"Do No Harm" Does Harm

Tonight on NBC there is the series premiere of a new show called “Do No Harm.” I’ve known this show was coming for quite some time. In fact, I knew about it when they were filming the pilot, mostly due to the fact that one of my favorite Broadway actors is in the show. Turns out SEVERAL Broadway actors I like are in the show, and it was directed by a Broadway director that I also like.

Because of that, I had been waiting on this show to air. Waiting for news about it. Getting little snippets of what was going on. A week or so ago, NBC made the premiere episode available online. I watched it last week. Of course, I watched it on the chance to see some actors I know from the stage, like Lin Manuel Miranda, Michael Esper, and the star of the show Steven Pasquale.

I won’t spoil the whole show for you. I won’t give away all the details, but the basic premise of the show is that Dr. Jason Cole is a brilliant neurosurgeon with a problem. He has Dissociative Identity Disorder… also known as a split personality. His alter ego, Ian Price, is not a nice person. He’s aggressive, a playboy, and an all-around NOT good guy. Ian shows up at 8:25 every night and goes away at 8:25 every morning. So basically, for 12 hours a day, Dr. Jason Cole can’t be around anyone he knows or cares about, as Ian will hurt them.

There is an outstanding cast of actors in the show. It has an interesting plot line. It COULD be the kind of show I would like to watch. BUT (there’s always a but) there was some terribly incorrect information regarding diabetes throughout the entire show. And the saddest part of the entire thing is that some of the information regarding diabetes will probably continue to be a part of the show for as long as it lasts.

“Why?” you ask? Most medical shows will touch on diabetes for an episode or two here and there, but it never lingers very long. In “Do No Harm” Dr. Cole says he has diabetes. As he is a brilliant neurosurgeon, he has to test his blood sugar levels before he performs surgery. The machine they use is interesting. It’s not an actually BLOOD sugar machine. It’s some sort of device that he places his finger in and it uses infrared light to test his glucose levels.

Honestly, it looked like a pretty awesome machine, except that it was HUGE (think a rolling blood pressure machine from a hospital). And I’m pretty sure it doesn’t exist. I did some research on the internet after I saw this. From everything I can find, this technology doesn’t exist yet. There areseveral companies working on the technology that would allow us to check ourglucose levels with infrared technology, but so far nothing has been approved, and from what I can find, it doesn’t even really exist more than what scientists seem to be TRYING to develop. Basically, nothing headed our way anytime soon.

So, what I wanna know is how to get one… cause if it’s on TV, it must exist, right? You see where I’m going with this? Um, I don’t want people telling me I don’t have to poke my fingers all the time cause I can get this cool machine that tests my glucose with infrared technology. I don’t want to have to take the time to explain that it’s Hollywood making something else up.

That was alarm bell number one in my head. But, you know, it’s not THAT big of a deal….but then Dr. Jason Cole has a conversation with the director of his hospital, Dr. Vanessa Young (a lovely and talented Phylicia Rashad).  

Dr. Young offers Dr. Cole tickets to a Phillies game because it’s his birthday. He tries to turn them down and she says “Just because your diabetes keeps you from working at night doesn’t mean it keeps you from going to a game.” And there’s alarm bell number two in my head. What do you MEAN that diabetes keeps you from working at night?!? I know several people who live with diabetes (T1 & T2) who work the night shift. And why wouldn’t a DOCTOR (and probably a pretty extensively trained doctor, if she’s running a major hospital like in the show) call bullsh** on that? A doctor that knows anything would know that isn’t true.

And that led into alarm bell number three….how does someone who is unable to work for at least 12 hours a day able to make it through medical school? I know people who have gone through med school. There are many, many long shifts. Many times they end up sleeping at the hospital and definitely working night shifts during their residency and/or fellowship. So how did Dr. Cole make it through medical school to become this stellar neurosurgeon??  

Obviously, he is using diabetes as a reason to be able to be home and away from everyone when his alter ego takes over, but what diabetes? It’s kind of a flimsy excuse, especially if you are in the medical profession. And this makes it obvious that the character doesn’t actually HAVE diabetes.

The show continues on and there is an incident in which Dr. Cole can’t remove himself far enough away from people to keep his alter ego from taking over. Dr. Cole reschedules a brain surgery for nighttime. At first I couldn’t figure out WHY. Alter ego Ian Price has no medical training. And Ian pretends to be Dr. Cole… so this untrained person is going to operate on a human? Turns out there is a reason that Dr. Cole did this. And this is where alarm bells four, five, six, etcetera went off in my head.

Ian Price, pretending to be Dr. Jason Cole, enters the surgery room and they demand that he checks his glucose levels (on that awesome, non-existent machine) before he operates on the patient. When the results come they are 315. Here is the basic of what happens in the operating room at that point:

Ian Price asks what’s going on. A nurse says, “You’re hypoglycemic (the closed captioning read “hyperglycemic”, but if you listen to it several times like I did, it SAYS hypoglycemic). You’re going into diabetic shock!” Another nurse/doctor says “Give him 20 units of regular insulin.”

I’m going to stop right there and point out the things wrong with JUST that part. First off, a blood sugar level of 315 isn’t going to send someone into diabetic shock. Possible ketones maybe. Thirst, headache, at worst, blurry vision. But I’ve never known anyone to enter into diabetic shock (I’m assuming they mean full diabetic ketoacidosis with unconsciousness) from a 315.

Secondly, 20 units of regular insulin for almost anyone with diabetes could be lethal. It’s way, way, way too much insulin for a 315. I assume there are cases of super insulin resistance that would call from something like that, but in general, 20 units of regular insulin is crazy. Also, regular insulin is kind of outdated. I know some people who use it still, but in general, it is so slow working that insulin like Levimir, Humalog, and Novolog are used. They work faster.  

Onto the rest of the scene (which was only about 30 seconds to a minute long). The doctors and nurses in the operating room restrain Mr. Ian Price (who fights them the whole time) and the jab him with some epi pen looking thing while he thrashes around. He immediately goes into convulsions. A nurse says, “He’s tachycardiac-Adverse reaction from the insulin.” Some else yells “Call anesthesia stat! And get me a stretcher.” Mr. Ian Price passes out.

Okay, all the things wrong with that part…. Oh my. Well, first off, the epi-pen looking thing. I suppose it might have been an insulin pen of some sort. Perhaps. But really it just look like they jabbed him with this thing in the arm. Insulin doesn’t need to be administered like that at all. And a true diabetic would have administered the insulin themselves.

Then there is the immediate onset of convulsions. Insulin does NOT work that quickly. There is NO insulin out there that works that quickly. It doesn’t exist. In fact, when you look at active insulin times, the quickest I could find was Aphidra, which according to WebMD has an active insulin time of 1 ½ to 2 hours. This means that while it might start working right away, there’s nothing that would drop the blood glucose levels so quickly as to put someone into immediate convulsions, even if their blood sugar was completely normal and they were given 20 units of insulin. Also a note: Regular insulin has an active insulin time of 5 to 8 hours. http://diabetes.webmd.com/guide/diabetes-types-insulin

Then there is the next part. About the tachycardia. I actually did not know what that word meant. I had to look it up. The American Heart Association says that tachycardia is a heart rate of more than 100 beats per minute in an adult. I didn’t know that insulin (or a low blood sugar) could cause a rapid heart rate. But apparently it can. I googled that one too, just to be sure. Again, I just can’t imagine blood sugar dropping so rapidly that it would cause immediate convulsions and rapid heart rates. I suppose that this could be considered an “adverse reaction to the insulin” but I just call it a low blood sugar.

And what was that about calling anesthesia?  Why? Were they going to knock out the man already passed out on the floor? I mean really? What was the point of that? Why did no one suggest glucagon (or the more medically potent D50, also known as dextrose). This would have brought around a person having a low in just a few minutes.

At this point, I’m laughing hysterically at the computer screen as I watch the show. I wanted to tell them how crazy they were being. But it just got worse and worse.

Dr. Jason Cole wakes up the next day in a hospital room and Dr. Marcado, a friend who is helping him try to keep Ian from coming out every night, is in the room with him asking him what went happened. Dr. Cole states that he moved up the surgery on purpose because he knew that Ian would fail the glucose test.

When Dr. Marcado asks how he knew he’d fail he says “Come on, Ruben, personality affects body chemistry. Aggression triggers adrenaline” and Dr. Marcado follows up with “Which looks like high blood sugar.” Dr. Cole finishes up with “He’d be given insulin, which he didn’t need.” And Dr. Marcado chimes in, “It would knock him out.”

Okay, I’m not a medical professional. I could be wrong. But again, I googled it. Everything I found in regards to adrenaline and high blood glucose levels was directly related to people who already have diabetes. I KNOW adrenaline causes my liver to kick out sugars, raising my blood sugar levels. But someone without diabetes (which we know Dr. Jason Cole to be) should be covered by their own, working pancreas, right?

And what was that about personality affecting body chemistry? Huh? How would it affect his body chemistry? It’s just so completely out there that I was appalled. By the end of the show I was laughing, but I was also saddened.

taken from the Do No Harm facebook page

What happens when a show is SO full of misleading information about diabetes? Especially when it’s a medical drama? I mean, people listen to the stuff on these shows. They believe the stuff on these shows. And I get to spend all of my free time and energy trying to correct what Hollywood destroyed.

I’ve been told that any medical show is supposed to have a medical technical advisor. I googled. I checked IMDB. I googled again. I couldn’t find anywhere that there was a medical technical advisor listed. It confused me. Maybe because it was a pilot episode they didn’t have one? I wanted to know who told them this information was correct.

The only thing I could find was the name of the writer of the episode and the producers of the show. It was written by David Schulner, directed by Michael Mayer (a Broadway person that I LOVE), and produced by Rachel Kaplan, Michael Mayer, David Schulner, and Peter Traugott.

I really do want to like this show, but they can’t ditch the diabetes storyline at this point. It’s too engrained in who Dr. Jason Cole/Ian Price is as a character. But it’s also a lousy cover for his Dissasociative Identity Disorder and perpetuates the myths about diabetes.

You can find “Do No Harm” on facebook, twitter, and about a million other social networking sites. Do something. Watch the first episode. Then SAY something. Blog about it. Post on facebook about it. Tweet them about it.  I tried to find twitter accounts on the producers and writer but was unable to.

Personally, I just hope this blog post gets out there. Because “Do No Harm” could actually cause a lot of harm by misleading and perpetuating untruths about diabetes. I plan on asking them on twitter & facebook who their medical advisor was. I hope I get an answer. If they don't have one, they should hire me. At least for the diabetes related stuff. I'd tell them to scrap the entire storyline involving diabetes. But then they'd probably try to write about a medical cure.