Film showcases health issues is it misleading?
Medical dramas offer teaching opportunities
Television makes it look so easy: A critically ill or injured patient being rushed into the emergency room on a gurney is administered cardio-pulmonary resuscitation (CPR) and survives.
Life isn’t so easy.
Researchers at Durham (NC) Veterans Affairs Medical Center say television dramas such as NBC’s "ER" and CBS’s "Chicago Hope" portray a survival rate from 66% to 75%. In the real world, survival ranges between zero and 30%.
The researchers’ concern is that such patients or their families will demand CPR, expecting the miraculous cure they witnessed on TV. There are serious risks to CPR, such as brain damage, which often aren’t portrayed on screen.
Television producers defend such inaccuracies as dramatic license. They contend that truly realistic programs would not hold viewers’ attention.
"Most viewers know that they are watching a fictional story, but many think the procedures they are seeing or the discussion of real diseases or physical conditions are always accurate," says Bernice Buresh, a writer and consultant in Cambridge, MA, who specializes in public communication, health care, and nursing. That’s partially because television shows list medical consultants in their credits and obtain advice about the treatment of certain diseases and injuries from specialists.
"ER" hires real-life emergency department nurses as extras who teach the cast how to handle medical emergencies and move around the patient. This gives a true-to-life impression, even when the filmmakers use dramatic license. "I’ve heard people who have gone to the emergency room say, I knew just what to expect because I saw it on ER,’" says Buresh.
The television movie, "First Do No Harm," about a family’s struggle with epilepsy and the treatment known as the ketogenic diet is a good example of the misconceptions people come away with even when a show has advisors. "About 90% of the calls we received after the movie aired were from adults interested in trying the diet. Of course, the diet is currently only prescribed for pediatric patients," says Peter Van Haverbeke, director of public relations and marketing for the Epilepsy Foundation of America in Landover, MD.
In the film, a boy was placed on the diet, but an adult who appeared in the movie had had epilepsy as a child and had been on the diet. People who did not pay close attention to the credits would not realize that the adult’s treatment took place in childhood, says Van Haverbeke.
Also, there is not enough time during a movie to do justice to the education process for the ketogenic diet. Usually, the diet is initiated under medical supervision in a hospital setting, and the parents receive intensive training on how to prepare meals. In the movie, there was only a scene at the hospital where the dietitian demonstrated to the mother, portrayed by actress Meryl Streep, how to prepare a meal. Such a portrayal leads to calls from parents asking the foundation to send a copy of the diet. (For details on the intensive education process that is required for this diet, see story in pediatric insert).
Another misperception viewers can come away with is that the diet is a magical cure. In reality, only one-third of the children on the diet show significant improvements. "Although films can be very accurate in what they show, they can’t show the whole picture," says Van Haverbeke.
The up side of television and movies that focus on a medical condition is that they increase public awareness. They provide a moment when the public is more open to additional information and education about a disorder, he says.
Programs often draw attention to problems viewers might not otherwise be aware of, such as the trauma of rape or elder and child abuse, says Marilyn Rice, MPA, RN, CEN, CNAA, a health care consultant in Freeport, IL, who has worked with the cast of "ER." Such publicity could be used by patient education managers as educational opportunities, she suggests. "Patient education managers can take advantage of that teachable moment when people’s interests have been piqued and they are open to additional information," agrees Van Haverbeke.
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