Medicinal reality

As a student in my final year of medical school, I spend up to 80 hours a week in the hospital. So you’d think whenever I have time to watch TV, I’d get as far away from medicine as I can. “The Bachelor.” “Desperate Housewives.” The History Channel. But no. I watch medical shows. But as I’ve gotten more versed in the jargon of disease-ese, my guilty pleasure has taught me one thing: Realism isn’t always the top priority on TV. And I don’t just mean that I’ve never seen any (Mc)dreamy neurosurgeons roaming the hospital halls. So which medical show is the most realistic? Here’s an authenticity-based critique of four of them, complete with standard medical school grades: Honors, High Pass, Pass, Low Pass, Fail. And trust me, in med school, “Pass” is the kiss of death.

“House”

Airs: Tuesdays, 9 p.m. on Fox.

About: Hospital drama that focuses on obscure diagnoses and the inflated ego of the eponymous doctor who makes them. Features dizzying zooms into patients’ innards.

Analysis: Gregory House (Hugh Laurie), the curmudgeonly protagonist, projects enough arrogance that the naive might assume he never errs. His character is called upon to solve the hospital’s toughest mysteries, and without fail he does so before his 44 minutes are up.

Confirming this image of infallibility, on a recent tvguide.com poll, House was voted the No. 1 TV doctor people would trust in an emergency.

But are the masses right?

I’ll admit that many of House’s diagnoses are brilliant. On one recent episode, he diagnosed gallstones – after glancing at a CT scan that showed no gallstones. (He saw the patient’s inflamed pancreas and put two and two together.)

But other times, the medicine is sloppy.

House later decided the same patient had Rocky Mountain Spotted Fever, an infection spread by ticks. He ordered treatment with an antibiotic, chloramphenicol.

But surely House, a brilliant infectious disease specialist, would know that the American Academy of Pediatrics recommends a different antibiotic, doxycycline, because of side effects.

House has three lackeys working for him – a neurologist (Omar Epps); an immunologist (Jennifer Morrison); and an intensive care doc (Jesse Spencer). They’re supposedly specialists, but they all do the jobs of many. Strike two for House: There’s no training program in the world that turns you into a vascular surgeon, a microbiologist and an ultrasound technician, all rolled up in one.

And then there’s House’s behavior toward his patients and colleagues. Yes, he was born rude, and this is intensified by his addiction to painkillers. Even conceding that, it’s ridiculous to think of an employed physician shining a laser pointer on his boss’s forehead while she’s in a meeting, or calling a patient’s mom a moron to her face.

For a show that claims to portray the best doctor around, he’s pretty far from the mark.

Reality grade: Low Pass.

“Scrubs”

Airs: Thursdays, 9 p.m. on NBC.

About: High-concept comedy that blasted Zach Braff into the hip-o-sphere. Not above potty jokes. Big on daydream sequences.

Analysis: J.D. Dorian (Zach Braff), the adorable medical resident from “Scrubs,” scored a lowly fifth place on the tvguide.com doctor-trust poll. But based on pure authenticity, maybe people should re-think their votes.

“Scrubs” offers proof that there can be realism in satire. Witness a spoof involving a crop of green interns in the season premiere: “The chart said to remove eight stitches, but we counted nine,” one said. “Should we leave one?”

Since “Scrubs” is a comedy, it can get away with showing the residents improbably dancing at a nurse’s station (unlike, say, “Grey’s Anatomy,” which took itself much too seriously during last season’s doctor-prom).

And what about J.D.’s recent discovery that he got Kim (Elizabeth Banks) pregnant … without actual penetration. Realistic? Well, it’s not exactly common, but it is certainly medically possible.

(Full disclosure: I went to college with Banks. Really. We were in the same children’s theater group. Now she’s playing a doctor named Kim on the “Scrubs” premiere, probably making tens of thousands for a half-hour episode. Meanwhile, I’m a med student named Kim, wearing scrubs while writing about her to make a few extra bucks. Not that I’m bitter.)

And to the other medical types reading this: Yes, the opening credits show a backwards chest x-ray. But in this case I’m inclined to think that’s a private joke to all the doctors out there.

Bottom line: Scrubs is funny, and definitely hits close to home, if home is the hospital.

Reality grade: High Pass.

“Grey’s Anatomy”

Airs: Thursdays, 9 p.m. on ABC.

About: Pithily narrated dramedy about life and love, for which the hospital happens to be a convenient metaphor. Or at least it’s an excuse to show hot surgical interns sleeping with hotter surgical attendings.

Analysis: What a good-looking show. Everyone fills out their scrubs and masks so nicely.

The costume-designers also manage some very authentic accessorizing – puffy shower-cap-style surgical hats for patients and family-members, tight-fitting bandana-caps for the surgeons.

Another nice touch: Chief resident Miranda Bailey (Chandra Wilson) recently asked someone to hit the microphone button so she could talk to an intern up in the gallery. (The button isn’t sterile, so if she’d touched it, she would’ve had to put on a new pair of gloves.) And when she returned to the operating table, she stood on a stool – a must-have for any height-challenged surgeon.

Unfortunately, looks may be the only reason why Derek Shepherd (Patrick Dempsey) came in 2nd in the tvguide.com poll: There’s a lot in this show that doesn’t ring true.

In a recent c-section, there was no barrier between the mom’s head and her nether regions. In real life, most new moms aren’t too keen on seeing their uterus cut open and then flopped out onto their stomach to be sewn back up.

Also, the TV-baby’s umbilical cord should look blue and twisty, not whitish and rodlike.

Unfortunately for TV-mom, TV-baby wasn’t breathing. Many things can cause this. But the diagnosis offered by OB/GYN Addison (Kate Walsh) – jejunal atresia – is not one of them.

But medical inaccuracies are just the tip of the inauthentic iceberg.

It’s completely improbable that interns – trainees who just graduated medical school – would get to scrub in to so many surgeries. Where are the senior residents? Interns are underlings. They rarely touch a scalpel.

So it was ludicrous when intern Cristina (Sandra Oh) performed surgeries to cover for her cardiothoracic-surgeon-boyfriend Burke’s (Isaiah Washington) hand tremor.

And most unrealistic of all: People don’t have this much sex in hospitals. Trust me.

Reality grade: Pass.

“ER”

Airs: Thursdays, 10 p.m. on NBC.

About: Fast-talking, chart-stacking, jargon-dropping granddaddy of the latest generation of medical shows.Breathless cries of “Clear!” and “I’m in!” as the camera cuts with whiplash speed from one catastrophe to the next.

Analysis: Luka Kovac (Goran Visnjic) and Kerry Weaver (Laura Innes) came in third and fourth place respectively in the tvguide.com poll. But this top-five duo is where the smart money is, since “ER” is in many ways the most realistic medical show on TV.

Let’s start with the actual medicine. On a recent episode, “ER” intern Gates (John Stamos) consulted surgical resident Neela (Parminder Nagra) about a patient’s abdominal pain. After looking at multiple X-rays, she gave excellent reasons why the problem was unlikely to require surgery.

ER also gets points for authentic lingo: “CF-er” for a patient with cystic fibrosis; “GC” for gonorrhea (short for gonococcus, the bug that causes the STD).

Culture-wise, the show is also strong, down to the communal junk food lying around: Too many real doctors preach vegetables but practice doughnuts. And the nurse-doctor rivalry is dead-on: Some nurses recently joked with nurse-turned-doctor Abby that she’d converted to the dark side.

The biggest problem: Every day in “ER’s” ER is melodramatic. In one recent shift, a woman swallowed a cell phone, a man wedged an icepick in his ear and a teenager sliced her vagina with razor blades. All are possible war stories in the life of an ER doc, but definitely not daily events.

At least it wasn’t all the same patient.

Reality grade: Honors.

So, in the end, which doc would I choose in an emergency? One who doesn’t play one on TV.

And if that’s not available … one who looks like Patrick Dempsey.