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Doctors are pushing Hollywood for more realistic depictions of death and dying on TV (www.npr.org)

submitted 11 months ago by MicroWave@lemmy.world to c/health@lemmy.world

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We've seen it so many times. A young, handsome man rushed into the emergency room with a gunshot wound. A flurry of white coats racing the clock: CPR, the heart zapper, the order for a scalpel. Stat! Then finally, the flatline.

This is Dr. Shoshana Ungerleider's biggest pet peeve. Where are the TV scripts about the elderly grandmothers dying of heart failure at home? What about an episode on the daughter still grieving her father's fatal lung cancer, ten years later?

"Acute, violent death is portrayed many, many, many times more than a natural death," says Ungerleider, an internal medicine doctor and founder of End Well, a nonprofit focused on shifting the American conversation around death.

Don't even get her started on all the miraculous CPR recoveries where people's eyes flutter open and they pop out of the hospital the next day.

All these television tropes are causing real harm, she says, and ignore the complexity and choices people face at the end of life.

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[–] Chetzemoka@startrek.website 59 points 11 months ago* (last edited 11 months ago) (8 children)

As a critical care nurse, the miraculous CPR recoveries are such a horrible disservice to our patients and their families. CPR is not two minutes of some light exercise and then the person wakes up and is ok forever.

It's 20-30 mins of intense, brutal, scary, undignified activity followed by best case scenario, we put you in the ICU, deliberately make you hypothermic for a day or two, and hope you wake up. That increases your chances of surviving the incident to a whopping 64%.

Surviving to discharge and having a meaningful recovery is a whole other ballgame, and depends a lot on the condition you were in when you had cardiac arrest in the first place. Your elderly grandpa with cancer, sepsis, bad kidneys, etc. is probably not going to go home. Your middle-aged wife who came in because she was having a heart attack actually stands a good chance.

Movies like to show people shocking a flatlined patient who just pops up and walks away when in reality presenting fully flatlined means you're 2-3 times less likely to be resuscitated at all.

I'm happy to leave some leeway in fictionalized depictions of medical care for the sake of story progression. But the complete ignorance currently common in fictional resuscitation scenarios feeds a really malignant sort of magical thinking that keeps us torturing elderly people. I'd really appreciate less of that in my job.

[–] funkless_eck@sh.itjust.works 9 points 11 months ago (5 children)

I heard that Defibrillators too don't work on stopped hearts - only weak pulses, and if you're hit with one you're not standing up instantly even if you wanted to. It's days maybe weeks of recovery

Can anyone confirm?

[–] Chetzemoka@startrek.website 15 points 11 months ago* (last edited 11 months ago) (1 children)

Yes, a stopped heart shows up as a flat line with no activity on an EKG. We don't shock people when their hearts have completely stopped because it doesn't do anything and can actually damage the heart. Defibrillators are named that because they're intended to shock a heart that is in a chaotic electric rhythm called fibrillation where the heart is just kind of shivering instead of beating fully.

If a person has flatlined, you can do CPR and administer epinephrine, and if you're extremely lucky get their heart to start fibrillating so a shock might have a chance of being effective at restoring a normal heart beat. This is why someone whose heart has stopped completely is 2-3 times less likely to survive CPR than a person experiencing fibrillation.

[–] lemann@lemmy.dbzer0.com 5 points 11 months ago

Thanks for the helpful info! Didn't know about fibrillation so this was very educational. I previously assumed that defibrillators were for flatlined hearts 😳

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