"Is working in the E.R. like it is on TV?"
[Warning: Some of the material in this article may not be suitable for the squeamish.]
Cast: George Clooney is not in the E.R. where I work. A Peruvian neurosurgery resident comes close. Because if someone who looked like George Clooney worked in my E.R., I would never go home, and I might even shower before night shifts.
Scenes: The busiest Level I trauma center in New York doesn't receive the frequency of traumas of the E.R. on the show. With that degree of emotionally wrenching experiences, a more accurate season finale would have one of the docs going postal. Reality is a little more mundane, thank God.
Behavior of health-care professionals: Real doctors don't talk that fast during the traumas. For chrissakes, real auctioneers don't talk that fast during auctions. "CBCchem7Chestxray Bloodgas2unitsO-negativeblood EKG36-24-hike"
And, even if they did … the nurses don't listen that fast. Even if I were able to rattle off a string of orders at the speed of light, on my 15th trauma patient of the day, while taking seven seconds to intubate him and put in a chest tube, I'd look up to find the patient flat-lining and three nurses flipping me the bird.
Pay: Contrary to popular belief, most E.R. doctors do not get paid as much as George Clooney. I, for one, do not get paid as much in a year as George Clooney did per episode, and I bet he didn't have med-school loans.
Smell: Experiencing the emergency room via television omits a major sense organ: the nose. The show would be much more realistic if they shipped out a scratch-and-sniff palette in advance to every household. The whole family could sit on the couch and sniff along.
Dr. Carter walks by a sleeping drunk whose feet are sticking out from under the sheet. A "1" appears in the bottom corner of the TV screen. Everybody scratch-and-sniff square No. 1: Ah, rancid foot odor.
After a day and a half waiting in the E.R. sans toothbrush or even glass of water, the 32 year-old HIV-positive patient stands two inches from Carol Hathaway's face and tells her he has to leave against medical advice to go to his Methadone program. Sniff along with square No. 2: the king of all halitoses.
One of the registrars, a young, hip dude who flirts with all the nurses, walks by delivering a unit packed red blood cells to Dr. Green. Scratch-and-sniff square No. 3, an entire bottleful of the cheapest cologne on the market.
Then you can't leave out those surprise aromas: Dr. Green is having a calm discussion with family members about Advanced Directives for their aged grandmother. A nurse practitioner in the next booth cuts into a buttock abscess. But you don't know this. You just see a "4" at the bottom of the screen and scratch square No. 4. For this one, in addition to scratching-and-sniffing, you must also hit yourself in the face—hard—with the smell board to simulate the full effect of unexpected pus stench.
Be thankful that the TV is unable to convey the stink. If it did, Suddenly Susan would soar past ER in the ratings. For one simple yet putrid procedure that will go unnamed and undescribed, I had to soak a gauze pad in tincture of Benzoin, this sticky, yellow-brown, potent, burnt-banana-scented substance, and tape it directly to my face. The saddest part is, the patient didn't even ask me about it. He knew.
Sound: In order to be more realistic, the phone should never ever stop ringing. The drone of vomiters, moaners, and suicidal weeps should be continuous. Someone should whistle "Jingle Bells." Belligerent drunks or prisoners should scream profanities that make your ears curl.
Other senses: Along with your scratch-and-sniff palette, NBC should send a nozzle to hook up to your TV. At various points, something out of one of the character's tracheotomy should land on your arm, and after the trauma scene you should look down and find your pants covered in blood where Dr. Benton leaned against a stretcher.
Sex: Unlike the TV show, at least at my E.R., there's not a lot of oral sex going down in the call rooms.
We do it on the patient stretchers.
Call rooms: There are no rooms available for E.R. personnel to sleep in. Most of the doctors work straight through their shifts, except those who take time out to write "Diary" entries. My naps, if they exist, take place sitting on the toilet with my head on the sink. Paper towel pillow—it's really nice. Set my beeper alarm for 10 minutes. Sometimes, on good nights, the tail of my white coat will steep in the toilet bowl while I snooze.
Waiting room: The health-care personnel on the show have discussions in the waiting room all the time. I'd sooner jump naked into a pit of venomous vipers than venture into the waiting room outside the E.R. Talk about a FRAY. A mixture of pity and disgust and frustration swirl around like noxious gases out there.
There is a woman who sits in the waiting room night after night after night. She is homeless and likely schizophrenic. She sits in the same chair each time, muttering to herself. She has a small pair of scissors and has cut the hair on her head down to raggedy nubbins. She has also, inadvertently I think, cut the skin in several places, so there are spots of blood all over her basically bald head. Sometimes, when I walk to the vending machine, I see her cutting the hair—and the skin—on her arms. She never registers, only wanders in and out sporadically.
My venturing into the waiting room is like being a rock star and wandering into the public restroom at my own concert. Except the people there don't love me, they hate me and I'm not famous and I don't look good, I look bad. And as much as I'd like to be, I'm not on any drugs, and the only place people want my autograph is on the bottom of their prescription. "How much longer do I have to wait?" "My father is in there and he hasn't eaten in eight hours." "Are you a doctor?" "Could you take a look at this?" All I want is a Mountain Dew!
Time: The show's an hour long. Cases present and resolve in that time. If ER happened in real time, the cases from Thursday's episode would just be wrapping up Saturday night. The only person who gets in and out of the E.R. in less than an hour is the deli guy coming to deliver food. And sometimes even he has to wait.
Extracurriculars: Lastly, as for extracurricular activities, there hasn't been a lot of free time for me to leave the E.R. to rescue somebody from a burning car and, unlike the rerun episode of ER I saw Wednesday night, I rarely find myself involved in hostage negotiations. But it is still early in the season.