Monday 18 April 2011

Unreality TV - Medicine in Medical Dramas

Immediately before I took poorly and had to give up work, I was teaching first aid and basic life support - CPR and the like. I spent what seemed like the best years of my life trying to stop people doing chest compressions with their elbows bent and the arms doing the work - they should be done with elbows straight, and the body rocking from the hips to provide the pressure.

The reason for the problem? That's how they'd seen it done in medical dramas on the telly. And my street cred clearly wasn't high, compared to Charlie Fairhead's...
There are loads and loads of medical dramas on television. And some more loads. Trying to think and write about them all, and how accurately they depict medicine to the general public, would give scope for a PhD thesis (funding, anyone??) so I'm just going to talk about the ones I watch regularly - Casualty, Holby City and House.

The most overtly "heavy medicine" comes in House. Every week, there's an obscure illness, diagnosed through analysing symptoms, through blood tests, biopsies and scans - and of course through the genius of the eponymous Dr House.

It's a bit unrealistic, compared to the life of a real hospital doctor, though. Most of the time, House and his "team" of four or five more junior doctors seem to have only one patient. Very occasionally, House will see out-patients in clinic - but this is depicted more as a punishment for one of his frequent misdemeanours than anything else.
House's team also seem to be the ultimate multi-skilled staff. As "diagnosticians", they do everything from radiological procedures to neurosurgery. Again, very unlike real life, where different people are highly skilled in these different areas.

Casualty and Holby City are linked programmes, both taking place in Holby General Hospital. Medicine is far less central to the plotlines than in House, though still important. Casualty includes a lot of location filming, with plots leading up to fairly predictable accidents or illnesses. The end of each series inevitably features a major incident such as an explosion, a major car crash, or, in one series, a gun siege in the department. Holby City is set in two of the wards of the same hospital.

In each programme, the staff of the department discuss their personal lives in the most lurid detail as they work - often literally over their patient's abdomen. I don't believe this to be professional conduct: it's certainly not something I've ever experienced, though of course I don't know what's gone on when I've been unconscious!
Then there's the CPR - as I mentioned at the beginning of this post. As you'll see in the photo above, when you're doing CPR for real, your arms are straight (though I'd like to see her more directly above the patient. She's going to break ribs doing it from there. However...)

Thing is, in some of the medical dramas, they do it with their elbows bent. The reason is that they're doing it on real people, actors, and they don't want to put any pressure on their hearts - it can be dangerous, unless they really need chest compressions. The bendy-elbows thing is to look impressive for the cameras without actually putting any pressure on the heart.

So, medicine in medical dramas. The depiction is better than it used to be, certainly - but it's still not a true depiction of medicine. Do we want it to be? I'm not sure we do. An hour's programme of a doctor filling in paperwork might not be the most riveting programme ever....

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