Dr. Jollywood rides again. In case you are unfamiliar with Dr. Jollywood–well, Dr. Jollywood is the insider who gives you the scoop on all of the idiocy and inaccuracy that you see in celluloid and in cyberspace. The silly and ridiculous renditions of healthcare and medicine.

So now we have the Terminator. The long awaited fourth Terminator movie, which has been resolutely panned by Terminator fans, film critics, and just about everyone else in-between. I’m not going to give a movie review–there are plenty of them out there, as well as endless forums to comment. What I am focusing on is the medical aspect of the movie.

Granted, this is a movie, and we do have to cut some it some slack. But the last 10 minutes can go down in history as some of the dumbest moments in the history of film–it was a totally pointless ending, it wasn’t needed, it was stupid beyond belief, and from a medical viewpoint–well, its enough to make you want to terminate the Terminator franchise.

So if you plan on seeing the movie and don’t want the wonderful ending spoiled for you, then read no further.

John Connor, the leader of the human resistance, is skewered through the chest by a big, mean machine. Now this piece of iron went clear through his chest, damaging his heart and undoubtedly puncturing his lungs. I mean, the lungs are there unless he has a unique physiology that eliminates his need to breath oxygen.

The machine/man, Marcus Wright, saves his life by chopping off the Terminator’s head and helping Connor out of the building before it blows up. Next scene, we see Connor all bandaged up, lying on an operating table in a makeshift hospital. Now, to emphasize, the human population left alive on earth is in pretty dire straights. No more fancy medical centers, no fancy equipment, no big Pharma companies left mass producing drugs…this is rustic and makeshift. This is hard times and make-do-with-what-you-have.

So Connor is lying on the table, with an IV running. For someone who is supposedly near death, whose heart is about to stop beating momentarily, he doesn’t look all that bad. Strange how no one mentions that his lungs have also been punctured, and for someone who’s heart is failing, he seems to have no trouble breathing.

But now everyone is all is a tizzy because they fear that their great leader and prophet is about to die. Wait, wait, we can save him. He just needs a new heart. What a relief, piece of cake.

Strangely enough, their only concern is finding a new heart for him. There doesn’t seem to be any question that a heart transplant can be undertaken with their primitive equipment. For no reason whatsoever, the hybrid man/machine Marcus decides to give his heart to Connor, and there just happens to be a heart transplant surgeon with no medical ethics standing by. I mean, heart transplant surgeons are a dime a dozen, especially in a war zone where most of the population has been killed.

Well, live and learn. And I guess they had a whole team assembled who could assist–everything from scrub nurses/techs, perfusionists to work the heart-lung machine (yes, I guess they just happen to have one of those–don’t you?), ventilators, oxygen, the right tools, and of course, all those drugs that Connor will need to take for the rest of his life to keep his body from rejecting his new heart.

And of course Marcus is just the right blood type, and no one has any ethical issues about killing him so that Connor can have his heart. Afterall, he has only proven to be more valuable than John Connor, and more of a hero…

Anyway, fast forward and the operation is a big success and Connor is being taken away somewhere by helicopter. So there we have it. People in the future are willing to kill someone to take a heart, and that someone is their best hope and their best weapon, and a lot more valuable than their fearless leader. And heart transplants have become so routine that its no problem to perform one in post apocalyptic times.

This movie is a contender for the most ignorance concerning a medical procedure, as well as one of the dumbest endings of all time. And the thing is, this ending had nothing really to do with the story. The medical tear jerker wasn’t needed, and I don’t know what the producer/director was thinking, but it certainly repulsed the audience. Not only because the idea of a heart transplant in these circumstances was so inane, but the idea that the great John Connor would be so selfish and self-serving to take the heart of a living person, and the one who saved his life.

It is hard to believe that people really rely on TV to learn about medicine and healthcare. I’m not talking about documentaries, but primetime shows and daytime soaps. While there has been much written on this, I am going to again say that these shows are not meant to be a learning experience. They are entertainment and often highly distorted–in other words, have little to do with the real world of healthcare.

But people still take them as the gospel truth. In a study that was recently presented at a neurology conference, the researchers found that TV does a miserable job of presenting seizures and first aid with any sort of accuracy.

“Television dramas are a potentially powerful method of educating the public about first aid and seizures,” study author Andrew Moeller, of Dalhousie University in Halifax, in Nova Scotia, Canada, was quoted as saying. “Our results, showing that television shows inaccurately showed seizure management half the time, are a call to action. People with epilepsy should lobby the television industry to adhere to guidelines for first aid management of seizures.”

The researchers screened all episodes of the highest-rated U.S. medical dramas including “House,” “Grey’s Anatomy,” “Private Practice” and the last five seasons of “ER” for scenes involving seizures. Of 59 seizures that occurred, 51 took place in the hospital. When measured against guidelines on seizure management, researchers found inappropriate practices — including holding a person down, trying to stop involuntary movements or putting something in a person’s mouth — occurred 46 percent of the time.

So if you are interested in learning first aid, please don’t rely on medical fiction. Take a course with the Red Cross instead.

…or the nearly dead. That is a common and worn out ploy used in many movies and TV shows–the person who is suspected dead suddenly rising up and ready for another round of battle. It is generally so contrived and so expected, and generally so silly and unbelievable, that it is a wonder why this gimmick is still so widely employed.

Well, today Dr. Jollywood is going to visit something similar that was employed in a book. Yes, a novel that was meant to be “real world” as opposed to sci-fi or fantasy. Although, reading this book, you have to wonder what reality the author was living in.

I feel a little bad about criticizing the book because the author is deceased, and died before any of the 3 novels of his trilogy were published. I’m talking about Steig Larsson, the wunderkind Swedish journalist and editor, who wrote three books and started a 4th before he finally sent them to a publisher.

He died suddenly of a heart attack, or so its said. There is a bit of controversy about his death, as he was a bit of a socialist militant, undoubtedly made many enemies, and his death was rather sudden.

At any rate, it was because of his obvious intellect, intelligence, education, and ability to do research that I was so astoundingly horrified by his second books, The Girl Who Played With Fire. No, I am not going to put in the link to Amazon–I refuse to perpetuate awful books that somehow make it to bestseller lists.

As a caveat, I enjoyed the first book, The Girl with the Dragon Tattoo, and was thrilled that he had written 2 more books before he died. But Fire was as if a different person had written, one who was too ignorant even to figure out that during flood conditions, people do not go and hide in basements (yes, there is a mind numbing chapter, the first, of a hurricane scenario on a tropical island–I should have stopped reading then).

The book plodded along at a frightening slow pace, filled with cartoonish one sided characters, shopping lists of what characters purchased at the local 7-11 (Billy’s Pan Pizza is a favorite), a dull plot, and one of the most moronic endings in the history of publishing. Can you tell how much I enjoyed this?

But it is obvious that the author got so caught up in his own agenda, that he neglected the idea of doing the simplest bit of research, or using basic common sense or his own life experiences (Steig, ever got an injection? More on that). The ignorance is most apparent in his rendition of human physiology and healthcare settings, police investigations, and weather.

Even though I’m starting to get carried away, I will climb down from the soap box and concentrate on what Dr. Jollywood does best–pointing out the faux pas and idiocies in the media, as it relates to health and medicine.

The Girl Ignored

The first medical idiocy is Larsson’s rendition of life in a psychiatric hospital. The protagonist, Lisbeth Salander, is a violent, non-communicative, and maladapted girl of 12. Now, do you think that this person is a candidate for oral medicine? Well, Larsson thinks so. In this story, they try to force pills into Lisbeth, undoubtedly to treat her psychotic and dangerous behavior (she just set a person on fire). Lisbeth makes herself throw up. The old hand down the throat and gag routine.

Next, the profoundly stupid doctors tie down her hands when they force pills down her, but Lisbeth outsmarts them and learns to make herself throw up without physically gagging herself. Of course, Larsson doesn’t explain what happened in the interim–between the time that they were forcing pills down her and when she learned to do insta-puke without her hands. I mean, surely the drugs would have kicked in and subdued her?

But at any rate, since Lisbeth has become so adept at throwing up her drugs, they just decide to stop giving them to her. Now I wanted to puke after reading this. Um, I guess that Larsson has never heard of injections? I realize that the man was no longer alive when the book was making its way through the publishing mill, but couldn’t a good editor intervene and redo this section?

Crazy psychos are given injections. Especially crazy psychos who set people on fire. Even if they did try to put her on oral meds, one attempt at gagging, and she’d be back to shots. Plain and simple. The stupidity of this scenario should offend anyone working in healthcare, but let’s move on.

In the psych hospital, Lisbeth refuses to talk to any of the doctors, who are of course, all male. She does however, speak to the nurses and everyone else. But in Larsson’s reality, nurses do not speak to doctors either, so no one really knows what’s bugging Lisbeth and thus, they can’t give her treatment.

I suppose that it never occurred to Larsson, who seems to harbor a hatred towards straight white men even though he was one himself, that nurses do confer with physicians and discuss patients. And that a trained psychiatric nurse could conduct therapy with Lisbeth, although I guess Larsson assumes that nurses only fluff pillows and wipe boo-boos. Also, a female doctor? Did that ever occur to him?

The whole segment of Lisbeth’s hospitalization was so pathetic, so poorly written, and so bogus and unbelievable (other plot lines fit into this that were ridiculous), I just fast forwarded out of there and moved on. And you will see, if you happen to have the misfortune of picking up this book, that you can skip multitudes of pages at a time, and not miss a thing.

Return from the Dead

Now, if the psych hospital scenario was bad, wait until you read about Lisbeth’s encounter with bullets. Yes, she is truly Wonder Woman, a superhero about to reveal herself….

At the end of the book, Lisbeth is shot 3 times. Unfortunately, you know that she can’t be dead because she reappears in the third book. But she is shot in the shoulder, the hip and the head. By the author’s own admission, the bullet penetrates the brain and causes “massive trauma.” I guess that was something he saw in a book or heard on TV, because he is obviously unaware of what massive brain trauma is, or what happens when a person is shot in the head. And apparently, way too lazy to spend 10 minutes on the Internet looking it up.

Lisbeth’s assailants assume that she is dead, as most people would be after 3 bullets and one to the brain. But being stupid white straight men, they don’t bother to check for a pulse, and bury her alive. Now, theoretically she should suffocate quickly, being comatose and suffering from blood loss.

But wait, Lisbeth is awake. And coherent. And isn’t losing any blood at all from wounds. Amazing! If a bullet to the head doesn’t kill you outright, you’re generally in a coma or at the very least, extremely non-responsive. But not Lisbeth. She begins to dig her way out, using one arm because of her gunshot to the other side. I supposed that Larsson meant for us to get up and cheer.

Then, after miraculously digging her way out, she gets to her feet and begins to walk. With a gunshot to the hip, she is able to walk a very long distance back to the house where her assailants are. Her thoughts are crystal clear, she is completely coherent, and just complains of a “pain in her head.”

And then, Lisbeth not only arrives back at the house, but takes on her 2 assailants–both grown and skilled men–and wins! She is only 4 foot 11 inches, weighs 90 pounds, but no sweat. No blood loss, no trouble walking, no trouble fighting. All this with a bullet in the hip and shoulder, and massive trauma to the brain. And then, Lisbeth realizing that she needs help in getting back to the city, whips out her cell phone and calls for help—to a straight white man that she hates for psychotic reasons all her own, even though he has only been kind and respectful to her. But Lisbeth allows him to have the honor of coming to fetch her.

Now I expect that in book 3, Lisbeth will don a cape and be able to fly faster than a locomotive, catch bullets in her teeth and bounce them off her skin….

Anyway, this book will set a new precedence in the annals of neurosurgery. And it must make the list of the 10 worst endings of all time.

It’s nice that there is a new TV show out with a nurse in the lead role, but why oh why do they have to pull same old, worn out and tire, dog and pony show? The average medical show (ER, House), has doctors performing deeds that are completely alien to real life. And now, here comes Hawthorne in their footsteps.

Please, a Cheif Nursing Officer (CNO) who steps in and does patient care? A CNO who even leaves her office? A CNO is an administrator, not a clinician. An executive who does not mingle with patients or staff, but instead, attends meetings and does paperwork. Maybe the CNO might put on a pair of scrubs if she worked in a 20 bed rural hospital, but not in a large urban facility. That the CNO is “fighting” for her nurses against the evil establishment is ridiculous, because she is the establishment. Or that she even knows who the nurses are working at the hospital. Even her strutting around in a white coat is ludicrous—CNOs are executives. They wear business suits, no white coats.

Plus, how difficult is it to come up with a script that doesn’t look like it was written by Mickey Mouse. Would a nurse in 2009 really give a med that he/she knew to be detrimental? No, of course not. If the doctor remained firm, the nurse would take it up with the nurse manager of the unit or supervisor, and hold the dose.

And of course, the primary problem that Hawthorne has to contend with is physicians being mean to nurses. Cruelty to nurses, the ongoing war between the money-hungry and callous MD and the saintly self-sacrificing RN. Yawn….

The show is just a jumble of the worn out and worst of Hollywood cliches of the hospital environment, only now we have nurse Hawthorne instead of Marcus Welby. We have the disgruntled male nurse who would rather be a physician, the newbie who cries because a doctor yells at her (and Hawthorne of course is by her side to wipe the tears), the sexy bimbo nurse (didn’t they disappear circa 1950?), the mean incompetent physicians (all of them on the show), nurses who speak in baby talk and giggle over the cute paramedic…need I do on?

Why not do something innovative, like have the main character as an “ordinary” nurse who is fighting for better working conditions, trying to get the nursing staff to unionize, showing how the hospital deals with uninsured, etc. Or even make her the manager of a single unit, where she would realistically be involved with nurses and could have easier contact with patients.

But no, in all their wisdom, Hollywood chose to give us…it’s a bird, it’s a plane, it’s SUPERNURSE! Making her Chief Nursing Officer means that Ms. Hawthorne can now be responsible for saving the entire hospital, as she appears to be the only one who is competent. And who is always right, and never loses her saintly affect.

Hawthorne’s CNO can do everything and anything, from rushing into the NICU to start an IV, because as we know, the regular nurses working there are just too dumb to perform such a “complicated” procedure, to having time for heart to heart talks with patients and even kissing one on the cheek, to making rounds on the hospital units, sitting in on report…and yet, somehow having time to do her job as CNO.

Here’s a hint for the uninitiated. In a large hospital, most if not all nurses have no idea who the CNO is. They wouldn’t know her by sight, name, and probably don’t even know she exists. Ditto for most doctors. The CNO generally got there because she sticks by rules, doesn’t make waves, and is firmly committed to the status quo. She’s not the renegade who’s out there fighting for truth, justice, and revolution.

I hope this silly show dies a quiet death, before making nurses look even more ridiculous. Or before spreading even more myths and legends about life in the hospital.

Very good review from St. Murse, which outlines the glaring idiocy of this new show.

This is Hawthorne, brought to you by TNT.  I guess nurse TV is in vogue now, because this is the second new show to make a debut. But just because these shows are about nurses, doesn’t mean that the medical accuracy is going to be any better than the standard fare. Or that the nurses are going to be likeable and realistic characters.

This is the blurb about the show:

Pinkett Smith plays Christina Hawthorne, a compassionate and headstrong Chief Nursing

Officer heading up a group of dedicated nurses at Richmond Trinity Hospital who spend long days and nights on the hospital’s front lines. Hawthorne is the kind of nurse you want on your side when you or someone you love is in the hospital. She is the kind of nurse who fights for her patients and doesn’t let them slip through the cracks. When necessary, she takes on doctors and administrators who are overworked, distracted or just unable to see the human being behind the hospital chart.

Whether showing humanity to a homeless woman, trying to talk a suicidal cancer patient off a ledge or exposing a doctor’s near-fatal error, Hawthorne will do everything in her power to help her patients. When a patient’s care is at risk, she doesn’t hesitate to violate protocol, defend her staff or stand up to administrators who seem to have forgotten a hospital’s true purpose.

But the long days at the hospital and Hawthorne’s intense focus on helping others take a toll on her personal life. Christina is recently widowed – her husband died one year ago after a battle with cancer, leaving her to raise a smart, rebellious teen-age daughter on her own. Hawthorne is still coming to terms with losing her husband, finding a way to balance her career with her equally important role as a single parent, and finding the time to take care of someone who always seems to fall through the cracks – herself.

Joining Pinkett Smith in HAWTHORNE is Michael Vartan (Alias) as Dr. Tom Wakefield, the oncologist who treated Christina’s husband and serves as Chief of Surgery for the hospital. The cast also includes Suleka Mathew (Men in Trees) as Bobbie Jackson, a fellow nurse and one of Hawthorne’s best friends; David Julian Hirsh (Lovebites) as Ray Stein, a nurse struggling with being accepted in a female-dominated profession; Christina Moore (90210) as Candy Sullivan, a nurse with a unique sense of duty; and Hannah Hodson (TNT’s The Ron Clark Story) as Camille, Hawthorne’s daughter. In addition, special guest star Joanna Cassidy (Six Feet Under) portrays Amanda, Hawthorne’s mother-in-law, who also happens to be a member of the hospital board.

Sounds a little hokey, but then, you never know.

Most renditions of healthcare on television are fairly pathetic. Even simple things that could be done correctly, without any added cost or airtime, are messed up. Do the medical advisers who are supposedly advising just not advising, or are the powers that be just not listening? Or both?

A survey from Medpage.com had some interesting results and responses. Nearly all respondents said that prime time medical TV shows have an impact on the doctor-patient relationship, for better or worse.  While they didn’t give a break-down of which were best shows vs. worst shows, they did offer varying comments. It would be interesting to see a large survey from healthcare workers, which gives an actual breakdwon on which shows they think are the worst, the best, the most unrealistic, etc.

But some of the Medpage comments were as follows:

• “Scrubs has the best portrayal of nurses. Also, the only show that gets it right on type 2 diabetes.”
• “As a medical technologist, I am very disappointed that the laboratory is ignored in most medical shows. In real life, most doctors wouldn’t know the first thing about how to crossmatch a unit or do a CBC or lipid profile.”
• “Frazier was the best show with the worst portrayal of psychiatry ever. I once had a patient ask me during an initial eval if I, or anyone else in my practice, did ‘ . . . what Dr. Phil does.’ I think that about says it all.”
• “I think a show like St. Elsewhere gave an inkling of what a city hospital is like as a reality check.”
• “I don’t know who teaches these actors how to play the role of a doctor but they do a horrible job.”

I agree with most of it (haven’t seen Scrubs so can’t comment). But really, most of these shows portray the physician as also being nurse, lab tech, ultrasound tech, radiology tech, housekeeper, and as having all the time in the world to sit and chitchat and solve a life time of issues with the patient.

I really did like St. Elsewhere. Yeah, there was the usual romance and the nasty stereotype big shot doc, but the show was realistic in many ways.  Better than most.

I just want to clarify, that unlike some of the nurse police haunting the Internet, I don’t have anything against nurses being presented as less than savory characters. Nurses do not have to be portrayed as wonderful, eager, helpful, saintly, flawless, and utterly perfect little creatures who can outperform any physician they tango with. I have nothing against presenting nurses as flawed human beings–in other words, like real people.

The Nurse Jackie show is supposed to be a comedy, but I have a problem with presenting the lead character of a show about a nurse as a complete stereotype. And that’s what it sounds like. Can we try another form of humor, please?

Can Jackie the nurse be funny without being a drug addict, a miracle worker, or the wisecracking hardboiled battleaxe? Yes, many nurses and physicians do have substance abuse problems, which includes smoking, drinking, abusing prescription drugs and illegal drugs. But please, does the main character have to have a drug problem, at least initially? Couldn’t one of the other nurses or docs have that problem? Does the young naive doctor have to touch Jackie’s boob? In a big, busy, NY ER, its not likely that very many of these stereotypes would be tolerated.

Anyway, I have no intention of watching the show. If and when it actually airs, it will be interesting to hear the feedback from nurses and healthcare workers.

And now, another bout of silliness from Hollywood, as reported by our own Dr. Jollywood.

It a new “nurse show” from Showtime cable. That means that they are free to use profanity and show nude butts all they want, free from the censors of regular television. So with that in mind, Nurse Jackie premieres. It is the story of a nurse working in the Emergency Department, who “walks the line between saint and sinner.”

Are we nauseous yet?

To their credit, Jackie is rather plain looking with short blond hair, small boobs, and looks like she’s been around the block a few times. She also looks like she’s in her 40s, which is novel in and of itself. For a television program, that is. Not for a nurse, where the average age in the US is 47.

But while the show hasn’t yet premiered, there are serious warning signs in the previews. Jackie is a wisecrack a minute kind of gal, and a young doctor can’t help but fondle her breast in public. It also seems that Jackie is a drug addict, and asks God to “make me good but not yet.”

I guess Jackie is going to be the sinner with the heart of a saint. A new take on the sleazy prostitute with the heart of gold. Jackie tells one nurse that “when it gets easy, its time to go.” Wow, those are fighting words. Everyone working in the ER should have a rough time everyday, and come home in tears or beaten up. And of course, have to work overtime without being paid. Life is rough in the ER and keep it that way. No nurse should expect to get used to it.

Now, if you’re done puking, back to our regular scheduled programming.

Is there any reason why a medical themed show can’t feature a nurse with a strong personality who is just normal?

Forbes magazine online has a nice slide show about TV Medical Missteps. Yes, I’m not the only one who’s noticed Dr. Jollywood “jollywoodizing” health and medical care. How hard is it to have a medical adviser read a script, and in most cases, making changes to remove the idiocy and make it more authentic will not cost more money and will probably make viewers happier.

One misstep that they mention is the reality of nursing. Yes, in Dr. Jollywoodland, physicians often do the work of nurses, particularly if they happen to be the star of the show. On ER, patients are often handed off for treatment by paramedics without the help of any nurses. Yup, that’s just how it is. The physician is standing around and waiting for the ambulance, and does the blood draws, hooks the patients up to a monitor, does all the triage, puts the chart together. La la la….

Another idiocy is that physicians often hire and fire nurses on TV shows. The only time I can imagine that happening is if the nurse is working in a private physician’s office, and he or she would then be the boss. Otherwise, physicians have absolutely nothing to do with staffing in a hospital. A nurse cannot be fired by a doctor, just like the doctor can’t be fired by the nurse.

Another TV plague is the super intern syndrome.

On shows such as ER, medical interns often end up alone with a patient who crashes and needs a dramatic, difficult procedure in order to survive. In reality, it’s very rare that an intern would be left alone to do something beyond his or her capability, Safirstein says. In most cases, senior physicians are on hand to guide them through their work step by step

Then there’s ER Drama! Most shows do their best to convince the audience that daily life in the ER is one of gunshots, stabbings, riots, mentally ill patients gone haywire, fires, bombings, terrorist attacks…basically, the excitement that just won’t quit. While violent incidents occasionally happen, most times the ER is just busy and monotonous, filled with patients with non-descript pains and fevers, some broken bones, maybe an out of control asthma case. And the ER staff, especially the docs, do not provide a full service menu. I know, in the world of Dr. Jollywood, patients basically move into the ER and receive all their care in there by the same dedicated physician who never goes home. ER docs on TV can do everything–brain surgery, organ transplants, diagnose a complicated case of Lhassa fever without even doing any labs, and they do it all themselves without the help of pesky nurses or techs.

In reality, patients are triaged and stabilized in the ER, and then either admitted to the hospital and transferred to the appropriate unit or sent home. That’s not very exciting, but that’s how it goes.

Another mangled medical interpretation brought to you by Dr. Jollywood. On a big budget show, how difficult is it to get something right?

First, I have to say that I love the show Fringe, and am addicted to it. I get it on iTunes and play it on a 30 inch computer screen, so it is easy to stop, start, move back, etc. I think the show is innovative, clever, creative, and the actors are perfect in their roles. That said, there is a lot of “real” medical stuff in this program, and they certainly can do a better job of it–do a better job of it without adding any extra cost or minutes to the show. It’s just called accuracy.

In the second episode, a woman with a quasi-sort of pregnancy was dumped at the ER entrance, screaming and in obvious pain. Of course, everyone thought she was about to deliver a baby, even though she said that wasn’t pregnant. But due to what they perceived as the urgency of the situation, and a quick check of vital signs, they decided to do an emergency C-section.

Now here’s the first flaw. Why were they going to do a section, and in fact, they were “so rushed” that they said they didn’t have time to put her under? It just seemed from their point of view, that the woman was in labor. They showed a flash of monitors and someone said that the heartrate was 60. If that was the baby’s heartrate, then yes, the kid was trouble. But it had to be mother’s monitor they were looking at, because they hadn’t hooked her up to an internal fetal probe, and she didn’t have any sort of external fetal monitoring device around her abdomen. So how on earth could they have been monitoring the baby? And so again, why the need for a C-section?

Okay, move along. Mom is screaming, and then suddenly becomes a flatliner. Again, we see the same monitor, but now the EKG is a flatline. Mom has died, suddenly and inexplicably. No one in that operating room seems to be surprised that this woman, very much alive and vital only seconds before, and seeming healthy except for having a huge abdomen (assumed to be carrying a fetus), suddenly dies.

So what do they do?

Nothing.

One guy says, “She’s gone.” No curiosity or shock that this woman who they assume to be in labor has suddenly died. And then someone says, “we’ve got to get the baby out now!”

Uh yeah, but what about the woman? In real life, I certainly hope that part of the team would be instantly “upfront at the woman’s head and chest” intubating her, pouring in drugs, doing CPR. In other words, she would be a full code. Another person would call for help, and the OB doc would get the baby out. They would not just stand there, stare, and mutter that “she’s gone.”

I can just imagine attorneys who watched this show, moaning and groaning that this wasn’t real life because what a plum lawsuit that would be. And maybe in George W. Bush’s world, the mother should always be sacrificed for the baby (especially if its a boy), and that they were doing the right thing by ignoring the dead slut (yes, she was unmarried and had just had an illicit affair) and saving the sacred child, but this is not how in works in real life.

Grade F- for this scene

A second blunder was the use of paralytic agents that the “bad guy” used to capture his unsuspecting victims. To my knowledge, all paralytics are neuromuscular blocking agents, meaning that that paralyze all voluntary muscle movement. This includes respiration. Because of this side effect, which is why they are used in the first place, all patients receiving these drugs must be on some type of life support–if the intention is to keep them alive.

But yet, the bad man was able to paralyze his victims but not suppress their breathing. Interesting. Since this show is about fringe science, and has a lot of weird stuff in it, this point should have been raised. It only would have taken one sentence from Dr. Bishop or his brilliant son to say that “wow, this guy must be using some avant-garde paralytic that bypasses the respiratory muscles.” Something like that. It would added a little credibility and offered an explanation–granted, most people don’t know how these drugs work, but still, make it as real as possible. Yes, this show was about a heinous scientific experiment that should have ended decades ago, so it would have been believable that a new form of paralytic was available.

Other than that, it was a great show. It would just really help to have medical advisers on the set, and to follow their advice.

A few nights ago we watched Firewall, a Harrison Ford movie where Indiana Jones reincarnates and kicks butt. Okay, not quite Indiana Jones, but Ford, who looks older and more wizened that his 65 years, still was able to beat the crap out of athletic bad guys half his age—-even though he was supposed to be a three piece suit type who sits in a bank and doesn’t get out much.

I did like the movie, despite the need to suspend the imagination, but I don’t know why Hollywood has given up on its own imagination. Like so many movies which have come out recently, this film had to include a silly and somewhat unbelievable medical crisis that is of course instantaneously resolved.

Firewall, in brief, is about a family held hostage with the threat of death, if the father (Ford) doesn’t do what the bad guys want. Of course, there is a child who has a life threatening allergy to peanuts, and this theme is really getting tiresome. I don’t know how many movies have come out recently that have the “child in peril.” You know right from the start, as soon as they mention the asthma, diabetes, allergy, etc, that the kid is going to have an attack and that is going to alter plans, get the parents to give in to demands, or have the bad-guy-with-the-conscience intervene. It is like, so boring already.

Anyway, in this film, the 12 year old boy has a severe allergy to peanuts. So of course, you know that sooner or later, he’s going to have a reaction. One of the bad guys gives the kid a snack and swears there are no peanuts. So the kid eats it. This scene alone challenges the intelligence—if you were a kid with a severe peanut allergy that you knew could kill you, and the chief bad guy with a big gun who has invaded your home and is threatening your family offers you a snack, would you eat it? This kid must have the IQ of a donut hole, and his lack of fear was also a little annoying.

But anyway, he goes into the movie version of anaphylactic shock. He becomes unconscious, looking nice and pink and healthy. While you can lose consciousness, generally, a severe reaction will cause trouble breathing as the throat swells–ie, lots of wheezing and gasping for air, and yes, the person will turn pale and blue. You can get a rash, vomit, moan and groan in pain—it is pretty rare that someone will eat the offending item and plop down into a sweet and peaceful coma.

Okay, so mom and pop are in a frenzy, screaming and crying and trying to revive their kid. Not sure how shaking him is going to revive him, and then it turns out that the bad guy has stolen the kid’s epinephrine. Ford pleads for it, so finally bad guy relents. They give him the shot, and the kid pops back to life like a jack in the box. He’s wide awake in an instant, no residual effects, nothing.

This scene really has to be added to the annals of idiotic celluloid medical escapades. In fact, beyond idiotic, and there really wasn’t any reason to make this scene so far removed from reality. Wouldn’t having the kid wheeze and gasp be more dramatic?

But the bottom line is that the kid in peril was totally unnecessary for the movie. It added nothing, and in fact, took away from the realism. These tired cliches really dumb down movies and TV shows, and just waste our time.

One of those medi-pop TV shows was playing on someone’s television recently, and since I am hopelessly naive when it comes to these things, my educated guess is that it was Grey’s Anatomy. One of the characters looked familiar–in fact, now that I think about it, he was on the cover of Seattle Magazine for their “Best Doctors in Seattle.” I’m sure that the real docs in Seattle were thrilled about that, but that’s another story.

Anyway, I have no idea what the episode was about, but a group of medical students or residents were all sitting around a table. It was a nice politically correct assortment that included both genders and a variety of colors and ethnicities. I doubt that most hospitals have such a nice ratio, and that residents tend to coordinate the gender/ethnic ratio when they all hang out together. You know, if there’s too many white guys one of them has to leave the table and they grab a Chinese woman to replace him.

But aside from the political correctness, all were young and good looking. While most residents probably are in their late 20s, some are noticeably older. A growing number of people are opting for medicine as a second career, or heading into medical school after completing a master’s degree in another subject. So by the time they reach their residency, they may well be heading towards age 40.

The good looking part, is really ridiculous. I know that TV people tend to be more attractive than the random population, but after working in a hospital, I can assure you that most residents are not good looking. Most are well, average. They look like everyone else—not better or worse. And none of these fine residents looked like they ever did a night of call in their life, and looked remarkably well rested and refreshed. Bright eyed and rosy cheeked, hair clean and styled, make-up perfect…. Yeah, and this is the same hospital where physicians change bedpans and personally discharge patients, even wheeling them down to the front door.

Aren’t they cute?

I have added a new category to my repertoire called celluloid healers, which will highlight the blunders, idiocy and occasional reality that pops up on both the small and big screen. Celluloid medicine, celluloid doctors, celluloid nurses. I have mentioned this in passing in other posts, but I think it’s a fun topic and that deserves some attention–considering that many people tend to think of medical themed television as quasi-documentaries.

This is a great article on the subject that appeared in Slate, and that was written by two doctors. In this article, they mention an old TV show called The Nurses, that was ultimately a flop. The article says that… “Its producer, Herbert Brodkin, refused to hire AMA vetters, instead employing a nurse to ensure medical accuracy. The Nurses flopped.”

I am curious why the show was a flop. It apparently ran from 1962 to 1963 and then the name was changed to The Doctors and Nurses. This is a description of the show from the IMDB:

The story takes place in a large hospital and revolves around two nurses, Liz Thorpe (Shirl Conway), the older head nurse, and Gail Lucas, the naive student nurse. The two nurses were joined by doctors in 1964 and these doctors tried to help the nurses resolve moral and ethical problems.

Were the nurses not all that interesting on their own, without the support of the handsome TV doc to solve all problems? Although, in 1962, nursing had far more limitations on it than it does now, and most vital decisions would have been deferred to the physician. Also, in 1962, nursing was a low paying job that many women entered because older professions were closed off to them, or difficult to enter because they were female. Since nursing education at the time was largely via a hospital which usually supplied room and board and even a stipend, it was a cheap way to get trained and enter the job market. Finally, many women did become nurses in hopes of meeting the doctor-husband who would raise their status in the world, and allow them to quit nursing!

So maybe the public didn’t find a show about nurses all that intriguing, due to attitudes and perceptions of the time period of women in general, and nurses.