How accurate is THE GOOD DOCTOR? Real doctor reaction

I've taken on house m.d. Oh and now I take on my equal another fresh-faced fluffy hair junior doctor I take on the good doctor hello everyone my name's ed hope a junior doctor in the UK and welcome to sick notes where I look at medical content and explain it in simple terms one of my previous videos I look back at one of my old favorite TV shows a show called house I watched a lot before medical school and you can watch that video somewhere up here I have some really good feedback so I thought I'd looked at the medical accuracy of another TV show one that's out at the moment called the good doctor for people who don't know what the good doctor is it's the latest hit medical TV drama sweeping the TV shows based off a South Korean drama of the same name created by David short the guy who brought us house it follows dr. Sean Murphy played by the brilliant Freddie Highmore in his early years as a surgical doctor and if that wasn't tough enough our main character has autism spectrum disorder season one has already been completed but to keep things simple I'm just going to be looking at the first ever episode so it will contain lots of spoilers judging from my previous videos and looking back at medical dramas I think let's try and play some medical bingo these are the classic things that medical dramas tend to do wrong number one these one in a million out of nowhere diagnosis which happened a lot in house this is pretty much a given because it adds mystery and a bit more drama to the episode number two we have a - pensa T of things going wrong so we tend to have a lot more complications which thankfully doesn't happen as much in real life number three I've got written here poor critical skills so anything from people not washing their hands to using gear in a strange way and the last one I put here relationship problems this is there's guaranteed to be some kind of romance somewhere that kind of goes wrong and spills out into the hospital environment obviously all of these things we're going to take in good humor because it's a TV show and the writers want to entertain people watching and take the sort of more extreme situations of what happens in real life so let's go on with it let's get medical firstly dr. Murphy looks very young in this I'm not sure how are you supposed to be but this is a very common thing actually I came into medicine late so I looked a bit Hagrid Haggard and from day one but many of my colleagues looked extremely young so I think or more likely to sort of get challenged by patients it's fairly natural to assume that age equates to experience however it's not necessarily true as I'm 35 and only been a doctor two years yet some people could be a couple years younger than me and be a consultant so in our opening he's off somewhere we presume his first day on the job I'd like to point out that heading into work as a surgical doctor usually involves very early morning so it's unlikely in as we see in this example to see anyone up to his verbs so that is already a bit far-fetched also kicking a ball back to someone in a part just in general is one of the most nerve-wracking things ever especially when you're kicking it back to a young person you want to impress them with how good you are at kicking a ball I'm always worried I'm going to slice it off in the wrong direction over a fence dr. Murphy though doesn't do a bad job it's not stylish but it's accurate so first job well done Wow blimey not what you want on your first date I'm pleased that someone here yelled call nine-one-one this is exactly what someone should do in the first instance because any help we give outside of hospital is normally very limited so we need to make sure that help is on the way before we sort of start intervening this guy sort of just yells it out I would maybe pick someone that looks pretty sensible and ask them to call an ambulance and maybe in this scenario there's a few people around so maybe ask someone else to get the kind of person in charge of that particular area because there may be some First Aiders or some medical equipment available so luckily there's two doctors on the scene and one of them is our man dr. Murphy is his first patient not exactly sure he does the best assessment of the patient when emergencies happen our natural reaction is to get quite amped up and panicky but actually the best approach is to stay very calm and do a systematic approach to the patient there is a mnemonic called doctors ABC so DRS a B C the D stands for danger in this instance nobody it has asked the workmen at the top if there's anything else that's likely to fall down so to limit the possible number of injuries the R stands for response so in other patients we tend to check their if they're awake or not so someone just might be asleep and the S stands for send for help so as we mentioned earlier someone making sure an ambulance is on the way and a stands for airway and this is where I think the two doctors should have given a better assessment they certainly did the right thing by stopping any major bleed before assessing the airway whenever you have a reduced level of consciousness you have a risk of not being able to keep your throat open a so called swallowing your tongue however you don't physically swallow your tongue you'll just in such a sort of deep sleep that you lose the ability to keep the tone in your muscles of your throat therefore these can close up your throat and mean you stop breathing therefore you'd expect the doctor to properly assess this because there's physicians that we can put the neck and the jaw in to make sure it's easier to breathe in this patient as well because there's been quite high in trauma from the sign falling but also from the patient collapsing to the floor with also worried there might be some damage to the neck so I'd expect one of these doctors to be actually securing the neck in place and making sure that they can breathe properly by opening up the jaw the so-called jaw thrust and then on to B stands for breathing so I'd expect a more formal assessment where you look listen and feel for the patient breathing but dr. Murphy can see the chest expansion there so or kind of letting off that one and see the last thing is for circulation or CPR so if the patient's heart isn't beating then we'd want to start CPR sometimes people add a D on the doctors a B C D the D standing for defibrillator because if the patient heart does start from you're performing CPR you need to get a defibrillator on as soon as possible because that can help restart the heart anyone interested in learning more about first-aid speak to your employer or check out the st. Johns Ambulance or the resuscitation council website so whilst this is going on we get taken to the hospital that dr. Murphy is due to be starting at and we have I don't know this is a bit of a tongue-in-cheek comment autism a mental condition characterized by difficulty in communicating and using language and abstract concepts that's the definition does it sound like I'm describing a surgeon well a little bit this I'm just kidding we need to be very careful here but the stereotype of a surgeon is that they don't really like communicates you may prefer to have a patient under anesthesia and to be operating on them obviously there are lots of different stereo types of different doctors and they're most the time complete rubbish but I wonder if that little comment is a bit of a wink not to people who know about this typical surgeon stereotype so the board of directors at the hospital are discussing the employment of someone with autism spectrum disorder to work as a surgeon firstly my knowledge of ASD is very much just with someone of the general public I've never dealt with any kind of conditions like that as a doctor in fact most of my knowledge of ASD has come about via this UK show the undateable swear people of varying disabilities including ASD are followed around looking at their dating lives now the show is generally pretty good although the actual name the undateable could be better perhaps something like dating with a difference because the show actually proves itself wrong because all the people tend to find a kind of relationship and do tend to date pretty successfully funny enough in the most recent series of the undateable there is a finding a medical student and it follows her dating life and she seemed like it should be a very good doctor so the good doctor is certainly realistic from the point of view that have it been entirely normal for someone with disabilities including ASD to work as a medical professional and do however have no knowledge if these doctors have a tougher time with employers as shown in the good doctor and you generally thought that this board wouldn't reasonably have any doubts about hiring a surgeon who's been diagnosed with autism there are obviously equality laws against this but I can imagine in practice face to face exams and interviews are a lot more difficult their autism spectrum disorder is a neurodevelopmental condition so this means something arising from the development of the brain that means people have difficulty communicating particularly with social awareness and often having different behaviors - as the name suggests it is a spectrum of severity and I was reading about how half of people with ASD have severe learning difficulties in the show dr. Murphy also has something called savant syndrome which is a genius-level intellect and it can be through anything like calculation memory art music and things like that we all remember to film Rain Man with Dustin Hoffman I thought it was unique to a small number of people with ASD but actually anyone can have savant syndrome is just more common in people with neurodevelopmental conditions so I'm thinking I might have some kind of savant syndrome something but I just haven't quite discovered it yet but savant syndrome is extremely rare even in people with ASD so the show's got at red at difficult line because you don't want a stereotype everyone with ASD of having severe learning difficulties all this kind of genius level of intellect and on the other hand you don't want to glamorize what can be a really serious communication and behavioral condition although there's a certain amount of irony people with ASD don't tend to like change however people around them are often unwilling to change to make life easier for people with disabilities and the attitude of other people to disability is given a plenty of screen time in the good doctor so then we meet some of the other doctors at the hospital sleeping on a night shift I should have put this in my list of things let's get a crop up because you know as an old cool doctor you don't tend to do a lot of sleeping other like [ __ ] it's one of the most hectic shifts because it's often not a lot of support around I remember my mum during my first night shift asked if I had a comfy bed for the night when I spent 13 hours running around like a madman completely out of my depth although there are some night shifts where you do get some sleep oh it doesn't obstetric doctor once and I think I got sometimes I got about four hours sleep they're gonna get a bleep jump up and go straight into theater and start delivering babies are pretty a pretty amazing wake-up call so as long as every episode doesn't show people sleeping in that room I'll let them off this one what the hell this faithful thing we get up to unbelievable there's someone in bed with him so this goes back to our relationship problem bingo okay I may admit that sleeping on night shifts may sometimes be realistic but having sex on a night shift I mean that actively doesn't happen or at least doesn't happen to me please comment below if this has ever happened to it just kidding don't don't do that I'll get all sorts of complaints so then we go back to dr. Murthy he's still dealing with this emergency so he's very late for his first day or maybe it's an interview for the job I'm not sure what exactly and the ambulance still hasn't arrived despite all this stuff happening presumably at the same time at the hospital the patient starts getting breathing difficulties and dr. Murphy diagnoses a tension pneumothorax so again this is a hit of that medical TV drama bingo and it's where we get air between the chest wall and the lung most often caused by a penetrating injury so this patient has had some glass in the chest and the air keeps filling up in that cavity means we end up getting the organs end up getting squash or the heart and blood vessel and the lungs which means people can die extremely rapidly if it isn't fixed so let me explain what I'm talking about on a quick diagram so we have our windpipe that divided into two main Airways that supply the lungs both sides and don't forget we also have our heart in here believe it or not the lungs don't have any muscles in them it's just the muscles around the chest wall and the diaphragm that when they contract they open up and this this causes a pressure difference and the lungs expand into that cavity so we have our diaphragm and we have our chest wall so a tension pneumothorax most commonly happens when we have a penetrating injury for example and this patient has had a bit of glass coming to their chest wall if you imagine this creates a kind of one-way valve because the penetrating injuries come in this direction so when the patient breathes in air will be sucked into this pleural cavity here but when the patient breathes out this gap will close meaning the air won't get out after subsequent breaths this potential space will fill up with air squashing the lungs this can eventually compress the heart and the blood vessels around the heart and this is why it can be life-threatening the compression of the blood vessels here is why the blood vessels of the arm become engorged in this patient dr. matthew probably would do well to perk us the chest that means to tap it because normally our chest is resonant because we can feel the air in the lung tissue so it's resonant like a drum but it becomes hyper resonant because there's no lung tissue now it's just air he should also check the check here because the windpipe can actually move across sometimes with the tension you authorities really bad he should probably do those two things first just so he's got a better idea of what's going on because what he's about to do is pretty extreme dr. Murphy uses a kind of MacGyver style do-it-yourself chest strain I mean there is a simpler way to decompress this air in the tension pneumothorax by simply putting a tube in the top essentially what dr. Murphy does is the ultimate treatment that we give which what people would get in hospital here we put a one-way valve in in the form of a chest drain and this is a one-way valve in the opposite direction so it lets all the air out that doesn't let any air back in obviously you need to seal off the original injury as well so by placing another tube into the chest so it allows air to escape out of the lung but the water seal at the bottom of the whiskey bottle stops any air going back through pretty nifty it's a nice little plot point actually because obviously these things would need to be done in a sterile environment normally and that mechanically there's no reason why what he did wouldn't work and clearly there is a huge infection risk because this was done out in a sort of unsterile environment with dirty equipment even though he poured a little bit of alcohol in to try and sterile it but actually infection takes you know a few days to really kick in by that time the woman would have been washed out antibiotics would have been given so the most important thing is to make sure the patient can breathe properly because that would kill them in potentially seconds so therefore it kind of all makes sense so we're finally on our way to the hospital and dr. Murphy notices a change in the patient's ECG saying electrocardiogram this records the electrical activity of the heart I would say these three lis tracers that you get on portable ECG and in the back of an ambulance are extremely rough and ready and for only interpreting basic rhythms so the fact that he can pick up something very small is a bit out there however in this scenario dr. Murphy has savant syndrome so maybe this explains away his ability to notice tiny changes having gone from one of the positive aspects of dr. Murphy's personality we now see a negative angle when the patient arrives at hospital he's unable to give a good hand over to the doctor and becomes quite irate and frustrated and ends up getting kicked out of the hospital altogether whilst the patient is in fear dr. Murphy is stuck outside with security shepherding him at every entrance now this is actually pretty realistic the security in my hospital oh my god I love them as an A&E doctor I've had my fair share of aggressive patients and on several occasions the security had protected me and patients from themselves so shout out to security people out of hospital places here is another classic error I told you what happened so the surgeon is all scrubbed in and therefore sterile it shouldn't be touching anything that isn't sterile and so you can mark that off your bingo sheet and I think we've got all four of them now preventing infection is crucial in operating theater I think that's why it's so jarring when you see someone scrubbed up touching something they shouldn't so eventually the theater team noticed something wrong with the heart rate as well so they actually go out and see dr. Murphy to ask what this the ECG changes were and eventually they find that there's a small piece of glass behind the heart and the patient is saved no piece of glass behind the bar diagnosis meanwhile in the boardroom the senior hospital staff are determining whether dr. Murphy should have the job or not when someone runs in and shows this amazing YouTube video of someone saving the life of a patient at an airport using a whiskey bottle and a piece of tube and who is it you've guessed it dr. Murphy is on YouTube getting lots of shares and lots of likes what medical doctor would ever be caught putting anything on YouTube dr. Murphy then gives a very heartfelt speech and we have season one of the good doctor underway so that's the end of the show hope you enjoyed my medical analysis of this TV show I was pretty impressed in general clearly the realism needs to take a bit of a backseat in terms of favoring the story and the characters and the drama if you found anything else that I missed I'd love to hear about them so leave a comment below just a quick thank you to all the medical students on reddit that recommended me take a look at this show thank you very much for that if you enjoyed this there are other videos on my channel for example I look at the TV show house that I mentioned at the beginning you may enjoy that and in general I just like to be the friendly neighborhood doctor just explaining anything medical in simple terms so check them out and thank you very much for watching

Channel: Dr Hope's Sick Notes

Views: 870,734

Keywords: the good doctor, how accurate is the good doctor, the good doctor episode 1, freddie highmore, is good doctor like real life, david shore, medical drama review, the good doctor review, doctor watches the good doctor, doctor with autism, medical accuracy of good doctor, shaun murphy, medical tv show, doctor reviews medical tv show, good doctor airport scene, doctor reaction, doctor breaks down, dr reacts, dr watches, dr breaks down, good doctor, good doctor reaction

Id: QImVWm101aw

Length: 21min 0sec (1260 seconds)

Published: Wed Dec 13 2017

Reddit Comments

[u/ColleenEHA]

Is this your video? Also, maybe /u/46_reasons can chime in - is a "junior doctor" the same as a "medical resident"?

EDIT: Also, long video but fun - I like it... AND FYI - season 1 isn't over yet, it's just mid-season break.

[u/[deleted]]

Hey DrHopeSickNotes! I love your videos and I'm an instant subscriber! :D

[u/pastadudde]

loved the video, and also you're very handsome.