Wednesday, November 21, 2007

Bringing Down The House



OK, I realize that in the order of things this is really small stuff. But I must have my say. Having watched (why, oh why do I persist?) "House, MD" last night, I conclude that if they ever had medical advisers, they must all have been fired, quit, or -- more likely -- committed suicide.

There was the usual leitmotif of erroneous diagnosis, treating for some disease and discovering another. There was the added sub-plot of women too old to do it, running around wearing thongs, or no underwear at all. (The import being too ridiculous to elaborate.) And the ducklings (what are they? residents?) as usual are doing things that no medical people would be doing: operating MRI machines, and drugging their mentor and biopsying several body parts. (What drugs can do that, by the way? Is there something you could put in coffee that would knock a person out cold in three minutes -- is there such a drug at all, let alone one that wouldn't be tasted?)

But the final straw was seeing Dr House once again barge into an operating room, hatless, maskless, gowned and gloved. The only way you can get gowned and gloved is if the scrub nurse helps you (ain't no sterile stuff like that sitting around outside the OR, at least not readily available), and no nurse would allow it. Not to mention the surgeons standing by dumbly while the guy reaches into their patient and pulls out a key in two seconds. Like Jack Horner. Like the surgeons were too dumb to have... Sigh.

It's not that I should care. But since reality is driving me crazy of late, it'd be nice if a simple attempt at escapism didn't make me want to slit my throat.

46 comments:

Anonymous said...

I found your blog a few months ago, and read every posting (I like it, in other words).

As for "House" - it's only television. It's not important. Every profession takes their turn at getting slammed on TV sooner or later. This, too, shall pass.

Keep up the good work.

MedStudentGod (MSG) said...

I too found this just too absurd. My stepson loves the show and I have a post cooking about this very episode since we watched it (he watched more likely). Dumb, dumb ,dumb.

Anonymous said...

I often wonder why we cannot recruit physicians who are as good looking as you see on 'House' or 'Grays Anatomy'.

The Enormous Clinic

rlbates said...

Don't know what to say. I missed that episode, thankfully. You are so right, the nurses I know would never allow such "unsterile" persons in their OR's.

NH Mind said...

Oh, I thought this show mirrored hospital reality. What are you saying? It's not really like this?? Seriously, I bet a good chunk of the populace believes this is reality based, which is far more comical than the show itself.

Anonymous said...

I hate House with a passion and groan with dismay every time I hear the show mentioned or any sort of allusion to the show. Along the lines of nh mind's comments, it's rather disturbing to have the information or scenarios on these "medical" shows make their way into the minds of the general public. It makes disabusing people from their fantastical notions about medicine that much more onerous and tedious.

Anonymous said...

As far as medical TV dramas are concerned, try "Bodies", a not so well known BBC series, written by a NHS escapee. By the looks of it, he's been there, with the T shirt et cetera. Rather crafty editing of medical procedures. But a very, very unhappy bunch of doctors.

DrShroom said...

Bodies was indeed good value, by Jed Mercurio; as for the drugs... midazolam might work? or chloral, or indeed heavy doses of barbituates, but I'd say they'd all be tasted...
My fave thing about House is address... 221b..?

Nice post

Anonymous said...

I admit I like this show--it's well written and the character is pretty funny. Whenever I comment on some absolutely unbelievable element, such as you point out, my husband always reminds me "it's a TELEVISION SHOW!" I think most people are able to differentiate between reality and drama. That said, I know it must be frustrating for doctors to see this stuff. Just keep telling yourself: it's only make believe...

Anonymous said...

Just as an aside, though - I worked at a hospital where you had to get your gown and gloves yourself from the supply cabinet and open them up onto the trolley before you scrubbed. even at my current hospital, if you wanted to gown and glove before you walked in, you could just grab a set from the anaesthetics bay.

(I haven't seen the episode in question, so I don't know how absolutely stupid it is yet.)

World Champ Stephen Neal said...

Stephen Neal can play the violin with a piano.

medrecgal said...

I have enough medical background to take House with a large grain of salt, but the one time I'll never forget is when I watched it while hospitalized with a nasty case of MRSA cellulitis & in that particular episode a guy actually DIED from MRSA! I almost had a CVA right there where I was laying, particularly since my docs had already freaked out a little bit over that MRSA in question. Of course, I realized underneath it all that it was merely TV, but sometimes there are moments when it's a little too close to reality, even though it's hyped up and overdramatized. Fortunately I've never met a doc who's as curmudgeonly as House.

Anonymous said...

"Whenever I comment on some absolutely unbelievable element, such as you point out, my husband always reminds me "it's a TELEVISION SHOW!" I think most people are able to differentiate between reality and drama."

I'd have to disagree. Too much television has left people thinking that a few quick hits with the defibrillator, and you can bring a dead person back to life without any CNS dysfunction, despite the 10 minutes of ischemia. I think we'd have a lot more DNRs (and a lot less wasted money on prolonging someone's life, well past its expiration date) if people realized that their ribs would be cracked, their brains would be mush, and they'd have tubes and drains providing all of their bodily functions for the last few weeks of their lives.


And to The Enormous Clinic, who said: "I often wonder why we cannot recruit physicians who are as good looking as you see on 'House' or 'Grays Anatomy'."

Take a look at some recent med school classes. I'd have to say I'm fairly impressed with the caliber of some of my classmates, haha.

Sid Schwab said...

TEC: before your time, about 25 years ago, you did. You did.

Dreaming again said...

Sid, my favorite last night ... the liver biopsy THROUGH the tshirt ...that ...was great!

that must have pleased the lab people!

Ooooo lookie! there is cotton in our lab sample!

charsbeast said...

I can't stand medical shows. "House" is among the worst. It gives the public a completely faulty perception of what doctors really do.

DLC said...

And police detectives usually scoff at TV crime dramas, and I'm fairly sure that real evidence recovery techs probably hate the entire CSI set of series. I guess I should be glad that there aren't any Engineering Dramas on TV.

NocturnalRN said...

I know, I know. I watch it too, usually with two of my friends who aren't in medicine. One is always asking, "Does that really happen?....Can you do that in your hospital?...." I'm like "NO". But still I watch,

Buckeye Surgeon said...

That show sucks. Apparently all the main characters have privileges to perform radiologic procedures, neurosurgery, and lung resections. Unwatchable.

Shauna said...

I used to cringe (being a radio announcer) watching WKRP in Cincinnati with all the technically wrong things they showed, but it was simply entertainment.

Shauna

Lynn Price said...

Thank you, Sid! As a writer, this type of stuff annoys the crap out of me. It takes little effort to research with docs to check for plausibility. I have a bevy of docs who put up with my ceaseless questions and will read my stuff so that I sound like I know what I'm talking about. Amazing that Hollyweird isn't willing to do the same.

Greg P said...

If it's any consolation, the medical logic is as bad as the surgical behavior.

Bongi said...

medically, rubbish, but occasionally there is something worth seeing or hearing.

i liked the episode when the stupid surgeon wouldn't 'run the bowel'. house rushes in and does. only thing, it's not bowel it's sausage. serious!!! with the twirls and everything. if he was so clever, why didn't he notice the absolute absence of mesenterium. no blood supply. pretty cool bowel.

but my all time favorite exchange is when they diagnose vaginitis in some guy's mouth (i also don't know what the hell they are actually talking about). but then the junior tells house that he hadn't engaged in oral sex in about six months.

'selfish bastard!' says house.
junior mentions that he has in fact had no sex in about the same time.

'selfish bitch!' retorts house.

now that makes me watch and ignore the sausage-bowel etc.

Sid Schwab said...

I saw that bowel-running episode, too. Hilarious.

Harry said...

hahaha nice post Dr S. I too get driven a little mad by inaccurate science, and am starting to pick up on the inaccuracies of medicine in tv and film now!

Chrysalis Angel said...

Fireguy can not watch any shows with firefighters portrayed, he goes nuts that they don't research it and get it right.

Anonymous said...

Actually, I love House. He reminds me of the Interventional Radiologist I work with...Same personality! As far as drugging the coffee goes, Ativan would work quite well. We give it SL to people all the time and they don't comment on any bad taste at all. Medical docs doing surgery and their own CT's, MRI's etc. are a hoot. The lay public has little understanding of the differences between Medicine and Surgery anyway...A doc is a doc is a doc.....

kïrstin said...

we rented a movie once about a hitman, and the key figure aka the hitman, touched everything and left finger prints everywhere, made noise, did everything wrong. it was so stupid we took it back.
i have been out of the loop for a bit, but im back, loopy as ever :)
kïrstin

gay CME guy said...

medredgal said, " Fortunately I've never met a doc who's as curmudgeonly as House."

You must be new to healthcare!

Sid Schwab said...

anonymous: yeah, but could you put in enough ativan in coffee to knock him out cold in three minutes and keep him that way for a kidney, marrow, and liver biopsy?

On the other hand, as so many have said, who cares?

Anonymous said...

Sid, you should watch Scrubs instead of House - far more realistic (and funny if not painfully formulaic).

But what interests me here is that since House is popular, it must pass muster with a fairly large audience. One might therefore conclude that: 1) most people don't know anything about medicine, nor care to 2) the same people who are developing CMS's P4P strategy are House fans 3) the "centers of excellence" checklists are probably derived from House episodes and 4) the public has a "House level of understanding" of healthcare and yet will be voting in a new President to reform the system. And I would not be surprised if that new President likes House just fine too.

Mike Haubrich, FCD said...

I personally don't care for the medicine but I love the show because of the characters. I see TV dramas as live action cartoons, so the actual details are unimportant to me.

Yes, I find it absurd that the docs do the radiology, are okay with sepsis and talk like brats in front of the patients. It has all of the scientific value of a Hallmark show, but it is just a show.

I had a co-worker who hated the movie Crimson Tide because he had served on a submarine in the Navy. I thought it was a good story, as long as one doesn't dwell on the details.

I know musicians who hate movies about musicians because they don't finger right, stroke the bow right, hold it right. You can get so wrapped up and personalize your own profession that you miss the fun of watching.

Suspension of disbelief for the sake of entertainment is as important in medical shows as it is in science fiction, politics, horror, fantasy and cartoons.

Driver: "Hang on tight, I want to try something. I saw it in a cartoon once, and I think it just might work."
Hitchhiker: Aaagggh!

Sid Schwab said...

Mike: (good end-moniker, by the way) Yeah, I know. It's entertainment. But I think they could make a good show with the same characters and have the "medicine" be within a universe or two of reality.

When I was a kid, back in radio days, a neighbor boy told me something or other (can't remember what) which I didn't believe. That's not possible, I told him. Yes it is, he averred. I heard it on The Hall of Fantasy.
Come to think of it, that could be the national mantra, of late...

Lisa said...

My mother-in-law once tried to counsel me on pain medications based upon her devotion to watching House on TV.

Good grief.

There used to be enough banter and wit that it was worthwhile to watch, but this season has *jumped the shark* in my humble opinion.

I prefer Scrubs.

medrecgal said...

For gay cme guy:

I was speaking from a patient perspective. I've heard enough stories via internships and such to know I'll surely encounter them when I manage to get back to a job in HIM. Some of the things I heard were quite interesting...I'm just hoping I'll never have to literally DRAG a doc down to the dept. so I can finish coding the records! (Supposedly that does happen on occasion...)

enrico said...

I will watch "House" under one set of circumstances only:

1) esteemed, like-minded company; no one should suffer this alone
2) enough EtOH so that BAC is at least 0.whee!!
3) mercilessly and profanely rip on most everything that follows

No exceptions.

Anonymous said...

I know the plots are mostly ludicrous, and not all that reality based. But.....
The actor who plays House is so good. It's amazing to me to see a British actor, who's mostly done comedy, do so well in a dramatic role. So much presence, and a good sense of timing when delivering his lines. Plus, he's tall and good-looking and has a deep voice, all three major points with me.
They do round out his character by showing his problems with painkillers; they certainly don't make him into the perfect specimen.
The one thing I don't like about the show is that House puts the patients through a lot of invasive procedures while he scouts around for a diagnosis, and he does it with nary a care in the world.

Larry said...

I'm sure that the medical details are wildly inaccurate, but they are not why I like ths show. I'm just fond of Hugh Laurie;I think he's a brilliant actor. If you want to see him in a non-medical show (in his younger days), try the old BBC series Jeeves and Wooster. Stephen Fry is wonderful as Jeeves and Laurie portrays the somewhat dim rich layabout Wooster admirably. Great chemistry between the two.

SeaSpray said...

Fun post. Saw it a couple of times bur never got into it. Grey's anatomy, ER and scrubs...totally addicted.

Interesting comments too.

Carol said...

The worst thing that could happen to a patient is to be assigned to House and his minions.
The only time patients get worse is when he or one of his staff is standng by the bed, the test site, or right outside the room.
Seems to me that his patients would all heal and be well if only he and his staff would stay away from them.

DoctaJay said...

On our first day of medical school, our dean of education told us that if we ever wanted to know how not to be a doc, we should watch house :). I hate it because the show is mainly about medicine and its not even funny. I prefer Scrubs for its humor and grey's anatomy for its fairy tale presentation of surgery

solipsistnation said...

You might like Polite Dissent's medical reviews of House...

http://www.politedissent.com/house_pd.html

Klari said...

It's so funny when professionals comment medical tv series. Usually much funnier than the series themselves.
Well, we have our own medical series in France, which are even worse.. As was mentioned on a blog the neurosurgeon would be seen hanging around the hospital with a sthetoscope.. oh well..

Anonymous said...

I prefer "Scrubs" if I want to watch a medical show. If you want a jolting antidote to "House" I suggest you pick up a DVD of "Black Adder III" starring Rowan Atkinson and Hugh Laurie. It's nearly impossible to believe that he is the same man.

Anonymous said...

very stupid show. I was seething while watching this episode... But what did I do, watched it anyways... very odd

Anonymous said...

Rohypnol or "Rufies" could do the trick but the onset of action of 3 minutes is pushing it. Versed has a quick enough onset of action but isn't orally available. Ketamine could be the answer but getting high enough dose to knock him out in such a short time without killing him would be really risky.