but wouldn't the shaving part take place before the patient entered the ER? Shaving the head in the room where the surgery is to take place seems unsanitary.
shareYou would think but apparently shaving before increases the risk of infection.
shareYou are absolutely right that shaving would take place outside of the OR and the site would have been scrubbed with hibicleanse or chlorhexidine in preparation. It would probably have been done the night before or in the surgical holding area. For one, surgeons are required by Joint Commission to mark the spot of the surgery so they don't drill into the wrong side of the skull and that's difficult to do when the surgical site is covered with hair. For two, hair is full of bacteria and the way they shaved it left it completely contaminating the area. I worked as an OR nurse and I have seen groins shaved in the room in order to place emergency arterial lines or balloon pumps, but that's about it.
But really, that's pretty minor when it comes to the medical fails in this show. A short list:
1. So Ian is the real guy but yet Jason Cole went to college, med school, and completed a residency? Um, are we to assume Ian got himself fake ID at some point? Becoming a doctor requires background checks and identification.
2. Just the idea that anyone could become a surgeon only being functional from 8:25 to 8:25 is HILARIOUS. Surgical residents routinely work 48 hour on-call shifts and start rounds at 0600.
3. Diabetes as an excuse not to work nights. Um...what? They would have told him to take insulin and deal.
4. "Our test results show that Dr. Cole never had diabetes." Again, um what? No test could EVER show that. A hemoglobin A1C could show his blood sugar had been well-contained for 6 months, but that's as far back as you can go. And a tox screen does not routinely include blood glucose monitoring.
5. The idea that another personality has different blood and CSF and that you can design a kill drug if you get a CSF sample. Yeah, that's about as science fiction as they come. While Ian could have had different levels of hormones in his blood (as w/ an adrenal tumor)his blood and CSF would not have differed. (Or if for some magical reason it did, then why was he so worried about cocaine being in his blood).
6. The idea that DID episodes can be treated w/ meds in the case of Will. No, just no. You cannot suppress alters w/ meds. The meds he was on were to treat mood disorder and hallucinations--fine--but if he had really taken 3 times the normal dosage he'd be dead. And prescription pads are printed with each MD's name and not left lying around at the nurses' station where any psycho could steal them and write scrips. And the pharmacist, once seeing the prescribed potentially lethal doses, would have refused to fill the prescription.
7. Haldol just "hanging out in a drawer" in the MRI area where Dr. Lena could grab it and inject Ian.
8. Ian magically escaping being strapped to the MRI table after Lena ran away. (I guess he really is The Hulk).
9. The sterile field breaks alone could serve as a drinking game. Drink when Dr. Cole scrubs in, gets gloved and then removes his glove to stick his finger in a non-sterile glucometer. Drink when Dr. Cole scrubs in before tying his mask. Drink when Dr. Cole reaches up to touch his loupes (spectacles) mid-surgery. Drink when Dr. Cole leaves an inch of non-sterile wrist between his gown and gloves. I get that the general public is unaware of this, but really, why alienate a ton of medical professionals who might gravitate toward your show (I watched ER, House, Grey's Anatomy and enjoyed all of them) instead of paying a consultant a few hundred bucks an episode to point out egregious errors?
10. I will admit this is nitpicky, but the fact that the writers couldn't even be bothered to google how to read a CT scan is just...sad. CTs are looked at as if you are standing at the foot of the scanner and looking up toward a recumbent patient's head. So when they talk about the tumor on the left, it's actually in the right half of the brain.
And all of that is without getting into the stuff that all the medical shows do wrong--like neurologists don't run MRI machines, neurosurgeons don't do sutures in the ER, etc. And I know someone will accuse me of bring a troll (feel free to check my other posts--I mostly only post to verify what people suspect are medical inaccuracies) and someone will be like "If it's so terrible then why did you watch it?" I watched it because in addition to being a nurse I'm also a published author. I have a story idea involving DID and I wanted to see how this show handled it. Poorly. Very poorly. And it's kind of a shame because the premise really was fun and exciting. Too bad the writers couldn't be bothered to do even the teensiest bit of research.
Wow Thanks for educating a non medical guy like myself. That was good stuff. Like you said, the premise is very interesting and exciting, I actually loved this show, especially Steven Pasquale. I had know idea that it was that many medical errors in the show.
share@letta326, Thank you, thank you, thank you!!! In my post on "All Questions Answered [SPOILERS]" I stated, "I would love to hear the reaction of a real scientist to this show as I'm not a doctor or a biochemist, but it all sounded pretty ridiculous!"
I would love to repost this over there and/or have you read what I wrote and address, if you can, what you think of the "kill drug" and it's administration via surgery. I tried to follow the science fictional internal logic of what Reuben and Jason were trying to do and it just didn't track - even for a non-physician/neurosurgeon/scientist science fiction lover. It didn't even make much sense from a plot perspective.
I don't know why they didn't have a medical consultant. Maybe because there was no "real medicine" way to explain the basic premise of a Jekyll/Hyde type that turns exactly every 12 hours? Still, they should have tried harder with the other patients because a big part of this show was a medical procedural.
I'm amazed that you did watch the show, despite all this. Maybe because it was well acted and kind of fun to watch even though a lot of it made no real world or even science fiction sense? I enjoyed it despite it's flaws...
My original thought was that you would shave prior to surgery but I saw orthopedic surgeons and urologists shaving areas in the OR before routine surgeries. I even asked why this was done and I was told that this is preferred to decrease infections. If you shave in a non-sterile environment the day before or morning of surgery, you can cause micro skin damage which may allow for deposits of bacteria into the wound leading to higher chances of post op infections. But I'm not an expert; just a student and I haven't done neuro surgery yet.
shareThanks for taking the time to create such an informative post, Letta326! I'll never forget an episode of Law & Order: SVU where one of the main cop characters is in a car crash w/her partners wife who becomes pinned and the medics can't get to the pinned wife so the COP starts an IV for the very 1st time EVER and of course it takes about 5 seconds to get a flash, hook up the bag & voila, save a life!
I still love the show (L&O: SVU) and I love Do No Harm but they can border on ridiculous and should definitely do their research before just allowing anything to pass thru.
I hope that Do No Harm comes back, I actually like the Ian character, he's a hoot! Jason is the sexy Dr. who saves all & talks to all of his patients but Ian makes me laugh and that's definitely a hot button for me :)
Actually you do it in the pre-op, but you may do it, in case of an emergency, maybe, which in this case was.
With no power comes no responsibility...