Op-Med is a collection of original articles contributed by Doximity members.
As you know (and shame on you if you don’t), I have a “thing” for medical shows. Maybe it’s even starting to become a reputation. And maybe that’s why I was even asked to review the recently-aired, two-episode series premiere of Fox’s new medical drama, “The Resident.”
So…where to begin?
Let’s go chronologically:
The series begins in a night time O.R. where selfies are being taken over a patient ostensibly getting an appendectomy. Suddenly, an artery is cut by the tremorous chief of surgery as the patient woke up from general anesthesia (“got light” in the argot of anesthesia, or “Gas World” as I like to call it). What artery and how is not explained, nor apparently important. (Nor is it explored why the chief of surgery in a large medical center would be the one attending doing a mundane appendectomy…unassisted…at midnight. Action, not thought, is the coin of the realm for “The Resident.”) Massive hemorrhage ensues to the point that the scrub nurse declares, “You need to clamp something. We’ve already lost two liters of blood.” (And people say Americans don’t know the metric system.) Of course, the patient dies of PEA arrest (more on that later). And, the selfies are erased once the entire O.R. team decides to lie about a massive MI afflicting a patient young enough to need an appendectomy, but old enough to have a MI, but one where the first rhythm is inexplicably PEA and not VT or VF.
Night becomes day, and we see a brand new intern start off his residency by being assigned to the star of the show, Dr. Conrad Hawkins. Dr. Hawkins is a brash, arrogant senior resident who bullies his newly minted intern from the instant they meet — which is, of course, why everyone loves him.
Apparently, no rewrites at Fox were thought to be necessary — despite the rampaging of real-life egomaniacs throughout the land that have came to light in the past 3–4 months (a la Harvey Weinstein, Matt Lauer, etc., etc.)— when Dr. Hawkins demands unflinching loyalty and blind obedience at all times from his new intern.
In fact, the intern is already even threatened with his job and informed a prior intern is no longer in medicine because the all-powerful Dr. Hawkins summarily dismissed him from the profession. (This is certainly how safe workplaces usually thrive.) This is juxtaposed by a side-room tryst with a nurse, Nicolette or “Nic” (no last name is given…presumably because she didn’t go to medical school), where she proves her bonafides by stiffing (so to speak…mind out of the gutters, people; Doximity is a family website) the alpha male of the show, which is to be taken as edgy and not at all disturbing or tawdry.
This was, of course, only after Dr. Hawkins diagnosed lupus sight unseen after hearing from a perplexed senior resident of some poor person with a discoid rash and worsening renal failure.
Chastain Park Hospital — where the senior residents are almost as good as M3’s elsewhere!
This is then succeeded by an increasingly agitated IV drug abuser in the ED, who the sainted Dr. Hawkins diagnoses with endocarditis, due to Osler nodes in the patient. The doctor bribes her to stay for treatment by granting her 2 mg of Dialudid, rather than the 3 mg that she asked for.
She, of course, also has PEA arrest (which apparently is how everyone on this show dies) despite the fact the monitor shows systole. Regardless, the crafty intern presses on in a code, which the eminently-gifted Dr. Hawkins declares should be ended. He even badly misquotes end-tidal CO2 in CPR data to (mis)prove his point. Once the patient achieves return of spontaneous circulation, Dr. Hawkins declares the patient brain dead and sarcastically congratulates his new fledgling trainee.
I suppose I should now admit how stupid I feel for doing EEG’s, apnea tests, and consulting neurologists over the course of several days. Only if I could have been constantly threatened and belittled by the omniscient Dr. Hawkins as an intern!
As the show barrels forward, it’s increasingly unclear what type of surgeon the chief, Dr. Bell, is — general, but also does prostatectomies — which is also OK given the fact that the show is called “The Resident”, and there is no sense at all of what residency they are actually in.
Even more puzzling is the total absence of attending supervision on the show. It’s as if a neutron bomb struck Atlanta and all but a few precious attendings survived.
The completely bogus medical error statistic gets floated at minute 35 of the show right after Nic states that the hospital administration would be full of glee for the opportunity to bill the patient’s family “thousands of dollars a day” for ICU care. Never mind that the patient in question is a 21 year old who just arrested (PEA remember?) and could only go to the ICU for further care and nowhere else.
For the sake of brevity, I’ll skip over the second-year surgical resident who announces to families in the waiting room how their loved ones are doing. (I have to imagine it was unintentional, but, in that scene, the darker the complexion of the family, the worse the patient was doing. But, hey, Hollywood covered its bases by making the bearer of bad news an autistic Nigerian immigrant woman, so they’re good there…I guess.)
As episode one mercifully nears its end, Dr. Hawkins reveals he’s essentially a murderous narcissist when he attempts to turn off the ventilator on the young lady who arrested, since he has the metaphysical certitude of God in knowing that the patient is indeed brain dead.
So, why is my article called a “Blast from the Past”?
Because “The Resident,” despite its claims of medicine in a modern world, actually harkens back to a thankfully bygone era (which never really existed to the extent it does on this show) when doctors could be walking personality disorders and not even be counseled about it, let alone be removed from their position, as long as they were talented and brilliant. (None of this sounds familiar in Hollywood or the media today, right?) Residency is where doctors in training are allowed to learn only by doing, not by being taught, so that by their second year they see themselves as experts, (those of us who have trained and can look back over the past decade or two know that the most dangerous doctors are the ones who think they know everything and don’t even know what their shortcomings are, while the best are the ones who aren’t too proud to seek help when needed), and all attendings should be eyed suspiciously for their ulterior motives as treating patients are just means to an end only they truly know about.
Fox’s summary of “The Resident” on IMDb reads as followings:
“It centers on an idealistic young doctor who begins his first day under the supervision of a tough, brilliant senior resident who pulls the curtain back on all of the good and evil in modern day medicine. Lives may be saved or lost, but expectations will always be shattered.”
You did it.
Consider my expectations shattered.
I’m a 46 year old pulmonary/critical care/sleep medicine physician who has been accused of being a TV and film junkie (which is pretty good considering all the other things you can be a junkie of).