SCRUBS "My Old Lady" real DOCTOR reaction | Medical drama review

hello and welcome to sick notes my name's Edie hope I'm a junior doctor working in emergency medicine in the UK and on this channel I like to talk about hospitals the human body general medical things and explain it in simple terms something crazy amazing happened last week as you guys know I'm a big fan of scrubs it inspired me and probably many of other people to consider medicine in the first place and the show's creator Bill Lawrence checked out one of my previous reviews and gave me a little tweet of support let me have a quick read to you hey I really enjoyed your review of our show that rabies case was based on a real case giant bummer yes a few of you commented and in the comments of the video about that crazy case the thing that actually happened it goes on to say you reminded me of always talking to my best buddy the medical adviser on the show and the cardiologist here his name is john doris real JD thank you so much mr. lawrence for I really appreciate the thought watching the video and give me a shout-out so a mr. bill Lawrence's blessing I thought I'd check out another classic episode of scrubs and the one you guys have been throwing around at me has been my old lady from season one I remember a little bit about this this is where JD Turk and Elliot get their first glimpses of death as a doctor so as always with these reviews is just gonna be a light-hearted look I'm not expecting it to be super accurate it's just a chance to revisit the episode talked about a little bit more what's happening on screen and to share some of my experiences so let's get on with it [Music] on my first day my resident told me if you don't count the maternity ward which is mostly you know or the emergency room which is mostly broken bone stitches you know that sort of thing he said that one out of every three patients that's admitted in this place will die here Wow is that statistic true sounds a bit high to me I like the sentiment about the maternity ward actually when I worked as an obstetric junior doctor that was one of the best things about the job was that it was kind of a hundred percent positive like people came in who are normally well and they had this it was not only such a special day of their life it was often the first day of people's lives the flip side of that is that when stuff does go wrong it can be even more devastating because you don't expect something to go wrong in something that is essentially you know a normal part of life what are you 16 unacceptable yeah yeah I mean young-looking doctors I guess in any profession if you're blessed with their youthful looks then you'll often have to deal with a prejudice that people don't think you're old enough to do the job he's young but he's probably a very good doctor are you a good doctor too soon to tell like that you probably want these people to wait outside that'd be nice make them know you're a man not a boy so one of the things I love about doctoring is shown here it's that the right word you know I read being a doctor is you have to kind of use every facet of your personality and sometimes you have to be quite sensitive and sometimes you have to you know kind of put your presence out there to get things done you don't always get it right and it does take time to develop that and it's probably common to a lot of jobs actually but it's really about stage-managing your clinical space so making sure the patient and the relatives feel comfortable and confident in what you're doing you know often has no bearing on your clinical experience but they just feel more at ease in that setting you know even if it is just asking them to set you know to sit out side everybody out of here now I say this is a simple laparoscopic hernia repair sir no see this is embarrassing you guys are wearing the same outfit great moving on where you guys going so then we see Turk on a surgical ward round and this is pretty much how fast the surgical ward round can be people wonder why us doctors notes are often really badly written but there's no real excuse for that but certainly what doesn't help is when we have to deal with you know documenting a super quick rate the Turks patient is a young chap with a hernia a super common condition you've probably all heard of now a hernia in medical terms just means any tissue or organ that protrudes through into a different space in this clinical context we're talking about the abdominal wall so the tummy muscles and there's there's often a small weakness there that the tissue organs beneath it get pushed through so in this context my thumb is going to be the bowel pushing through generally speaking hernias are not huge issues they do need to be surgically repaired but can often wait so you may have heard of sports people getting hernias but waiting till the offseason before they become repaired they may sometimes need to be repaired as an emergency if this hernia gets stuck and is unable to be pushed back through this is called an incarcerated hernia this can stop the bowel working what we call bowel obstruction or even worse cause strangulation so as it's pushed through the blood vessels that supply that part of the tissue of the bow become compromised and can lead to the tissue dying so this is why it can be an emergency I called down and requested a spanish-speaking nurse no English huh we move on to Elliot's patient who can't speak English this is super relevant I see this pretty much on a daily basis frequently you can rely on family members to help give a history but in an emergency setting particularly with injuries you have to get a hospital translator or another healthcare professional that can speak the language to translate just to rule out any kind of domestic violence or anything that may have caused the injury mrs. Guerrero's a four-tier old lupus patient who presented with shortness of breath so I started her on a heparin drip in order to VQ scan Elliot's patient has come in with a flower of lupus so House famously said it's never lupus but we know it is in this this particular episode of scrubs for those of you don't know lupus is a long-term autoimmune condition which means your immune system ends up attacking your own tissues and organs causing inflammation now it's a spectrum of disease so people may just be well medicaid to the rate and just feel tired with it or the extreme end people can have these flare-ups which means they're in and out of hospital with fevers and the disease affecting you know pretty much every kind of organ in the body so it can attack your lungs your kidneys your heart your blood vessels your joints and even your skin in fact the name of the illness lupus comes from the Latin of wolf and because the skin lesions can be so severe that they look like a kind of wolves bite I feel like you're missing out like this miss tanner she's got this incredible energy so I've said it with several of these reviews that I've done that you do get these patients that you really connect with and it doesn't happen with everyone it kind of happens for me kind of on like a weekly basis really clearly happens more in these shows because that's a really interesting thing to explore as part of the story but when you do in A&E I'm generally with patients for no more than four hours but in that time it can be such an anxious part of their lives that you can get to know people really quickly and some people I will then if they get admitted to hospital come see them you know while on the wards while they're still there and not only do you get to know people quickly you kind of get to know them perhaps in a way that not many people have known them before like through this difficult time so you know that's really one of the ways that is real privilege and a pleasure to do what we do this is pretty much the exact opposite relationship I have with the domestic staff in my hospital thankfully they don't try to kill me or maybe that sneakily doing it and just hiding it by being nice to me look I don't know how it's been with your other doctors but when you're under my care you stay in the hospital until I say it's okay for you to leave we saved your place yeah traditionally the doctor would kind of make the plan and the patient's kind of obey the plan but we've kind of moved away from that it's much more about shared decision-making informing the patient and making a plan together when people are in the hospital though and acutely unwell that's very often one world trodden route that we'll do first and say it is more laid out but then sometimes you do get people resistant to that I think it's because often it's a bit of denial because they associate with being unwell with being in the hospital and they just want to get out the hospital because then they won't they feel like they'll no longer be unwell and they'll often make excuses like well I've got this at work to do or going on holiday and you know I can't miss this and things like that and it can be frustrating and take a lot of energy to try and you know help them come to you know help them overcome their fear and come to the right conclusion you know and sometimes you don't and that can be really frustrating because you feel like you know I'm taking more care of your health then you are of yourself and you know you know what can you do about that hey come on man so fourth quarter you got a minute sure cool David right yeah I'm Turkey what's up you want some ivy no I'm good you sure mmm Tech only just introduced himself to the patient even though seen him on the water and effectively is his patient I mean I laugh at that but sadly I have seen this you know it's just kind of common courtesy isn't it let alone professional courtesy but you know sadly does happen as you think I'm ready [Music] hospital bow leg happens all the time I can order an ABG just to be safe I think yeah so Elliott's having difficulty trying to come up with a plan for your patient as a junior because this is don't forget very early in the scrubs episode this is really really relevant and what pretty much your whole first couple years are like because even when you make some decisions that you know you're then comfortable with there's an overload of decisions waiting for you to then be indecisive about this isn't necessarily a bad thing when medical students talk to me about having these issues I always say Tim you know being a conscientious doctor at first that is a good thing you know that shows you our safe doctor so Turks hernia is having keyhole surgery to repair it and they notice unfortunately there's more going on than they first thought and they suspect the patient has lymphoma so in reality you know actually need a sample of tissue to confirm that so maybe they did that but you just didn't quite see it so lymphoma for those of you don't know is a cancer of the white blood cells called lymphocytes and that make up your immune system and it can lead to tumors forming in lymph nodes and other parts of your body so lymph nodes form part of the lymphatic system which is kind of the sewage system in the body so it takes you know fluid protein cells that are in the tissues and distribute it back up into the bloodstream that's often where you get signs of infection that the lymphocytes can latch onto and develop their immune activity that's how they normally work I'm the furthest thing from an expert on lymphoma but I do know there are so many different types and you need to get a piece of tissue to look at it under a microscope and perform some tests you know what treatment is likely to work well treatment options are generally things like immunotherapy so giving the patients an antibody so the body can recognize and fight the cancer or things like chemotherapy and radiotherapy surgery generally not done so much her own sets in the eighties and take a look at her heart so Elliot's patient with lupus has got a pulmonary embolism or PE pulmonary meaning lungs and embolism meaning something that travels through the bloodstream and then blocks a blood vessel most often a blood clot this is realistic because people with lupus are much more likely to get pulmonary embolism that's because during the inflammatory process this kind of activates the clotting in the blood and also we talked about earlier you can get in lupus you can get damage to the blood vessels which means the blood are more likely to clot so when you get this blood clot in the lungs it means that the blood can't get oxygenated by the lung so we'd get breathing difficulties and this is why the oxygen starts dropping in this case she seems to be decompensating but thrombolytics scare me I mean a lot of times a patient bleeds out she needs to know what's going on in this scenario you definitely get more help the treatment is High Flow oxygen with a mask so not just with the tube or the nasal specs that are shown here and usually in Pease as they did in this episode we start with blood thinning medication but this works very slowly over days two weeks two months but in a massive piece or a huge blood clot meaning lots of the blood can't get oxygenated the patient's going to decompensate I know you're gonna be unable to provide enough oxygen to their body and that's what's happening here so in that scenario if you actually have to give medication so that breakdown the cop very quickly and these are scary medications to prescribe as shown here in scrubs Elia is extremely nervous about doing it and when you have to give these really powerful drugs that can have these massive side effects so if you're stopping the blood clotting you can cause massive bleeds to patients that's a huge call to make so even though it's an absolutely necessary in this patient I can totally empathize with Elliot here having to make that call so JD's neat old lady as he described her has end-stage renal disease or kidney disease for those of you don't know that kidneys are these kidney-shaped organs that live in your back I normally use the really bad joke that they literally take the piss out of you but as well as having a excrete reef function they kind of main role is a regulatory function in the body so they make sure you've got the right amount of water that your Bloods the right pH that all the right electrolytes or the sodium and the potassium will be salts on the right levels and they also help with red blood cell production as well if without them you only live days to weeks really so JD has the difficult job of telling the patient that her kidney disease has progressed basically it your kidneys aren't responding the medication anymore I'm afraid we have to start you on dialysis I'm not a big fan of dialysis yeah unfortunately we don't really have a choice actually I do have a choice certain things you never expect to come out of a person's mouth I think I'm ready to die for dr. Dorian that is brilliant how does Grubbs do this they sort of turn those moments that we kind of all dread and they all happen but they just they they make it funny but it's never dark it's quite sensitive isn't it patient autonomy so the right for an individual to make their own decisions on their care is a key principle of medicine even if as a doctor you don't think they're making the right decision there's no ethical dilemma well what about our duty as doctors to do everything in our power to look this has nothing to do with the patient it's all about you you are afraid of death and you can't do dr. Cox is exactly right medical school you think that the worst thing about being a doctor is dealing with death and certainly the question I get asked a lot by friends is kind of how you deal with that particularly because I worked in palliative care but death is not the worst thing that can happen to some sometimes it's the right time for someone so as a doctor it's not that we prevent death at all costs sometimes it is just about being there and you know being by someone when they have their last few moments it's not always you know about preventing the inevitable I would wear a Nazi yeah pretty sneaky dish only scrubs could get away with that kind of segue beautifully from that poignant moment to this brilliant picture of JD playing Connect four with with death the Grim Reaper and not really I think that he's lost so JD tries to create a list of things that the old lady could do with her life in a way to try and convince her to take the dialysis and - you know extend her life but she says she's pretty much done all she's wanted that should tell me those things have you done for that matter how many times you're sat on the grass and done nothing hmm you need to start taking some time for yourself young man yeah exactly right I mean one of the biggest negatives in medicine and I know it's not unique to medicine lots of careers alike this is the sacrifice you make at medical school you're really encouraged to do sports or artistic pursuits and travel and things like that but as soon as you do the job and you're working on like a full shift rotor it's very difficult to coordinate that with other people's lives and what they're hinting at here is really something that I've thought about a little bit is that you know although you know medicine can help people live it doesn't give you something to live for you have to find other things that really you know make your life rich as well as just doing the job here also the bittersweet song of hallelujah you know it's not gonna end well when this starts for you [Music] so we had JD's patient who he knew would die Elliot's patient was acutely aware with a PA so you know this has a high mortality so we're not really surprised that that happened Turks patient with lymphoma however the timeline is a little bit off so as mentioned the treatment would usually be things like chemotherapy and radiotherapy surgery doesn't really have a place although it can be used if it's I think if the lymphomas infiltrate a particular organ clearly there's an artistic license at play it's not about the accuracy at this point it's about the feelings and what happens at a hospital when people die and in this context it's about the showing what the doctors go through and how they're dealing with their kind of first steps of was they're gonna see a lot of their career and you know how it affects them so they say that one out of every three patients admitted to this place will die here but some days the odds are worse than that and on days like that I guess the best you can hope for is that you took something from it hey Turk anything that anything else even if it's just taking the time to lie in the grass and think about all the things you still have left to do [Music] brilliant I couldn't have said it better myself well clearly the writers are much better way of putting things together but what a perfect sentiment to end on so there we have it I mean I'm know why you guys wanted me to revisit this episode it's pretty much perfect I mean something that is so funny and real and educational and you know incredibly moving and all this around the subject matter of dealing with death I mean bill if you're watching Bravo May and it just leaves me to say thank you guys for watching if you enjoyed this why not check out some of my other scrubs reviews I really appreciate all the support or the comments or the shares all the subscribers so until next time look after yourself and I'll see you soon [Music]

Channel: Dr Hope's Sick Notes

Views: 439,072

Keywords: doctor reacts to scrubs, scrubs review, medical drama review, medical drama reaction, my old lady, scrubs tv show review, doctor watches scrubs, S1E4, doctor reaction, tv medical drama review, zach braff, JD, scrubs reaction video, doctor explaining scrubs, how accurate is scrubs, real doctor watches scrubs, doctor breaks down, dr reacts, dr watches, dr breaks down, dr review, scrubs

Id: fEp6NQ-ICYo

Length: 22min 13sec (1333 seconds)

Published: Fri Jul 27 2018

Reddit Comments

[u/Andrew_Parkinson]

Sweet, I was waiting for the next one of these.

[u/[deleted]]

Holy shit he looks and laughs like J.D

[u/[deleted]]

Still one of my all-time favourite episodes, and I'm sure many others feel the same way. I hope lots of people listen to Mrs. Tanner's advice.

That rendition of Hallelujah at the end is also wonderful.