Everyone loves a good hospital drama. They tick all the boxes for good TV: Gritty plots, life and death situations, steamy relationships, ethical dilemmas and blood and gore. Now more popular than ever, medical TV dramas have come a long way in the last 50 years. But just how accurate are they?

You might be surprised to discover just how many inaccuracies modern hospital TV dramas have in them. Here’s the Top 10 list of things you will only ever see in a TV hospital…

.

10. The White Coat Myth

Doctor’s wear white coats right?

Doctors have always liked to wear garments that set them apart, but did you know that historically doctors wore black suits? About 100 years ago, medics abandoned this form of power-dressing and started wearing white coats as they symbolised science and cleanliness.

It is something of an irony then that most hospitals are now stripping doctors of their distinguished white garb because they are so unclean! Even though most of us prefer to be treated by a white gowned doc, about a third of white coats harbour disease-causing bacteria and ‘superbugs’ like MRSA.

So, Never trust a doctor in a white coat…

9. The Successful Resuscitation Myth

All self-respecting medical dramas have at least one dramatic emergency resuscitation every episode.

We all know the formula: The doctor-heroes sprint to help the collapsed patient, stethoscopes swinging. With a bit of chest pushing and after a shock with a “defib” the patient splutters and coughs back to life!

TV shows are however far too optimistic. The reality is pretty grim: Cardio-Pulmonary-Resuscitation (CPR) is rarely successful.

When I was a hospital doctor, most emergency ‘crash calls’ were a far cry from the adrenaline-fuelled scene from TV; most would end up in failure. Even with the best equipment and training only about 5-10% of hospital resuscitation attempts are actually successful.

8. The Next of Kin Myth

Incapacitated by some dreadful condition, on the TV relatives are invited to consult with doctors about what treatment their loved-one should receive. Invariably, they are faced with an impossible ethical dilemma:

“Should we try to save Jonny’s life even though he is suffering so much?”

Such dilemmas are often a reality in hospitals in the USA (where decisions are handled by a ‘surrogate decision-maker’); but in many countries this simply is not the case. In the UK for example, the next of kin has no power to make decisions. Doctors will talk to relatives and take their opinions into consideration, but ultimately the decision for giving life-saving treatment is made by the doctors.

7. The Flat-Line Myth

Back in the ‘Emergency Room’, a patient has been wheeled in from a car accident. Their blood pressure is dropping, they’ve stopped breathing and the heart monitor shows a ‘flat line’. Everyone seems to be panicking! Someone grabs a defibrillator and shouts “Clear!”

The patient jerks and is shocked back to life! Phew!

Wrong, wrong, wrong!

Defibrillators do send an electric shock to the heart but, unlike in the dramatised TV version, they certainly don’t cause someone to jump out of bed in a complete body spasm!

Shocking the heart never works when a person is ‘flat-lining’ (a condition called ‘asystole’)! Shocking the heart only works in certain conditions – e.g. when the heart monitor will shows erratic trace:

6. The ‘Paranoid’ Schizophrenia Myth

Mental health issues carry a lot of bad stigma in today’s society. I get very cross when medical dramas don’t take the opportunity to dispel common myths and misconceptions. Schizophrenia is nearly always portrayed very badly: Characters either have a ‘split personality’ or are ‘blood-thirsty psychopaths’.

In reality, people with schizophrenia are rarely violent, and do not have a ‘split personality’.

‘Paranoid’ schizophrenia is the name given for the commonest type of schizophrenia but many psychiatrists don’t even use the term because of the negative and inaccurate connotations it has.

Unlike what you might have read in tabloid newspapers, people suffering from schizophrenia usually withdraw into themselves and are troubled by worrying delusions.

‘Split personality disorder’ is something altogether different and is steeped in controversy; many professionals don’t believe it even exists.

.

5. The Pulling Out the Blade Myth

Having just survived a terrorist explosion, ‘Jack’ lies wounded on the floor. Without feeling the pain, he realises that a sharp piece of metal has impaled in his side. Being a well-trained action-hero, he knows that the best thing to do is pull it out…

Don’t ever do it!!

It looks very manly and brave but it is probably the worst thing to do. Trying to pull out anything much bigger than a large splinter is likely to cause much more bleeding. Don’t try to be Rambo: Leave it in and let the professionals take it out!

.

4. The Defibrillator Rub Myth

Go on: give those defibrillator paddles a rub while it charges up!

But it’s not done! Rubbing paddles together looks cool but is completely pointless, and may even damage the equipment.

3. Made up Diseases!

Script writing for medical dramas must be great fun. To most of us, medicine is shrouded in exotic-sounding diseases and unintelligible jargon. Granted, people are now more informed about health and disease than ever before; but who really knows the difference between a medullary glioblastoma and a cavernous sinus thrombosis?

And would you know if ‘Uromysitisis Poisoning’ was real or not?

Even though all medical dramas have at least one doctor advising the script-writers, they are still be pretty liberal with the truth.

In an attempt to put the record straight, one doctor has dedicated a website to catalogue every single medical inaccuracy in the hit American TV show House MD!

(Uromysitisis is made-up, and featured in an episode of ‘Seinfeld’)

.

2. The Doctors Do Everything Myth

My favourite hospital drama at the moment is ‘House MD’, but it is happens to be one of the worst culprits for peddling this particular myth.

Not only do Doctors have IQs off the scale and can diagnose and treat any condition; but they are also experts in operating MRI scanners, analysing blood samples in the lab and performing complex surgery! These academic super-heroes must save the hospital a small fortune: Whatever happened to the radiologist, lab technician, nurse, pharmacist or specialist surgeon?

It might sound strange, but in reality doctors are actually humans…

.

.

1. Behind any Storage Room Door there’s a Couple of Doctors having a Romantic Moment

Are you lonely and in need of a relationship? Then become a medical intern!

‘Grey’s Anatomy’ did to hospital dramas what ‘Sex and the City’ did for sit-coms. Bringing the medical drama to new levels (or lows), the hospital has been transformed from a bad-smelling institution for the sick to a hip and modern Club 18-30!

What a relief to know that most medical professionals are far too busy with work for a ‘quickie’ in the sluice cupboard.

Either that or I always worked in the wrong hospitals…

.





Thanks for reading – comments and feedback are warmly welcomed!

Follow @realdoctorstu

.

BORED WITH SCIENCE WRITING? I was – but I’ve been lucky enough to part of a team that has launched a free, bi-monthly digital magazine which tries to deliver understandable science writing. It’s also about giving new or undiscovered writers a chance to write to a growing audience of readers. Why not check it out here! I think it’s rather cool…

References and Further Readings:

Treakle AM, Thom KA, Furuno JP, Strauss SM, Harris AD, & Perencevich EN (2009). Bacterial contamination of health care workers’ white coats. American journal of infection control, 37 (2), 101-5 PMID: 18834751

Hochberg, MS. The Doctor’s White Coat–an Historical Perspective American Medical Association Journal of Ethics April 2007, Volume 9, Number 4: 310-314

What is a superbug?

Get more information on Schizophrenia from NHS Choices and the excellent website Rethink

Read about real defibrillators here

Cardiopulmonary Resuscitation on Television — Miracles and Misinformation (New England Journal of Medicine)

A comprehensive list of made up diseases is on Wikipedia

Another article of medical inaccuracies in the Eagle Tribune

Why you should never do CPR like you see it on TV: An article by Free Radicals

Multiple Personality Disorder (aka ‘spit personality’) is discussed here