The Death of Dr. Mark Sloan

Ahhh… Grey’s Anatomy Fans.

I need your help . . .

This may seem funny coming from a medical expert like myself but . . .

I. Have. No. Idea. What. Mark. Sloan. Died. Of?

Anyone know?

The tumultuous end of last season– the plane crash with almost every major character on the plane left us in doubt as to who survived and who didn’t.

At the beginning of the current season, it’s assumed Mark Sloan is dead. But then, he’s not. But then, he is.

From a medical standpoint, I do give Grey’s credit for showing some true aftermath of the crash. A renowned neurosurgeon who no longer has full function of his dominant hand and can no longer do surgery. Kudos. The post-traumatic stress aspects that had one character going through some fairly severe post-traumatic stress. Honestly, how Christina is still walking upright . . . you know after the whole gun situation too when she had to operate on Derick with a weapon to her head.


The confusing thing about Mark Sloan’s death was the ACTUAL cause of death was never mentioned. He had a major chest injury. We know that. He was coherent and talking after the crash. Good! But then, his happiness at Seattle Grace is noted to be “the surge”– which I guess is to equate with a real thing that can happen when a terminal patient has a period of lucidity in order to say good-bye.

But what would have been terminal for this doctor? His heart was too weakened by the crash he wouldn’t live? Hmm… how about a heart transplant? Vasoactive drips? An LVAD device?

To confuse matters more– he signs a 30-day DNR order where if he hasn’t fully recovered, they are to discontinue life support.

But, he still has the breathing tube in his mouth at the end of 30 days.

And here is my teaching point at the end of all my musings. Generally, a ventilator dependent patient (or one who isn’t recovering quickly) is typically taken to surgery and a trach is placed somewhere between 7-14 days (sometimes sooner.) A trach is easier to take of and a more secure airway. Having an endotracheal tube in the mouth and through the vocal cords for that long can cause damage.

So keep this time frame in mind fellow fiction authors.

And please . . . someone tell me . . . what did Mark Sloan die from?

Top Three Medically Inaccurate Shows: IMHO

Let me say first, television shows are not a good resource for medical research. Scratch that– reality shows where they actually film a medical team in action are good for sights, sounds, etc.

However, those fictionalized series written by writers are likely not. Here are my top three offenders as far as medical inaccuracy goes. This is not to say that I don’t love watching these shows– how else would I know they were so horrible for medical inaccuracy?

#3  Dexter: The reason I include Dexter on this list is that it perpetuated one of the leading medical myths. . . that you must keep the head injured patient awake. This is not true and doesn’t prevent a serious medical outcome. You can read here about this medical myth.


#2  FlashPoint: From giving a patient (my favorite character) too much Morphine that would have likely killed him to my favorite sentence, “I can’t detect a heartbeat. His blood pressure is low.” For one, if you are listening to the patient’s chest and can’t hear a heartbeat, then your patient is dead and therefore has no blood pressure and should receive CPR post haste!

#1  Grey’s Anatomy: I’m not even a surgeon and I know that watching Grey’s likely causes surgeons across the country to go into lethal arrhythmias. Two of my favorite instances of medical inaccuracy. One was a patient who needed major neck surgery– twice. After the first neck surgery, he’s placed in a C-collar to prevent movement. But then, it becomes medically necessary to do plastic surgery on his ear (not life saving by any means). In that shot, the patient’s head was turned all the way to the side so they could reach it. Guess his neck was stable after a mere few hours. Then he goes back for a second neck surgery and after that, isn’t even in a C-collar. That is some rapid healing– let me say.

My next favorite Grey’s inaccuracy was the chief resident having control over the nurses’ schedule. People, let me tell, physicians do not have anything to do with staffing nurses. Never. Especially to put them closer to a physician they are pining over.

What medical shows would you add to my list?

How to Write a Hospital Scene: Amitha Knight

As a doctor, I don’t like reading books or TV shows about doctors. Not because I’m jaded and think I’ve heard it all before (quite the contrary) but because often, it feels like the writers just haven’t done their research. I’m not talking about highly involved medical research—it’s the basics that can trip you up.
Here are a few questions to think about when writing a character’s hospital scene (please note that some of this is for US hospitals only).
1. Is your character on the right floor?
As many people know, hospitals are set up with different patients in different areas of the hospital. There are pediatric floors, adult floors, surgical floors, maternity floors, ICU’s, etc. Knowing where your character/patient would be placed in the hospital depends a lot on the type of hospital you’ve chosen for your story. Is it a small community hospital in a small town? Or a large teaching hospital in a major metropolitan area? The smaller the hospital, the fewer wards there will be (and often the really serious cases would quickly be sent over by ambulance to a bigger hospital). In larger hospitals, the ward will be more specialized so you shouldn’t expect to see mixing of patient types (i.e., adult surgery patients in a medical ICU ward).
Why does this matter? It has to do with your setting details. For example: If your character is in the ICU, he/she won’t see a lot of patients walking around with IV poles in their hands. And the rooms in maternity ward have more privacy than in an ICU setting. If your character is the doctor rather than the patient—they won’t be wandering around random hospital wards. Your medical intern isn’t going to be regularly wandering around the pediatric wards and playing with kids there.
2. Who will be taking care of your character/patient?
This can be confusing and again, depends a lot on the type of hospital in your story. Let’s say you choose a teaching hospital. Who will be taking care of your character? I’m going to focus on the different types of doctors and doctors-in-training because that’s what I know the most about.
Medical students: These are students in medical school. They have not yet yearned their MDs so they are not “doctors”. Medical students are often allowed to see the patient first and ask questions—but not in an emergency situation. They do not make medical decisions for your patients.
Residents and Interns: These people have graduated from medical school and thus are “doctors”. They see their own patients and make some medical decisions, but are still in training and run major decisions by an attending physician (see below). Interns are what residents are called when they are in their first year of residency. In some specialties, residents have to do a separate intern year at a different program before beginning their specialty training. That’s why the distinction is made.
Fellows: These are people who have finished their residency but are doing further specialization and are also overseen by an attending physician, though less closely than a resident.
Attending Physicians: An “attending” is the doctor who is ultimately in charge of your patient during their hospital stay. All major decisions will have to be run by him or her.
This hierarchy can make a huge difference to the believability of your story. For example—a medical student or an intern will not be in charge of breaking bad news to a patient unless they have forged some strong bond with your patient. This is generally the role of the attending physician. Likewise, the attending physician will not be doing “scut work” (tedious hospital work, ordering tests) unless they are in a hospital where they don’t have interns and residents around.
3. Which patient will your doctor characters see?
This is one of the reasons I can’t watch Grey’s Anatomy. If you are a surgery resident, you will not be delivering babies. If you wanted to do that, you would have done ob/gyn. If you are an ob/gyn resident, you will not be taking care of babies in the neonatal ICU. If you wanted to that, you would have done pediatrics. And if you are a pediatric resident, you will not be doing surgeries. Please, get it right! Your doctor characters really can’t do it all!
Originally posted to the Guide to Literary Agents Blog. Reposted with author permission.


 Amitha Knight is a former pediatric resident turned writer of middle grade and young adult fiction. She’s also a blogger, a book lover, an identical twin, and a mom. Follow her on twitter @amithaknight or check out her website: