Real DOCTOR reacts to SCRUBS "My Mentor"

hello and welcome back to the channel my name's Ed your friendly neighborhood Junior doctor and today we are going to be breaking down another episode of Scrubs we've done a bunch already on the channel we're going to go back to one of the early episodes this is season one episode two called my mentor and stick around to the end because I'll give this a realistic rating out of 10. and yet just after two weeks all the little things that scared me at first are like second nature catheters chest tubes IVs everything has started to click definitely something I can relate to I remember at med school learning to do IVs like sticking in cannulas I used to get really caught up in my own head I thought there was a really big pressure on me to be able to get the cannula in but you realize over time there's a whole team and it actually doesn't matter who does it as long as somebody gets it done but being confident putting in a chest tube after a few weeks that's pretty good going even now after a few years I would need someone to help me with that Elliot here giving the needle a little flick you've probably seen that a few times that's what she said once you draw up something in the needle there's sometimes air within the syringe so you flick it to get the air bubbles up to the top because you don't want to be injecting that into the patient this uh defibrillating is not up to the standard of accuracy that scrubs usually gives you I mean there's multiple things wrong but the biggest thing was the pads weren't in the right place if we look back here here the pads are very Central on the chest but actually you want the current to go through the heart so you should have one on the right side of the chest so that's not in a bad position but then round under the armpit we actually don't use paddles a lot anymore but clearly this would have been accurate for the time nowadays we have sticky pads on so there's multiple other things wrong clearly in a cardiac arrest the patient's not going to be breathing so you need someone ventilating them but I don't think this scene is here to be particularly accurate it's more like to give JD some good sounds to jam along to interesting Turk here doing uh abdominal examination patient's arms should be uh by the side of them this helps to relax the tummy muscle so you can feel better and we usually palpate the abdomen to see where the pain is because that gives us an idea of what could be going on but this particular percussing here actually is to determine whether it's air or fluid so normally if the abdomen is distended we need to figure out why it's distended and by hitting on it if it's a nice resonant sound that's probably gas or if it's a dull sound it's probably fluid are you because if you have time to listen to music then I assume you have time to finish your paperwork yeah I I haven't actually seen any of the medical staff wearing headphones before but I've worked with a few Porters and domestic staff that I've seen some airpods in probably not allowed because there's various alarms and it's kind of unprofessional but I have seen it particularly on a night shift and Dr Cox we've really connected I'm kind of like his Protege I need to see his chart talk screen copied and highlighted unfortunately radar I'm fresh out of gold stars not too low bar pneumonia at 31 how much this guy smoke I don't know I think JD is showing here what you kind of need to do as a junior your first two years in the UK are called Foundation years and you end up doing six jobs over those two years so rotating every four months and you'll not only learning a completely different specialty you're also learning to work with different consultants and they have different ways of working each consultant would want things delivered and presented in their own unique way and you know they're not going to adapt to you you have to adapt to the way that they want it and so JD's doing a good job here and a low burn pneumonia is an infection of the air sacs of the lungs so the furthest part of the Long Way gas exchange happens and it's often called lober pneumonia because your lung has three lobes on the right and two lobes on the left because the infection happens on the edge it tends to spread out and only affect one lobe hence the term lobe and pneumonia how many packs a day genius half pack oh I'm sorry I phrased the question wrong how many packs a day really eleven now you don't know where I'm coming from two or three packs well let's hear yeah us gig people how much they smoke yeah you really need to ask the question the right way for example you might say to someone do they smoke and they might legitimately say no but then have only given up a week ago and smoked 20 years there I typically go with is have you ever smoked and then say how many and for how long for and that gives you an idea of really what the lung damage and other damage to the rest of the body might be to communicate in a Common Language we often use the phrase pack years in medicine so that assumes someone smokes one pack a day so 20 cigarettes for a whole year that would be one pack year so if this chap had smoked for 10 years and he's on what two packs a day that would be 20 pack years I ordered blood cultures and a high resolution CT what are you looking for cancer when you say the word cancer every person reacts the same way excellent no okay I wouldn't necessarily jump to cancer in this chat smoking a lot of cigarettes obviously predisposes you to cancer but he's still pretty young to get cancer even if he is a smoker more than likely he has just got a lobe of pneumonia so a lung infection what's actually most likely to happen in this scenario is the patient comes in with an effusion so fluid that's collecting at the bottom of the lung which can be caused by infection and can be caused by malignancy so in that case we might think it's an infection but we also need to rule out of cancer so that might actually be the kind of underlying story here but there isn't enough time in the episode to talk about all that uh we'll see two results back no cancer so uh what should I tell them yes so I guess we've ended up revisiting some realism here it wasn't ever likely in my opinion to be canceled you're a great patient I like you have to hope I never see you again but I promise you if you keep smoking you'll be back here I bet my own life on that absolutely right JD and often when when patients come into Hospital like this you know not just for lung problems but for heart problems and they smoke it's a really good time to remind them and encourage them to consider quitting because of the wide-ranging effects COPD so lung damage lung cancers as we know cardiovascular problems like heart attacks and strokes causes all manner of cancer it's not just lung Cancers and fertility problems too and the reality is you're just paying vast amounts of money to kill yourself but I also know it's extremely difficult so you have to be sensitive to the conversation not come across as preachy because it's easy to lose the sympathy if people have contributed to the problem themselves so smoke many years and developed complication but actually if you put that in your patients shoes that is going to be a very hard thing to deal with to know that you've done this to yourself that a lot of Shame can come with that maybe some embarrassment so you have to be extremely sensitive Dr Cox about will not now I have a 10 minute break and my soap is on hey Skech if you do go ahead and change the channels I swear I'll suture your hands together I've actually been in the staff room before where there's been Holby City so hospital drama on TV and everyone's watching it and it's kind of like this video it's a multiple people reacting live to the madness and the inaccuracies of the show turns out we can't save people from themselves newbie we just treat them I'm gonna treat that kid with a respiratory problem and when he comes back with cancer go ahead and treat that too well thanks for the pick me up hey that is pretty good advice this is one of the things I do really struggle with is when patients don't take the responsibility themselves for their health and you feel like you're doing you're always being more responsible on their behalf than they are which is kind of a weird thing because it is their health right and there's lots of different reasons why patients might do that they might have had some really challenging and difficult things in their lives so what people need is Support over a long amount of time and the healthcare system at the moment is just not set up to do that there's no money or resources to spend the time to really help these people and if you decide to take that responsibility on individually it's just gonna burn you out like what Dr Cox has given the advice to JD here and reality what does that mean exactly what he says patients come in time and time again with the same issues smokers drinkers druggies fatties whatever all I'm saying is that if you keep living and dying on whether or not a person changes well you're not going to make it as a doctor that's all so there you go another brilliant episode of Scrubs and what it always does so well is weaving the medical science which is kind of easy to do because you just read a textbook but it's with the actual stories and the feelings that you go through which it always Nails it's so well done so giving this a realism rating it's pretty solid there are a couple things that didn't quite strike a call with me but I'm going to give this one an 8 out of ten just so there's some room to go in future episodes the things that let it down was really jumping straight to cancer in a young patient that's coming with infection and my WTF moment was definitely Dr Cox using that defibrillator at the beginning I know it was supposed to be a joke but still it wasn't very realistic so I hope you've enjoyed my breakdown also you might have noticed the breakdown's a little bit different I'm trying to be able to do more of them so I'm trying more of a live recording type setup rather than spending hours editing so it might be a bit of adjustment but hopefully it's good enough in the meantime and so I hope you enjoyed this video if you did give it a like and consider subscribing thanks again for all the continued support on the channel I hope you're all well and I'll be back soon [Music] thank you [Music]

Channel: Dr Hope's Sick Notes

Views: 58,840

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Id: -oqEhBC8eMY

Length: 11min 17sec (677 seconds)

Published: Thu May 04 2023