Urology Pearls: Televison medicine vs. real life

Shahar Madjar, MD

Audrey Hepburn, an actress and fashion icon best known for her beauty and her roles in Breakfast at Tiffany’s and in My Fair Lady once said: “Everything I learned I learned from the movies.”

The quote came to my mind, one autumn weekend night–the leaves out of my windows in Marquette were changing colors–while I was watching the movie Ambulance.

Ambulance is an action movie. The plot is implausible as is the case in many action movies. In fact, when making a decision what movie to watch, I first asses my alertness status. If I am tired, I choose an action movie because I can fall asleep for a great portion of the film, wake up toward the end of the movie, and still get the gist of the plot.

The story of Ambulance is something like this: Will Sharp, a man desperate for money to cover his wife’s medical bills and his brother Danny, who is a charismatic career criminal embark on a $32 ,million heist, the biggest in Los Angeles’ history. With one of the robbers wearing Birkenstock sandals and without an escape plan, the heist fails miserably. The brothers flee the scene by hijacking an ambulance carrying a wounded police officer and a paramedic, Gonzalez, who’s fighting to save the police officer’s lif e.

The movie quickly turns into a series of dramatic chasing scenes from which I learned that, when it comes to bank robbery, the LAPD is well equipped and spares no expense (an impressive fleet of police cars and helicopters are lost during the chase.)

The next scene, perhaps because it was related to medicine, hit me hard. I changed my position from lying down to sitting up and my mental status from semi-stupor to full alert: The condition of the wounded officer quickly deteriorates. Will and Gonzalez discover a bullet wound through which the police officer bleeds profusely. Gonzalez calls her ex-boyfriend who happens to be a surgeon. Her ex-boyfriend calls several of his colleagues who are on a golf-course. The doctors, via online conference call, quickly establish an on-the-job surgical training for Gonzalez, who, with no prior (operating room) experience, limited surgical equipment, and no anesthesia, cuts into the body of the wounded policeman, identifies his injured spleen, dissects the spleen free, and removes it, with no hesitation, nor complication. And all that, mind you, during a high-speed police chase, on a rocky, winding road, and under fire.

At the end of this movie … well, I can’t really tell you what happened at the end of the movie, because exhausted from all of this surgical drama, I fell asleep.

Do inaccuracies, exaggerations, and sometimes total falsehoods often play an integral part in movies depicting patients, doctors, medicine, and surgery? Does character development and the story line–The Drama–take precedence over medical truths?

A study by Luz Ramirez and her colleagues published in The American Journal of Emergency Medicine in 2021 examined a small slice of medical drama–scenes in which cardiopulmonary resuscitation (CPR) was performed. The researchers reviewed 836 television medical drama shows and identified 216 CPR attempts. A team of healthcare providers then evaluated each scene for the adequacy of the CPR technique that the actors employed during the scenes.

The American Heart Association publishes from time to time new guidelines regarding CPR with recommendations that include the rate and the depth of the heart compressions among other measures taken during cardiopulmonary resuscitation.

The study concluded that the technique shown on TV medical dramas was mostly inaccurate. Chest compressions, for example, were within the recommendations rate in only 42% of the CPR attempts performed by TV physicians (TV nurses and paramedics performed better). The chest was allowed to completely recoil before the next compression was applied in only 34% of the resuscitations performed by TV physicians (here, too, TV nurses and paramedics complied better with the AHA recommendations). And, finally, patients on TV did much better than in real life with an overall rate of survival from CPR at 61.9%.

Luz Ramirez concluded that the portrayal of CPR in medical dramas on TV is inaccurate and represents a missed opportunity for improving performance and communication on CPR.

Audrey Hepburn’s quote, “Everything I learned I learned from the movies,” is cute, charming, and rings true. For everyone else, consider reliable medical sources, consult a knowledgeable medical provider, perhaps take a CPR course. And, please, please, don’t rob a bank and refrain from performing heroic surgery while on an ambulance chase.

EDITOR’S NOTE: Dr. Shahar Madjar is a urologist at Aspirus and the author of “Is Life Too Long? Essays about Life, Death and Other Trivial Matters.” Contact him at smadjar@yahoo.com.


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