Grey's Anatomy -- "No Man's Land"

I returned home just in time to grab some dinner and watch Grey's Anatomy. This episode, entitled "No Man's Land," had the following plot synopsis gleaned from the abc.com website:

Cristina's encounter with a former nurse, now a patient at Seattle Grace, changes her forever; Derek and Meredith treat a construction worker who has miraculously survived an injury but is now faced with tough decisions about his future; and a patient recognizes Izzie from a lingerie ad, which makes her the subject of hospital gossip.


This turned out to be a fairly entertaining episode, though the writers continue to take significant liberties with their presentation of the world of surgery. I present to you this week's list of gripes:

1) Interns do not all arrive at the hospital at the same time and don their scrubs to the accompaniment of the morning's motivational speech, compliments of the chief resident. Actually, interns will arrive at the hospital at varying hours depending upon the particular demands of the surgical service to which they happen to be assigned at the time. Also, 4:30am is typically not a time for loquacity; even if the chief resident were naturally inclined to speak at length about the day, her natural volubility would likely wane significantly at such an early hour.

2) Patients do not come to the surgical service to die. Even an ex-scrub nurse would likely receive admission to a standard medicine floor, though her status at the hospital might earn her a single-bed room.

3) I admit, words spoken through a surgical mask lose some of their impact, without the listener able to observe snarling lips and defiant clenchings of the jaw. Nonetheless, nobody removes a surgical mask in the middle of a procedure just to make a point; doing so compromises sterility, and it's a great way to find yourself kicked out of the room post-haste.

4) Sandra Oh's character, Cristina Yang, remains a hideously distorted caricature of the heartless surgeon in training. In this episode we watched her try to save a DNR (Do Not Resuscitate) patient who had come to the hospital to die; somehow, we are led to believe that this surgical cyborg had formed such a bond with her patient -- though no evidence of said bond ever became apparent in their interactions -- that she was pushed by a flood of emotion to forgo reason and sense in the interest of saving the patient's life at all costs. Well, I suppose that notwithstanding the problems of plausibility with this exchange, we can hold out hope that the writers might use this "epiphany" as a door through which to inject some semblance of humanity into a character who is otherwise as cold and sterile as the scalpel she aspires to wield.

5) I realize that essentially any injury -- conceivable or not -- can befall a person, and that practically everything -- including a head-full of nails accidentally incurrred -- has probably happened at some point in the history of medicine. However, falling down the stairs with a nail gun would more likely splinter the torso and legs with nails, rather than the top of the head, due to inherent limitations in the length of the arms and the standard manner with which one holds a nailgun (i.e. with the index finger on the trigger and the tip of the gun pointing away from the hand, a position from which it would be impossible to put a nail in the top of the head). Nonetheless, for the sake of argument let's assume that such a nail-ridden skull could result from a fall. These nails pierced the skull and entered the brain along its convexity, pointing inwards radially; although an optic nerve injury could result, as the show alluded to, most likely the patient would not escape without some damage to the motor or primary somatosensory cortex. The nails plunged right through these areas, judging by the head CT depicted. So "Jorge" would likely have had difficulty with movement or sensation of his face or his arms. As it turned out, the nails caused him essentially no harm, but a hypothalamic tumor caused his fall down the stairs. I didn't get the best look at the MRI showing the tumor, but operating too aggressively on a tumor in and around the hypothalamus can, indeed, lead to significant changes in memory and even personality.

6) Oh, one more thing -- any neurosurgery attending who has to have his interns perform a literature search in order to inform him that the risks of surgery include bleeding & infection, and that surgical outcomes are better when the procedure takes less time, really has no business cutting into somebody's brain in the first place.

Well, that's all I have for tonight. I could say much more, but I'm beginning to bore even myself, so I think it wiser for me to sign off for now.