Netflix Suspense Movie Clinical: Treatment of the Suicidal Patient

Proper Treatment of a Suicidal Patient. 

clinical-netflixNetflix recently released a psychological suspense (perhaps some would call it horror) movie called Clinical. It surrounds the story of psychiatrist Dr. Jane Mathis who is an expert in dealing with PTSD. She is recovering from her own traumatic experience, a patient attempting suicide in front of her, and has vowed to not care for these types of patients until her own issues are resolved. However, the work of regular psychiatric problems doesn’t seem fulfilling enough so she takes on the case of a facial transplant patient named Alex.

In one particular scene, Alex calls Jane and states he “took too many pills”. I don’t know how this could be viewed other than a suicide attempt. Instead of calling 911, she goes to his home. Once there, Alex is first scene barely conscious, but is evidently able to stand up and answer the door. From that point on, the conversation goes something like this:

Alex: “Did you call an ambulance?”

Jane: “What did you take? If you don’t tell me, I’m going to have to call 911.”

Alex eventually becomes unconscious. Jane then administers a drug via IM injection. In the next scene, Alex is vomiting.

Jane is holding a prescription bottle in her hand. “How many of these pills did you take?”

Alex: “I just wanted to sleep for a while. What did you give me?”

Jane: “It’s called naloxone. I only use it for emergencies.”

Just. Awesome.

Issue One: I can’t imagine how many ethical and legal lines it crosses that this psychiatrist did not have this patient involuntarily committed to the hospital under an M-1 hold when he clearly tried to commit suicide. I’ve seen M-1 holds placed on patients for far less than an actual attempt.  Clearly, this is a big medical no-no and really doesn’t do the patient any favors. Just because the patient’s worried financially about an ambulance ride doesn’t mean he doesn’t get one.

Issue Two: Let’s discuss the medical drug naloxone or Narcan. This is a reversal medicine for drugs that contain opiates. This would include drugs like morphine and heroine. It’s not clear what drug Alex took— all he says is sleeping pills. To me, sleeping pills would more than likely contain some kind of benzodiazepine, of which there is no reversal a doctor would personally carry, though one is available in the hospital setting.

Issue Three: The scene where the patient is vomiting after the Narcan is administered. I’m not sure if the writers are portraying that the drug induces vomiting so that the patient throws up the pills. If so, that’s not medically accurate. Narcan reverses the effects of opiates at the receptor level. It immediately brings the patient out of their high and they’re usually not very happy about that. Most often, we don’t want to fully reverse the drug as this can put a patient at risk for seizures so we may titrate the dose just to reverse the diminished (or lack of) breathing induced by taking too much of the drug.

I actually think it’s okay the doctor did these things if it would have been pointed out by her mentoring/treating psychiatrist that she acted inappropriately and he was going to report her to the Board of Healing Arts because of her actions.

That would have ramped up the tension/conflict on many levels.

Author Beware: This Is Us

Dear This Is Us— please portray nursing accurately. 

Few can argue with the success of the new NBC drama This Is Us. I’m an avid watcher of the show myself. If you like your heartstrings being tugged at every conceivable corner and you’re not watching then you’re missing out on a great opportunity for a good cry. Well, really, several good cries per episode.

nbc-this-is-us-midseason-aboutimage-1920x1080-koThat being said, I was mildly disappointed in a medical scene portrayed in Season 1, Episode 11. If you haven’t seen it, I don’t think I’ll be spoiling much unless you don’t the the fate of Toby post his Christmas collapse. If that statement is true then you should stop reading here.

In episode 11, Toby is getting prepped for heart surgery. He is anxious, but not overly so. It’s a cute and funny scene. There is a flurry of activity as the nursing staff gets ready to take him to pre-op. The conversation goes something like this:

“Name.”

“Toby Damon.”

“Place of birth.”

“Hope Springs.”

At this point, a nurse comes in with a very large needle and makes it noticeable to the patient.

“What is that?” Toby asks. “Holy Cow. Look at the size of that thing! I’m a big guy but geez.”

The nurse then inserts the needle into the IV port and delivers the medication. Another staff member says, “Look this way, we’re getting ready to take you to prep.”

Toby— after the medication takes effect. “What’s in that?”

Nurse replies, “You’re fine. Don’t worry about it.”

Toby asks again. “What was in that needle?”

Nurse responds. “Just medicine.”

Ugh. I mean, really? Let’s take a look at the medical problems with this scene from mild to annoying.

Problem #1: Place of birth is never asked. Although, I do like that they use what is called two patient identifiers— it’s never place of birth. Usually, it’s your birthday. Also, if he’s going to surgery, there should be some communication with the patient about his understanding of the procedure he’s going to have. “Sir, my name’s Jordyn. I’m one of the OR nurses here to take you to the pre-op area. What procedure are you going to have done today?”

Problem #2: It’s called Pre-op. Not prep.

Problem #3: This is getting more egregious. We don’t insert needles into IVs anymore. They are all needleless system. I get that it looks more dramatic to come in wielding a big needle, but it isn’t medically accurate. I haven’t seen an IV system you had to access with a needle in over fifteen years. In fact, in most tubing systems you can’t even insert a needle anymore.

Problem #4: If you are using a needle and the patient is anxious— don’t show them the needle. Obviously, this is one way to increase the patient’s anxiety which is not the direction we want them to go.

Problem #5: The patient asks the nurse twice what he’s being injected with and she doesn’t disclose it. Honestly, this goes against the very fiber of the nursing code. Nursing is about telling your patient the truth and educating them about what’s happening to them medically. Now, in an anxious patient, the explanation doesn’t need to be long. She could have simply stated, “Sir, it’s very common to be anxious before surgery. This medication is called Versed and will help you relax a little bit.”

Just so the staff writers of This Is Us are aware, I am available for medical consultation. Don’t make me hate a show I love by portraying medical people like they don’t care about a patient’s very direct questions. Little is seen in this scene of the medical staff using other methods to calm and relax this patient other than shoving a medicine in his IV and not even educating him about what it is.

That’s not how we take care of patients.

Author Beware: Ransom’s (TV Show) Cancer Problems

Author Beware: Ransom’s (TV Show) Cancer Problems 

There’s a new show airing called Ransom on CBS that centers around a high priced, privately paid negotiation firm. However, they might want to shell out some dollars and hire a medical consultant.

ransomIn the second episode, the show centers around a young man who has just received a lucrative major league baseball contract when he’s diagnosed with cancer, specifically AML, which is a form of leukemia. People kidnap his bone marrow donor and hold her for ransom.

What follows is a major spoiler alert for this episode so read no further is you haven’t seen the show.

The main medical problem centers around this patient’s choice for treatment. In the episode, he decides he doesn’t want chemotherapy and wants to go directly to a bone marrow transplant because “chemo will ruin my lungs and I won’t be able to play baseball.” Of course, the donor is found in time, the baseball player has “surgery”, and quickly recovers in a few days.

Issue One: A patient cannot go directly to bone marrow transplant. Conventional therapy must always be tried first. Bone marrow transplant is never first line therapy for this type of cancer.

Issue Two: A patient will get chemo and/or radiation to wipe out their own immune system in order to receive the bone marrow transplant. A patient cannot have any of their own immune system when they receive their “graft”. It also takes days to accomplish this and the patient is in strict isolation during this process because they have on immune system to fight off disease.

Issue Three: A patient receiving a bone marrow transplant does not go to surgery. The donor does get the cells, but it is simply via a transfusion (as in the same fashion as receiving a blood transfusion). They don’t even leave their hospital room. The person who actually goes to surgery is the donor to harvest their bone marrow.

Issue Four: Can anyone say isolation? Both before and after a bone marrow transplant, the patient is in strict isolation. This means ALL visitors must be gowned, masked, and gloved. The mother cannot be having a conversation with her son without any of these in place.

Showing the patient sicker would have made for a more intense episode. Even better would have been if his own immune system had been wiped out and the actual cells were taken for ransom— that would have truly been a life or death scenario.

I’ve never seen a situation where portraying the real medical scenario makes stories more boring. Writers everywhere— real life is always better than made up implausibilities.

Can You Commit Suicide With an AED?

Recently, my husband and I have been binge watching through all five seasons of breaking-bad-s5-400x600-compressedv1Breaking Bad. In the last season, a gentleman decided to kill himself using an AED.

AED stands for Automatic External Defibrillator. It is a quick rescue device used mostly by non-medical people for cardiac arrest. It is designed to recognize lethal heart arrhythmias and deliver a shock (electricity) if the patient is in one. The AED will not always fire. In fact, there are really only two arrhythmias it is designed to treat.

The question becomes, can you use an AED to commit suicide? An AED has two large, white patches connected to the device. In the show, the gentleman places one patch on his chest, pulls off the other patch and places the exposed wires in his mouth. After this, he turns on the device and discharges it, thereby killing himself.

aedThis scenario is highly improbable and here’s why:

1. Both patches must be in place for the defibrillator to analyze the patient’s rhythm. If they’re not, the machine will not progress any further.

2. Let’s say the AED would read the rhythm (one patch on the chest and exposed wire in the mouth)— it won’t deliver electricity for a normal rhythm (which this gentleman likely has because he’s alert and conscious.)

3. Let’s say the AED did fire for his normal heart rhythm— would he die? There is a slight chance that he might die, but only if the AED fired during a very sensitive time in the electrical cycle of his heart which has a very low probability.

All in all, I don’t find this method of suicide possible. Sorry, Breaking Bad, though I did love the series.

Author Beware: Don’t Make Medical People Look Like Uncaring Idiots 3/3

Today is the last post on my displeasure with a particular, bestselling novel. Click on the links to find Part 1 and Part 2.

In short, a fourteen-year-old girl has come to Planned Parenthood for the Morning-after Pill.

What follows in italics is an excerpt from the book where the nurse giving the patient her discharge instructions. I’m keeping the identity of the author and the name of the book anonymous.

 girl-1149933_1920Several more minutes ticked by before the nurse, her peppiness especially noticeable in the wake of her cool, serene, superior returned.  A brown paper lunch bag full of brightly colored condoms bunched underneath her arm, a prescription bottle in one hand, and a glass of water in the other.

“Take six right now.” She shook six pills into my clammy palm and watched me chase them down with water. “And six twelve hours from now.” She looked at her watch. “So set your alarm  for four am.” She shook the paper bag at me teasingly. “And being careful can be fun. Some of these even glow in the dark! ”

Wow! Just yikes. Trust me, nurses are usually not so peppy. How does the patient know the “brown paper bag” is full of “brightly colored condoms”? Can she see through brown paper? I digress.

Problem: What’s really wrong with this passage is the patient instructions. The author makes it clear in the novel that the patient is taking the Morning-after pill. There are two such pills. One by the same name and the other is Ella. Neither pill has such a dosing regime. Both are one pill only. That’s it.

I honestly don’t get the point of writing something so ridiculous that is so easily researched.

More seriously, this nurse’s teaching is cringe worthy. I don’t know a nurse on the earth who would talk about condoms glowing in the dark. How about having a serious talk about contraception? How about having a serious talk with a fourteen-year-old girl who is having sex and how she feels about that?

So much more should have been done for this girl in this book by these medical professionals that it was truly disheartening to read. Why? Because this is not the impression I want any woman of any age to expect when they interact with a medical professional about something as important as this.

Writers and authors everywhere— please, do better. Your words educate those we interact with as patients and this is not the impression we want them to have. I’m only asking for one, redeemable, medical person. Make all the rest awful— you have my permission.

Author Beware: Don’t Make Medical People Look Like Uncaring Idiots 2/3

Today, I’m continuing my discussion of an uber popular book that didn’t paint medical people in a good light— like at all.

You can find the first post here. I’m not mentioning the author or the novel here to protect the author from angry medical people everywhere (okay, perhaps it’s just me.)

What follows is the same encounter, different section. As a quick reminder, this fourteen-year-old girl believes she’s been raped and is looking for guidance from a female physician.

What follows in italics is an exert from the book.

doctor-563428_1920-1There had been a question burning in my throat for the last ten minutes, but it was her reaching for the handle of the door that forced me to say it. “Is it rape if you can’t remember what happened?”

 The doctor opened her mouth as if she were about to gasp ‘oh no’. Instead, she said so quietly I almost didn’t hear it, “I’m not qualified to answer that question.” She slipped out of the room soundlessly.

 Problem: There are so many problems with this response from this doctor to her patient that I am flabbergasted as to even know where to start. First, how about starting with a doctor who cares enough to simply ask a few follow-up questions?

Such as, “Please, tell me what happened.”

What is shocking is just the amount of information that has been disseminated to the population about getting mutual consent before a sexual encounter. In fact, in just the last couple of years was the infamous “Tea Consent” video which you can view below.

In fact, the video states, “And if they’re unconscious, then don’t make them tea. Unconscious people don’t want tea and can’t answer the question, ‘Do you want tea?’ because they’re unconscious.” So it seems the issue of whether or not this was consensual would be fairly easy to determine.

No consent, then a crime has occurred.

The first signal to this physician is her patient’s memory problems. This is very concerning for her getting slipped a drug so that she could be raped. If the physician feels this is something she can’t explore, especially considering the patient’s age, then she should seek outside guidance. This could rise to the level of needing to be reported to the police.

Never just stop and not say anything more. This young girl is clearly in crisis. A doctor is qualified to help this patient, particularly one in this setting, who should be clearly educated in circumstances just like this.

Who else can this girl turn to for answers if not a trusted physician?

Author Beware: Don’t Make Medical People Look Like Uncaring Idiots 1/3

I’m starting out my medical posts of the New Year truly fired up . . . and not in a good way. This title sounds harsh, doesn’t it? Sadly, it’s exactly how I feel.

If you’ve known me for any length of time, then you know I’m passionate (just slightly) about medical accuracy in novels. This is why this blog exists and a major reason was to clear up misconceptions about medical people and how they perform in their job.

teen-girl-2Let me first state, clearly, that you can have a bad medical person in a novel. They can even be doing bad things. Criminal things. That’s what drives fiction. Tension. Conflict. However, also should the author help the reader realize, in some fashion, that the author knows this fictional medical character is doing these things inappropriately and it is not a normal medical experience. To help with this, I encourage all authors everywhere to write a medical person performing ethically as a balance in the scene or book. This is beneficial so you don’t anger every medical person out there to want to hold gas and flame to your hard earned written prose.

Professionals like to be portrayed accurately in their profession. Anyone remember how Joy Behar angered thousands of nurses? Yes, this is what writers should avoid.

What follows is an exert from a highly popular mainstream novel. This novel hit both the New York Times AND USA Today Bestseller lists. I’m not naming the book or author here and if you know what either of these are, please do not leave it in the comments section. I’m only using the quotes as a teaching points.

For background, a fourteen-year-old female (from what I can tell from the book) believes she has been raped. She’s going to Planned Parenthood for the Morning-After Pill. The rape occurred on a Friday around midnight. The character is presenting for treatment Monday after school. What follows in italics is an exert from the book.

While she examined me, she explained what the Morning-after pill was. “Not an abortion,” she reminded me twice. “If the sperm has already implanted the egg, it won’t do anything.”

Problem: Medical professionals are careful to separate opinion from medical fact. A patient might view what an abortion is differently than their medical provider and ultimately a medical provider’s job is to disseminate medical information and not their personal opinion. If it is their personal opinion, it should clearly be identified as such.

Some people view abortion as terminating a pregnancy at any stage— including just after fertilization. You will find web sites that claim the Morning-after Pill is not an abortion pill. However, you also can find two, well respected medical sites (Web MD and The Mayo Clinic) that state one of the actions of the Morning-after Pill is “keeping a fertilized egg from implanting.”

Solution:  It would have been better for the medical provider in this passage to simply state the following. “The Morning-after pill works by delaying or preventing ovulation, blocking fertilization, or keeping a fertilized egg from implanting in the uterus. However, there is evidence out there that suggests that it also doesn’t keep a fertilized egg from implanting in the uterus. My personal opinion is that this is not an abortion pill.”

Given this information, a patient can then decide for themselves if this is ethically something they want to choose to do without the personal bias of the medical provider influencing their decision.

A patient should always be given opportunity to choose medically what works within their ethical framework. If the medical provider cannot support them in doing that (what is a reasonable decision) then they should refer them to a provider that can.

Next post, we’ll continue our discussion on the medical issues in this novel.

In full disclosure, I am pro-life.

What are your thoughts on this passage in how the medical provider relays the information to this fourteen-year-old girl?

Medical Scene Diagnosis: Part 2/2

Today, I’m continuing my analysis of this medical scene. You can read the Part I here. Last post we learned this patient has been in a terrible car accident. We’ll resume with the physician entering the room to give the patient the low down. My comments will be in parentheses in red. I’m just focusing on the medical aspects, not grammar.

doctor-840127_1920-1The door opened, and an older gentleman in a lab coat walked briskly into the room. He checked the clipboard hanging from the end of the bed, noted the numbers on the monitors beside the bed that were tracking Tony’s vitals, and nodded, apparently pleased with what he saw. (Patient information is not kept in plain view. Clipboards hung on the end of the pateint’s bed with medical information is a HIPAA violation. HIPAA is the law that protects patient information.)

“I’m Dr McGregor, your attending physician. Arnold says you remember the accident?”

“Just parts of it.”

“Do you know what day it is?”

Tony squinted his eyes as he concentrated. “Well, I was driving home from San Jose late Saturday night or early Sunday morning. Other than that, I couldn’t say for sure.”

The doctor made some notes on the chart. (Many hospitals have gone to computer charting.)

Tony forced a grin. “Is that a good nod or a bad nod?”

Dr McGregor smiled at him, peering over the frames of his bifocals that perched on the end of his nose. “That’s good. It’s Sunday, actually. You haven’t lost much time. Considering the shape you were in when they brought you in here, that’s a miracle.”

Tony nodded gently. “Yes, sir.  God is in the business of miracles.”

The doctor peered intently at Tony, then smiled. “Apparently so. You should have died.”

Tony tried to shift, then winced at the waves of pain and nausea that threatened to engulf him.

The doctor moved closer to him and laid a restraining hand on his shoulder. “Take it easy. If you want to move, ask your nurse for help.”

“I’d like to have my head up.”

“I think we can arrange that.”

Dr. McGregor beckoned to Arnold, who came around to the head of the bed. Using his forearm, he propped Tony in the bed, adjusted the pillows, and nodded to the doctor, who stood at the end of the bed. Dr. McGregor pushed a button that raised the head of the bed. Arnold eased Tony back to the pillows and adjusted the sheet covering the lower half of his body. (I like that it’s a male nurse because it’s unusual. However, the doctor is coming across as very stereotypical. He’s older, long lab coat, bifocals on the end of his nose. What are some ways to vary this character to make him more unique?)

Tony gripped the handrails as another wave of nausea passed over him.

Dr McGregor patted his shoulder. “It’s normal to have some dizziness after a head injury, and you got a pretty nasty bang on the head.”

Tony held up one bandaged hand. “What else is wrong with me, Doc?”

Dr McGregor cleared his throat before proceeding. “Well, some lacerations on your hands from broken glass.” He flipped another page on the chart. “Same on your legs and back. A couple of broken ribs. The most serious injury is to your liver.” (Remember in the first part of this scene, the writer noted his legs and feet were unscathed. Maintain consistency with the patient’s injuries.)

“My liver?”

“Yes. You sustained a fairly serious tear in the accident. We were able to stop the internal bleeding, but right now your liver is not working well. In fact, the most recent blood panel we did shows it is deteriorating quickly.  I’m sorry, Tony.”

Instinctively Tony’s hand moved to his right side. He felt the edge of a bulky bandage that covered his flank, the incision still tender.

“A person can’t live without a liver, can they, doctor?”

“Your only option at this point is a liver transplant.” (I liked this a lot because I learned something new. As a confessed medical nerd, the first thing I thought was really? Went and looked and transplant can be used in cases of severe traumatic injury to the liver. Check it out here if interested.)

“A transplant?” Tony felt sweat running down the back of his neck and realized his face was wet, too. He ran a hand across his forehead.

“Yes. We’ll enter your name and statistics on the national database for liver transplants. To be honest, although your need is critical, your physical condition at this point in time would place you near the bottom of the list. In the meantime, you will have to stay in hospital so we can monitor your liver function.”

“Come on, Doc. Don’t beat around the bush with me. Not everyone who needs a liver transplant gets one, do they?”

“That’s true.”

“So, what other alternatives do we have?”

The doctor squinted. “I’m going to be honest. Your best bet at this point is to have a close family relative donate part of their liver. That will be the best match and can be accomplished a lot more quickly than a regular transplant.” (This is a place to be careful with your statements. After all, a stranger can come up as a perfect match. It may be better to say, “Your best hope for a new liver is to test a close biological relative like your mother, father and any siblings. If they prove to be a match, this process will be faster than waiting on the transplant list.”)

Tony’s heart sank. This didn’t sound good. “So what exactly are you saying?”

Dr. McGregor blinked at him myopically. “I don’t think you would survive the waiting. If you have any close relatives, you should call them.”

“My parents are dead and I’m an only child.”

“I’m so sorry, Tony. I wish I had better news. There’s not much more we can do at this point. Except pray.”

This writer deserves a lot of credit for setting up some nasty odds and conflict for this character. Strong work!! Do you have any other medical suggestions? 

Medical Scene Diagnosis: Part 1/2

This medical scene was submitted by a fellow writer who wanted some critique and agreed to allow me to post my suggestions leaving her name off the piece. The scene begins with a victim of a motor vehicle collision coming into the ER. His car rolled several times during the accident. What follows is her scene. My thoughts will be in parentheses at the end of the sentence in red. I’m only going to comment on the medical accuracy. Grammar editing is not the focus.

crash-1308575_1920Tony screamed out to God, and flung his hands over his face. Rough hands grabbed his hands as he tried to pry off whatever was smothering him. (This is good as patients often feel like an oxygen mask is smothering. Kids particularly aren’t fond of them.)

“Hey, take it easy. You’re all right. You need that oxygen.”

Tony opened his eyes, blinking rapidly in the bright lights. As his blurred vision came into focus, he tried to see who was holding his hands.

Blue scrubs. Dark face. The whitest of teeth. Name tag. Arnold.

Tony tried to speak, but his throat was dry. Arnold reached over, raised the mask on Tony’s face, and placed something cold and hard in his mouth. Making sure the mask was securely replaced, he sat back in his chair. (In the initial evaluation of a trauma patient in the ER, a patient is never given anything by mouth until it is ruled out whether or not they need surgery. The more the stomach is empty, the less likely the risk of aspiration during intubation. In this situation, aspiration would refer to inhaling vomit into your lungs while the endotracheal tube is placed. Aspiration can mean different things in the medical arena. And I also don’t know too many nurses who actually sit vigilant at a patient’s bedside.)

“It’s an ice chip. It’s all you can have right now.” (I know, we’re mean. But not even ice chips.)

Tony nodded his gratitude and slowly savored the small chip. It may have just been ice, but at that moment, it was like ambrosia to his parched throat.

Swallowing carefully past the pain in his throat, Tony lifted the mask and tried again. “Where am I?”

“You keep that mask in place. You can talk through it just fine.”

He waited until Tony complied before continuing. “You’re in the Regional Medical Center in San Jose.”

“Accident?”

Arnold’s smile faded. “Yes. Doctor said you’re lucky to be alive.”

Tony nodded towards the container of ice. Arnold placed another chip in Tony’s mouth, replaced the mask, then set the cup where he could reach it on the bedside table.

“Where is the doctor?”

“I’ll go have him paged.” Arnold rose and left the room. (This is a situation where it is reasonable for a nurse to give the patient an update on his status and condition without needing to page the doctor. I may say something like, “Your leg is broken, but your other tests looks good. I’ll let the doctor know you’re awake and he’ll come in and talk things over with you in more detail.” Also, in the ER, doctors are generally present, and there may not be a need to have them paged. This can be very unit specific so you’d have some latitude as a writer.)

Tony surveyed his situation, beginning with his toes, and moving up to his hands. While he was achy all over, his feet and legs seemed to be unscathed. His chest and abdomen hurt, burning all the way through to his spine, and were heavily bandaged. (Saying his feet and legs are unscathed may be reaching a little. Remember, he rolled his car several times. At a minimum, there should be some bruising, cuts, or abrasions.)

His hands were bandaged but usable, and he took this opportunity to pop several chips into his mouth, crunching them to make them go down faster. Feeling with his hands, he knew his head was bandaged. Vaguely he remembered blood running into his eyes.

We’ll resume the analysis of this medical scene next post. Any other medical aspects you would change?

Medical Errors in Manuscripts: Criminal Minds and Bodies Hidden in Cement

Happy Halloween Redwood’s Fans! What fun festivities do you have planned for today? What will your kids be dressing up as to celebrate?

criminalmindsToday, I thought a fitting Halloween post would be an evaluation of a recent episode of Criminal Minds. I’ve been a fan of the show for years and am always intrigued with the cases and devious/suspenseful minds of the screenwriters.

A few episodes back, uber chipperPenelope was presenting a case about a woman who had been buried in a barrel full of cement. She stated the woman’s body was discovered using ultrasound and then proceeded to show a picture of the body that looked like a plain x-ray.

This is a common mistake among writers— not knowing the proper technology to site or the right radiology equipment to use. First of all, ultrasound couldn’t penetrate cement to find the body and the scan images would not resemble anything that you’re used to seeing.

What probably would be used is something that utilizes Ground-Penetrating Radar (something that can actually look through cement) and I found an extensive article that discusses its indications and use which I’ll definitely be referencing later.

Writers— keep in mind that not all forms of radiology are interchangeable with one another. If you’re discussing the use of a particular radiological study in your manuscript— make sure it’s the right one.

Have a safe and happy Halloween!