We are back with another installment of the "Doctor Reacts" series and this time I'm covering Fox's new show The Resident.

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Real Doctor Reacts to THE RESIDENT | Medical Drama Review | Doctor Mike

not even one year ago I was a resident now there's a TV show called the resident let's get started [Music] it is shoe surgeons play their favorite music when there are operating you guys know this is my first surgery dr. Bell no kidding wait to get a photo make it quick get into ok no no one's taking out their cell phone in the middle of an operation and taking selfies Oh tremor [Music] he's an artery on an appendectomy number [Music] he's breathing very heavily rightfully so what's splattered on him maybe a quarter of a leader two liters is a lot of blood and that's probably not two liters he has some shaky hands may have hit an artery when you hit an artery does splash like that the first step during a surgery is to get one of the tools called the hemostat and basically it clamps off the artery to get it to stop bleeding I'm assuming this is someone's bad dream because they're not following proper protocol I have no idea why he's stopping CPR nothing makes sense here okay you guys told me the resident is the most accurate medical show on television so far this has been incredibly inaccurate this gentleman's heart stopped in the middle of the procedure because he was losing blood they were supposed to get blood and start the blood flow through an IV they started chest compressions they didn't follow the cardiac life support algorithm of giving epinephrine rechecking the rhythm after two minutes and it looks like they called a time of death after 30 seconds I think we can all agree it was the mist Oh steve-o Wyatt let this unfortunate situation you're kidding right the patient woke up his arm hit my hand you left the blade in the field you never should for surgery in the first place as INR was adding up a range of normal that's never gonna be no I'm we're all on the same team here right good he's trying to blame it on the patient coming in with a high INR which is basically the ability of the patient in the inability of a patient to to clot properly so if you have a very high INR you're more likely to bleed out if this happened I hope that the people around me have the courage to speak up and say something about it in fact one of the biggest initiatives that have been going on in hospitals over the last 10 to 20 years is to give nurses the voice and the courage to speak up when they see doctors especially senior doctors like this gentleman who's a chief of surgery who's been practicing for 30 years to speak up and say no you've made a mistake and we need to own up to it and figure out what went wrong and how we can prevent this in the future this is awful this is an awful situation I have goosebumps honestly we toured is exposed I can name each one it's a very cheesy way to turn somebody on everything you thought you knew about medicine is wrong all the rules you followed will break I have only one rule covers everything I'm never wrong you do whatever the hell I tell you no questions asked I can't take this guy seriously he sounds like he's from a western movie and he's like welcome to the wild wild west yes in reality medical school is quite different from life as a resident there's a lot that you think you know about working in a hospital when in reality you start working in a residency you realize that you didn't know or what you thought you knew was actually wrong and you practice it in a different way that's why those who get overly confident by regurgitating facts and figures really have their minds blown when they enter the hospital and they see the way medicine is practiced because humans are very complex they don't present like the way the textbooks says they will present they don't always give you a clear indication of what's wrong with them it's a lot more of a and figuring out what's going on the heart of what he's saying is true the way he's presenting it is way overblown and dramatic my last resident had an attitude too and you know where he is now he's teaching eighth grade biology I got him right you know what that means it means I can end your career just like that remove you from this residency at any time for any reason and if I do that no other residents do thank you completely untrue senior residents don't have the ability to get you kicked out unless you do something just horribly wrong and if you lose your spot in a residency because you disagree with a senior resident doesn't mean that no other residency's will touch you again a completely overblown statement and untrue I guess for the dramatic factor of the show this is dauber sloth he's Croatian speaks no English yes severe cauda equina syndrome what are we worried about early paralysis hey man what's the first sign of paralysis anal tone stick your finger up his ass normal procedure is to get an MRI thank you so much for telling me about normal procedure Cota Aquino syndrome is where you have severe narrowing of the area of the spinal cord where your nerves travel through so you lose the sensation of your lower limbs you lose the ability to have proper anal tone some people have incontinence where they just pass their their bowels they lose urinary control and just have urinary incontinence meaning that they pee themselves and if any of those things happen you have to call 911 queena this procedure this conditioner they're talking about is a medical emergency obviously one of the ways to test that is to do a rectal exam and check the sphincter tone but he's being really rude about it afternoon we need to explore your rectum [Music] back in the day we used to have translators that lived in the hospital I mean worked in the hospital now we have really good intercom systems some hospitals even have iPads that connect you to another person who can be the functioning translator the correct way to do this is to not talk to the translator and have them translate it but talk to the patient normally and have the translator somewhere behind you or on the phone talking to them translating so you're still having a conversation with the patient not a conversation with the translator that's a very important distinction to make I was hoping this show wouldn't involve sex but I'm striking out week by week because apparently everyone's in love in the hospital maybe I've just worked in the wrong hospitals leukemic on chemo fiance caught because she's shaking uncontrollably she swiped the fever this morning a hundred point eight also there so commonly someone who has chemotherapy performed on them they can develop something known as neutropenic fever it's what a specific type of white blood cells very low and you have a fever it's a very dangerous situation broad-spectrum antibiotics meaning antibiotics that cover a whole host of different bacteria need to be given right away in order to prevent the person from dying because their immune system is incapable in dealing with the bacteria on its own so I think this is a pretty interesting case already and I've just seen like five seconds of it there was some vomiting there's no blood in it my skin was a week ago very accurate presentation so far knowing when the last chemo treatments very important when judging what the next step of the treatment plan is scared you're running a fever just an infection chemo still pushing your immune system I'll get you started on broad-spectrum antibiotics again I see the menifee to get your fever down the cultures from both arms here and she'll need a head CT okay don't worry get this under control get your both back home soon having a good rapport with patients like that is very important nurses and some doctors and even people that are just spending time in the hospital for a short period of time are very somber when they're around sick people especially chronically sick people who've been sick for a long period of time but in reality they would love for someone to come in with a little more lighthearted approach can laugh with them make them smile I'll always try and have a laugh with them tell some jokes especially if I know the family well and I think that makes a very unpleasant experience a little bit more bearable that's just my take on it how do you get that cheeseburger check looks like you haven't been following your diet diets don't work have you been taking your insulin I don't want to let your name right here cuz I'm toes killing me severe gangrene oh so a gangrenous just really gross a gangrenous toe could be so infected and dead it's basically necrotic that means dead tissue daddy can't fall off like that obvious that's a little exaggerated this smell is probably the worst part of all of it because the bacteria once they eat your tissue they release a very foul smell it will light up the entire room I'm not talking about you have to sniff the wound as soon as you walk into the room and there's gangrene present you're gonna smell it that is very true 21 year old girl history of IV drug use likely endo those who use drugs especially injection drugs they're predisposed to a whole host of illnesses so this is a common presentation unfortunately especially in light of the opioid epidemic that's going on right now when you inject into your body anything especially in a non sterile technique meaning the needle isn't clean your skin isn't clean you're more predisposed to things like meningitis endocarditis meningitis is an infection of the pads surrounding the brain and no carditis is infection of the heart valves these are life-threatening illnesses that can make you act this way because bacteria is festering in your body and unless it's treated quickly and correctly you can die and that's just talking about infection think about all the other things that could be going on when you're under the influence of drugs it's very possible that you're acting this way as a result of an overdose from simply the drug when a patient comes into the emergency room and they're presenting with this kind of outcry screaming what we call altered mental status AMS we have to figure out is it related to the drugs is it because of infection is it something more sinister has this patient had a seizure there's a lot of things that are happening simultaneously in a doctor mind so it's not an easy situation to deal with but ER doctors are the frontline in dealing with this and then once the patient is stabilized and ready to be admitted into the hospital it's then goes to internal medicine doctors like this gentleman or family medicine doctors like myself if you walk out of here without any antibiotics this would kill you give us a chance we can save your life I'll stay if you give me three milligrams of dilaudid two if you calm down I can't say what he's doing is wrong because she's likely withdrawing from dilaudid or opioids or heroin whatever it may be in order to help her condition it's possible that you need to taper her off meaning give her smaller and smaller doses more spaced apart of the same chemical that she normally gets high on Plus if it's gonna make her reconsider and stay and get treated with antibiotics for her endocarditis you're saving her life some people may disagree with his approach and say absolutely not she's not getting that law did some will say that there is a medical benefit so that's why practicing medicine is an art it's not a science because two doctors can look at the same situation and have different approaches for solving it I understand what he's doing and I sort of respected [Music] get a crash cart not getting a pulse someone falls and they have no pulse you call for help and without even thinking about it you're pumping on the chest chest compressions chest compressions save lives I've said it before chest compressions I'm gonna say one more time chest compressions is the first thing you do even if you have no training in it start pumping on the chest you're running the car I've never run a code do you want an amp of bicarb he's in charge page anesthesia when you're running a code blue you're following the advanced cardiac life support algorithm it's literally written out for you you give each person role you do chest compressions you monitor the medications you monitor the time you monitor the rhythm and everybody has roles after that there is a specific algorithm you literally follow steps on little cars that you can carry in your pocket of when to recheck the rhythm what medications to give what options of medications do you have what dosage what is the first question you ask you code rhythm what's rhythm pa pa is pulseless electrical activity it basically means the heart has a rhythm but you do not feel a pulse there's some electricity going through the heart but it's useless because it's not creating enough of a muscular motion and within the heart to create a pulse to make the heartbeat peña is not a shockable rhythm meaning you do not use the paddles for that you use epinephrine you use drugs use chest compressions and you hope to get the patient back and you wait for the rhythm to change into one of the two shockable rhythms shoe shock no we can't we will get me one event B make those compressions harder and faster so when you're doing chest compressions you want to make sure you're doing quality chest compressions you want to push at least 2 inches deep into the chest which sometimes can break ribs it's a horrible sound to hear but you're doing this to help resuscitate the patient basically bring them back to life so if on the off chance you break a rib that's okay it does happen and elderly folks much more than in young folks you also want to do it to at least a hundred beats per minute so if you think there's 60 seconds in a minute you're pushing a little bit faster than once per second a good way to sort of monitor if you're doing it right is to sing the song in your head please stay alive because that does go to about a hundred beats per minute it's the classic way that we're taught funny that it's called stayin alive and we try to bring someone back to life but that's some of that raw medical edgy humor it's been 24 minutes is time to come home no this is my coat you gave me this coat [Music] we got a pulse you see if don't laugh doing a code on a young person for 20 minutes is not unrealistic also not unrealistic to recommend stopping the code because the brain without oxygen for 24 minutes is obviously very dangerous and even again even if you bring the pulse back will the brain work again you won't even know until the person wakes up the first line that one of the other residents tells them as you saved her life in reality that could be a great thing but also on the other hand it could also be an awful thing because she may just need to be on a ventilator for the rest of her life functionally brain-dead just her heart beating in her lungs working because she's on a machine so very difficult situation to find yourself in you came in here all right I should say over to save lives but today didn't save a life you saved a brain stem he didn't listen to me did he do the wrong thing not necessarily in this situation especially because her family looked like they were there this is the time to have a conversation with the family very quickly and explain to them what's going on and explain the consequences of hey if we bring her back at this point 20 minutes in she could could come back with a pulse but also be brain dead and help them decide what to do in the situation allow them to make the decision because you know they're her next living kin some hospitals have a cooling procedure that when someone undergoes either a heart attack or a sudden stoppage of the heart like she did that they cool the body down which slows them metabolic rate which can help the brain survive a little bit longer so this doesn't always hold true don't use this as an application for your own life or making decisions for your family's life treat each situation on its own talk to the doctors in front of you and make the best decision that you can with the information given to you at the time what was rule 1 then do whatever you tell me no questions asked all we want to do is help our patients but what they don't teach us in medical schools there are so many ways to do harm the first job of a doctor is not to heal it's to first do no harm because if you look at the history of doctors in the past we've made a lot of mistakes over treating patients under treating patients deciding what's right for our patients and going against their own wishes I think we've done a lot better in recent years but there's still plenty of room to go to improve is it were easy everyone would be a doctor because this is the best job in the world despite everything because of everything [Music] [Music] there you have it the rezident season 1 episode 1 in the books initial impression this shows absolutely ridiculous this resident while he's you know smart and has some experiences he just does some crazy things he's a cowboy in my eyes deciding who lives and who dies I'll say the way that they're talking about medicine is accurate some of the medical terms that they use or use accurately the procedures somewhere in the middle 50/50 of their accuracy I think it's gonna make for a fun show I definitely relate more to this show because it's more internal medicine and I'm family medicine so I practice a lot of internal medicine on my own as compared to Grey's Anatomy which is a surgical show and I'm less of a surgeon I like watching all medical shows so if you have a show you want me to watch or an episode of this show or any other show drop it down below in the comments and again the most important thing you can do to help this channel grow and get yourself more content and better content is to subscribe and not just subscribe but click that little bell on the bottom to make sure you get notifications when my video first comes out as always stay happy and healthy [Music]

Dr.

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