Why Is Medical Fiction So Entertaining for Docs?

September 14, 2012

Medical games and TV shows are at their best when they are least relevant to the actual health care. And they let me imagine a more glamorous professional reality.

I’m a bit of a sucker for medical fiction. A very little bit - I don’t have a collection of related paperbacks, nor did I get hooked on Grey’s Anatomy or St. Elsewhere. The only time I watch Scrubs is when I’m on a treadmill at my gym and I have no other choice. But I do admit to having seen most if not all of the ER and House series.

I have not been able to define what it is about these shows that captures my attention. It’s certainly not the wonderful acting or the brilliant storylines. I’ve heard some health care workers express fondness for identifying all of the bad medical factoids - the No. 1 favorite seems to be whenever somebody hangs an X-ray backwards or upside-down. I tried, but just found it impossible to keep a running tally of errors while following the actual plot. It was also exhausting to try; I work in health care all day (or, in my teleradiology case, night), why on Earth would I want to keep thinking about it in my downtime?

It’s not just passive entertainment, either. I’ve played a handful of medical-based games over the years, and they’ve come a long way since the old days of Operation. My current addiction is a House-based game, courtesy of Facebook. I suppose I was a setup for this one since I’d already watched the TV show.

I think these games have finally shown whence comes this morbid fascination of mine: Their content, much like that of the TV shows, is at its best when it’s least relevant to the actual health care. And it sometimes lets me imagine that my professional reality is a little more glamorous than it really is.

Take, for instance, the House game’s demonstration of radiology. When you are supposed to be reading an MRI, you are in fact given a short time to play a sort of concentration game. The more tiles you match, the more “budget” you get for your department (and incidentally, the game pays more for a fake MRI in 30 seconds than real life does for a case that takes me five to 10 minutes).

Far more appealing, it is, than the truth of what we actually do. Imagine if the “game” were to scroll your mouse through a few hundred images and draw calipers around a dozen lesions - to say nothing of comparing against calipers drawn in a previous round of game play. And your reward would be the same for each “case,” regardless of how much time you spent or how good a job you did.

Similar substitutions of more realistic depictions could rapidly gut the rest of the entertainment value of these diversions. Take away the pleasant flirting between a fictional ER doc and charge nurse, and instead show the convolutions of a hospital’s HR department in response to the nurse’s write-up of the doc being a “disruptive physician.” Get rid of the scenes of a doc partying it up after hours with his colleagues, and insert depictions of him sitting alone at home with a stack of paperwork he must complete to comply with his MOC program.

Then again, I’m sure health care is not unique in a need to depart from reality in order to be entertaining to outsiders. I’m sure Merlin, and wizards in general, would have a few things to say about the way they’re being depicted in his current series.