I have a conversational topic for the med students that is REALLY moronic (good to give my brain a rest while I prepare for a really hard bio midterm this afternoon).
How realistic is “ER” (Thursdays at 10! NBC!) as an insight into the life of residents, interns, and medical students on a clinical rotation?
I am a BIG devotee of this show, and I have some guesses as to the answer: the amount of fatal mistakes, cutting of corners, and intra-office romance that occur on the show would happen in a normal hospital over a decade maybe, not over a nine-month TV season.
Any thoughts?
This doesn’t answer the questions (I don’t work in an ER and am only an expert in so far as I’ve spent way too much time as a patient in DC area ERs) but I have found Noah Wiley is never at any of the ERs I visit and this has made me very sad.
I’d have to go with ‘not very’.
It (and all the dramatic shows like it about medicine) have to, by nature, focus on the drama of life and death issues. EM is, at best, about life and death somewhere around 10 - 20% of the time, depending on where you work. Even in big city EDs, the majority of what you’ll see is urgent/emergent cases.
In addition to the folks with minor care issues (I have the flu, my kid has a runny nose, what should I do?), the majority of ED cases are urgent…MIs, strokes, abdominal pain, headaches, infectious diseases (really wide range of stuff there) and the products of social issues gone amok (drugs, EtOH, weapons and vehicles).
The show ER, and Rescue 911 and Emergency before it, have some benefit in that they raise awareness of what we do. The downside, however, is that they create false expectations. The public things every ambulance has well trained and professional paramedics on it (sadly, often NOT the care) and students attracted to EMS and medicine often go into these fields expecting life and death at every turn. Sadly, they frequently get bitter and ‘burn out’ when they realize it just isn’t that way all that often.
Take care,
Jeff
Our Genetics professor last year said that if you wanted to hear what some of the most rare genetic conditions are, just watch ER and they’ll diagnose them just from the history alone 
She said this full of sarcasm. But since then I’ve seen that in some respects it’s true, at least for the few minutes of study break I take to go down to the family room to visit the hubby.
I have to agree with Alyson, I’m just sad I’ve never met Noah Wiley in an ER! I was in ER 2 weeks ago with what turned out NOT to be thrombophlebitis but a severe case of tendonitis in my foot. The guy who saw me first (an RN) was not a poster child for the nursing profession by any means. The doc was in for less than 5 minutes and stood back from me like I had parasites crawling all over me. The waiting room was full of children at 3am! Some sick, some with sick? parents coloring and playing. No drama in Garland, Texas I suppose.
Hi Folks,
About 75% of the work that ER physicians perform is essentially walk-in clinic. Many folks still use the ER as their primary care physician. The other 25% is spent stabilizing folks for the other specialties.
Typically, in the ER at UVA, Traumas are “alerted”; the anesthesiology resident handles the airway; the general surgeons handle the injuries and the ER handles the paperwork. If the patient is very unstable, they are in the OR within 5 minutes.
Some good things about the ER is that you don’t take your work home with you and you don’t typically live at the hospital. ER is so totally different from anything that you will see at any hospital. Most of the action is for entertainment purposes. I do like the way they use the 360-degree pan on the camera and the spurting blood.
Natalie 
I was so totally focused on not seeing Noah Wiley I forgot I have also never seen Goran Visnic. Though one of the hottest men alive works at St. Vincent’s ER in NYC.
If the residents on ER come anything close to reality, then you should run, not walk, as fast as you can away from medicine. Case in point:
A family was brought in with severe hypoxia due to CO poisoning. The woman was preggers and everyone was out but her. She called 911 and they get there. The daughter, who looked around 11 or so, came out fine on her ABG reading. Only one problem twit! You as a resident should have learned in 1st year that a CO binds avidly to the Hb and that if it takes up 2 sites then the other 2 are taken up with O2. Still a 100% reading according to the clip we place on their finger. You have to know this already and he was a resident.
I was yelling at the TV and I am sure someone in the US heard me since all of London could as well.
My wife thought that was funny. THe consultant they have on ER is weak now I think. He probably just reviews the script and provides lame advice.
I was at the St. Vincent’s ER just a few months ago. (No cute guys but plenty of raving lunatics.) But my adventure very much illustrates the general point you’ve all been making.
Thought I had: pleuritis, pericarditis
I actually had: pulled an intercostal muscle at the gym
Time I wasted: seven hours, although I did catch up with reams of chemistry homework
My insurance company wasted: upward of a thousand dollars…
Yes, we’ve been spending way too much time in the ER lately, and I have never seen any guys that made it worth the wait. The docs I see look more like the chief of staff guy.
And the medicine hasn’t been too good either. My kids’ RSV was diagnosed as “I don’t know, maybe asthma” and then the croup was diagnosed as “I don’t know, maybe asthma” (by a different doctor). Both of these were diagnosed by the pediatrician in two minutes from the history. Maybe I should trek the kids downtown to the “real” hospital.
Anyway, I have always loved the show ER (until I had kids and can’t stay up that late anymore!) but I’ve also always known that it’s not very realistic. I thought they were doomed around 3rd season when everyone had already slept with everyone else - but they managed to salvage it.
You’re probably right as far as the time compression.
Of course, med students don’t spend entire years in the ER, residents (even EM residents) don’t spend years and years (non-stop) in the ED, etc.