Tuesday, September 27, 2005

MedTV: Network TV blows

Here's a nice piece by some Brigham and Women's House Officers bitching about how Grey's Anatomy and House are screwing the entire health care system by making everyone think that doctors are over-sexed insensitive bastards. Some nice historical perspective as well about how the AMA has influenced medicine on TV since the 60's and how the shift of focus from the patients to the physicians explains some of the generation of dramatic conundra.

Many moments would make the old-time AMA vetters cringe. Instead of asexual father figures, the doctors on cast are hyper-hormonal. Attendings sleep with residents. Interns bed nurses. Even patients are fair game. On one episode, Grey kisses an injured biker brought in to the hospital after an accident involving spokes sticking out of his abdomen. Normally, any of these infractions would be grounds for dismissal. At Grey's hospital, they're all in a day's work.

These breaches, however, are minor. What matters are the glaring inaccuracies in complicated and delicate areas of medicine. In one egregious episode, the character played by Sandra Oh, Cristina Yang, asks a woman to donate her husband's organs after he dies unexpectedly. Yang botches the job, dispassionately asking for the husband's eyes and skin as if they were no more than items on a grocery list. Then she runs out of the room as the wife begins to cry.

The scene is rife with errors that could damage public perception of organ donation, starting with the premise: Yang is angling for the husband's organs because another patient (who also happens to be a close friend of the chief of surgery) is dying from liver failure and will be saved if the wife agrees. In real life, hospitals go to great lengths to prevent exactly these types of conflicts of interest, barring doctors from approaching patients directly and designating statewide organizations instead of individual hospitals to distribute organs. Maybe we're just two overeducated doctors who take television too seriously, but we worry that this plot line could have done real harm by discouraging people from donating.

In another episode, two of the characters experiment on a patient, performing an illegal autopsy against a family's wishes. On the show, the characters are forgiven, instead of arrested, because they discover the patient had a rare genetic disease (which Oh blithely mispronounces). But as doctors, we could not forgive the producers for their superficial all's-well ending. Since the
Tuskegee tragedy, doctors have instilled institutional checks to ensure that clinical research is ethical. Still, many patients avoid doctors because they are afraid of being experimented on. The autopsy on Grey's Anatomy's casually corroborated their worst fears.

Watching these episodes makes us long, in spite of ourselves, for the days when the AMA had television producers on a tight leash. Don't get us wrong: We don't miss Dr. Welby's starched white coat. But we are afraid that TV's worst inaccuracies may compromise what trust remains between doctors and patients.

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