TV medical school: where doctors don’t need nurses and bullets heal themselves

Clearly, four years of college, four years of medical school, and three years of pediatric residency weren’t a complete medical education. There are so many things I didn’t know until I started watching action-packed TV shows, especially the ones with SWAT teams, detectives, and lots of blood.

My training was clearly deficient in neck jabbing. You know, when the bad guys sneak up on the good guy, jab him randomly in the neck with a HUGE needle and syringe, which contains a sedative that works instantly. I have NEVER gotten to do that. Yes, I have put central lines in a patient’s neck, slowly, with deliberation and careful notation of the anatomic landmarks, with a small needle and tape. But I so want to jab a neck! It looks essential, and I wonder how I have never gotten to do this in real life.

Let’s talk about field medicine—all that stuff that happens before you see a doctor or EMT or nurse. If you are the bad guy and you get shot, you will probably die instantly, even if you were shot in the leg. If you don’t die right away, you will have just enough time to say something mean to the good guy who shot you, and then you will flop your head to the side and die. No gasping, no crying, no flailing about in pain.

If, on the other hand, you are the good guy and you get shot, you will live, even if it is a shotgun blast to the chest at close range. Miraculously, the bullet will miss your heart and lungs, and it will only be a shoulder wound, from which you will recover in a day. Never mind if the bullet hole in your shirt is right where the heart is; you really only had a flesh wound.

You will live because your friends have the good sense and training to shout, “Stay with me! Don’t you die on me!” or something of the sort. This incantation is powerful and works in 95 percent of TV shootings. (I really must try this the next time I am running a code in the hospital.)

However, there may be a plot twist, and you can’t get medical attention right away. In that case, your friends, with no medical training, KNOW that it is ESSENTIAL to get that bullet out right away! They will go through a lot of contortions to dig the bullet out while you are stoic. Forget the fact that there are war veterans with bullets in them that were never removed. Forget the fact that the damage done by the bullet is way more important than the bullet itself; everyone is going to focus on digging that bullet out. Oh, and at some point, one of your friends will say, “It’s already getting infected!” even though you were just shot 30 minutes ago. Jeez! Remember President Garfield? He died in 1881, not from the bullet from the assassination attempt, but from the damage the doctors did, mucking around to get the bullet out. In all fairness, the germ theory wasn’t understood then, and the aseptic technique wasn’t in vogue. Still…

Let’s say you are shot, and you make it to the hospital. The first thing you will notice at TV hospitals is—there are only doctors. No nurses, no respiratory therapists. The doctors are all-purpose doctors who provide all your care. One doctor will see you in the ER, whisk you to the CT scanner, perform and read the CT scan, take you right to the OR (I guess to get that pesky bullet out your friends left in), watch over you in the recovery room, and probably bring you your lunch! These TV doctors specialize in everything! And they need no help, no radiology tech to run the CT scanner, no radiologist to read the CT scan, no anesthesiologist to keep you sedated during surgery, no scrub nurses to help the doctor in the OR during surgery, and no ICU doctors and nurses to take care of you while you recover. Amazing! I wonder why we need all those other people at my hospital.

Perhaps you were grievously injured, and you are in a coma post-operatively. Your ICU room will be at the quiet end of the hall. A nurse will almost never come in. You’ll have one little IV, no stickers on your chest attached to wires, yet there will be a heart monitor. Magic! Odd because in my real-life ICU, the patients are covered in wires, have multiple IVs, have IV poles with 4-5 bags of IV fluid, and can’t move without setting off some kind of alarm. Watch out; the bad guy may sneak in, stick a syringe of poison into your IV bag, and squeeze the bag. You will immediately convulse the second the bag is squeezed (I’m chortling now). Hopefully, your doctor (who took care of everything else) will happen along and save you. And no matter how long you are in the coma, months, or years (a la Steven Segal in Hard to Kill—seven years in a coma), don’t worry. Your muscles won’t waste away; you won’t be weak or confused when you come to. You’ll be able to hop out of bed and sneak out of the hospital without any problem.

If you are a good guy in the ICU, you will probably be able to talk, even though you are intubated and on a ventilator (Be aware, should this happen to you IRL, talking is impossible in the situation.). If you are one of the rare bad guys who makes it to the ICU and you arrest, your monitors will flat-line, the doctor will look sad and surprised, and you will just die. You are at particularly high risk of this if you are supposed to make a statement in court or identify a drug lord. If you are a good guy and arrested, this same doctor will miraculously know how to run a code, and you will survive.

And no matter what kind of surgery you had, you will heal quickly and be able to walk out of the hospital with only a limp, a sling for your arm, or a Band-Aid for your forehead. And you’ll be determined to return to work tomorrow.

All I can say is thank heavens for TV medicine: I have learned a lot! And it’s clear; be the good guy, not the bad guy!

Ann F. Beach is a pediatric hospitalist.


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