Medical misconceptions and the media

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Most of us are educated in medical matters by medical television shows and depictions of medical procedures in movies. Unfortunately, media representations of medicine are often highly inaccurate, not only about the success rate and popularity of certain medical procedures, but about the procedures themselves. This article discusses some of the more common misrepresentations.

Contents

[edit] CPR

On TV, cardiopulmonary resuscitation, or CPR for short, is a show-stopping moment, rife with drama. Screenwriters make a lot of hay (and a lot of cash) out of dramatic scenes of drowning, car accidents, or other emergencies, after which people pound on the victim's chest shouting, "Live! Damn you!" And just when the doctor is about to give up, the victim coughs and opens his eyes. Behold; a miracle! Hallelujah, amen!

Cue record needle scratch.

The reality is very different. CPR is not actually used to restore someone's heartbeat, but rather as a stopgap just to keep the blood flowing until more serious efforts can be made to resuscitate the heart. In the TV world, it is effective 75+% of the time; unfortunately, its real-world counterpart is not even half as effective (2-30%).

The way the CPR is performed on TV is extremely misleading,[1] with actors often moving their shoulders exaggeratedly and bending their arms at the elbows (proper CPR requires stiff deltoid stabilization and locked elbows), as well as pressing against an area slightly lower than the approved hand placement (which is focused on the sternum). This allows CPR to be mimicked without causing injury to the "dying" actor (actual CPR can break ribs) and would be mostly ineffective against an actual victim.

Additionally, most episodes of cardiac arrest on television are shown to be caused by an acute injury (wounds, drowning, etc.), while in reality 75-95% of such episode are the result of heart disease. [2]

There was an urban legend about self-administered CPR circulating by email around 1999. This is, of course, absurd, since in order to be resuscitated, one first needs to be unconscious; if one can breathe, one is in no need of CPR. There is a technique called "cough CPR" that can be useful for patients experiencing sudden irregular heartbeats, but it works only in certain cases and doing it wrong may make things worse.[3]

[edit] Brain damage

...and it's not out of the question that you might have a very minor case... of serious brain damage. Try not to be alarmed. But if you are alarmed, try to hold to onto that feeling! Because that is the proper response to being told that you've got brain damage.
—Wheatley

"Brain damage" is a layman's term with no real medical significance broad term, which can refer to just about any damage to the brain and is widely used in the media to avoid having to name more technical and esoteric diagnoses.[4] On TV, "brain damage" is used to refer to an entire range of dramatic symptoms such as paraplegia, speech impairment, and disordered thought; as well as that all-important plot device, amnesia!

The reality is that various types of traumatic brain injury, strokes, and even infectious diseases can cause trauma to parts of the brain, resulting in a host of issues ranging from mild headaches to comas; this is why "brain damage" is not a technical term.

When brain damage is suspected, the level of damage to the brain can be assessed by testing how damage affects a patient's skills such as motor skills or their reactions as well as MRIs to see actual areas of the brain that are not firing correctly, are not getting enough blood, or are affected by tumors.

And no, you cannot "cure" amnesia by hitting someone on the head; this trope has led to the old joke in which you make sure to get hit an odd, rather than even, number of times. Cases of amnesia portrayed in the media are also almost always retrograde amnesia (loss of memories before the injury), but anterograde amnesia (inability to form new memories) is common as well.[5][6]

[edit] But can you become a doctor from TV?

Ironically, no matter how inaccurate these representations are, they can be helpful for medical students. There is a workshop for medical and health-professional students at the University of Massachusetts Lowell dedicated to analyses of the accuracy of medicine on television. This helps medical students in that they are able to see a variety of situations and how the characters react, then ask themselves, "Is this what I'd do?" With House, M.D., specifically, the dramatic situations in the show do present some real questions to be mulled over in Medical Ethics courses, such as, "If the fastest way to diagnose a dying patient could cause more harm, should you do it?"[7]

[edit] See also

[edit] Footnotes

  1. Reminding us of that old catch-phrase, "Do not try this at home!", and also that most things on TV are done incorrectly for the sake of "Lights! Camera! Action!".
  2. 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
  3. http://mendedhearts.org/resources/about-heart-disease/the-coughing-rumor
  4. Remember, folks: on TV, meaningless technobabble is just fine, but real technical terms are verboten.
  5. Can you get amnesia from a blow to the head? The Straight Dope
  6. Easy Amnesia, TV Tropes
  7. http://www.uml.edu/News/stories/2011-12/Anatomy-Med-Drama.aspx
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