Medical misconceptions and the media
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Revision as of 21:04, 18 November 2011
Medical shows on tv and medical procedures in movies are usually the way most of us get our medical degrees. Unfortunately, the representations on TV are often highly inaccurate descriptions of the medical procedures used, and how successful they are, how commonly they are used. This is a list of some of the more common misrepresentations.
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CPR
Cardiopulmonary resuscitation, is a dramatic, show stopping moment. People pounding on chests shouting "Live! Damn you!" often after dramatic scenes of drowning, car accidents, or other emergencies. And just when the doctor is about to give up, the victim coughs and opens his eyes. Rescued! AMEN!!
Of course the reality is nothing like this. CPR is not actually used to restore someone's heartbeat, but rather to keep blood flowing even a little, until someone can actually try to fix the heart. In the TV world, it is effective 75% of the time, but sadly, in the real world, the success rate is 2-30% only.
Further, the way the CPR is performed on TV is extremely misleading[1]. Noteably, on television, actors can be seen bending their arms that the elbows with exaggerated shoulder movements [2] and pressing against an area slightly lower than the approved hand placement (which is focused on the sternum). These techniques are used to mimic CPR without causing injury to the "dying" actor (actual CPR can break ribs) and would be largely ineffectual against an actual victim.
Additionally cardiac arrest on these programs was more often than not shown to be a result of acute injury (wounds, drowning, the like) whereas in the real world 75-95% of arrests are the result of heart disease. [3]
Other myths about CPR
There was an email circulating around 1999 about performing CPR on yourself. This is, of course, absurd, since resuscitation implies unconsciousness. If you can breathe, you don't need CPR yet. There is a technique called cough CPR which can be useful for patients experiencing sudden irregular heartbeats, but it works only in certain cases and doing it wrong may make things worse.[4]
Brain damage
Brain damage is a layman's term with no real medical significance used to refer to damage to the brain. But the concept is deeply ingrained in our TV shows, cause it avoids actually having to address real illnesses and real treatments. On TV, "brain damage" is the diagnosis for a collection of dramatic symptoms such as losing the ability to walk, to speak, to think clearly, and of course the all important plot device, amnesia! "Do I know who you are", "Doctor, why doesn't he remember me (and the affair he had, or the fact that I'm a raving lunatic)"
The reality is that various types of Traumatic Brain Injury, strokes, and even infectious disease can cause trauma to parts of the brain resulting in a host of issues from mild headaches, loss of depth of field of vision, to total comatose state. In fact the causes and the effects are so varied, there is no medical concept "Brain damage", as that term provides nothing of value to the doctor or patient. [5]
When suspected, the level of damage to the brain can be assessed by testing how damage affects a patient's skills such motor skills or their reactions as well as MRI's to see actual areas of the brain that are not firing correctly, are not getting enough blood, or are effected by tumors.
And no, you cannot "cure" amnesia by hitting someone on the head.
Brain Surgery today, up and walking tomorrow
When you have 60 minutes to solve a "rare medical dilemma" that happens every week (requiring a team of four to work only on your case and nothing else), you cut into people's heads as easily as if it were freezing off a wart. And the patient wakes up all happy ready to expose the next symptom that proves it's an autoimmune disease after all. And of course, brain surgery is effective, cause those tumors are so easy to cut out.
Of course, the sad reality is that Brain surgery, which is of course still very serious, does not have such a high success rate. Tumors are not lumps in the brain easily cut out, but are usually twisted into the actual healthy brain tissue, and may require removing some of that healthy tissue. If you survive the surgery itself, you still are likely to experience some level of dysfunction due to the removal of part of the brain.[citation needed]
But can you become a doctor from TV?
Ironically, no matter how accurate or inaccurate Medical TV is, it can be helpful for med students. University of Mass Medical and Health professional students can take a course that analyzes the accuracy of TV medicine. Not to complain, but as a way to see a variety of situations and ask "is this what I'd do". In a somewhat fun setting, they can discuss how fast tests actually take; how accurate tests are; and how likely the "unlikely" really is. With House, specifically, situations that are dramatic but do present some real questions can be used for Medical Ethics courses. If the fastest way to diagnose a dying patient could cause more harm, should you do it? [6]
See also
External links
Footnotes
- ↑ Reminding us that no one should ever attempt something, even CPR, from Tv... cause it's usually done incorrectly for the sake of "lights, cameras, action!".
- ↑ proper CPR requires locked elbows and stiff deltoid stabilization
- ↑ Cardiopulmonary Resuscitation on Television — Miracles and Misinformation Susan J. Diem, M.D., M.P.H., John D. Lantos, M.D., and James A. Tulsky, M.D. N Engl J Med 1996; 334:1578-1582 June 13, 1996
- ↑ http://mendedhearts.org/resources/about-heart-disease/the-coughing-rumor
- ↑ Brain damage can affect moral decisions; a person with a specific type of brain damage is more likely to endorse killing, for example. Injury to a specific part of the brain has a specific effect on moral decisions. Brain Injury Said to Affect Moral Choices This might indicate that morality is a function of the brain rather than of any hypothetical soul.
- ↑ http://www.uml.edu/News/stories/2011-12/Anatomy-Med-Drama.aspx