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Taking the Drama out of Medicine

By: Ronke Olowojesiku

A look into the misconceptions of medical professions in some of TV’s biggest shows

While taking a break from studying for that big test, we choose to unwind by watching some of our favorite TV shows. Today, many of these shows portray professionals in the medical field, often in largely dramatized and idealized roles. Depicted here are four characters from popular TV series, along with some questions they raise.

Dr. Gregory House – Former Head of Diagnostic Medicine, House, M.D.

Is diagnostic medicine an actual specialty?

Gregory_House

Photo credit: guilhembertholet / Foter.com / CC BY-NC-SA

His prickly persona, questionable and at times unethical methods, and callous bedside manner place Dr. House miles away from the ideal image of a healthcare provider. Moreover, his title as head diagnostician at the fictitious Princeton-Plainsboro Teaching Hospital is actually not an approved certification by the American Board of Medical Specialties. The act of diagnosing a patient plays an integral part in all fields of medicine. In the event that a difficult case does present itself, such as in each episode of House, the attending doctor can call in his peers from different specialties as consults; however, departments of diagnostic medicine do not exist. The show itself alludes to the uniqueness of House’s department during an episode in which hospital administrator Dr. Lisa Cuddy says that the department was invented to appeal to House’s “Rubik’s complex” or his need to solve a puzzle.

However, Dr. House is certified in the ABMS subspecialties of nephrology and infectious disease. Both subspecialties require three years of residency in either internal medicine or pediatric medicine followed by fellowships in the respective fields. Infectious disease physicians work to prevent and treat communicable disease and nephrologists diagnose and treat diseases involving the kidneys.  Median expected salary for both specialties is around $200,000.

Carla Espinosa – Former Nurse, Scrubs

Do nurses report to physicians?

Carla Espinosa

Unlike some other portrayals of nurses on television, Scrubs depicts Espinosa as a smart and hardworking individual who can hold her own and be an effective leader.  At certain points in the show, Espinosa is even seen teaching junior physicians at Sacred Heart Hospital. Espinosa is a main character in Scrubs,appearing in all but three episodes of the series’ first eight seasons, and is married to Dr. Christopher Turk, the hospital’s Chief of Surgery.

Scrubs has been praised for addressing certain issues and concerns within the nursing profession, such as the pursuit of advanced nursing degrees and men in nursing. However, some criticize the show for its representation of the relationship between nurses and doctors. During the show, physicians at Sacred Heart often perform tasks that nurses typically perform and these same nurses are seen reporting to the doctors. In truth, nursing is an autonomous profession in which nurses and doctors collaborate to provide effective care. However, as Scrubs, like many of the other shows explored here, is a physician-centered show, this incomplete picture of the nursing profession is perhaps unavoidable.

Dr. Woodrow “Woody” Strode – Coroner, Psych

A coroner and a medical examiner are essentially the same, right?

Woody is the eccentric coroner working for the Santa Barbara Police Department who shares many traits with the show’s protagonist, “psychic” consultant Shawn Spencer. In the show, Woody is often performs autopsies to ascertain the cause of deaths of victims involved in the SBPD’s cases.

The role of a coroner is essential in most criminal and police dramas, spanning from CSI, to Rizzoli and Isles, to Bones. However, confusion comes in with the fact that while the titles of the characters portrayed in these shows differ, they all execute the same task: directly discovering the cause of death. In some shows, this character is known as a coroner, such as Woody in Psych. In others, the individual is known as a medical examiner. The interchangeability of the two terms can leave viewers perplexed.Woody

In general, a medical examiner is a physician often specializing in forensic pathology who is appointed to their position. A coroner is an elected official who does not necessarily have to be a physician ;the only requirement in most counties is that the individual seeking election must be of legal age with no felony convictions. A coroner, or medical examiner for that matter, does not necessarily have to perform an autopsy on an individual and can, instead, request a physician to perform the procedure. Salaries for coroners and medical examiners differ greatly, with coroners earning on average $41,000 and medical examiners earning $75,000-$150,000, up to $200,000 in the private sector.

The coroner system exists exclusively in 11 states and alongside medical examiner systems in 17 other states. Currently, 16 states have exclusively centralized medical examiner systems and 6 have exclusively medical examiner systems by county. With such a patchwork of different systems, no wonder confusion exists regarding the titles and tasks of post-mortem investigators.

Dr. Christina Yang – Surgical intern, later Cardiothoracic surgical fellow, Grey’s Anatomy

So, is this what residency like?

It is no secret that Grey’s is an over-dramatized representation of physicians in a hospital setting. The show, which takes its name from the popular anatomy textbook, features the storylines of various surgical interns and their attending physicians and focuses on their interactions with each other and in turn, the effects of these interactions on their patients. Dr. Yang begins the show as the fellow surgical intern to the series’ protagonist, Meredith Grey. Soon afterward, she develops a sexual relationship with one of the attending physicians at Seattle Grace Hospital, Dr. Preston Burke. Portrayed as a driven, ambitious individual, Yang often struggles to express her emotions, misleading others to perceive her as cold and detached.

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The physicians in Grey’s at times go to extreme lengths in their practice, and flirt with certain ethical lines.  In an episode from the first season, Yang and Dr. Izzie Stevens perform an autopsy on a patient against the wishes of his family and the instructions of their attending. The illegal autopsy leads to the discovery of genetic disorder that caused the death of the patient, and the pair does not face any repercussions for their actions. However, in reality, Yang and Stevens could have been charged for their actions, effectively placing their medical futures in jeopardy.

An article from the Washington Post details the reactions of interns and residents at Howard University Hospital to an episode of the famed drama. From the abrupt manner in which the interns address the attendings, to improper relationships between attendings and interns, to exaggerated scenes of daily resident experiences, the doctors at Howard sum up the show in a manner that can be applied to all of the series’ presented here: it is more about entertainment than necessarily medicine.