* * Anonymous Doc

Saturday, December 4, 2010

Someone tell me why I'm still watching Grey's Anatomy.

And especially at 8AM on my only day off of the week.

Okay, I don't need you to tell me, because I know. I'll watch anything. What else am I going to do at 8AM on my only day off? My body can't sleep past 8 anymore. I'm lucky I can even sleep this long. I had a dream about my patients. I'm always having dreams about my patients. Nightmares, really. I forget to put in orders. I get in trouble. People die because of me. And I wake up panicked until I realize it was only a nightmare.

So, Grey's Anatomy. I can't do it. I can't sit through an episode without wanting to pick it apart, every little moment that makes. no. sense. if you've ever worked in a hospital. Or even been in a hospital.

If you don't want to be spoiled about the plot, stop here-- this is this week's episode, from Thursday, that I'm writing about. And I'm not even giving away any of the real plot, just the stupid medical stuff that's really incidental to what the show is actually about. But I don't care about Christina and Derek and whether Christina's ever going back to work-- as if a residency can just lose a resident mid-stream without repercussions, and as if they would really hold a spot for her-- and as if everyone would care! How do they have time to care? They're surgical residents!

But that wasn't the point I wanted to make.

First of all, scheduling same-day hip replacement surgery for a patient who walks in to be checked out. Nope. Never. No way. Makes no sense. No pre-surgical testing? No advance notice to book an OR and get a team together? No fasting for the patient? Etc. No way. Nonsense. And then he goes and gets a second opinion-- again, the same day!-- and then comes back to have the surgery, because of course her calendar is still open and there's still an available OR. They compressed a couple weeks of time into what we're supposed to think took half a day. Insane.

Meredith at one point says she spends her days off in the hospital. I had to pause and go back for a second. She says "I have days off, but I spend them here," or something like that. Nope. Sorry. What do you do, wander the halls distracting the people who are working? Do you have so little going on in your life that you can't bear to actually take your days off and sleep, or don't sleep, or-- anything-- but there is nothing for a doctor on a day off to do in the hospital but get in the way. So that's insane. Moving on...

The nurse who seems to know everything about post-op complications. I'm not going to argue with the idea that a nurse can be competent and know things the doctor doesn't-- nurses can be good, sure. But no patient is a particular nurse's patient, no nurse would be there to monitor a patient from surgery until five days post. They're on 8-12 hour shifts, they work 3 or 4 shifts a week, any particular patient is rotating through a number of different nurses, and it makes no sense to be able to say that all of the patients of nurse X do well because nurse X knows what he's doing. Great if nurse X is there when something's happening, but nurses Y and Z are going to be there too, and they're probably going to listen to the doctor even when the doctor wants them to do something bad for the patient, and it'll probably get done.

And attendings don't know nurses, or care. Nurses deal with residents, residents deal with attendings, the equivalent of Dr. Bailey would not be able to say something like, "sure, none of my patients who you're the nurse for ever have a complication," because Dr. Bailey won't have any idea what nurse is doing what, and she won't care.

What else? Doctors offering to marry patients without health insurance... and apparently there is no public hospital where the uninsured guy can get his surgery, I guess. Public hospitals exist. I'm there every day -- this month, at least. It may not be luxury, but we do treat patients. Patients who don't have insurance.

Okay, that's all that's coming to mind. I'm sure there was more, but I didn't take notes. Tune in next time, when I work myself up over the lack of hand-washing we see from television doctors when they enter patient rooms.


  1. You need to pick up a nice wholesome hobby, like maybe videogames.

  2. Well, we don't have a public hospital here in Reno, NV. I'm lucky -- I have good insurance (but it still cost me about $3,000 when I had a diabetic coma). I think you are a little too Pollyanna about the state of health care for the uninsured, working class poor and homeless!

  3. For some reason, I want to watch an "ER" marathon with you, just to hear you pick it apart.

  4. I'm a nurse, and I do the same thing to all medical shows. People don't want to watch them with me anymore.

    My only beef with this post is that you say attendings don't know and don't care who the nurses are. Again, what hospital are you at? I have worked emergency department, and I knew all of the attendings, and was on a first name basis with most of them. I worked cardiology, and the attendings who ever graced us with their presence at night knew us. And now, I work OB, and those attendings all know us by name. Sure, the residents do the grunt work. They do most of the deliveries that the doctors are too slow to get to. They manage the real emergencies when the sleeper doc doesn't wake up. And a lot of them are only second years! But the attendings do know us by name, even if they don't show up half the time.

  5. as an acute care RN, i take issue with your views of nursing. what you are not presenting is that most rns work 3 12 hour shifts, 2 days in a row. the day shift rns and night shift rns usually follow the same pattern rotation. so with long term acute care patients in a hospital setting nurses can pinpoint issues with a patient because of the continuity of care. of course there are pool staff too, and they can input with a fresh set of senses.

  6. Instead of Gray's Anatomy, you should be watching Scrubs. Maybe you could pick up some Dr. Cox tips on how to chew out your med student (I believe calling him girls' names is one key here).

  7. After reading your comments about "Love and Other Drugs" and now this, I'm with the person who wrote the first comment. Pretty sure it might be helpful for you to step away from all things work related once in a while. You could watch Good Morning America at 8am...or any one of those morning shows.

    Or you could get started on the great American novel. You tell a good story and I like your dialogue!

  8. A friend of mine is not only an attending, but the director of the medical residency program at the particular hospital I use. I was once in the ER when he happened to be there to see one of his patients. (I was there with my son).

    I watched him stop and address nurses by name, carry on a conversation with a transport person ..whom he called by name and then grabbed a cup of coffee and handed it to the med tech that had just finished a rather hairy procedure with a patient who wasn't participating.

    What's more .. his behavior was not unusual for what I'd seen in the hospital .. I've been in 27 times in 21 years, my husband has been in 8 times, my one son has been in 5 times and the other 7 ... and that doesn't even start to account for ER visits. Those are only admits that lasted at least 36 hours (not including 24 hour admits in those numbers) I've spent close to a year in the walls of the hospital (all days total as patient, wife of patient, mother of patient or daughter of patient) That's a lot of interactions between dr's, nurses and staff witnessed ...

    too bad you're not at my hospital, I think your views would be dramatically different.

  9. Ha, my doctor washed her hands, put on gloves, went over everything, took her gloves off, washed her hands. It's amazing how little people even put on gloves in these shows when seeing a patient. A lot of times they just give them a once-over with their eyes and diagnose them.