A recent episode of medical drama House opened with MD Remy “Thirteen” Hadley and her latest conquest engaged in a steamy girl-on-girl romp. Later, as Thirteen injected her lover with a massive needle for a bone marrow biopsy, Dr. House did some probing of his own, pressing the pair for details of their one-night stand.
With screenwriting like this, it’s not surprising that the show attracts 20 million viewers per episode. As with any major network drama, the focus is on developing the characters and their relationships. Naturally, attention to detail dwindles elsewhere: namely, the medical issues that the show supposedly revolves around.
According to most professionals, the “science” of shows like House misrepresents reality, and is often utterly inaccurate. U of T Professor Dr. Marsha Cohen recently worked with the writers of House to create a character—Thirteen’s lover—that displayed the symptoms of the debilitating lung disease lymphangioleiomyomatosis, or LAM for short. As the founder of LAM Canada, Dr. Cohen is an expert on the disease. Unfortunately, even her collaboration with the writing staff could not guarantee an accurate portrayal. Upon watching the episode, she was stunned with the number of errors they had made.
“With LAM, you get cysts in the lungs. And so in the show they had them cut out the cysts by surgery. That’s totally ridiculous, it just would never be done,” she said. “They specifically sent [the lung biopsy] to a pathologist who said there were smooth muscle cells, but then in the end, she gets a diagnosis of Sjogren’s Syndrome. There’s no way a pathologist would ever not distinguish between the two conditions on a lung biopsy.”
The blog Polite Dissent (politedissent.com), written by a family physician known as Dr. Scott, offers professional medical reviews of each episode of House, often criticizing errors in the most fundamental of medical judgments. His recent observations include criticisms such as: “the team should not have missed an ectopic pregnancy, that’s a first-year medical student mistake,” and “it’s sad when a team of alleged medical geniuses can’t diagnose a tension pneumothorax.” Each post receives a stream of comments from medical students, doctors, and fans who view the show with a healthy degree of skepticism. The site’s popularity remains a comforting indicator of the number of people who take the show’s scientific content with a grain of salt.
Granted, these shows never claim to be accurate. But at the same time, the science they feature has sound scientific foundations—the writers are just exceedingly liberal with dramatic license. The right balance of fact and fiction is crucial to the success of programs like House, ensuring that they are both compelling and believable. The problem with the constant intermingling of reality and fiction emerges when viewers cannot distinguish what is true.
The medical consultant for Grey’s Anatomy, Dr. Zoanne Clack, admits a need for drama always takes precedence over keeping the show grounded in scientific reality. In an interview featured on CBC podcast White Coat, Black Art, Clack spoke of being frequently overruled by the show’s producers for Hollywood’s sake. “Usually what we don’t keep real are time periods, how long it takes to recover from something, or how long it takes to be cured from something,” she said. “We had an ear surgery recently where a boy got a new ear and that usually takes about six months. We did it within a day.”
The show Numb3rs, which revolves around FBI agents who use mathematics to solve crimes, finds this balance, though it too is heavy on the fiction and light on the details. Nobody wants to watch a show that gets bogged down in the finer points of fractal patterns and Dijkstra’s algorithms, though everyone would like to think they understand the concepts. The show’s technical jargon, when combined with its oversimplified mathematical ideas, gives the viewer a false but satisfying sense of comprehension.
Programs like CSI: are often guilty of sweeping generalizations that summarize complicated scientific processes into neat conclusions. For most viewers, these synopses bring a pleasing finality to each episode. But for members of the scientific community, the oversimplifications and inaccuracies are disappointing. They are seen as a dumbing down of work that takes years to understand and is constantly shrouded with uncertainty and ambiguity.
When asked if she watches any of the scientific dramas, Dr. Cohen responded with a laugh, admitting, “I can’t stand watching them because of these inaccuracies. It drives me crazy.” Fortunately for the TV networks, many scientific and medical professionals simply do not have the time to watch these shows.
Of course, most TV audiences are willing to believe what they see. Millions of viewers inevitably glean a sizeable amount of their “scientific knowledge” from them. Is there anything of educational value these shows can offer?
According to public health experts, the answer is yes. Despite the technical imprecision and misrepresentations of scientific reality, these shows have proven to be good for one thing: increasing awareness of health and scientific issues in the general public. A report by the Kaiser Family Foundation (KFF) entitled How Healthy Is Prime Time? analyzed the health content of popular programs, asserting “the health content in entertainment television has the potential to influence the public’s knowledge, attitudes and behavior—for good, or for bad.”
Studies show that the influence of television has been beneficial in increasing public interest in scientific issues. The KFF’s case study of Grey’s Anatomy found that 17 per cent of viewers have sought additional information about topics they saw on the show. A recent episode focused on the effect of treatment on the rates of HIV transmission from mother to child. The analysis found that “the proportion of viewers who were aware that, with the proper treatment, there is more than a 90 per cent chance of an HIV-positive woman having a healthy baby increased from 15 per cent to 61 per cent” after watching the episode. Dr. Clack acknowledges that television is an excellent way of getting public health messages out. She said, “When I see a patient, I can tell that one person and they can tell a friend, but you’re not going to reach 25 million people.”
In spite of her qualms with the depiction of LAM, Dr. Cohen was ultimately pleased with the huge spike in interest in the disease after the “Lucky Thirteen” episode of House aired. “That was my goal, to try and get it on the show,” she said. “I think that goal was met. The number of hits to the LAM foundation website was ten times the normal number of hits the week after the show.”
Producers, scientists, public health professionals, and doctors cannot ignore the educational power of television. The U.S. Centre for Disease Control and Prevention now offers fact sheets on their website for producers who wish to responsibly incorporate health and science messages into their shows. The increasing integration of certain issues into primetime drama has been likened to the blatant proliferation of product placement on television (with less negative connotations, of course).
All things considered, television’s capacity to educate cannot be denied. It’s the viewers who must do their part by ensuring that what they interpret as fact is actually true. Doing your own research will help to clarify the issues featured on these programs, but leave the technical education to your professors—nobody will benefit from the surgical techniques shown on Grey’s Anatomy.
Dr. Andrei Hirsch, a family physician from Toronto, acknowledges the educational value of these programs but reminds us that they are, first and foremost, for our entertainment. “If I would want to look for mistakes or things that are not the way they are in real life, I could. But that’s not the purpose, that’s not why I’m watching the show. When I go home at night I’m looking for something to relax me,” he said.
His advice to budding doctors and scientists? “For anybody who wants to learn, there are, obviously, other things to do.”
