As you’ve no doubt noticed if you read this or practically any other medical blog, we in the medical field tend to have dark senses of humor. They psychologists and other egg candlers tell us that this is a coping mechanism and maybe they are right. We often have to be careful to control that when there are non medical people, especially family, are around us. Still, we see humor where other people see tragedy. In many cases that extends to entertainment. A few years ago there was a cable show called “Maximum Exposure” on TV. It was billed as,

This fast-paced reality show features the most incredible stunts caught on tape. Camera crews from around the world catch everything from botched stunts to natural disasters. MAXIMUM EXPOSURE’s adrenaline-filled moments bring viewers the most awesome action on television with frame-by-frame, replays, extreme close-ups and slow motion.

The show featuired a lot of stunts gone wrong, sometimes with injuries. One memorable episode featured a kid on a skate board who road it down a steep railing and right under a SUV. No serious injuries fortunately. I’m sure most viewers were horrified, but those of us watching it at the station thought it was hilarious.

You get the picture.

When I’m asked what this job is like I often direct people to the following multi media resources for a realistic, if maybe discouraging view of what emergency medicine is like.

A Movie  The Hospital starring George C. Scott, Dianna Rigg, and Barnard Hughes. Set in New York City in the early 1970s, it shows the craziness that went on in some hospitals back then and in some cases still does. It’s a comedy, although a dark one. It doesn ‘t seem to get any air time these days so you’ll probably have to buy it or rent it if you want to watch it. I looked on Hulu and Youtube, but couldn’t find it.  I think it’s worth watching.

A Book I recently re read “The House of God” which was published in the late 1970s. Based on the internship experience of the author, Stephen Joseph Bergman MD who wrote under the name Samuel Shem. The book is set at the Beth Israel Hospital, now Beth Israel Deaconess Medical Center in the early 1970s, which puts it in the same time frame as “The Hospital”. It is a novelized version of his experiences as an intern in various areas of the hospital. It’s a pretty good read and although dated in many respects is still a good read and pertinent to EMS. The first half of the book in particular is very good, even though I get the feeling that after it was accepted for publication Bergman was told to make it longer and “punch it up” with some more material. Thus we are subjected to his political views on Watergate as well as several not so well written sex scenes. Bergman is a psychiatrist and was on staff at the Massachusetts General Hospital and in fact still practices. How much of that colored his writing the book I can’t say, but I wouldn’t be surprised if there was some influence.

Take his politics for what it is worth, read the book, learn the rules of the House.

GOMERS DON’T DIE.
GOMERS GO TO GROUND.
AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.
THE PATIENT IS THE ONE WITH THE DISEASE.
PLACEMENT COMES FIRST.
THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14G NEEDLE AND A GOOD STRONG ARM.
AGE + BUN = LASIX DOSE.
THEY CAN ALWAYS HURT YOU MORE.
THE ONLY GOOD ADMISSION IS A DEAD ADMISSION.
IF YOU DON’T TAKE A TEMPERATURE, YOU CAN’T FIND A FEVER.
SHOW ME A BMS (Best Medical Student, a student at the Best Medical School) WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.
IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.
THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.

The Fourth Rule is one that I’ve blogged about here in the past and has been mentioned by other bloggers. Since it was almost 30 years between my first and second readings of the book, I’ll deny any influence of the book on my thoughts. I just finished the second read of the book and I appreciate it more than I did all those years ago. Much of what Bergman wrote about back then still applies to medicine in general and a hospital that I won’t name in particular. I think it’s a must read for anyone getting into medicine of any type. Remember, the patient is the one with the emergency.

Which brings me to the Second Movie. The book was made into a movie which never saw theatrical release. At least to my knowledge. The story I was told was that the people who ran the Beth Israel were not pleased and threatened legal action. In any case, the movie can be occasionally found on cable and is supposed to be available at NetFlix. I saw it on TV several years, but don’t remember all that much of it.

TV Series Scrubs. The best medical show ever. Even non medical people get the humor. It’s also the most realistic medical show ever to be aired on TV. None of the “serious” shows even comes close to portraying the craziness we see on a daily basis. Sadly, no one will ever be able to do a show like Scrubs about EMS, because no one will ever believe it. As I’ve said a million times over the years, you just can’t make up the stuff we see. Only the people that wrote Scrubs did make up some of the stuff that we see on a daily basis. It’s a must watch if you are even thinking about getting into medicine. I read somewhere that the writers of Scrubs read “The House of God” as part of their research. That doesn’t surprise me one bit if it’s true.

Those are your homework assignments for the summer. Which is almost over, so you better get started.