The Mob Doctor Forums

FOX (ended 2013)

Needs better Medical advice or new writers ...

  • Avatar of sleeper1428

    sleeper1428

    [1]Oct 10, 2012
    • member since: 06/02/06
    • level: 3
    • rank: Soup Nazi
    • posts: 45

    I'm not sure if this show will be able to make it but I must say that they're starting off with the same sort of mistakes that many other medically related shows seem to exhibit. As an example, in the second episode you have the chief cardiac surgeon asking who the anesthesiologist will be for her case and then telling the resident that she wants sevoflurane used on her patient. Any medical advisor to TV shows ought to know that in this day and age the surgeon DOES NOT, I repeat, DOES NOT decide on the anesthetic that will be used on any given case. That is a decision that is up to the anesthesiologist who is a specialist in and who's expertise is in the art and science of Anesthesiology. The surgeon may CONSULT with the anesthesiologist as to his/her choice of anesthetic but there would be NO demanding, as was done in this episode, that a specific anesthetic be used. This would be tantamount to the anesthesiologist telling the surgeon what surgical procedure he/she would be doing and that, of course, would be an untenable situation. As a practicing anesthesiologist, I had this happen to me only once when a surgeon with whom I was not familiar, but one whom I had heard was terribly slow, sent in his chief resident to tell me that I was to do what he termed a 'routine epidural' for his abdominal operation. I sent his resident back with the message that I'd be happy to do so but that I would assume that he was going to do a 'routine thoracotomy' (a chest opertion), that if he could tell me what type of anesthetic to use then I would decide what surgery he would do. After that I had no further problem with this surgeon and we worked together for many years without another problem.


    Now, I understand why this was done, specifically, to provide an opportunity to introduce the real possibility of malignant hyperpyrexia in a patient with a family history of that complication. However, a good writer could have avoided this bit of medical protocol mayhem by simply having the resident who reviewed the record and made note of the family history of MH, speak up and suggest that the anesthesiologist be consulted to be sure he/she was aware of the problem. That would have avoided the absurdity of having a surgeon who knows next to nothing about anesthesiology making a demand for the use of a specific anesthetic.


    And finally, for a procedure such as was planned, essentially a cardiac transplant using the patient's own heart in order to remove a tumor situated in a rather inaccessible position, it's quite likely that the anesthetic chosen would be based primarily on a potent narcotic (narcotics have not been associated with MH), possibly in combination with small amounts of something like propofol, although the use of propofol would not be considered as a commonly used drug in this situation. In actual fact, a narcotic based anesthetic technique is probably the most common anesthetic technique in use for cardiac surgery of all types in this day and age.


    Looking over these errors, it's once again obvious that the medical consultant to this show either failed to understand the problem - a surgeon specifying the use of one specific anesthetic agent plus a resident and the chief surgeon being unfamiliar with current cardiac anesthetic technique - or as is more likely, the advice of the consultant being disregarded in favor of the easiest and most 'in your face' way to stage a given scene. This is the problem plaguing many medical shows these days - actors wanting more 'face time' and thus disregarding proper surgical mask protocol, residents being allowed to do cases that are far above their meager capabilities and the very worst, surgical cases being done with no evidence of either an anesthesiologist or a CRNA (Certified Registered Nurse Anesthetist) in attendance managing and supervising the anesthetic care of the patient, including the administration of ALL required medications and fluids such as whole blood, blood products, balanced salt solutions and any other drugs necessary during the procedure. These things are commonly violated in these shows with the surgeon often demanding that 'blood be given' or some 'drug' be administered when, in reality, the anesthesiologist or CRNA will generally do these things on their own, without the need for the surgeon to worry about them, thus diverting his/her attention from the surgical site.


    sleeper1428

    You must be registered and logged in to post a message.
  • Avatar of haldrey

    haldrey

    [2]Nov 27, 2012
    • member since: 02/23/08
    • level: 22
    • rank: Freak and Geek
    • posts: 3,919
    Forget the medical advice, although it lacks on that side it is a secondary plot. The show started a bit slow but has gain good momentum so what it need is more viewers and to generate more interest for it is a damn good show.
    You must be registered and logged in to post a message.