by Sarah Amaladoss
Let’s face it, medical dramas are addictive. Despite the blatant lies and glaring inconsistencies with the actual medical field, we still find ourselves glued to them. Perhaps it is because they offer us a most coveted glimpse into the lives of medical professionals, the chaos that surrounds them, and, at times, even the medicine itself. One of the most popular medical dramas of the 21st century, Grey’s Anatomy, has become a favourite for its depiction of the medical field and the characters that portray doctors within the show. Still yet, we have to consider: how accurate is all of this?
Myth #1: Residents work extremely long shifts.
In one of the most memorable and iconic moments of the show, we are introduced to surgeon Miranda Bailey who tells the new residents “your first shift starts now and lasts 48 hours”. Despite this being true at one point in time, this is no longer a plausible command due to recent concerns of fatigue, burnout, and ultimately patient safety. Prior to the 1980s, there were no regulations and restrictions regarding how many hours physicians could work in one shift. The standard was to keep working for as long as possible to get the work done. Usually this would fall to younger, more junior doctors, who were considered to be at the bottom of the “hierarchy”. In spite of the risk it posed to both doctors and patients, this expectation prevailed. Then, there was Libby Zion: a young woman who’s cause revolutionized the field of medicine. In 1984, Zion was admitted to a hospital in New York. Under the care of a senior physician and two doctors in training, Zion would ultimately die as a result of human error from her doctors, likely because they were working extremely long shifts. A proposal in 1990 from the Accreditation Council of Graduate Medical Education (ACGME) set an 80 hour maximum workweek. This proposal was ultimately disregarded and residency training programs continued operating under this precedent. In 2011, the ACGME further tightened work hours by also restricting interns to 16 hour shifts-a stark contrast to the 48 on Grey’s Anatomy. So whilst it may seem like residents work these insanely long hours on the show, they don’t work for nearly as long in reality!
Myth #2: Doctors can defibrillate someone who flatlines
We’ve all seen it:a patient flatlines on their bed and a doctor jumps in to save the day with a defibrillator. A defibrillator is intended to shock an irregular heart rhythm (an arrhythmia) back into a regular rhythm (sinus rhythm). To do this, an electric shock is released from the defibrillator to shock the patient's electric rhythm back into their sinus rhythm. In order for the defibrillator to revive this rhythm, there needs to be some form of electrical activity in the heart. When a person flatlines their rhythm is called “asystole” as no electrical activity is currently present in the heart. Without this electricity in the heart for the defibrillator to shock back into rhythm, a defibrillator is rendered ineffective and futile. In order to bring back a patient from asystole, CPR is typically used to keep oxygenated blood circulating until intravenous vasopressors, such as epinephrine (adrenaline), can be given. It is estimated that less than 2% of patients survive asystole-a far cry from all the patients that are resuscitated with a defibrillator on Grey’s Anatomy.
Myth #3: First year residents get to perform surgeries
New first year residents operating frequently appear in Grey’s Anatomy. Despite all the screen time these scenes get, they are actually far from the truth. First and second year residents spend more of their time on the hospital floor learning how to care for patients and observing other cases-quite disparate from tv residents performing solo surgeries in the operating room. Most of the surgeries are done by chief residents and attending surgeons as they are technically more advanced and they have an abundance of experience compared to the first year residents. Not only would it be too risky for the patients if the first year residents did their surgeries, but it would also create a large liability risk for the hospital because of the relative inexperience of these budding surgeons. After decades of training, most hospitals have come to the same conclusion: leave the surgeries to those who are more experienced!
After taking all of these myths into account, it is fair to say that like Grey’s Anatomy, most of the medical dramas you see are highly inaccurate. Despite the entertainment provided, these shows do not provide the most accurate insights into the medical field because of their medical inaccuracies as well as the constant pattern of bias regarding the personal/professional mix of the lives of doctors. It is important to remember that these shows are produced for entertainment-not to be taken seriously by those who are considering entering the medical field.
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