Medicine seeps into television shows of all kinds: Hospital dramas, crime procedurals and even supernatural series rely on the dramatic device of illness or injury to create suspense.
But the real-life doctors who advise Hollywood on medical matters prefer that you don’t bring expectations for fictional care into real-world emergency rooms.
As a Los Angeles-area doctor, I have consulted on several TV series and can attest from first-hand experience that a drama can only handle so much realism. Here are a few Emmy-worthy medical myths that real-world doctors wish would stay on screen and out of the hospital.
1. CPR Saves More Lives on TV
In one case, Jennifer Love Hewitt was close to solving the medical mystery I had cooked up for the small screen. “Ghost Whisperer” had called needing a nerdy cause of death, and I created a suitable story after consulting some medical and chemistry textbooks.
Scientific explanations that I sent to the show even popped up in the morgue-scene dialogue. But I had not been told that there would be a CPR scene at the end of the episode.
The show had faithfully represented its medicine — right up until Love Hewitt frantically but delicately caressed the victim’s chest in a rather watered-down version of CPR. Of course, the victim popped up as though awakened from a nap. I buried my head in my hands.
Medical topics abound on television, but accuracy often plays viola (stodgy, theoretically dispensable) to entertainment’s concertmaster violinist (sexy, moneyed, attention-grabbing) ― no offense intended, viola players.
In the “Ghost Whisperer” case, there were only minutes left in the episode, and the producers likely needed a quick happy ending that left enough time to cut to commercial before the next show came on. And they probably didn’t want their lead actress to break her nails doing CPR the “real” way, which usually involves breaking the ribs of the recipient with hard, forceful thrusts. You’re trying to shock the heart into beating again, after all.
Of course, JLH wasn’t trying to resuscitate a 90-year-old heart-failure patient, but CPR recipients who do “come back” are more likely to have a weak pulse, still be pretty much unconscious from the lack of oxygen to the brain and need a lot of assistance and rehabilitation before they can return to their normal lives. Ceasing to circulate blood is no joke.
“The obvious [departure from reality] is that the success rate of resuscitation is, like, 100 times greater than what it is in real life,” says Greg Moran, a former “ER” consulting physician who now helms the emergency department at Olive View Medical Center in Sylmar, California. “That’s been documented. There have been formal studies where they’ve observed X number of full [cardiopulmonary] arrests resuscitated on TV with a 90 percent survival rate, when in reality it’s more like three percent.”
2. Magical Time Compression Skews Public Expectations
While working on the show, Moran had to adjust his real-world ER mindset for the fictional “ER” in several ways.
“First of all, everything on TV is time-compressed. Things that would happen over many hours to days will happen very quickly,” Moran says.
So, no, your tests won’t be ready before the next commercial break. And, no, you won’t wake from a coma and immediately be able to recite the full works of Shakespeare, eat a bacon double cheeseburger or hatch an elaborate escape plan to evade the police guarding your hospital door.
3. Cutting-Edge Treatment for Everybody!
Moran also noted that real patients usually get standard treatment, not risky new procedures.
“On TV, it’s all about ‘do the advanced, supercool thing,’” he says. “Of course, on TV they always work, when the reality is the new treatments, the experimental things — most of them do not pan out, and they don’t work." But that doesn’t make for good television.
Also, the work the characters would do often extend far beyond the skill scope of a real ER doctor.
“Very often on TV, where they have kind of a limited number of characters, they have people doing things outside their specialties. We were guilty of that on ‘ER’ a number of times, because it’s just not practical to bring in a new character every time you need some new procedure done. They would have individuals doing these advanced techniques that, in reality, only some specialist would be doing.”
4. You’ll See a Specialist — Stat!
Moran sees the effects of some of these “TV cheats” in his own ER. Most of the time, for instance, when an emergency patient needed to see a specialist at his own ER, he says, “we would set them up for a clinic appointment the next day. But on TV [specialists] come in and talk to the doctor who is the main character of the show.
“People come in and they think they are going to get their gallbladder surgery that day or that the eye specialist will come see them at midnight. They think the plastic surgeon will come in and sew up their laceration. I’m sure some of that is from television and some is that they just have unrealistic expectations.”
5. Experimental Treatments Always Work
“TV is about creating drama and creating that situation where,” he intones in grave, TV-doctor voice, “‘There is this experimental treatment, but there’s only a 5 percent chance that it’ll work.’
“Of course they do it, and of course it works. And I think very often on TV you don’t see those long-term sequelae,” he continues, referring to a condition that arises from a previous trauma or sickness.
“You don’t see the person who survives and lives in a wheelchair for 40 years. You don’t see the person who ends up in a nursing home on a [feeding] tube and in diapers. That’s the part of medicine that isn’t reflected on TV very much.”
TV Doctoring Slapped With a Dose of Reality
Harvard-educated pediatrician Neal Baer, who produced many seasons of “ER” and “Law and Order: Special Victims Unit,” recalls a turning point in his work when researchers at Duke University wrote an article in the New England Journal of Medicine saying shows like “ER,” “Rescue 911” and “Chicago Hope” misled the public because they showed cardiopulmonary resuscitation was more effective than it was in real life.
“That gave me pause, and I wrote the response in the New England Journal,” Baer says.
“I said that ‘Rescue 911’ showed rescues, so of course the results were skewed! But they had a good point. We didn’t want to mislead the public. So it had huge ramifications in a number of ways. One, we actually did a show where Noah Wyle [Dr. Carter on ‘ER’] did CPR on an elderly gentleman and breaks several ribs. He gets him back, but at what cost?”
It’s Not Just Entertainment
Baer helped to initiate a new project to ensure that TV writers would have access to expert medical resources.
“[The knowledge that] people believed what they were seeing was the impetus to start Hollywood, Health, & Society at USC,” Baer says. “I was working with the CDC to get accurate information from them because it was important to give accurate information to the writers. People believe what they say, and we might be having some actual impact on people’s lives. Writers didn’t want journal articles. They couldn’t read them. They wanted stories.”
Baer then did his own research study looking at an unaired episode of “ER” and how the plotline about human papillomavirus as a cause of cervical cancer affected study subjects’ knowledge of the topic.
“The results were profound — really stunning,” he says. The study showed a threefold gain in medical knowledge compared to before the patients had seen the episode and was published in Health Affairs.
Baer now heads a new UCLA initiative to portray the social determinants of health in the media. He’s interested in educating the public on how stories about food security, LGBT issues, pollution and more can be health stories as well. His commitment to realism on screen is evident in his voice.
“If you’re going to go to the effort to make it look realistic, you can’t use the excuse of ‘it’s just entertainment,’” Baer says. “Television compresses time, you can’t get lab tests back in five minutes, but that’s not really the issue. When it comes to things like ‘vaccines cause autism,’ you’re doing a disservice.”
He made a point of featuring AIDS on “SVU,” in an episode in which a character believed that the disease was caused by a nutritional deficiency rather than the human immunodeficiency virus (HIV).
Moran agrees and points out that the style of “ER” was to be realistic whenever possible.
“We did pride ourselves that we were more realistic than other medical shows,” he says. “They liked to use the medical jargon and ‘talk like doctors and nurses talk.’ That was part of the novelty and appeal of the show, I think.
“’House,’ by comparison ― it’s a cool show and entertaining, but it is so far removed from any reality it was crazy,” Moran says, explaining that he found the show’s logistics, including a team of doctors all focused on one patient all day, ridiculous.
Get a Second Opinion
Medical shows run the gamut from fanciful to enhanced reality. Audiences should always do a reality check before taking anything on television at face value. It’s heartening to know, though, that the doctors behind the scenes really do want to communicate information and stories that can save lives.
Read More: How to Grow a Smarter Child
What Do YOU Think?
Are you guilty of diagnosing an illness in yourself or someone else based on something you saw on TV? Did you get a real doctor’s opinion, and were you right? Have you ever insisted to a real-world doctor that you had an ailment because of something you saw on a TV show? If so, how did he or she take it? Tell us your story in the comments.