Doctor, We Need You in the Writer’s Room, Stat

I’m also a big watcher of medical dramas. Of course they are unrealistic, for all the reasons the commentators have mentioned and more. But the thing that infuriates me the most, because it’s so easy to fix and is instantly recognizable, is that everyone always has a private room. There have been some exceptions, but 99 percent of the time, not only is the room private, it’s spacious enough to accommodate several hospital personnel. Drives me crazy!

Physicians are obliged to be honest to their patients about their maladies, and in some circumstances this is applicable to the general public. According to this article https://www.nejm.org/doi/full/10.1056/NEJM199606133342406 75% people on these shows survive their arrest and 65% survive to hospital discharge. Anyone who works in the ICU knows this is not true. The public has an unrealistic expectation concerning what happens to critically ill patients. You should know this. If you knowingly contribute to the false expectations that these shows engender you should beware that you may shirk your truth-telling duties.

While tv medical shows are meant to entertain and show the day to day life in a hospital, lets get real! Why aren’t they showing the true day to day happenings in this institution? Best answer; because it is embarrassing. To be real one needs to show patients turned away for lack of insurance, unaffordable treatment and meds, the workings inside the board rooms during administration meetings, the sexual harassment of nurses, the negligence and malpractice perpetrated upon patients, the lack of sepsis, the shortage of nurses and other healthcare personnel to save a buck, the deaths of people in the most undignified of ways, the lack of concern for the families of victims, the school children shot while in school, the innocent child molested by the trusted priest in his or her school, to name a few. LETS GET REAL!

I used to watch medical dramas. All the way back to "Medical Center" -- Chad Everett as Dr. Joe Gannon anyone? -- and something called 'Emergency!' maybe even before that ... and of course, the mother lode that was "E.R", especially the early seasons. While I was young, fit, healthy then and my family -- parents, one sibling -- had a lot of serious medical issues at that time, and maybe it was a bit of an escape, or a sense of weird 'belonging,' to watch these programs and understand what they were saying, etc. But that was then ... and this is now. I can't bear to watch anything medical, 'cause I know I'm next in line. Very next in line. And so, for me, it's mostly PBS and anything calm and lulling. But nice to see 'Cary' from "Good Wife" is back on the tube :)

Medical drama as therapy? Yes. As I was learning to navigate the profound dreaded darkness that followed the death of my 26-year-old daughter (opiate-related accident), I turned to medical dramas for comfort, measured factual information and oddly enough a sense of community. I know it’s a fictional world, but in that world… I could cry with others facing the death of a child. I could feel the emotional helplessness of doctors struck with elements out of their control. I could see the social drama and stigma attached to mental health and addiction play out. I could cheer the efforts to make others aware of the importance of being an organ donor. And, I could witness human frailty, an experience I knew all too well. We don’t do grief very well in this country. It can be isolating. And, the uncertainty of how to support others grieving can be bewildering too. Yet medical dramas can model some that, even when it’s packaged as entertainment. My daughter was able to be an organ donor. And at times, as I watched The Resident, Grey’s Anatomy, and a favorite that was canceled, Code Black, I felt gratitude and some healing. During the worst moments of my entire life, I witnessed an incredible hospital staff providing compassionate care, respect, love, and empathy. Medical dramas have helped remind me of those kind human moments. Yes, medical dramas are fictional, but at times, they can and do reflect reality. Thank you: Loma Linda Hospital in San Bernardino, CA

After 40+ years in hospitals of every shape and size, I have learned a lot. I have loved medical shows since Ben Casey and still do. I have also learned enough to have DNR tattooed across my chest and pray that my wishes will be respected. Yes, they are often very high tech soap operas, but they also teach some of us humility. We will never know everything, be the perfect judge of every human being, and always be right on the first guess, but we will never stop trying to be better.

In fantasy there's always a world where the patient chosen for the resperator lives and so does the one rejected for the medical miracle machine. In reality, as anyone with, say, a loved one with cancer, knows, it isn't that way. There's constant triage as specialists decide your person doesn't have a chance and turn a deaf ear to your pleas for the immunotherapy drug just approved by medicare--or does that only happen in New York City?

The medical show I found most realistic was Scrubs, a comedy. It shows the interactions of residents, attendings, administrators, risk management, and the patient. Plus it helps to see medicine as a comedy for a change. The best medical drama I've seen was "getting on." Not well known, had just a few seasons, but great acting and cameos. Dark and poignant and funny. I suggest everyone watch it, especially if you are in either geriatrics or academic medicine.

I sometimes watch medical shows, but I confess that it's their “soap opera” aspects that I pay the most attention to. I really only attend carefully to the medical aspects when I have some personal connection to the malady, or when some turn of the plot disrupts my disbelief suspension system.

I never warmed up to these "medical" drama series. They do not match my own experience, and from the ones I have seen, they grossly underreport on the real essence of what medicine is or should be: The doctor-patient relationship. Sure, I have lived through my share of excitement, dramatic resuscitations, crises in the OR, etc. Some things one never forgets, for example when at the stroke of midnight (literally) on my 27th B-day a patient died under my hands from a massive pulmonary embolism. But the real success and rewards come from establishing the bond between patient and physician that is essential to healing. And those successes I cherish. That is why I love to be a physician.

"At first fiction and reality unfolded as if in parallel. But then they diverged" I imagine that there is tremendous tension between telling a good fictional story that does not leave your audience totally depressed and portraying the frequent sad reality that clinicians face in most of our ICUs. On the one hand, your primary job is to entertain an audience by telling a good fictional story but on the other, you can't mislead the gullible public by giving the impression that most patients placed emergently on ECMO survive, that most patients who receive CPR walk out of the hospital, or those with major strokes or brain trauma return to normal lives. Dr. Lamas, you have a daunting task. Great article and a good show.

Thanks for the insights. I'm a little biased as "The Resident" is one of my favorite shows. You really captured the essence of the show and how I feel about it. I recall the episode you co-wrote and it was very good. I appreciate the comments here on "realism." And, I get it. I'm a Social Worker and while the portrayal of my field on TV has gotten better overall most performances are cringe worthy. But--it's entertainment. Maybe we can focus on that and just enjoy the show?

Nicely written Story...I never watch medical shows, but I have been stuck in movie theaters, where almost a whole operation was shown...my GF loves medical shows, but has to close her eyes when there is blood...I don't have a problem with blood or bleeding injury...so why don't I watch medical shows?...they are so well done, that I might begin to believe that in real world they can save a love one and I don't want to have that much hope, and be destroyed by the failure to save someone.

Show the actual survival rates from cardiac arrest and attempts at resuscitation. Show the voices of those who feel they have lived a full life and want no more medical interventions, despite their anxious family members' hopes. Show the futility of much of what we do to our patients in their final weeks of life, at the expense of dignity, quality and finances. Show the open and often abusive hostility that patients and their families inflict upon nurses and doctors, blaming everyone but themselves for their situation or outcome. Then you will have the reality of many an ICU

"At first I worried that made the televised version misleading." Televised medical shows are misleading. They are fiction, of course, but they set expectations of families about medical procedures. According to the NYT https://well.blogs.nytimes.com/2014/07/17/the-cpr-we-dont-see-on-tv/ only 40% of those receiving CPR in a hospital are revived and only 10-20% leave the hospital. On TV 75% are revived and 2/3rds leave the hospital. Nor do hospital shows typically reveal the brutality of the procedure on the elderly in which ribs are broken by the medical staff, who in turn are forced to do procedures they don't want by families believing it usually works (in part thru what they see on TV dramas). The medical writer's room is not the real hospital. There is no rule that the one must reflect the other but it would be great if the characters at least evinced surprise when a procedure works and they get the happy TV ending.