Please, view the YouTube clip prior to reading…
The first show to ever capture my fascination with medicine was Doogie Howser M.D. Shortly after my ‘Doogie Days’, as I affectionately refer to them as, I became obsessed with a new show that revolved around medicine; ER. Unless you have been living under a rock I am sure you are, at the very least, aware of this shows existence. The show followed the lives and work of physicians working in the fictional Emergency Room of County General in Chicago. Perhaps the reason I loved this show so much was for its dedication to depicting scenes with medical accuracy. Granted, for entertainment sake, a lot was dramatized and blown out of proportion but looking back on it now as someone who has worked in an Emergency Room, there are a lot more similarities than differences.
The clip I have selected showcases the culture of the ER perfectly. There is a sense of family among the people who work there, as they depend on each other to save lives. The first portion of the scene shows a nurse leaving a patient’s room and alerting the new interns and medical students that a patient is coughing up “red snappers.” A new medical student, unfamiliar with the speech community of the ER, asks for clarification. Red snappers, which are used in this instance to refer to a patient with Tuberculosis, are part of the language of infectious disease. As Ludwig A Lettau (2000) explains, terms like these incorporate color to explain the various spectrums that these terms represent. Various shades of red seem to be most common in describing infectious diseases.
In addition to a dedicated language, medical students and interns are presented with many ‘rites of passage’ on their journey to becoming a physician. This scene in particular shows the commonality of experiences between the medical students and interns by their telling of medical school stories. Everyone was told during medical school that it was highly competitive and that over half of the people enrolled would be gone within the year. It was this socialization process that ultimately shaped them into confident physicians. As Athena du Pre (2010) explains, students in medical school often feel belittled or punished. An example of this can also be seen in this clip when an intern talks about her days as a medical student when she referred to nurses by title rather than name. Punishment was doled out on the medical student in the shape of recurring requests for pain medication. However, this is all a part of the process in becoming socialized into the world of medicine.
The final portion of this scene shows a nurse referring to a patient by his diagnosis (naked, drunk and disorderly guy) rather than his name. As Athena du Pre (2010) points out, it becomes the norm to dehumanize patients. It starts in medical school where medical students are conditioned to treat the human body as inanimate. They work on cadavers in an effort to draw the line between emotion and medicine. Research suggests however, that communication is a vital component of patient satisfaction and many medical schools are now including communication studies as part of their core curriculum. The line between medicine and emotion is becoming more blurred than it was in the past. Patients are viewed as a person with feelings and emotions instead of just a body.
It is evident from this short clip that people who work in healthcare tend to have their own distinct way of communicating. Speaking from experience, its important to remember your audience. It is not always appropriate to speak with a patient the way you would a co-worker. I remember a patient I had a few years ago. We referred to her as ‘the lady with the halo’, referring to the brace she wore for a spinal fracture she sustained. She overheard us talking in the hall one evening and when I entered her room later that night she voiced her concern over us referring to her by a diagnosis rather than by her name. I’ll never forget that patient for she was the one who taught me to remember that a patient is also a person, a fact I pushed aside over the years as I became assimilated into the medical community.
Until next time…
Athena du Pre. (2010). Communicating about health. New York: Oxford University Press.
Lettau, L.A. (2000). The language of infectious disease: A light-hearted review. Clinical Infectious Disease. 31(3), 734-738.