Monday, January 15, 2007

Expect the unexpected

Remember the girl with Hepatitis A?
It's not Hepatitis A.

She seems to be getting steadily better, but after consultation with 2 specialists, and many tests, we still don't have a definite diagnosis. It's probably a viral hepatitis, just from an "unknown" virus. So the treatment and course remain the same, though the community as a whole gets spared.

This is what medicine is often about. This is why I like House, M.D.
No, I don't know why House and his lackeys do all the procedures themselves. And no, I don' t know if those lackeys are residents, fellows, or just visiting professors. But at least the writers get the process of medicine right. Problem leads to hypothesis leads to testing and/or treatment. Evaluate results. Rework hypothesis, start over again.
Granted, on the TV show, the patients usually have an inexorable decline towards death, with numerous evolving complications; patients don't just spontaneously start getting better again. But that's what makes it a television drama. It wouldn't be satisfying TV to end an episode with the docs escorting the patient out the door, followed by just sitting around with no good answer as to what just happened in the last 58 minutes, taking consolation in the fact that at least the patient is better.

Despite what patients may think, medicine is often without satisfying, definite answers. Learning to deal with that uncertainty is part of the art of medicine.

I also like House because the characters are compelling and very well-acted, and I have fun trying to guess the diagnosis. But I won't get to watch it for three weeks: American Idol starts tomorrow night!


Dr. Mary Johnson said...

(Good-natured chuckle). Blech with a capital B on both shows.

I posted my thoughts on House a while back.

Dr Scott said...

I'm intending to post more on TV medicine soon. No show gets it all right (if it did, who'd want to watch?) but I do like House when it does, and I think it gets more right than most other medical shows. Can't stand ER or Grey's Anatomy, never cared to watch Scrubs or Chicago Hope. I did like St. Elsewhere (back in the day) and Northern Exposure for the same reason that I like House: the medicine is (mostly) real and the doctors are (mostly) real. Unlike ER, where the medicine is just a backdrop for a soap opera.
I have no rational excuse for liking American Idol however.

Dr. Mary Johnson said...

I liked Chicago Hope. I was quite fond of Peter MacNichols' lawyer ("the Eel") who got no respect (they eventually killed him off) . . . and Mandy Patinkin's manic-depressive surgeon.

There's always M*A*S*H.

There are no rational reasons for watching American Idol:)

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