Medical Dramas: They Can Educate

Medical Dramas: They Can Educate

I like reading and sharing pieces I find in the NYTimes, Chicago Tribune, WSJ. THIS IS ONE OF THEM… the title of the piece:

IN A TV SCRIPT, I CAN REWRITE A PATIENT’S FATE  by Daniela J. Lamas  

Dr. Lamas is a writer and co-producer for the television medical drama, The Resident, though her main employment is that of a pulmonary and critical care physician at Brigham Women’s Hospital in Boston. 

MEDICAL DRAMAS AND REALITY 

In her piece in the NYT, Dr. Daniela J. Lamas is very aware that she straddles two worlds, finding the writing gig an uplift from the death and dying she sees in her hospital’s Covid unit. When she can retreat to her messy call room, she uses Zoom to join a group of writers struggling with a scene, another medical emergency for Conrad Hawkins (Matt Czurchry), the eponymous hero of the The Resident.

Lamas never works in a vacuum, taking with her the image of the older female patient who now has Covid, her pastor having insisted she not get the vaccine. Dr. Lamas presents this situation to her writing team, hoping they will change the story line. Example: the pastor visits, sees his parishioner suffering and begins to preach from the pulpit that all his people need to get vaccinated. (But like Dr. Lamas, this story line is my creation. Will the writers group accept it?)

Dr. Lamas writes her reality: …though her lungs are slowly improving, her kidneys are worsening, and she is profoundly delirious, not waking up. We stand at the bedside and call her name, her eyelids flutter.

Down the hall, we titrate drips and manage vent settings for a man whose stem cell transplant cured his leukemia but ravaged the rest of his organs. His wife would be at his bedside, but she is at her father’s funeral.

And though the article does not say, I imagine this elderly woman did die from Covid, an unnecessary death.

STORY LINES THE WRITER’S ROOM REJECTS

Dr. Lamas writes: I used to want to show the hospital as it truly exists, to reveal the humor and tragedy and grace that characterizes my world. (She explains with the following examples.)

  • The family that came to say goodbye to a dying woman, a misplaced ID card leading them to believe, wrongly, that she was their mother.
  • A patient’s brother, with skull tattoos on his shaved head, who told us he could not be in the room when we took his brother off the ventilator. So when he left, we thought we would never see him again, but were surprised when he returned, not to sit by his dead brother, but to collect the man’s prosthetic leg. Another nurse said he spent the rest of the day in the hospital chapel with the leg beside him.

Dr. Lamas writes that even producers and writers for The Resident say such stories are simply too grim. The public does not need or want to be reminded of how quickly things can go bad, how families fall apart, how doctors do their best but patients still die.

Especially now, viewers want to see their doctor as heroes, to follow a formula that has doctors saving lives more than losing them.

IN THE WORLD OF THE TV HOSPITAL

Dr. Lamas writes: “During my first experience on the set…I learned that when things went wrong (a medical word being mispronounced) I was assured, “Don’t worry. We can fix it in post.” She underlines that she loved that phrase, one she wanted to say to her patients over and over. “…to be able to have another chance, to treat the sepsis earlier, to stop the pastor form advising against vaccination, to fix it in the post.”

Dr. Lamas reminds us that during the pandemic, her roles as a critical care doctor and a television writer are often in conflict. Though she wants to honor and remember every patient who died, she also yearns to tell stories that are hopeful, where there is always the chance for recovery, no matter how dire the diagnosis.

“It’s a tension I am still learning to navigate. How do we tell stories that feel true while also keeping viewers engaged? What kind of cheats are acceptable, and which are irresponsible?”

Dr. Lamas then makes a particular reference to the struggle that often ensues when the team is trying to save a cardiac patient. She reminds us that TV characters survive cardiac arrests far more often than people in real life do.

“…and the nurse left alone to clean up after the death…” If our viewers could see that, “they would change the channel.” She is right. I still remember during my Cardiac rotation, watching a team try to save a patient, the family waiting in an adjoining room. The man died. And yes, the floor was littered with medical pads, bottles, wipes, tubing…

IN THE REAL WORLD

Dr. Lamas is right when she stresses that medical dramas are important, that they can provide escape, but also education.

“In the writer’s room, we have a change to …offer a different ending to the story. And in doing so, we can sneak in potentially lifesaving education—early warning signs of certain illnesses, the dangers of overtreatment or the impact of inequities in access to care…television dramas have an unparalleled opportunity to educate and even to change behavior…I have come to believe that it is worth glossing over the facts IF we can weave a story that encourages viewers to trust science, to get vaccinated, to look differently at disease. When I find myself fact-checking what I see on the television monitors, I remind myself of this more important goal.”

Dr. Lamas ends her piece, mentioning a patient that she met one morning on rounds, asking him to mute the TV show he was watching, a medical TV show, as she needed to listen to his heart. He seemed surprised that he had to miss something, explained that medical dramas had been his one constant. The plots reassured him, taught him what might be ahead in his own medical story, while helping him feel less alone on his own medical journey. Dr. Lamas smiled. She understood.

(I confess that one of the reasons I became a nurse after having my three children—was my propensity to be gripped not only by books and articles about medicine, but by watching television medical dramas. I’ve written about that before. I was an avid ER fan. Now it’s New Amsterdam, Chicago Med, and of course The Resident.)

Empathy in the Workplace

Empathy in the Workplace
Thanks to GREEN APPLE BOOKS

A recent article in the Oprah Magazine underlined something I have known for a long time–the necessity of bringing empathy into your workplace. The Patient Experience Book Club, which is held at New York City’s Tisch Hospital, talked to Oprah about how the club can enlighten them, as they read about the background of certain groups of patients and thus are better able to empathize with their patients’ individual situations.

The group had read HILLBILLY ELEGY by J.D. Vance so that they might know better how to help patients whose needs echoed the society featured in the book. One of the doctors explained how the reading might help: “This reminds me of what we see all the time. Social determinants of health, right? How do you help a homeless person who comes in repeatedly? You get him a home. Then he stops coming back, because he can care for himself.”

Another participant in the group echoed that saying, “You can give all the medical assistance you want, but if you’re not addressing the underlying problems…well” and her voice trailed off. But everyone was nodding. The group comes together so that they can better understand the role of the healthcare system in our ever-changing society. Legal assistance, housing, food assistance, all of these needs weigh on the social worker who in the hospital situation works with the physicians and other staff members. Empathy and understanding is needed by everyone.

On a recent episode of NEW AMSTERDAM the hospital is challenged by a frequent flier, a homeless person who visits the hospital regularly for care–and because his care is free, he is costing the hospital millions of dollars. What Dr. Max, the head of the hospital, decides to do is out of the normal scope, for sure, but he finds the homeless man a place to live, using hospital funds to pay the rent. Yes, this is TV, but the idea is an interesting one, because paying the guy’s rent is so much cheaper than his constant medical care. And eventually this homeless man takes on a small job at the hospital to help pay his rent and everybody wins.

Reaching back to HILLBILLY ELEGY, another hospital official asks: “Can we apply anything from this to our patients–who, admittedly, are not from Kentucky and Ohio?” Another participant provides an answer that seems to satisfy the group: “If we get a sense of where patients come from, it can help us meet them where they are.”

I remember when I worked at Mercy Hospital in Chicago in the maternity unit–the impact of a woman who presented: usually in pain, often ready to deliver. There was much to do immediately–get her situated in a gown, in a bed. Take vitals, take blood. Start an IV and most of all evaluate the baby by listening to its heartbeat and doing an exam to determine how far along the mother was in her labor. There is little time to expand questioning that provides empathy. Even when hurrying, I had to be open and calm, understanding and warm. And often patients are frightened and don’t want to cooperate. As another member of the Tisch book club states: “Everything they bring with them is important in the presentation of the illness. It’s important to always understand their social factors–” Yes.

The group at Tisch Hospital stressed the importance of social workers who obviously are trained to assist healthcare workers with patients who need help with housing, food, and often protection from a family member or partner. One of the social workers replied: “Those (needs) ARE healthcare.” She’s right and I think we forget that in the voices and noise we hear everyday in the news, on television or see in the stories on film and television series. Healthcare is about maintaining homeostasis and all aspects of a patient’s life affects that–so do their social interactions.

This is an excerpt from one of my posts about forgiveness, which calls out for EMPATHY: In recent years medical science has urged forgiveness as an aspect of balance or homeostasis in one’s health.  Some studies have shown that forgiving reduces chronic pain, aids cardiovascular problems, and decreases depression and anxiety.  People who don’t forgive and harbor anger can have higher heart rates and blood pressure.

Final thought: we don’t need to be working in a hospital or have a social worker’s degree to know that being empathetic to another human is the right thing to do. Oprah’s piece about the book club at Tisch ends with a vision of these workers hurrying back to their jobs and the chaos of patient demands. The writer states: But thanks to a few dozen dedicated readers, today might be a little different. 

Why not head to your local library, bookstore or online store–purchase a book today. Let’s all stay empathetic.

P.S. I am asking for empathy from my readers! I am using an new editor and working to get used to it AND, many of you did not get my post last week and might not get this one today. MANY WENT TO SPAM. This will be fixed and I apologize. If necessary this post will be re-posted this week. Thanks for hanging in there with me.