The Good Doctor: Season 1 Episode 4

I wasn’t sure if I would continue to do these posts on the new ABC drama, The Good Doctor. One of the first posts I did got one of the largest responses ever on my FB page. The responses were 50/50 for and against the show. Many people want to champion the series because it highlights someone with autism working in the medical field.

The other half agree that if you’re going to highlight a medical drama— it would be nice to have it be the teeniest bit accurate. I’m not asking for a lot . . . just don’t give patients false hope or have them get such a skewed view of medicine that they trust medical professionals less. We’re already fighting that battle.

My disgruntlement with the show is not the fact that they highlight a character with autism— it is with the medical aspects of the show and how they handle their patients.

That is where my fight is . . . so let’s carry on.

In episode four, the main story highlights a woman who is pregnant with a child who has a large spinal tumor. The woman has already miscarried two children as the result of a clotting disorder she suffers from.

Issue #1: All surgeons cannot do all things. This continues to be a big complaint of mine for the show. One of the general surgery attendings is also a specialist in fetal surgery. I cannot tell you how specialized a field fetal surgery is. There are only a handful of these specialized doctors in the country. A general surgeon is not even, in their right mind, going to attempt something so risky for a notch on their proverbial belt. It would be negligent for them to do so.

Issue #2: OR’s are well lit. In this particular episode, I noticed all the OR scenes are shot in relative darkness. I’m sure this is so it looks uber cool for the viewer and there are times when OR light is dimmed, but we do generally want surgeons to be really able to see what they’re doing. Which is why they get really big lights.

Issue #3: Medical equipment called for— never placed on the patient. During the first surgery to remove the tumor from the child, the mother suffers a heart attack and they place her on a balloon pump that mysteriously never gets put in place. These are obvious pieces of equipment and it is never shown or mentioned again.

Issue #4: Surgery without patient consent. Despite the pretty serious complication of the first surgery, the mother is gung ho to go at it again, despite having had a heart attack. That’s actually believable. Mothers will do anything to save their child. What’s a little surprising is how gung ho the surgeons are. What follows are some pretty mind boggling discussions of who lives and who dies under what circumstances.

The attending surgeon offers a plan to not tell the mother that her surgery will end up being an abortion to save her life. That they’ll essentially lie to her telling her they’re going to take her to the OR for another attempt at saving the infant while really going in to end his life. On a one to ten scale of how unethical a plan that is to even be mentioned is like one hundred. The better person to float out an idea like that? A medical student. A resident. The attending? Those are the people teaching our young doctors— please have them be a representation of some sort of ethical boundary.

To be clear, the surgical game plan can change during an operation, but to go in knowingly deceiving a patient is malpractice.

Issue #5: The baby is just as monitored as the mother during the surgery.  In the scene of the second fetal surgery, the baby is just lying there on the mother’s stomach with no monitoring equipment. The baby is monitored as thoroughly as the mother.

What are your thoughts on The Good Doctor?

5 thoughts on “The Good Doctor: Season 1 Episode 4

  1. Totally unrealistic. I don’t have any medical experience. I have had four babies a miscarriage with a D&C and a surgery. That’s it! I don’t watch it anymore.

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  3. If the writers wanted tension in their drama, they would have written in a quality control department desperate to avoid medical malpractice lawsuits. If they wanted to burnish the reputations of medical centers as places of healing and scientific advancement, they would show a team of professionals doing their jobs with focused dedication and compassion–nurses on the front lines through the dark hours; impressively credentialed doctors reduced to frustration because the only answer they can come up with is “I don’t know”;* patients and families who refuse to give up even when everyone says they should. So many stories to tell, but the writers in Hollywood only know what they have seen on TV and in movies, and so what they write is a distorted reflection of reality.

    I wanted to like The Good Doctor, but I couldn’t embrace the premise. If a surgeon/doctor has problems communicating or following established procedure, I don’t know of any hospital that would ethically be able to employ him or allow him to practice on patients. Lawsuits are filed for much less, and I’m pretty sure a lawyer could gut a hospital for even taking the risk. I also couldn’t believe that an entire nursing staff would allow deviations from established procedure to the detriment of their patients. Even if it worked one time, they know that the odds aren’t in favor of it working again, and I just can’t believe that many nurses would be willing to risk THEIR patients just on a doctor’s say-so.

    *or THREE specialists reduced to playing hot potato because there are multiple comorbidities and they are trying to figure out which one needs to be addressed first.

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