Research Archive

RESEARCH ARCHIVE

Here you can find links to previously published articles Dig in!

Vol, Issue 1. September 2010

GREY’S ANATOMY: THE IMPACT OF A MEDICAL DRAMA ON THE REAL WORLD ATTITUDES OF UK JUNIOR DOCTORS.
Fox A, Smith S, Heindrich Jnr III. MD.

Aims: To assess the reality of a popular medical drama and its effect on people’s medical belief systems.

Methods: A retrospective case notes analysis and prospective questionnaire of some doctors.

Results: Its not very much like real life. People seem to have more sex, and no one in our hospital looks like that girl that went on to be in Knocked up.

Conclusions: Meredith Grey is a pain in the arse.

INTRODUCTION:
The IMDB describes this television program as “A drama centered on the personal and professional lives of five surgical interns and their supervisors.” It is more widely recognised as doctor porn. Recent non published data suggests that this has had a damaging effect on the public’s real world opinion of medical doctors. Moreover, there is some fictional data to suggest that these programs influence the happiness of medical professionals at work and their opinion of their colleagues in varying specialties. In some dramatic cases, it may even effect the actual delivery of medical care by practicing physicians. Therefore, this study sought to determine if this was true in a population of junior doctors in a UK district general hospital.

METHODS.
Medical TV dramas score points with their medical audience in a number of random categories such as realism, sex appeal, drama, the number of fatalities and successful resuscitations after decapitations, sex appeal and George Clooney. We reviewed all 126 episodes of grey’s anatomy and scored each episode according to the above criteria using a Likert scale of 1 to 5. We also scored the program for style, and the capacity of some of the actors to sound like they understood some of the terminology they were using. We then surveyed 10 totally biased medical interns for their views using a statistically non validated method for comic effect. This data was based on the first episode, because we did not have ethical approval to subject them to any more stress.

RESULTS AND DISCUSSION.
Total score

The total number of episodes reviewed was 126, and none were excluded. The maximum potential total score for the complete series was 3,780. This data was then mortality adjusted to account for budget, advertising revenues, directors influence and the patient cohort.

Grey’s anatomy scored 12 (OR 12.4). As part of a separate meta analysis publisher elsewhere, ER scored 1034, House 563, Holby City 13).

Survey data and individual case study of first episode.

Episode 1. It’s minus 5 points for a dreary play-on-words, before the program has even started.

‘They say a person either has what it takes to play… or they don’t. My mother was one of the greats…me on the other hand…I’m kinda screwed.’

So says Dr Meredith Grey, in the first line from episode one of Grey’s Anatomy. 7 out of 10 of our young doctors instantly wanted to place her on the Liverpool pathway after hearing this. It was unclear to the reviewers from this dialogue whether she was a poker player or a doctor. Everyone knows that doctors do not gamble.

On Dr Grey’s first ever day as a doctor at Seattle Grace Hospital (the first Wednesday in August we presume) she wakes up nude on the sofa, with a man who’s name she can’t remember lying next to her. Ten bonus points for this sexy opening. Surely this is how every day at work in a hospital should begin? The authors assumed the man had a preview of Dr Grey’s anatomy the night before. It is certainly a very different start to life as a doctor than any of the surveyed doctors had experienced, and seven out ten were virgins. Most junior doctors enjoy a very sweaty night before their first day of proper work. Alone, sitting on their bed, regretting every time they had missed a ward round in the previous six years, feverishly thumbing through medical text books trying to pick up some last minute hints. It’s very different in the United States, and Meredith is an experienced hand and heads off to work stinking of sex like some irreverent slut. Plus five points for showing how doctors are very cool in this sort of awkward situation.

The first day pep talk is more in keeping with Top Gun, than surgery as we recognise it. There is no ‘Induction day’ with safe lifting procedures, Niel the fire safety officer and Sue from the patient liaison team. The surgeon giving the speech can hardly conceal his erection he’s turning himself on so much…he really does seem to have an over-inflated opinion of himself.

‘Each of you comes here today hopeful, wanting in on the game. A month ago you were in med school, being taught by doctors. (Um…yes) Today YOU ARE the doctors. The seven years you spend here as a surgical resident, will be the best and worst of your life. You will be pushed to the breaking point. Look around you, say hello to your competition. Eight of you will switch to an easier specialty, five of you will crack under the pressure, two will be asked to leave.This is your starting block, this is your arena, how well you play…. That’s up to you.”

Pretty much the same in Watford A+E thought our random selection of juniors and 6 out of ten expressed the urge to vomit. Minus fifteen points for this emesis-inducing oratory.

The rest of Meredith’s team was then reviewed. Five points for each cliché here. Cristina Yang (She’s the hard-nosed, kind of ugly one, came top of her year at Stanford, she thinks she’s it, but has a chip on her shoulder…about everything. Take off 5) Izzie Stevens… ex-model. Her and Cristina do not get along (another 5 off). And George O’Malley, who is a complete cock (and that’s five more off). Our cohort of doctors felt he was so incompetent and had such poor common sense, that it was a wonder he managed to get dressed this morning, let alone get through medical school. So finally, some realism although they were suprised he was not an orthopaedic surgeon as this would have been more realistic.

The group are assigned to Resident (The authors think that’s like a ‘registrar’ or ST3 or above) Dr Miranda Bailey.

The reviewers found her another painful walking cliché in blues (minus 5). She’s a bit prickly (‘Rule number three…If I’m sleeping, don’t wake me unless your patient is actually dying….Rule number four, the dying patient better not be dead when I get there. Not only will you have killed someone, you will have woke me for no good reason’. Minus ten. Alot of thought went into nicknames here, as they think up an absolutely brilliant one for this nasty lady…The Nazi… do you see what they’ve done there? It’s because she’s a bit nasty you see. Minus two for making doctors look like they have no sense of humor or imagination.

The Case-Mix

The first patient is on the roof. She’s been choppered in, in status epilepticus. She’s a teenage beauty queen, and is assigned as Dr Grey’s first case. They are all forced to do a 48 hour shift on their first day, and will work every other night on-call. With the EWTD UK doctors thankfully don’t have to do that anymore, but doctors within the NHS would probably have more than one patient at a time to look after, which is all these goons seem to have. They spend all of their time sitting around on their arses, and there is about one bleep that goes off the whole time. Plus ten points for saying how hard junior doctors work. Minus ten for not actually showing them doing any.

And……..Well that guy Derek who she woke up with, he’s only the neurosurgical attendant! And he’s been assigned this girl to look after! It’s very awkward as you can imagine. Minus ten for a desperately implausible turn of events.

The young girl nearly dies when she has another intractable fit. (This is a blatant pseudoseizure, which can be seen from a mile off. The poor actress has clearly not been directed by anyone who has ever seen a real fit but this was missed by our cohort of juniors who would all have given her diazemuls). Meredith gives her diazepam, lorazepam and phenobarbital, and surprisingly the patient arrests and Meredith has to give her a couple of shocks to get her out of VF…(although it’s not VF on the monitor and the shocks are administered through the gown by the looks of it… another one for the Crash Calls archive. Minus ten) Anyway, Derek gets all the housemen in a room and asks for their help. He can’t work out why she’s fitting, Bloods, LP, CT are all normal, he needs their collective brain power.

Anyone who can come up with the answer gets to go to theatre (the OR) with him (apparently a great honour. The reviewers felt that if he’s having to ask the housemen (F1s) for advice, he can’t be all that can he? Meredith and Christina team up, and hit the library. Minus five for showing that doctors don’t know what they are talking about all the time and may in fact be fallible. They spend hours in the library (clearly a VERY busy on call they are having) and go through all the ins and outs….. metabolic?…no, tumour?…. normal CT, so no…..infection?, CBC normal, so no. It’s then that Meredith has a brainflash to something the girl said…she’s a gymnast. Turns out she had a minor head injury some days ago. Nothing much, but it might just have…. Could she have an aneurysm? They ask Derek… No, it’s one in a million that a minor injury could cause an aneurysm to leak…. Ok, lets go…Where? To find out if Katie is one in a million. They do an urgent angiogram and we see images of an apparent subarachnoid haemorrhage on angiography. They also spot an aneurysm (which is clearly not visible from the images)

The reviewers felt that if that neurosurgical consultant could not come up with the diagnosis of subarachnoid haemorrhage, he should be struck off. It is not likely that the CT showed neither the bleed, nor the aneurysm, that they never sent the LP for xanthochromia or that in a fifteen year old girl with intractable seizures in a hospital in America, they didn’t do an MRI, MRA, EEG or some other even more expensive scan. Minus fifteen points for not bothering to get a doctor to advise on the script, and for treating the audience like a bunch of idiots.

The other interns aren’t having much more fun. Izzy the model is only allowed to do PRs on everyone (minus five). George is allowed to do an appendicectomy (in front of the whole staff, with no assistance, which the reviewers thought rather irresponsible, especially as there was no WHO check). Of course, he perforated the caecum and froze, the consultant had to take over, calling him a pussy, and earning George the nickname 007 (licensed to kill). Minus five more.

There are so many more desperately awful lines and in the spirit of sportsmanship the authors couldn’t find it within themselves to dock them any more. It was felt by the reviewers that everyone in this hospital was an idiot, and acts like an arsehole. So plus ten points at least for a realistic vision of surgeons at work.

‘I could quit, but here’s the thing, I love the playing field….’ Oh shut up.

Final score -73, CI 95%, P<0.0001.

CONCLUSIONS:
Meredith Grey is a bit of a dick and our junior doctors would not like to work with her. Those junior doctors questioned in the survey thought it was very unrealistic and it did not effect their attitude towards real world health care delivery, although they were equally poor at detecting some of the staged clinical conditions as Dr. Grey. We propose further work is now needed in this area to assess the effect of House on drug addicted sociopathic medical consultants. Soupy twist!

LEAVE A REPLY
Enter your comment here…

THEJOURNALOFMED TWEETS

when Ed Miliband is PM“@GaeMar01: when will #DavidNunn be reinstated at Guys and will he be promoted to #NHS Board?” 9 hours ago

@serafinowicz buttock recruitment 17 hours ago

@serafinowicz idiopathic 17 hours ago

Research: An RCT of A strong slap across the face vs. The sternal rub for assessing the GCS. Assault as a lifesaving clinical tool #ALS 3 hours ago

BMA chair claiming ‘victory over #NHS health reform’ is like George Bush claiming ‘victory’ in Iraq. It is stupid. http://bit.ly/l8zLpD #Doh 8 hours ago

FACEBOOK BUTTON

Gravel Sorrell-Williams | Create Your Badge

Blog Stats

5,948 hits

The Journal of Medicine · The sluice for medical science.
Blog at WordPress.com. Theme: Structure by Organic Themes. Fonts on this blog.