- What is up?
I watched my first episode of "Scrubs,"
and it was a little mean-spirited for me,
but you guys have been telling me nonstop in the comments
that I'm gonna love the show.
I scoured the internet,
and found out that Brendan Fraser is on episode 22
of season one.
Beeyooop!
(upbeat bass heavy music)
- This isn't gonna end well for you,
I used to wrestle in college.
- I remember one of my favorite movies as a kid,
and don't ask me why, 'cause it's not a great movie,
was with him and Elizabeth Hurley called, "Bedazzled,"
where she plays the Devil and he gets wishes,
and he gets to do all types of stuff.
I loved his humor.
I also found Elizabeth Hurley very attractive.
- Oh my God, that's disgusting.
- I already dosed him with morphine,
and the x-ray says the nail went straight through,
so it's not that big a...
Oh, dear God, she's getting woozy.
Quickly, show her the bloody side.
- Look at that.
- Yeah, yeah. - Touch the nail.
- You wanna touch it?
- Touch it.
- Touch the nail. Touch my nail! Touch it!
Lick the tip of my--
(thuds)
(laughs)
- That's so mean,
but it's true.
Some people do have what we call a vasovagal reaction
when they see blood.
Their blood pressure drops. They faint temporarily.
This is not a deadly condition,
but the sight of blood, it's scary.
It stimulates the part of your nervous system that makes you
fear for your life.
And to some people, if it gets overactivated,
you can faint like that.
When I was a medical student, I was doing a lot of ABGs,
which is an arterial blood gas.
You have to put the needle right into the radial artery.
Unlike veins, you can't see the arteries,
you have to feel them,
which makes the procedure that much more difficult,
but it's a high-pressure system,
so when you put the needle in, if you miss,
or the needle tip is not inserted properly,
blood can start squirting out.
One of my first few times doing that,
I put the needle in, blood started squirting out,
the patient fainted.
Luckily, they were laying in their bed,
but they were so worried that they saw the sight of their
own blood that they passed out.
- Now, let's get you to a hand surgeon.
- What about tough guy?
- [J.D.] Ow.
- Somebody'll get her.
- So, the reason why the ER doctor,
or the internal medicine doctor, doesn't handle this
complicated case of the nail going through the hand is
because the hand is really complicated.
That's why you'd need such a subspecialist.
You don't just need a surgeon, not just a plastic surgeon,
you need a hand surgeon.
The hand has tendons, ligaments, bones,
nerves, blood vessels,
and they're all in such close proximity.
If you don't know the anatomy inside and out,
and how it reacts to a nail going through it,
you're gonna have a tough time.
There's gonna be a higher rate of complications.
- Wait, wait, wait.
Stop, stop, stop.
I'm guessing Mr. Weinberg is Jewish?
- Yeah, so?
- Why isn't he circumcised?
(wacky guitar chord)
- [J.D Voiceover] A recent medical study found that a
mistake is made on about 20% of all patients.
Most of these are clerical, and harmless,
but it still adds up to a lot of near misses.
- Dr. Wen wants me to ask you if there could be a mix-up?
Because our appendicitis patient...
That dude doesn't have an appendix.
- Hospitals make mistakes.
Patients, unfortunately, get ill as a result of
a hospital complication.
When you go to a hospital, if you notice that the doctors
are trying to eagerly get you out and expedited as fast
as possible to go home,
the reason is not because we want you out,
but it's because we want to lower the chances of you having
a hospital complication.
- You're pregnant.
- I'm what now?
- Yup! Pregnant! Your fiance's gonna be so happy!
- My fiance and I decided not to have sex until
we were married.
- So, he's not gonna be so happy.
(laughing) - More curious.
- Can't stop thinkin' about Mr. Weinberg's testicles.
- Dude.
- I mean, I almost removed one of them, Todd.
- Which one?
- Like it matters.
- Oh, it matters.
- Fun fact about testicles:
One of the testicles usually hangs lower than the other.
Some men get worried about that,
and actually come see me to make sure everything's okay,
but that is a normal variant.
- You're not pregnant!
The lab tech just switched the samples!
- You're killin' me.
Hey sweetie, you know I was just jokin'
about all that stuff, right?
- (laughs) Jesus.
Samples can get switched up.
This doesn't regularly happen,
but we talked about this on the past episode of "Scrubs,"
that when hospitals are more ready to admit their mistakes,
and point out what they did wrong, apologize,
tell the patients what the plan is gonna be so they don't
repeat the mistake,
there's less likely to get sued.
That's always important to keep in mind,
even though that's just a totally hilarious scene.
- So, turns out she wasn't really pregnant after all,
'cause some idiot mislabeled her urine sample.
- I was a heartbeat away from giving an appendix patient
a crotch lobotomy.
- Oh my god.
- If I do my best and I lose a patient,
you know what?
I can live with that,
but if a clerical error's the reason why a guy's walkin'
around here with only the lonely...
Well, damn!
That don't sit well with the big dog.
- Well, that's why nowadays we do a timeout,
where we literally, before we start the operation,
before the patient gets put under,
we say the patient's name, we describe the procedure.
We talk about the site of the surgery.
We get the nurse to confirm, the doctor to confirm.
So, everybody's on the same page,
which decreases the likelihood of making a mistake.
Oh, and very important to note,
while the patients asleep and we're performing the surgery,
the nurse that's in charge of assisting the doctor is
counting all of the instruments,
is accounting how many gauze pads are being used,
all of the rags.
Everything is counted before and after to make sure nothing
gets left inside the patient,
'cause this has happened before,
and it's a horrible, horrible mistake.
- [J.D. Voiceover] I was paged because Ben's blood work was
finally ready.
Unfortunately, the chart wasn't in the outbox.
I'd knock but the hematopathologist is the meanest,
intern-hatingest, monster in this hospital.
- It's funny because nowadays all our results are
in the computer. So, as soon as we get results back (snaps),
we just pop open a computer, all of the results are
there to review.
If we have any questions, we can contact the pathologist,
or radiologist, whoever's running the test to get more info,
but computers have made this process a lot easier.
- Come on, good news.
- [Carla] Hey, Bambi.
- Couldn't quite catch that.
- You okay?
- [J.D. Voiceover] Leukemia.
- No.
- Leukemia's a form of blood cancer.
It's been known to be a children's cancer,
which is slightly incorrect 'cause more adults get it.
Essentially what you have is an increase
in white blood cells,
and this is an improper increase,
and it's such a big increase that it pushes out the
red blood cells, even the platelets.
Platelets are the cells that clot.
So, if you have a cut, they're the ones that come in,
and fill that clot.
So, for example, here.
He has such a spike in his white blood cells that he's
actually pushing out the platelets,
and he's unable to clot properly.
That's why he's bleeding while shaving,
he's bleeding out of his wound too much,
and also, something very commonly that happens
patients tells me, is when they brush their teeth there's
an excessive amount of blood,
and it stays around for a while.
- Oh, Janice. Are those the test results we've
been waiting for?
- [J.D. Voiceover] Wait a sec...
First Turk's patient, then Elliot's...
This is a mistake. I just, I feel it in my gut.
I'm sure of it.
- Hello? Janice?
- Uh, no. This is something...
You know that lab is backed up again,
and so, I'm gonna, it's, you know, a little while.
- Actually, he's not wrong in doing that.
When I have a patient who...
I guess it's not the same as this situation,
but let's say I have a patient who doesn't
have any symptoms,
and I order blood tests for a screening purpose,
and something comes out horribly inaccurate signaling a
form of disease,
my first job is to recheck that lab value to make sure
that there wasn't a mistake,
'cause that does happen!
There's been times where I checked the red blood cell count
of my patient,
and found them to be horribly anemic.
It didn't make sense.
It didn't fit their clinical symptoms.
It didn't fit their vital signs,
so I asked the lab to repeat the test,
and voila!
Their labs were totally normal.
So, if you feel that the clinical presentation doesn't match
what's on the blood, recheck it.
- You know there's only one more person to talk to.
(power guitar chord)
- [J.D. Voiceover] The hematopathologist.
(thunder booms)
- Hello?
- Call me Dr. Bob. - You go by your first name?
- No, first name's Fred.
- Fred Bob?
- What can I do you for?
- (laughs) I love that interaction!
- I was hoping you could recheck Ben Sullivan's blood smear.
- Well, that depends, young man.
Do you actually think I made a mistake,
or do you just wish I did?
- I kinda wish you did.
- Then I'll do it.
- Sorry there, giant, '70s, security guard guy.
(chuckles)
Cold out here, huh?
- Yes.
(grunts)
- Where is his wound?!
He just a nail go through his right hand!
♪ Once we take ♪
♪ To be always workin' ♪
- Being a lab nerd, that was a mistake.
Whenever you put a slide onto a microscope,
you have to use the lowest magnification possible so that
you don't put the high magnification on,
and then end up breaking the slide.
- Let's try this again.
Are those the test results?
- Uh, yeah.
Ben, you have leukemia.
- This sucks.
- Yeah.
- As much as they try to make light of the situation,
I think the way that he delivered that news
is actually ideal.
When you're straightforward,
and honest and quick to the point,
that's the best way of delivering bad news.
You have to understand what a patient is going through.
You have to give them time to process it.
If you feel that they need some more information,
or reassurance, you can give that to them,
but I like to hold out and ask them what
questions they have.
And understand that when you're delivering bad news,
a lot of it is not gonna stick,
especially the dense information,
like about treatment options, this, that.
You have to let the patient process it.
Just give them a little piece of information,
and then just be there for them.
They can scream, they can yell, they can be quiet,
everyone has different reactions,
depending on their personality,
and it's not an easy situation.
This also hits home for me,
because, unfortunately,
I lost my mom while in medical school to leukemia,
a form of leukemia known as CLL.
Delivering this type of news is something
I have to do often.
It's a tough situation, all around,
but if you can be straightforward, you can be honest,
and really care...
And even cry!
That's okay.
A lot of doctors think they have to be unemotional,
and not cry.
If you feel the, to cry, cry.
You're human, that's okay.
"Scrubs" is truly starting to grow on me,
so please keep recommending the episodes,
and click on this playlist that I created of my favorite
medical drama reviews.
Stay happy and healthy.