Trust Me, I Went to Primetime Medical School

The medical drama is an oldie but goodie in the television genre, dating back to at least the 1960s. There are all kinds of creative explanations for why medical dramas tend to be so popular; interest in pop science, plunging into the hidden depths of the human body, fascination with professional trades, and a myriad of other theories. One thing the medical drama has given us is the belief that we know about the practice of medicine; how to diagnose patients, how to treat patients, how to interact with people who are ill. All of us graduates of Primetime Medical School may be lacking professional qualifications, but that doesn’t seem to stop many people from attempting to practice anyway.

I speak in a more metaphorical sense when I talk about practice; I don’t see anyone hanging out a family practice shingle on the basis of years watching Grey’s Anatomy and Chicago Hope. But there’s a general belief in the population at large that medical dramas teach us something about medicine. That, by watching such shows, we have a better understanding of how medicine is practiced. And it’s not uncommon to encounter ‘oh, I saw that on an episode of [some medical drama]’ when someone mentions having a particular illness or impairment.

Is the ‘reality’ of the medical drama an accurate reflection of medical practice today? Such shows do hire consultants on medical issues and clearly take the recommendations of their medical advisors into account. Yet, as testified to by the fact that there are medical reviews of popular dramas, it’s clear that they get a lot wrong. How much wrong seems to vary from show to show as well as between individual episodes. Looking at the Private Practice rape arc, for example, I saw both really solid and fantastic depictions of rape and its aftermath, and really horrific and questionable messages about rape and sexual assault.

Medical dramas look for the flashy diseases. They want something interesting and high profile to add tension or teach their characters a lesson. They want the drama, and drama comes from things that are unusual or shocking in some way. More mundane medical issues rarely arise because they aren’t considered as interesting. Consequently, a skewed image of fields like general surgery is created, because we see what the television shows us, not an actual surgical practice. For every clinical emergency where Bailey rushes into the operating room, there are scores of routine procedures, although sometimes not so routine, as illustrated this season when a colostomy reversal went wrong. Seeing her do appendectomy after appendectomy all day long would be pretty boring, so the show implies it rather than showing us, creating an image of surgery as a high-drama, constantly on the go medical profession.

The diagnostic criteria presented to us are often not very accurate, as are the courses of treatment. People getting an idea about how to manage and treat a condition from the television may step away with some very skewed perceptions. I notice this in particular with psychiatry, a profession that tends to be portrayed with disdain and at arms length in medical dramas. They tell us that people with mental illness are dangerous and scary and should be locked up somewhere while also informing us that psychiatry is bunk, whether we’re talking about the use of medications or talk therapy or other measures. Sort of hard to see how anyone comes out ahead there, let alone the patient.

People may also come away with some funny ideas about issues like informed consent and medical liability. Medical dramas are pretty much repeat violators when it comes to obtaining informed consent from patients and that means that people actually receiving treatment in the real world may not understand what is happening when they’re provided with information about a procedure and asked to indicate that they understand and accept the risks. Some of the risks are scary, I know, and being told ‘you might die, here sign this’ may come as a shock when people are used to seeing doctors say ‘you need this surgery, right away!’ and the informed consent part of the conversation is left out. Or, conversely, the risks may be overinflated due to years of watching emergencies unfold on the small screen during even ‘routine’ medical procedures.

Not being in medical practice myself, I can’t speak to the accuracy of medicine as depicted on television although a lot of my sources inform me there are some serious issues. But I can talk about the experience of being a patient, and the experiences depicted on television are a far cry from most of my own. Facilities in medical dramas always seem to have the newest equipment and the best technology. Patients receive considerable diagnostic testing, lengthy consultations with doctors, one on one nursing care. This is a pretty drastic departure from conditions in a lot of hospitals and clinics; shows that do show more realistic conditions tend to play them for sympathy and horror, rather than just pointing out that, for a lot of patients, this is reality.

The lingering love for medical dramas is one that’s unlikely to go away any time soon; honestly, I can’t even tell you myself why I love them so much, but I note that I have shelves of memoirs by doctors, veterinarians, and lawyers about their experience in professional trades, and I think that speaks to an interest in the working lives of others as well as a desire to look into professions often cloaked in mystery and mythology. As I watch these shows, I try to remain aware of the fact that I am getting a very skewed picture of proceedings, and that my hours on the couch probably don’t equate to a medical degree, let alone years of experience in medical practice to go along with it.