through the sliding window between the front and back of the hearse….. yep, I was the one got “volun-told”.
We need to grab a beer (or a coffee)…….
Aesop · December 4, 2024 at 2:33 am
It was as accurate as it could be, mostly, for the 15 minutes it ran.
It also died, because you can only watch them do the same five things so many times before boredom kicks in.
If anyone ran on as many heart attacks in a year as they did in a single season, half the city would be dead.
And if they’d showed the <20% survival rates (probably close to single digits, I'm being generous here) for pre-hospital cardiac arrests with defibrillation, most people would say "F**k CPR class", as the mostly total waste of time it is. If people were told that for every 100 cardiac arrests the paramedics rolled on, 93 were dead and were never coming back, they'd cancel most of the paramedics in their city and pocket the savings, and they'd only be called to respond to situations that needed something beyond EMTs for transport.
After 30+ years in the biz, I've saved some patients, and some even survived to walk out the door again.
Mostly, you can count them on your thumbs.
The rest were just expensive prolongation of death, allowing the family to wrap their heads around the fact that Grandma is really dead, so maybe you shouldn't have been so neglectful and sh*tty to her while she was still around to talk to; the rest were organ donors.
The survival rates for in-hospital cardiac arrest are only a couple of points better.
Divemedic · December 4, 2024 at 8:10 am
In my 35 years of life in this career, I have seen 4 people who experienced prehospital arrests live long enough for hospital discharge. One was a 20 something who lived in a nursing home as a complete and utter invalid for over 20 years after it happened.
The most successful was the president of the local chamber of commerce. He was found in a park in cardiac arrest by people walking by, who did CPR. We got there less than 2 minutes later while he was still in VF, shocked him to restore a pulse, gave him a healthy dose of lidocaine and a ride to the hospital. He was discharged, and 2 months later we all got AHA lifesaving awards. That’s how rare it is- the American Heart Association actually takes the time to give awards for it.
Even in hospital arrests are comparatively rare- most of the people who arrest and have pulses return live for a few days before dying in the hospital.
Greg · December 2, 2024 at 1:00 pm
As much as I enjoyed the show House because the science was real, even if the plot and action were totally bogus, it annoyed me no end that his team of residents would decide they needed some exotic lab work, and would go into an always unoccupied lab and run the tests themselves, with results always within minutes. I spent a career in medical technology, and even in our big medical center lab, many of our tests had to be sendouts to a reference lab. Yes, results are now online within a day or so, but you have to get the specimen there first.
What you describe as a real world EMR is spot on.
Botan · December 2, 2024 at 1:04 pm
99.999999999 of anything seen on tv or movies isn’t real/true. Most people have read or seen a story on TV that they know isn’t true but continue to believe the next story is true. Thank you Dr. Joseph Goebbels for the observation. Even if the “story” is factual they get the details wrong which can change the hole story. No wonder the propaganda from the media is so affective.
Fishlaw · December 2, 2024 at 1:12 pm
As a retired lawyer, I echo your disgust at lawyer shows. Never even close to reality. Same for firearm stuff–doing ballistic tests on shotgun pellets, for example, or digging a .223 bullet out of a person shot at 50 yards. Like the bullet would not be in a tree 200 yards downrange.
Vlad · December 3, 2024 at 12:20 am
“She doesn’t watch them while I am around any more.”
My wife…she’s been a nurse for over 20 years and watches ALL these stupid shows!
I can’t name them all because I don’t give a damn. She watches EMS and phony cop shows too. Drives me nucking futs because they’re STUPID AS HELL!!! I worked EMS/Fire (in my city of employment, the FD ran EMS) and she knows how ridiculous they are…yet she still watches. Docs doing bedside…yeah sure. Nurses spending hours bedside with one pt that tears at their heart strings…yeah sure. 🙄🙄
That’s why we have multiple TVs.
Plague Monk · December 3, 2024 at 4:01 am
I hope you eon’t take this as off-topic, but why do so many nurses have extensive tattoos? When I was in both the hospital and the rehab center, nearly all the nurses and nurse aides had tats. Don’t get me wrong all of them were caring, skilled at their jobs. But when I’ve worked in deciding who works for me in engineering, I won’t hire people with visible tats; I consider them unprofessional, and 40 years in the field only cemented my belief.(I NEVER criticize the medical people; I prefer to pray for them and to be cheerful, unlike my moniker)
Divemedic · December 3, 2024 at 7:45 am
I don’t have any tattoos. I think that it’s a generational thing. Younger people have them, older people tend not to. When I was a kid, the belief was that only whores, sailors, and motorcycle gangs had tattoos. Now everyone does.
Aesop · December 4, 2024 at 2:22 am
What DM said.
I survived paid service with both the Army and two DD-214s in the Marines without finding the need for any tats.
I gave up trying to figure out why the younglings all want to look like yakuza, biker chicks, and hookers from Tijuana.
When they’re 50 or 60 and saggy, their poor life choices will sound a lot like their mothers’ and fathers’ voices echoing in their heads.
I’ll probably be dead by then, so I don’t care.
Dan D. · December 3, 2024 at 5:54 am
The new NBC series St. Denis is as accurate as a copy of Guyton’s Medical Physiology, so check it out.
Himself · December 3, 2024 at 8:58 am
The one that cracks me up is “House”.
Got a whole team of hotshot doctors sitting in a room throwing stuff at the wall to see what sticks. And they do everything. They’re in the lab, they run the CAT and MRI, They draw blood, rarely a nurse or tech in sight. In virtually every scene the staff is background scenery.
SiG · December 3, 2024 at 10:28 am
I was going to go on a rant on the virtue of assembly lines, but this is really the problem with TV viewership. Anyone who has ever seen their profession depicted in a TV show knows it’s fiction. Only people who think TV is real would expect medical care, or really anything, to be like a TV show. Which means they’re out of touch with reality.
Aesop · December 4, 2024 at 2:15 am
“There’s a phrase to describe cinematic works where every last detail is correct to the most exacting scrutiny, where everyone is wearing the right uniforms, and using the correct equipment the correct way, exactly as it happens in real life.
We call them historical documentaries. I don’t make those.” – Steven Spielberg
Word to your mother:
There are exactly ZERO historical documentaries in prime time, on any channel but PBS, since about ever for 95% of you.
And unless you’re over 50, you never saw Victory At Sea or The World At War first run, in prime time. If you’re under 50, and don’t watch PBS, you’ve probably never seen one in your life.
If this is news to anyone, allow me to stomp on your balloons and cake with sharpened cleats.
Divemedic · December 4, 2024 at 8:05 am
That is true, but the issue I have is the number of patients who expect and demand that their care be just like what they saw on TV.
Aesop · December 8, 2024 at 2:17 pm
Have you tried telling them their 46 minutes are up, the show’s over, and they’re kicked out because you’re changing the channel? Just like on TV? 🙂
I’d also tell them that when they start paying the staff what Hugh Laurie ($700K/episode) or Edie Falco ($500K/episode) got, then they can demand TV levels of care?
It usually shuts up even the stupid ones pretty quick, if they’re sober enough to count.
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