Wayfaring MD

I am a family medicine resident who likes to highlight the hilarious in medicine as I write about patients, medical school, residency, medical missions, and whatever else strikes my fancy.



Disclaimer:
HIPAA is for reals, folks. All of my "patient stories" have been changed to protect patient privacy. I will change any or all identifiers, including age, location, race/ethnicity, sex, medical history, and quotes. Also, I am an anonymous internet person. Why should you trust an anonymous internet person to give you medical advice? Don't ask me, ask your doctor!
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Posts tagged "House"

jameslj:

Does anyone know what that little hexagonal thing worn by TV doctors is? This is from House, but I see it on Grey’s Anatomy, too, particularly while they’re in surgery. #doctor #medicine #hospital

The hexagon thingy is a docimeter. It’s a little device that measures how much radiation you’ve been exposed to when you’re working around x-rays, CT scans, radiation therapy, or fluoroscopy. It’s an OSHA requirement that anyone who works around radiation wear one so that your total radiation exposure can be documented. 

Unless they’re using fluoroscopy in surgery, there’s no reason to wear one. I don’t wear one unless I go to the cath lab or something. I guess they wear in on TV to look more doctor-y. 

wayfaringmd:

I dont usually relate real life MD’s to fictional Tv series doctors. But I was curious to know can/are some doctors as really cynical,cold and aloof as Dr, Cox, Kelso, and House? If their are Dr. like this what got them to that point, and is it permanent/reversible? -illegallyawesome

Of course there are doctors like this. I think the big difference between the real life guys and the tv docs is that the real life guys (hopefully) don’t show their cynicism as blatantly to their patients. 

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How do doctors become cold and cynical? Personally I think they start out with a little of that in them already, and then it just grows through their career. I constantly hear snide remarks about patients in the “behind the scenes” times in the hospital. I know fellow residents, attendings, and students who very clearly hate patient care, yet they’ve chosen a profession that requires them to interact with people all the time. I’m not sure why people do this.

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If money is your goal, be a businessperson. If it’s prestige, do research and win the Nobel. If you love science but hate working with people, work in a lab. Get a PhD. Be a non-clinical physician. Don’t be a doctor if you don’t like dealing with people. 

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wayfaringmd:

  • For every cool medical show or funny story on a medical blog, there are hundreds of boring stories. 
  • Tv shows like House and even the ones on the Discovery channel are made for entertainment
  • They all have a morsel of truth (a very small morsel in the case of House), but it’s portrayed in such a way as to make it sensational so that more people will watch it. 
  • The boring parts like paperwork, charting, waiting for test results, dealing with insurance companies, and the tons of routine patient visits are left out because they don’t draw tv viewers (or blog followers…). 

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Asker s-seeking Asks:
Okay, I'm seriously wondering, please don't think I'm being a jerk: On a scale of 1-10, how similar is working at a hospital to the show House?
wayfaringmd wayfaringmd Said:

It’s about a 3. 

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The similarities: 

- real life and House happen in a hospital

- there are patients 

- patients often lie

Um, yup. That’s pretty much it. In real life, doctors stick to one specialty. We’re not all beautiful, especially after 24 hours on call. The puzzles are often less complicated, but sometimes just as hard. Our treatments are rarely effective immediately. There’s a lot more boring paperwork and procedural stuff that is never shown on tv. And generally, doctors who are drug addicts are given much more than a slap on the wrist when they get caught. 

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For more similarities and differences between tv and real life, check my Tv Medicine tag. 

I know real life doctors named House, Cox, and Kelso, and none of them are anything like their tv counterparts. All three of them LOVE medicine and patient care, and haven’t lost their joy for the job. 

I dont usually relate real life MD’s to fictional Tv series doctors. But I was curious to know can/are some doctors as really cynical,cold and aloof as Dr, Cox, Kelso, and House? If their are Dr. like this what got them to that point, and is it permanent/reversible? -illegallyawesome

Of course there are doctors like this. I think the big difference between the real life guys and the tv docs is that the real life guys (hopefully) don’t show their cynicism as blatantly to their patients. 

image

How do doctors become cold and cynical? Personally I think they start out with a little of that in them already, and then it just grows through their career. I constantly hear snide remarks about patients in the “behind the scenes” times in the hospital. I know fellow residents, attendings, and students who very clearly hate patient care, yet they’ve chosen a profession that requires them to interact with people all the time. I’m not sure why people do this.

image

If money is your goal, be a businessperson. If it’s prestige, do research and win the Nobel. If you love science but hate working with people, work in a lab. Get a PhD. Be a non-clinical physician. Don’t be a doctor if you don’t like dealing with people. 

image

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I understand how stupid it is to go into medicine solely based on a TV show but on a related note to that post, how often do you actually have puzzles to solve in family medicine? How many intellectually challenging cases would you, or a real-life doctor in a specialty similar to House's, get? Obviously you're not gonna be getting a case of smallpox from someone who was cut while diving in an 18th century shipwreck, but do you often have cases that are interesting and difficult to solve?
wayfaringmd wayfaringmd Said:

Whoa, I forgot this question was in my inbox. My bad. 

Well, every patient you see is a puzzle. The puzzles range from 10 piece kiddie puzzles to 1000 piece 3D jigsaws. Some don’t require much thought, while others can be very challenging. 

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Many patients will have something about their case that makes you go “hmm”. It may be something like “what drug did they overdose with,” “why is their sodium 124,” “what’s causing that weird feeling I get when I talk to the family,” “they’re allergic to every antibiotic I want to give them” or “is this appendicitis or something ovarian”. 

In the hospital, I’d say that maybe 1 in 40 patients is a real head scratcher. In an outpatient setting, it’s less. But almost all patients have some element of mystery. Also, every patient is different, so patient X with electrolyte imbalances may be handled very differently than patient Y with the same thing. That’s where your intellectual challenge comes in to play. 

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Regardless of your specialty, you’ll get challenging cases. You don’t have to be double boarded in nephrology and infectious disease (which is totally random, btw) like House to get good cases. 

  • For every cool medical show or funny story on a medical blog, there are hundreds of boring stories. 
  • Tv shows like House and even the ones on the Discovery channel are made for entertainment
  • They all have a morsel of truth (a very small morsel in the case of House), but it’s portrayed in such a way as to make it sensational so that more people will watch it. 
  • The boring parts like paperwork, charting, waiting for test results, dealing with insurance companies, and the tons of routine patient visits are left out because they don’t draw tv viewers (or blog followers…). 

image

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Just out of curiosity, if you had to pick a television medical drama to be in, which one would it be? (I'm going to go for Grey's Anatomy, my days at the hospital would be way more interesting if I was at Seattle Grace)
wayfaringmd wayfaringmd Said:

Hmmm….  I’d probably have to go with Scrubs, mainly because I think I’d totally melt under the pressure of Dr. House’s differential diagnosis sessions and his scathing insults to his team members’ intelligence. Dr. Cox from Scrubs insults people just as much, but it’s just a front, and unlike House, he seems to actually care about his patients. 

I never watched Grey’s, so I got nothing to go on there.

I did watch one episode of Hart of Dixie, and I’m 100% sure I could have handled that small town better than Dr. Hart. 

Is all that stuff that happens on grays anatomy true? and what about the TV show house. If that was real i would for sure really like be a dr. Also are you cute like the other Dr's?
wayfaringmd wayfaringmd Said:

Unfortunately, I can’t speak for Gray’s Anatomy, because I’ve never watched it (I know, I know). But if it’s anything like every other medical show out there, it’s only loosely based on reality. 

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Yes, medical cases like the ones on House do happen in real life, but they are not nearly as dramatic. People don’t get diagnosed and treated for major illness in the span of an hour (usually), and no doctor does everything like House and his team do. I mean, on House, the team is in the lab examining slides and doing their own blood work and such, whereas in real life you would be sitting at a computer hitting “refresh” until the lab results popped up, much like you do when Tumblr is down.

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And of course, the illegal shenanigans that take place on House and Scrubs —breaking & entering, switching patient charts, HIPAA violations, doctors working while impaired, etc—get you much more than a slap on the wrist in real life. 

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I wish a lot of that stuff was real. Real life goes at a much slower, often more frustrating pace. But I assure you, real life medicine is just as interesting and fun and rewarding as tv medicine (and probably more so).  


For more reasons why tv medicine is different than real medicine, check out these posts.

As for your last question, please know that real life doctors (and people in general) don’t look like they do on TV. But hey, after a 30 hour call when my hair and face have enough oil to run a diesel truck and I smell like C. diff and gangrene, I always feel like 

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EDIT: And it’s the jam. It was my #1 pick and I’m super excited, can you tell?

HAHAHAHAHAHAHAHA!

HAHAHAHAHAHAHAHA!

mrsmd:

This is extremely appropriate after our health literacy session this week. 

Favorite House moment ever.