Morbidity and Mortality Review: Good and Bad Doctoring

[Driad]

This is where we can post reviews, comments, and questions about the medical aspects of The Good Doctor, including how the main character’s autism is portrayed.  Maybe we can get into as much detail as the medical reviews of House, M.D. at http://politedissent.com/house_pd.html  

In this medical thread we can compare episodes and discuss long term aspects of the show such as Shaun's condition, as well as diagnoses and procedures in individual episodes. Enjoy!

Edited October 3, 2017 by Driad

[rwlevin]

I think I'm going to do a little disclaimer. I'm not a surgeon. I am, however, a pediatrician and have spent plenty of time in both medical school and residency in the OR (when it's your patient, you're sometimes allowed to just be in the surgical suite regardless of whether you're a surgeon or not). I also did do one of those traditional rotating internships I spoke about in a previous thread so I did do 3 months as a surgical intern.

 

First year surgeons do not do surgery in the beginning of their residencies. When I was doing a rotation in trauma surgery, I saw the OR lists and most first years were removing fat pads or assisting on cholecystectomies. And this was in February, so more six months after they started. Mostly, first years do procedures such as chest tubes or IJ lines or central lines. Or, even more fun, changing wound packing and wound vacuums. That's pretty much what rounds was, going to each room and checking on their incisions and changing dressing or removing sutures/stitches if need be. Sometimes, I got the joy of doing arterial sticks if the patient had no access whatsoever. The rest of the day was spent writing pre-ops and post-ops, getting consents for procedures and getting patients cleared for surgery-which required talking to the medical team. Patients were not discharged by residents, they were discharged by attendings (even though the residents did the actual paperwork)

All surgeries have at least 2 doctors, be it 2 attendings, 1 attending and a PA, 1 attending and a nurse practitioner, 1 attending and 1 resident or 2 senior residents, however that's not until the end of the year after they've seen the procedure before. In addition to the doctors, there's a surge tech (surgical nurse, scrubbed in, to give equipment when needed), a runner nurse who gets any equipment the surgery team needs and another nurse who's the scribe. These guys can take turns if it's a long surgery.

 

Bigger hospitals have residents rotate in different surgical departments. The program I was in was small, so no matter what subspecialty was needed, we were the same residents that saw the patients. We did, however, answer to different attendings, not the same one. In any case, Shaun shouldn't be with the same attending the entire length of the show.

 

Now as for the show, if that girl were that sick, it would show in her bloodwork and she'd be in exquisite pain. I haven't seen malrotation, but I've seen intussusception and intestinal blockage and these kids do not look good. I've had kids where I just look at them and they start crying, they're in so much pain.

 

Path lab is not the same as the chemistry lab. Sometimes it's not even on the same floor. Astrid would not be helping with the bloods at all.

 

And there's no way that nurse would be there at 1am. Nurses have either 8 hour or 12 hour shifts. She'd be home sleeping by the time Shaun came back.

 

The woman with the tumor, it wasn't a medical emergency. They could have closed her up, discussed the options and then gotten consent, like the girl said. Or they could have asked the son. Hell, they could have tried shrinking the tumor with chemo and radiation to make the removal easier. If she didn't want the kidney removed, she has a case for malpractice. I actually saw a similar case where a girl had tumor all over her ovaries. The surgeons removed her ovaries and then it turned out she had lymphoma. Her mother was ready to leave the hospital AMA and sue (seriously, we ended up calling security to keep her in the building) because the oncologists said they could have salvaged the organs. Also, if all she has is one solid tumor, that can't be staged as a IV. You need metastases for that. And stage IV can't be cured with surgery alone. It doesn't matter anyway. Her case would have been discussed at a tumor board before her surgery was performed.

 

Can I also add that I've been in a multitude of different OR suites and not a single one has had an observation deck? Usually, they just have small windows. I was a little upset when I found that out.

 

Yeah, that's all I have for now. I can talk about the autism issue at a later date when I know a little more about Shaun (and as a pediatrician, I'm very well versed in the subject of autism)

[Lizzing]

A few questions from the second episode:  Is it even remotely possible that it was appropriate to order "morphine, as much as she wants" for the patient just diagnosed with cancer?  (Morphine I could see, it's that "as much as she wants" part that reads as unbelievable.)  Second, why was the girl with a stomach ache even in a hospital room being seen by a surgical consult?  Shouldn't she have been seen in the ER, and not even have gotten to a proper room?

[MalroMom]

Stumbled across this thread while googling more information about the episode. Found it interesting that a pediatrician commented that the girls symptoms were not consistent with malrotation. My daughter had malrotation and I was always very worried and her pediatrician always told me I was overreacting because she didn't look sick enough. Took her to a pediatric GI and they said abdominal migraines. Took her to the hospital and they acted like I was crazy. Took her to a different hospital, where they also acted like I was crazy. Finally an emergency physician listened (or perhaps just tried to placate me), and discovered through ultrasound she had a volvulus. Surgeon opened her up and her intestines were purple and dying. She survived but barely. Not all children are in miserable pain. I've connected with many parents who have experienced the same thing, some who have even lost their children because of it. No one believed them because their kid wasn't "in enough pain". (Some kids are in A LOT of pain, but definitely not all).

Edited October 5, 2017 by MalroMom

[Pink-n-Green]

On ‎10‎/‎3‎/‎2017 at 9:02 PM, rwlevin said:

 Can I also add that I've been in a multitude of different OR suites and not a single one has had an observation deck? Usually, they just have small windows. I was a little upset when I found that out.

Wait just a minute.  Do you mean to tell me that the Seinfeld episode where Kramer accidently dropped a Junior Mint into a patient's open abdominal cavity couldn't really happen?  :(  I'm kind of disappointed.

Edited October 5, 2017 by Pink-n-Green

[crgirl412]

4 hours ago, Pink-n-Green said:

Wait just a minute.  Do you mean to tell me that the Seinfeld episode where Kramer accidently dropped a Junior Mint into a patient's open abdominal cavity couldn't really happen?  :(  I'm kind of disappointed.

There have to be some hospitals out there with an "observation deck."  I'm an RN and witnessed a few surgeries in school but there was no where to drop a Junior Mint from- much to my disappointment.  Don't worry!  I wasn't going to really drop one even if I been in that location.  I was in the OR right there with the nurses and surgical techs for one case and right next to the surgeon for the other one.      

[rwlevin]

At the hospitals I’ve worked at, a child with abdominal pains would get blood work and an ultrasound (and maybe a ct) no matter what. It’s sad but true. I once had a kid with obvious appendicitis,the surgical consult Pooh poohed it but we got the blood work and ultrasound anyway. We were right but by the time the surgeons listened to us, his appendix had burst. I hate to say it but some doctors are just lazy.

 

As far as the morphine question goes, you start with a standard dose, 2mg IM, let’s say, but if you want to go above a certain amount, you either call palliative care (pain management)or a pca, which is a machine that gives a basal amount and allows the patient a button to push to self medicate(it locks out for a certain amount of time so if the patient can’t overdose themselves)

 

i dont know what was up with the girl in the room. We have had kids admitted to the floor with stomach aches before and if surgery was consulted in the ed and didn’t see them there, they will show up on the floor, however, like I said, most, if not all, of the imaging and testing will have already been done.

[Pink-n-Green]

I finally got to sit down and watch the second episode of "The Good Doctor".  Did anyone else notice that the young female's white coat had "FACS" after her name?  I thought she was a resident?  But FACS means she passed her boards so that wouldn't make sense.  I think I'll just continue to enjoy this show as mindless fun and try not to pick it apart or it'll drive me nuts!

[statsgirl]

On 10/3/2017 at 9:02 PM, rwlevin said:

Can I also add that I've been in a multitude of different OR suites and not a single one has had an observation deck? Usually, they just have small windows. I was a little upset when I found that out.

Now that you mention it, it makes sense that OR suites in real life don't have observation decks.  That's a waste of space that could be used for another OR or beds or even staff offices.

On 10/5/2017 at 9:29 AM, MalroMom said:

. She survived but barely. Not all children are in miserable pain. I've connected with many parents who have experienced the same thing, some who have even lost their children because of it. No one believed them because their kid wasn't "in enough pain". (Some kids are in A LOT of pain, but definitely not all).

I'm glad that your daughter was okay in the end. That must have been a horrible experience.

I know too many doctors who refuse to listen to patients because they "knew better".  It happened to both my parents.  My parents were both doctors and too much of the time their symptoms and impressions were dismissed.  My mother warned my father's cardiologist that the drug he was on was having adverse effects ten years before they took the drug off the market because it was killing patients.

[jhlipton]

Also, too, I would imagine that labs do their own "triage" and don't just go by "first come first served". 

On 10/3/2017 at 6:02 PM, rwlevin said:

ICan I also add that I've been in a multitude of different OR suites and not a single one has had an observation deck? Usually, they just have small windows. I was a little upset when I found that out.

But... every doctor show I've seen has them so the characters not in the room can make pithy comments as the surgery progresses.  Are you saying I've been lied to all this time?   [sobs]

[jhlipton]

RE the transplant: wouldn'f the donating hospital send the organ to the transplanting hospital? (and checked the weather first???) It seems like that would be faster than waiting for a team to come up.

[TwirlyGirly]

5 hours ago, jhlipton said:

RE the transplant: wouldn'f the donating hospital send the organ to the transplanting hospital? (and checked the weather first???) It seems like that would be faster than waiting for a team to come up.

IIRC, I believe what happens in RL is members of the recipient's transplant team travels to the donor's hospital and retrieves and "approves" the organ as suitable for transplant. Then the recipient's transplant team transports the organ back to the recipient's hospital. I suspect it's done that way so the recipient transplant team has first-hand knowledge of every step of the process and anything that may have gone awry that could compromise the suitability of the organ for transplant:

“For the transport of an organ itself, a medical crew is not required. But, if hearts, lungs or livers are procured, surgical teams from the transplant centers travel to harvest the organs at the procurement hospitals. Often, they are accompanied by a transplant coordinator, who provides proper information about timelines and organ quality to the team conducting the transplant in the transplant centers” (http://www.flyreva.com/the-gift-of-life-air-transport-of-organs-for-transplant/ )

[jhlipton]

Thanks for the reply, @TwirlyGirly.

[Pink-n-Green]

I can't believe I actually took the time to look this up, but the University of Wyoming is located in Laramie as is the University of Wyoming medical school.  So, if Shaun went there, he wouldn't have had to leave Laramie until he started his clinical training during year 3 of med school. 

Edited October 17, 2017 by Pink-n-Green

[TwirlyGirly]

I put links to some reviews I found online of the first three episodes, written by a woman who is autistic, in the Media thread. She has some good information about what the show is getting right, what they're getting wrong, and what things are over-generalizations.

[possibilities]

Did they say Laramie? I though they said Caspar.

[Pink-n-Green]

1 hour ago, possibilities said:

Did they say Laramie? I though they said Caspar.

Hmm, that's completely possible.  Now that I think about it, I can't recall if they mentioned Laramie or not!

[Annber03]

Yeah, I heard Casper, too. 

[Shellie]

I heard Casper as well, but he couldn't have gone to med school there, so he still had to live somewhere else during that time.

[MalroMom]

On 10/6/2017 at 9:49 PM, rwlevin said:

At the hospitals I’ve worked at, a child with abdominal pains would get blood work and an ultrasound (and maybe a ct) no matter what. It’s sad but true. I once had a kid with obvious appendicitis,the surgical consult Pooh poohed it but we got the blood work and ultrasound anyway. We were right but by the time the surgeons listened to us, his appendix had burst. I hate to say it but some doctors are just lazy.

I'm so glad they are so proactive there! Malrotation is really a scary killer because it so often looks like the flu or a stomach bug, so often hospitals just brush it off as such. Since you're a pediatrician I hope you don't mind me sharing with you that often kids with malrotation and volvulus do not have abnormal blood labs. They did check my daughters blood several times and it was mostly normal or occasionally slightly dehydrated (slightly low sodium and potassium usually, and I think slightly elevated calcium and one other thing - but just slight). Amylase and lipase were always very normal (not sure what those really mean, but I do know the doctor said those can sometimes indicate obstruction). Even with volvulus her blood was very near normal, nothing they would have been concerned about. Her surgeon said he had seen this happen several times with volvulus because a lot of the necrotic fluid and tissue can remain trapped in the tightly twisted loop for awhile before it starts permeating out and effecting blood test results. Something to keep in mind if you ever come across it. Also worth mentioning ultrasounds don't always catch a volvulus, it did catch my daughters which I am so thankful about because if it hadn't I don't think they would have done further testing. But most are actually found by barium swallow which is about 95% accurate for catching it.

 

Thank you StatsGirl!! She is doing so well now, which I am thankful for every day. I am so sorry your parents had to go through the same thing!! But it is a good reminder to all patients and caregivers that if you think your doctor is wrong, you really truly should keep fighting until you find one who will listen.

[Pink-n-Green]

On ‎10‎/‎8‎/‎2017 at 3:13 PM, Pink-n-Green said:

I finally got to sit down and watch the second episode of "The Good Doctor".  Did anyone else notice that the young female's white coat had "FACS" after her name?  I thought she was a resident?  But FACS means she passed her boards so that wouldn't make sense.  I think I'll just continue to enjoy this show as mindless fun and try not to pick it apart or it'll drive me nuts!

Watching last night's episode I noticed that The Costuming Powers That Be took FACS off of EVERYONE'S lab coats.  Poor Dr. Melendez, got his board certification ripped out from under him :(

[cyraxote]

On 10/8/2017 at 3:13 PM, Pink-n-Green said:

But FACS means she passed her boards so that wouldn't make sense.  

FACS doesn't mean you've passed your boards. You have to pass your boards to join the ACS, but ACS membership is not automatic. And you have to have practiced for a year after residency before you can apply, per the ACS website.

Edited December 3, 2017 by cyraxote

[Pink-n-Green]

9 hours ago, cyraxote said:

FACS doesn't mean you've passed your boards. You have to pass your boards to join the ACS, but ACS membership is not automatic. And you have to have practiced for a year after residency before you can apply, per the ACS website.

The ACS is an organization with different membership levels.  Membership is, I believe, open to med students and residents as well as attendings .  In order to be a Fellow (Fellow, American College of Surgeons), however, you need to already be certified in your surgical specialty.

[Driad]

Do surgeons actually talk that much in surgery, about subjects other than the surgery?  In “Seven Reasons,” Shaun probably thought he was being helpful by asking whether Melendez was in good enough emotional condition to operate, but if he needed to discuss that he should have done it earlier IMO.  If I were the patient and could hear them, I would want them to concentrate on their job.

[Driad]

In S01E15 "Heartfelt" a man is about to donate part of his liver, but he is allergic to the anesthetic so they stop the surgery.  They implied that there was no other anesthetic they could use.  Is that really true?

[Driad]

People have pointed out medical errors in several episode threads.  Is this show the typical case of "we have medical advisors but we ignore their comments because we want to make the story more interesting"?  Real medicine can be very interesting, and errors lower my opinion of a show.

[The Wild Sow]

One more thing -- if St. Bonaventure is such a state-of-the-art medical center -- WHY are the  surgical residents performing MRI's, PET scans, & other diagnostic imaging?  

Does this hospital not employ technologists (who actually know how  to do the exams?) Um, doctors generally don't know how; they have enough to learn without becoming techs, too!  How about radiologists, who know how to interpret the studies?  Not to mention admin & scheduling staff!  (Guess I'd be out of a job there!)

Last week Claire was talking to her friend right before her PET scan, just before she went into the scanner.  Claire, a young woman in her childbearing years (whether she is actively bearing children right now or not) was standing about 6 inches from a patient who was literally radioactive, without any shielding -- the patient's body was full of fluorodeoxyglucose-18, since she would have been injected an hour before lying on the scanner.    You just don't DO that.  

Guess that hospital  doesn't employ a Radiation Safety Officer, either.

[Morlock]

Let's be really honest, You or a loved one are very sick. You get this obviously autistic Doctor talking to you in that android voice. He may be a genius but you don't know him and furthermore you are not knowledgeable in medicine so are at the mercy of the medical professionals around you. 

So given all the cold hard facts, would you feel comfortable trusting someone like this?

[Drogo]

40 minutes ago, Morlock said:

He may be a genius but you don't know him and furthermore you are not knowledgeable in medicine so are at the mercy of the medical professionals around you. 

This describes every visit to every doctor. 

[Annber03]

Yes. He clearly knows his stuff regarding medical procedures and will consider all options, he's not afraid to be honest about what to expect and the risks involved, and he's very diligent and won't give up on a patient. That's plenty enough for me to trust him and let him help me. 

[theatremouse]

14 hours ago, Morlock said:

Let's be really honest, You or a loved one are very sick. You get this obviously autistic Doctor talking to you in that android voice.

"Obviously autistic" or not, it's very common for surgeons to talk "in that Android voice", or if not precisely that, a voice that shows they clearly know their stuff, and are in their own head, and in their own terminology, and will only speak in layman's terms when you say "what does that mean". Bedside manner or sympathizing with the patient is not a concern. The nurses are the ones who act like they care that you are an actual human and not just an opportunity to cut. If it's an emergency surgery, you talk to the surgeon for maybe 5 minutes, and depending on the procedure may not ever interact with them again. The juxtaposition between Murphy being "obviously autistic" on this show vs the rest of the doctors is exaggerated because the rest of them are shown to be 100% more empathetic (and more physically present with the patients outside of the operating room) than is normal in real life in the US. There are tons of not-autistic surgeons who might seem robotic or only interested in the mechanics of the procedure. They might even be more common than those who aren't. Murphy would fit in very well. Whether that's a good thing (or pleasant for the patients) is a separate matter, but it's an everyday occurrence the show ignores.

[Lady Calypso]

16 hours ago, Morlock said:

Let's be really honest, You or a loved one are very sick. You get this obviously autistic Doctor talking to you in that android voice. He may be a genius but you don't know him and furthermore you are not knowledgeable in medicine so are at the mercy of the medical professionals around you. 

So given all the cold hard facts, would you feel comfortable trusting someone like this?

I can say with complete honesty that I want a doctor who is good at their job and can give me all the facts. I can get past a little rudeness if they're able to do their job. 

I had an experience a few years back in university, where I hit my head after fainting and was taken to the ER just after midnight and the doctor there didn't seem to give a shit about me. But what bugged me wasn't as much his attitude than him not listening to me when I told him I was feeling sick and he gave me no information that I likely had a mild concussion. He just shrugged it off, put some glue on my head where I cut it open, and sent me on my way. I thought I was pissed at him being outright rude for a while, but then I realized that my anger was more about him not giving me any information or answering my questions. Looking back, what would have helped is if the ER doctor had told me "You have a mild concussion." If he had, then I wouldn't have had such a rough sleep that night, being afraid about the possibility of being concussed. 

It's not that I want a rude doctor with no good bedside manner. I don't want a rude doctor who doesn't answer my questions when I express concern, because then I just think they don't know what they're doing. And that experience was just at an ER in the middle of the night. I imagine having major surgery is different, but I still think people would rather a genius doctor who can do their job than someone who can't. After all, a surgeon is there to do surgery first. Bedside manner isn't their primary concern. If I had an autistic doctor who had performed my eye surgery at eight years old, my only concern would have been if the surgery was successful. Yes? Then who cares about their attitude? They're only going to spend a few minutes with the patient, anyway. Whatever ill feelings you could have toward someone like Shaun in terms of his behaviour, it's only temporary because in the long run, you'll realize what's more important is that he can do his job well. Long term success always outweighs short term uncomfortable behaviour.  

Also, there can be workarounds with someone like Shaun. It just takes some time and patience to find it. 

[possibilities]

Some people are not comfortable with a woman doctor because they believe women to be too emotional, or a doctor who isn't white because they are racists who think POC are not smart enough. Tough shit. If someone has a prejudice that prevents them from accepting medical care, that's their problem. We can't cater to people's prejudices like that. You'd have no reason to assume the hospital didn't vet their hires, and thus you have no reason to suspect a doctor is not competent, just because you have a prejudice against their gender, race, or disability.

Now, when they do things like fail to listen to you or take your symptoms into account, or they don't answer questions relevant to your treatment, yes. That's a real problem. But Shaun is actually the opposite of that, so a patient who is not comfortable accepting care from him is really no more justified than one who would say no to being treated by Dr Lim or by Claire. And we saw that when a racist patient wanted a white doctor, the hospital didn't cater to that, and they provided him with competent care despite him spewing his terrible disrespect toward his physician.

[Madding crowd]

I wouldn’t have a problem with a competent doctor who spoke in a robotic manner or a doctor who didn’t sugar coat things. I would have a problem with a surgeon who could freak out in the middle of a surgery and could endanger my life in the process. I have felt all along they are showing Shaun a bit too easily rattled and I would rather see him very calm and controlled while practicing medicine and perhaps having issues in social situations.

I understand they have not shown him endangering a patient’s life and they won’t, but it would be a possible concern with me seeing his various freak outs in the series. All that said, as a TV viewer I like Shaun and want him to succeed. 

[possibilities]

There's no evidence that Shaun freaks out during surgery. We've seen him handle pressure in medical situations, from the airport in the very first episode, to the ER and the OR on numerous occasions. All these fears are based on assumptions and prejudice, not based on Shaun's track record at all.

[Madding crowd]

Shaun just freaked out in Han’s office (and Han was not touching Shaun or doing anything to him at the time) and Shaun freaked out over a light bulb. I like Shaun as a character and as I said I would have no problem with a doctor who speaks bluntly. I didn’t say Shaun has been shown to freak out during a surgery.

I never worked in a hospital but I witnessed a woman get fired when she became angry and started screaming in the office because the manager was concerned about the safety of the employees. I never said the character of Shaun should be barred from surgery, I said I would have concerns as a patient. 

[sleepysuzy]

Many specialists and surgeons are off socially and have terrible bedside manner. I saw a pediatric pulmonologist for my two youngest children, and at firat he had me terrified that my daughter was going to die or need a lung transplant. He definitely just blurted everything out without context or consideration for how it sounded. Over the years that we saw hum, I came to believe that he is brilliant but socially inept. Our speech therapist tild me she thinks many of the specialists would probably be diagnosed as on the spectrum if they were growing up today.

Shaun's demeanor with patients is not a problem, as I see it. It is his sensory issues and lack of proper boundaries that are more or a concern. I thought Dr. Han was a gaslighting narcissist, though. He clearly knew how to needle people in subtle ways, then step back all ahocked and say, "Why are you getting so upset?"

Edited December 3, 2019 by sleepysuzy

[PinkRibbons]

My father has an eye surgeon that I swear was told he wasn't a real doctor when he was young and has been trying to prove otherwise ever since. Ask a simple question and you get a long, unnecessary and incredibly condescending speech in response. We put up with his demeanor and complete lack of self-awareness because he is apparently very good at his job. Any other profession and I would suggest we take our business elsewhere, but in this situation, you take the bad with the good and deal with it.

Similarly three years ago my father had the Whipple procedure as part of removing a tumor from his pancreas. It was a 9-hour surgery and my mother, (visibly pregnant) sister and I stayed in the waiting room all day while it gradually emptied out. When the surgeon finally came out, we practically mobbed him because no one had give us any updates and the surgery had run long. You could tell from his demeanor that he had completely forgotten we were waiting and when he explained the surgery you got the strong impression that my father's liver and pancreas were the parts that interested him, not my father. This surgeon is considered one of the best on an international level. And you know what? I couldn't give a fuck about how he behaved towards us or Papa on a human level. He saved my father's life.

[Driad]

In S03.E10: Friends and Family, how should the football player have been treated? Would he really have been allowed to play football again after his broken neck and surgery?

[bros402]

On 12/3/2019 at 1:55 AM, PinkRibbons said:

My father has an eye surgeon that I swear was told he wasn't a real doctor when he was young and has been trying to prove otherwise ever since. Ask a simple question and you get a long, unnecessary and incredibly condescending speech in response. We put up with his demeanor and complete lack of self-awareness because he is apparently very good at his job. Any other profession and I would suggest we take our business elsewhere, but in this situation, you take the bad with the good and deal with it.

Similarly three years ago my father had the Whipple procedure as part of removing a tumor from his pancreas. It was a 9-hour surgery and my mother, (visibly pregnant) sister and I stayed in the waiting room all day while it gradually emptied out. When the surgeon finally came out, we practically mobbed him because no one had give us any updates and the surgery had run long. You could tell from his demeanor that he had completely forgotten we were waiting and when he explained the surgery you got the strong impression that my father's liver and pancreas were the parts that interested him, not my father. This surgeon is considered one of the best on an international level. And you know what? I couldn't give a fuck about how he behaved towards us or Papa on a human level. He saved my father's life.

Ehhhh, I have a limit that I reach even with those super fancy experts. I fired an oncologist who is internationally recognized in his field because he was horrible with me. All he cared about was my cancer - he did not take any of my other conditions into consideration when prescribing meds (Like the fact that I have epilepsy - which is very important for anti-nausea meds, having epilepsy cuts down the meds available to you significantly, which I learned after I had some super uncomfortable side effects on the medications he gave me) and he didn't take them into consideration when discussing plans with me. I have cerebral palsy, autism, fine and gross motor dysfunction. and underdeveloped muscles. During appointments, he would always comment on how skinny I am and that I just "need to go to the gym and pump up" and that I should just "start out by lifting some light weights, only 20 or 30 pounds, nothing heavy) - when on a good day, I can lift maybe 10 lbs for a few seconds. He also had no idea how to talk to patients under 60, and he refused to listen to my side effects, saying "well that must all be in your head, go find a psychiatrist who will throw some pills at you and you should be good, because if you go on the next line of meds, the side effects will be even worse!"

[possibilities]

Good God, that sounds like a terrible doctor. Shaun isn't anywhere near that bad!!

[bros402]

4 hours ago, possibilities said:

Good God, that sounds like a terrible doctor. Shaun isn't anywhere near that bad!!

Oh yes, he was a terrible doctor. I mean if I had a family member with a rare disease in his specific niche, I would recommend him every day of the week - the guy was like a real life Dr. House, sans limp or a writing team to make him seem charming.

He was also shocked when, in the middle of my bone marrow biopsy, he asked me my favorite country I had traveled to. My response was "I haven't traveled outside of the country."

His response? "Oh, it doesn't have to be this year, it can be any time!"

I said "I have never left the country"

he said "Never? How?"

I said "Nope, never. It's too expensive."

Then he was like "Oh well next month i'm going to Switzerland for a cancer convention, then a few weeks later I am headed to Israel to give a consult, then i'm going to China to talk to some doctors there."

then afterwards he did not give me any medication because "well you can just take some Tylenol tonight and then you'll be fine, none of my patients complain about pain after getting a bone marrow biopsy done by me."

I went home, got pain meds from my local oncologist, and had to take them for 2 weeks because I was in so much pain from the bone marrow biopsy (Mostly for sleeping in the last week of the pain meds)

[QueerGirrl]

What a dick. 

[bros402]

7 hours ago, QueerGirrl said:

What a dick. 

Oh yes, quite the dick. Luckily, my insurance was at risk of changing to one that didn't cover where he practiced, so we preemptively switched to another cancer center a month before the switchover so I would be an established patient in case of emergency. Then a few days before the change was going to happen, we were told it wasn't going to happen!

And now I have a new managing oncologist - great guy, willing to communicate with my local oncologist and the doctor who named the kind of leukemia I have.

[Trizzi Trace]

Hello everyone!  I'm a newbie; both on these boards and watching the Good Doctor.

Disclaimer:  I know nothing about medicine or how hospitals work and I have a question about what these doctors work on.  What kind of surgeon is Dr. Malendez?  When I binged on the entire show recently, I noticed that he does orthopedic surgery, cardiothoracic surgery and, if I'm not mistaken, neurosurgery.  I know there is such a thing as a general surgeon.  Is that a surgeon who can do every specialty?  Does that apply to Malendez and, to an extent, Dr. Lin?

[statsgirl]

It's TV Doctor Syndrome.  In order to keep things interesting, TV doctors, especially TV surgeons, do everything even if it's beyond their training or skill set. Often they even become ER doctors.

Grey's Anatomy is the worst where the surgeons do every doctor function in the hospital and some of the ones that should be done by nurses too. But I think all shows do it as well.

[Annber03]

Just want to say welcome aboard, @Trizzi Trace :)! Look forward to chatting with you on here. 

[Driad]

TV doctors spend much more time with their patients than real ones do.  Real surgeons don't always even meet their patients.  I had a tricky surgery once (as a patient) and my surgeon told me that an extra-specialist surgeon, Dr. Park, would also be involved in my surgery.  When I was waking up from the surgery but still groggy, various doctors came in.  One looked Korean, so I asked if he was Dr. Park.  He said "No, but I am Korean."  After I was more awake I realized that Park is not necessarily a Korean name.  I never did meet Dr. Park.

[Trizzi Trace]

On 3/23/2020 at 4:04 PM, Annber03 said:

Just want to say welcome aboard, @Trizzi Trace :)! Look forward to chatting with you on here. 

Thank you so much!  I got hooked early in my epic binge watch when I saw Lea had a Penguins jersey in her closet and called Dr. Glassman "nebby".  I knew she had to be a fellow Pittsburgh girl!

[bros402]

On 3/23/2020 at 4:40 PM, Driad said:

TV doctors spend much more time with their patients than real ones do.  Real surgeons don't always even meet their patients.  I had a tricky surgery once (as a patient) and my surgeon told me that an extra-specialist surgeon, Dr. Park, would also be involved in my surgery.  When I was waking up from the surgery but still groggy, various doctors came in.  One looked Korean, so I asked if he was Dr. Park.  He said "No, but I am Korean."  After I was more awake I realized that Park is not necessarily a Korean name.  I never did meet Dr. Park.

I have only had one two doctors spend as much time as TV doctors do with their patients with me.

One was my neurologist as a kid - a doctor who was certified in pediatric neurology, adolescent psychiatrist, and clinical genetics. He would have me do some exercises, then ask my parents to do them, and compare. He was just interested in how my parents performed and how I performed (I have cerebral palsy, autism, epilepsy, anxiety, and a few other things). He would routinely spend 30 minutes with me every 3-6 months when I saw him.

The other is the oncologist who discovered the type of cancer I have (as in he was the guy who named it) - the research coordinator for the registry told me he wanted to see me, because I have a rare case of the rare cancer, and he spent like 60-70 minutes with my parents and I, answering any and all questions we had - and when he didn't have an answer, he said so and had his research coordinator contact us with the answers after he found them.