Working in Medicine ruins Stuff: Edition 1- Television

When you decide to go to medical school there are a lot of sacrifices you know you will be making. You know that you will have to work extreme hours, go without sleep for 24-30 hours at a time on a weekly basis and that you will leave with crippling debt. You may not know then that all your relationships will have to take a back seat to your work a lot of the time and that you are sacrificing a decade of your life, but that understanding comes quickly.

These are the things I knew, but then there were the unexpected sacrifices. Edition 1 of those unexpected things- TV shows. It may sound silly and trivial to complain that your TV watching experience has been forever altered by your work and it probably is, but it’s my blog and I complain about what I want! Before I decided to go into medicine, one of my favourite shows was House. I loved the show and watched it all, even the horrendous and best ignored Season 8. When you love someone or something, you are willing to ignore their embarrassing attempts to stay relevant. Like when your Dad starts saying “what is going up?” to your friends when they come over. Oh immigrant dads…

Anyway, over the last week and half I have been sick and that meant I actually was forced to lie down for extended periods of time. I ended up aimlessly scrolling through Netflix looking for something to distract me when I came across House and decided to start rewatching it. I was expecting some gentle nostalgia and was interested to see how the show came across now that I was actually a doctor myself. I did not get gentle nostalgia. What followed were waves of panic and anxiety followed by outrage at House’s actions. I have a new sympathy for Lisa Cuddy trying to corral this monster.

Can you really say you are “always right” if you were wrong about thirty times before you got to the right answer? On the show everyone is always defending House’s shittiness because “he always gets the diagnosis in the end”. Also, apparently he can diagnose rare and crazy things that no one else can. Except that we do diagnose these things all the time. They might be rare, but that doesn’t mean we never learn about them or see them. House is usually wrong about his diagnosis at least 4 times in the first 40 minutes before he eventually gets the right diagnosis. Every time he insists he is right and is totally confident. I know you have a big ego, but doesn’t being wrong 4/5 times make you question the possibility that perhaps you got it wrong this time? The worst part is that in a lot of the shows, he probably would have gotten the diagnosis originally if they didn’t insist on ignoring the history and physical exam and bloodwork. Instead they sit around brainstorming and inevitably House will say “no time to test! Just treat for the illness”. What in actual heck? Seeing as the probability is your diagnosis is wrong and you are probably going to make the person more sick for the next 3-4 days, why don’t we spend the 30 seconds to draw blood and order a rush in the lab to test?

Case in point: In season 1 episode 16, a young overweight girl comes in with a heart attack. Let’s back track to the basic presenting history. Apparently, this girl has been having headaches, difficulty concentrating and has had intractable weight gain despite changes in diet and exercise. She is way off her growth chart. And oh yeah, she looks totally Cushingoid. How did this get ignored for all this time? Who does not think pituitary tumour? Yet this girl almost has a mastectomy because everyone is too busy rambling on about fat phobia and diet pills. This is the worst team ever.

In the final episode of season 1, House treats his ex-girlfriends husband. He has intermittent abdominal pain, anxiety and personality changes and some neuropathy. This dude gets subjected to so many unnecessary invasive tests. His presenting complaints are LITERALLY the classic triad for porphyria which he ultimately gets diagnosed with. Isn’t he supposed to have two board certifications? Plus he has 3 other specialists on the team. This department needs to get it’s funding cut. The worst part is the crazy claim that they can only confirm the attack by inducing one and then driving a needle into his bladder to test. Umm no. That is unnecessary. Oh, you say he doesn’t have time and may not survive the next attack? Perhaps that is because you were so busy misdiagnosing him and giving him treatments that made him worse. Dude walked into the show smiling, making jokes and having dinner with his wife and by the end was paralyzed and getting stabbed in the bladder by a psychopath with a wrinkly shirt.

 

I still like the show, Hugh Laurie is amazing and I like the back stories as well. I just did not expect to have most of the fun and mystery sucked out of it. 10 minutes into the schizophrenia episode in Season 1 and I was like, has anyone tested this woman for Wilson’s disease? Seriously, I am the worst now. I know most medical TV shows are not made to be very realistic (Grey’s Anatomy anyone?), but it’s still disappointing to have them forever ruined. Interestingly, the most realistic medical show I have ever seen is Scrubs. Luckily that is also on Netflix so I am ready for my next binge!