- "The Big Bang Theory" is smart, but is it medically accurate? We're about to find out. Let's get started. Peewoop. (water running) - Hello. (audience laughs) - I slipped in the shower and I think I dislocated my shoulder. - Ow. - Not surprising; you have no safety mat or adhesive stickers to allow for purchase on a surface with a low
coefficient to static friction. - Basically, she had
no grip in the shower. I actually am a firm believer that you need to make your shower safe. Whether that means
putting grips on the side so you can hold on in case you do slip or, or maybe even better than or, and putting some textured floor, either tape or rug or mat or something that's secured down to the floor to prevent you from slipping. - Oh my God, I gotta go
to the emergency room. - Well, assuming you're correct 'cause you're right humerus is no longer seated in the glenoid socket. I would certainly think so. - That's actually very accurate. That's what happens during
shoulder dislocation. You're humerus, which is so
funny that it's called that, actually gets dislocated
out of the glenoid fossa, which is the shoulder joint in here, and it creates a lot of pain. That being said, to put it
back in is very painful. Once it's in, unless you tore
something, it feels fine. There's actually been videos of UFC fighters
dislocating their shoulder, getting it popped back in and then continuing on with a match. And if you have an instance of dislocating your shoulder once, you have a higher rate of
recurrence of it happening again, because the ligaments and
all the attachments to it start becoming lax,
basically very stretchy, and as a result, they're not as secure and it can pop in and out. - Moving to psychiatric disorders. List all major behavioral diagnoses, e.g., depression, anxiety, et cetera. - Oh my God, what the hell does this have to do with my stupid shoulder? - It's important to know for doctors a complete picture. In order to be properly practicing, you need to use holistic care. In order to be holistic, you need to know the entire picture. Do you have any other
medications on board? Do you have any other
medical problems on board? Some medical problems
can cause certain others to behave differently. Some medications cannot be
used with other medications. If you're pregnant, we may be
less likely to wanna scan you. If you're pregnant, we might not be able to give you the same antibiotics,
et cetera, et cetera. - You were given powerful pain medication and a muscle relaxers. - In a lot of these situations, we give a patient maybe
mild to moderate sedation in the emergency room when we try to reduce
the dislocated joint. Reduction of a joint literally means popping it back in place. I don't know why, in medicine, we always have to complicate everything. Just say pop it back in. Why reduction? - Wait! You have to help me get into bed. (Penny chuckles)
(audience laughs) Sheldon has to get me into bed. - Now, unless there was something broken, putting a patient in a arm cast like that for more than a day is not ideal, because then you start really risking the development of adhesive capsulitis from lack of mobility. So you wanna get that mobility
going as quickly as possible, ideally working with a physical therapist to make sure that you're not going too far and harming the injury. - How's your family? - Oh, it was the worst trip. Everyone got sick over the weekend. - Sick?
- Here we go. - I don't know why people
have a habit of this. When someone in their family gets sick, they spend all their time with them and then they come and
hang out with others. You know you're gonna be the
one spreading the illness. - Sheldon, relax. She doesn't have any symptoms. I'm sure she's not contagious. - That's not how it works. You're contagious usually,
or at least up to 24 hours before you show symptoms. - Here, swab my throat. (audience laughing) - I don't think so. - Leonard, if I'm going to
get ahead of this thing, I need to find out what's
growing in my throat. - You don't generally swab
someone who's asymptomatic, meaning someone that's
not showing symptoms, because that's not gonna give you a lot of useful information. You may be just colonized
with a specific bacteria, but if it's not infecting you, meaning it's not creating symptoms, treating it may actually
cause more harm than good. - I'm going back to bed. (audience laughs) - Wait, put this in the bathroom. - What for? - I need to measure my fluid intake and output to make sure my
kidneys aren't shutting down. - Why would your kidneys be shutting down? You feel great. Why? Why? Why? - Why? Why? - We actually do monitor
patients 24 hours ins and outs in the hospital. Usually it's reserved for patients who have some sort of kidney issue or they're having a
diagnosis of heart failure and they're fluid overloaded. - I want soup. (clears throat) - Why didn't you- (Sheldon clears throat) - Send the person home! - Don't you imagine that
if there were a way for me to have had soup at home,
I would've thought of it? (audience laughs) - You can have soup delivered. (audience laughs) - I did not think of that. Clearly, febrile delirium is setting in. Please bring me some soup while I still understand
what a spoon is for. - Febrile delirium is
something that happens when someone's temperature is so high that their brain is no longer
able to function cognitively. But your temperature would
need to be quite high for quite a long period of time, unless you're incredibly frail
or old age, which he is not. - My mother used to make me this split pea with little frankfurter slices and these homemade croutons. - We have chicken
tortilla and potato leak. - Could I get any of those with little frankfurter
slices and homemade croutons? - No. - Then surprise me. - You know chicken noodle
soup has actually worked as a viral upper respiratory
infection remedy? It warms the throat,
creates more circulation, gives you added electrolytes to help you better manage
your fluid intake and output. Maybe grandma was right. - Okay, nice and cozy. Okay? I'll see you later. - Wait, will you please
rub this on my chest? - People love Vicks. They swear by Vicks. And the way Vicks works is you rub it onto your chest and it creates a cooling sensation because the menthol
evaporates quite quickly, thereby cooling the superficial
portion of the skin. It takes away some of the discomfort that you may be
experiencing in your chest. And at the same time, if you have a fever, it can help cool your
body down from that fever. That being said, I'm not always in favor of getting all fevers down, because a fever is actually advantageous to your body in order to
fight off said infection. There are instances where
fever can be problematic, if it's incredibly high, you have other medical conditions,
you're frail, et cetera. But for a young healthy
adult like Sheldon here, he'd probably be fine. Is this Sheldon? (laughs) - You're the doctor, but I'm constantly hearing
this annoying sound. - That could be tinnitus where you hear, most people describe it
as ringing in their ears, but other people call it
a drum, a weird sound, and it could happen for
a whole host of reasons. What I've been seeing an
uptick of in my office is younger people coming in who have sensorineural hearing loss from damage to their hearing from listening to music too loud, and when you damage your hearing, that you actually end
up developing tinnitus. But there's obviously a whole host of other potential options there. - Yep. There's no
inflammation at all, Sheldon. - Then it must be a tumor. - Inflammation in the tympanic membrane or in the inner ear
canal really just rules out infectious causes by bacteria. There still could be
other things going on. There's viral causes, there's
non-infectious causes. So you gotta really be careful. - Sheldon, what are you doing here? - Hang on. 130 over 80. It's a little high. - Yeah, 'cause you're taking it yourself and you're not resting and your feet aren't flat on the floor. - All I need is for you
to authorize these tests. - (scoffs) A cardiac stress
test, a full body MRI, an electromyogram, a CBC
baseline glucose, upper GI? - What symptom is he having that he's requesting all these tests? Those tests are not even
routinely done together, let alone in one patient. - You were right. You're larynx is terribly inflamed. I mean, I've never seen anything like it. - I knew it. - First of all, there's no
shot she sees his larynx. That is ridiculous. She means his pharynx. The larynx is the voice box
and it's much further back. In order to visualize that, you're gonna need a fiber optic scope to go inside the nose and
actually go past the pharynx. - You're gonna need to
stop talking immediately. (audience laughs) - For how long? (audience laughs) - Immediately. - There are conditions
where someone's vocal cords are inflamed and we do
encourage voice rest, especially post-procedural stuff. And by the way, in instances where your voice box is very inflamed, whispering, people think, will
be easier on their voice box. That's actually more
difficult for the voice box and provides more stress and inflammation and damage to the area. - Bernadette and I are getting married. (audience laughs) Ma? (Ma thumps) - That's always worrying. - Ma? Stand back. I'm gonna break the door down! (audience laughs) - Does he have a dislocated shoulder now? - So how is she? - They're running tests. I don't know. May have been a heart attack or heart-attack-like event. - So in some instances when a patient's going to the
bathroom and is bearing down, they can develop something
known as a vasovagal syncope where, because they're bearing down, their blood vessels widen
so that when they stand up, they actually don't have
enough blood pressure to bring blood to the brain. And when the brain doesn't
getting enough blood, it makes the human body collapse in order to make it easier
for blood to get to the brain. That could be quite problematic, 'cause if you hit your
head on the way down, now you're bleeding into your brain and you see where that goes. - Regardless, coronary problems
are imminently treatable. What's more likely going
to kill Howard's mother are the antibiotic-resistant
super bugs festering in every nook and cranny of this hospital. - Hospitals do have higher rates of MDRs, multi-drug resistant organisms, but that's not to say that
all hospitals have them. We're actually aware of what bacteria our patient population's exposed to so that we have our own guidance as to what antibiotics we should use based on local resistance rates. - Is there a history of
heart disease in your family? - My family is the
history of heart disease. (audience laughs) - I've also never heard of
a heart-attack-like event. I've heard of a stroke-like event. That usually means a TIA, which is a transient ischemic attack. It's basically when a person experiences stroke-like symptoms,
their speech gets mumbled, they lose ability to control
portion of their face, their tongue doesn't move
appropriately, they pass out. But it's usually very short-lived. That's why it's transient. - Howard, I have to go to the bathroom and no one will take me home. - What's wrong with the bathroom here? - Pneumococcus,
streptococcus, staphylococcus, and other assorted coccuses. - Those are different
bacterias he's talking about. - Will you at least go with
me to the restroom here so you can open the door
and flush the urinal? - No! - Actually in the restroom, there's probably more
enterococcus, which is E. coli, and E. coli is the most
common bacteria found in poop. When you flush a toilet, that's the moment you should really leave, because that's when a lot of the pathogens and bacterias and stuff
fly outta the toilet. - I think I'm too sick
to go to the funeral. - You're sick? You poor kid. Well, see ya. (audience laughs) - Sheldon? Aren't you
gonna take care of me? - Me? No. No, I'm not That kind of doctor. (audience laughs) - Looks like she's suffering from a URI, an upper respiratory infection. See some congestion, rhinorrhea. Overall, looks okay. I wouldn't say toxic appearing. - 102.2. (Amy coughs) - That is a fever and that is what the body's supposed to do when one is ill. - Exactly what it was half an hour ago. - I'm not a fan of checking
temperature that often. It's not gonna give you vital information, unless something happened
to you clinically, like you're suddenly feeling much worse, then maybe you check it again. But just repeating it every
30 minutes, every hour, it's not gonna give you
any valuable insight. - Do you believe in the placebo effect? - Of course I do. There have been many studies
proving its validity. - Great.
- True. - Now, this may look like a Tic Tac, but it is really a powerful medication specifically designed to cure your illness as well as freshen your breath. - The way a placebo effect needs to work is not that just you need to
believe in the placebo effect. You need to believe in the treatment that's supposed to be the placebo effect. And usually that comes in the shape of a doctor coming in with a
fancy white coat or scrubs and telling you this will work, but only if you pay 29.99. - [Announcer] It's just common sense. Apply today. - Hey Amy, I brought you some drugs we've been working on in the lab. This is proving really
good for congestion, but there's a slight chance it can make your tears burn like acid. So if you take it, happy thoughts. - She looks so much healthier already. The color is back. The nose is less red. - I'm gonna draw you a soothing bath. - I don't recommend people to
take baths when they're ill, just 'cause it's gonna ruin the thermo regulation of your body. You're just not gonna get
a lot of benefit out of it. If you wanna clean yourself,
take a quick shower, but don't linger for too long. - This is a really good expectorant. Although, some test
subjects reported lactating uncontrollably when they heard music. - A lot of these expectorants, like Guaifenesin or Mucinex,
most people know it as, don't have actually great
evidence for working. They also have a pretty
mild side-effect profile and rare side-effect profile. So people tend to use them quite often. But they expect them to work miracles, and in many instances, they don't do much. - I don't need your
medicine. I'm not sick. - I don't understand. - I got better two days ago. - I knew it. - It's just been so nice
having Sheldon take care of me. - This is called Munchhausen syndrome. - See the stuff in my nose? Rubber cement. (audience laughs) - Ah! - [Crew Member] Uh-oh. Okay. - We've been exposed! What does your underwear say about you? Click here to find out. And as always, stay happy and healthy. That's not really what the video's about, but watch it anyway. (cheerful music)
