Clearly, four years of college, four years of medical school, and three years of pediatric residency did not constitute complete medical training. There are so many things I didn't know until I started watching action-packed TV shows, especially those with SWAT teams, detectives, and lots of blood.
My training was clearly deficient when it came to neck strikes. You know, when the bad guys sneak up on the good guy, randomly hit him in the neck with a HUGE needle and syringe, which contains a sedative that works instantly. I could NEVER do that. Yes, I placed central lines in a patient's neck, slowly, deliberating and carefully noting the anatomical landmarks, with a small needle and tape. But I so want to hit my neck! This seems essential, and I wonder how I've never been able to do this in real life.
Let’s talk about field medicine – everything that happens before you see a doctor, paramedic or nurse. If you're the bad guy and you get shot, you'll probably die instantly, even if you get shot in the leg. If you don't die right away, you'll just have time to say something mean to the good guy who shot you, then you'll tilt your head to the side and die. No panting, no crying, no pain.
If, on the other hand, you're the good guy and you get shot, you'll live, even if it's a shotgun blast to the chest at point-blank range. Miraculously, the bullet will miss your heart and lungs, and it will only be a shoulder injury, from which you will recover in a day. It doesn't matter if the bullet hole in your shirt is right where the heart is; you really only had a bodily injury.
You will live because your friends have the common sense and the training to shout, “Stay with me!” Don't die on me! Or something like that. This incantation is powerful and works in 95 percent of television shoots. (I really need to try this next time I run code in the hospital.)
However, there may be a twist and you may not get medical attention right away. In this case, your friends, without medical training, KNOW that it is ESSENTIAL to remove this bullet immediately! They will go through many contortions to extract the bullet while you are stoic. Forget the fact that there are veterans with bullets that have never been removed. Forget the fact that the damage caused by the bullet is much greater than the bullet itself; everyone is going to focus on extracting that ball. Oh, and at some point one of your friends will say, “It's already becoming infected!” » even if you were just shot 30 minutes ago. Damn it ! Remember President Garfield? He died in 1881, not from the bullet from the assassination attempt, but from the damage caused by doctors digging around to extract the bullet. In fairness, germ theory was not understood at the time and aseptic technique was not in fashion. Always…
Let's say you get shot and arrive at the hospital. The first thing you'll notice about TV hospitals is that there are only doctors. No nurses, no respiratory therapists. Doctors are multi-skilled doctors who provide all your care. A doctor will see you in the emergency room, take you to the scanner, perform and read the scan, take you straight to the operating room (I guess to remove that damn bullet your friends left), watch over you during recovery. room, and probably bring you lunch! These TV doctors specialize in everything! And they don't need any help, no x-ray technician to operate the scanner, no radiologist to read the scan, no anesthesiologist to keep you sedated during the operation, no care nurses to help the operating room doctor during the operation, and no intensive care doctors and nurses to take care of you during your recovery. Amazing! I wonder why we need all these other people in my hospital.
Perhaps you were seriously injured and are in a coma after surgery. Your intensive care room will be at the quiet end of the hallway. A nurse will almost never come. You will have a small IV, no stickers on your chest attached to wires, but there will be a heart monitor. Magic! Weird because in my real ICU, patients are covered in wires, have multiple IVs, have IV poles with 4-5 bags of IV fluid, and can't move without setting off some sort of alarm. Attention; the bad guy can sneak in, insert a poison syringe into your IV bag, and squeeze the bag. You will immediately have convulsions the second the bag is squeezed (I'm laughing now). I hope your doctor (who took care of everything else) will come and save you. And no matter how long you're in a coma, months or years (a la Steven Segal in Hard to Kill – seven years in a coma), don't worry. Your muscles will not waste away; you will not be weak or confused when you come to your senses. You will be able to jump out of bed and sneak out of the hospital without any problem.
If you're a good guy in the ICU, you'll probably be able to talk, even if you're intubated and on a ventilator (Be careful, if this happens to you IRL, talking is impossible in this situation.). If you're one of the few bad guys to arrive at the ICU and you get arrested, your monitors will stay online, the doctor will look sad and surprised, and you will die. You are at particularly high risk if you are supposed to make a statement in court or identify a drug lord. If you're a good guy and you get arrested, that same doctor will miraculously know how to run a code and you'll survive.
And no matter what type of surgery you had, you will heal quickly and be able to leave the hospital with only a limp, a sling for your arm, or a bandage for your forehead. And you will be determined to return to work tomorrow.
All I can say is thank goodness for TV medicine: I learned a lot! And it’s clear; be the good guy, not the bad guy!
Ann F. Beach is a pediatric hospitalist.