Jane McCredie: Medical melodramatics

“IT’S been six wonderful years of watching people being run over by trucks and electrocuted on their wedding night”,  one of the cast members of The Young Doctors said when the hospital drama became Australia’s then longest running TV soap back in 1982.

The program, which was axed soon after reaching that milestone, had also offered 6 years of shootings, bombings, illicit sex on operating tables and unfortunate hairstyles.

There may have been a bit of medicine in there too. Producer Alan Coleman, who died last week, did at one point claim the show had three medical advisers.

I’m not sure anyone’s done the numbers, but I’d be surprised if any other workplace could beat the hospital as the favourite setting for TV drama.

From The Young Doctors to Grey’s Anatomy, a procession of improbably glamorous doctors and nurses have battled and romanced each other on the small screen, often grappling (or failing to grapple) with complex ethical dilemmas along the way.

Decisions that would probably get a flesh and blood doctor deregistered have few consequences in TV land.

In an episode of House M.D. cheekily entitled “Informed consent”, the maverick Dr House pretends to agree to a request for assisted suicide so that he can deliver a sub-lethal dose of morphine that will allow him to continue his investigations against the now-sedated patient’s wishes.

Health law practitioner Caitlin Podbielski looks at this and other cases of ethical breaches by TV doctors in an article published on AANS Neurosurgeon.

Sexual entanglements are a perennial theme of medical soaps, but it’s hard to go past one plot line Podbielski describes from Grey’s Anatomy.

Dr Izzie Stevens falls for cardiothoracic patient Denny Duquette. She decides to cut the wire to his left ventricular assist device, in a bid to worsen his condition and help him move up the waiting list for a heart transplant.

Denny gets the heart transplant, but dies anyway. Dr Izzie just keeps on practising.

TV dramas offer new perspectives on many aspects of medicine, not just ethics.

An anonymous Texan anaesthetist on the Anesthesia Goes to Hollywood website writing about another episode of Grey’s Anatomy says: “I have no idea what the pink jelly like thing being cut here is. I’ve seen the inside of thousands of bodies and never encountered such a thing.”

This doctor, who has possibly, just possibly, spent too much time thinking about the way medicine is practised at the fictional Seattle Grace Hospital, catalogues a multitude of other errors and improbabilities in the popular series.

“This patient, like every other at this hospital, is 32.1 degrees”, he notes about one episode, also cataloguing missing eye protection, incorrectly connected tubes, diagnostic and procedural errors, and a monitor showing a newborn’s weight at 50 kg.

Now there’s a mother in need of medical assistance.

Does it matter? Well, possibly. The authors of one study suggested patient’s resuscitation preferences, for example, were influenced by the way cardiopulmonary resuscitation (CPR) was portrayed in TV drama.

Interestingly, they found the immediate success rate of CPR portrayed in the dramas was similar to that experienced in the real world. What was missing — and you could imagine this might have a real effect on people’s preferences — were the less immediate outcomes.

“The lack of depiction of poorer medium to long term outcomes may give a falsely high expectation to the lay public”, the authors concluded.

But let’s not get too serious about it. The silly season is upon us after all.

I wish you all happy festivities — and that you never need the attentions of the impeccably coiffed staff at Seattle Grace.

Jane McCredie is a Sydney-based science and medicine writer.