"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.

Steel Magnolias....Updated or Not

On Sunday night the new "updated" version of the classic movie (based on the classic play) Steel Magnolias. I've written about my concern and worry about what this movie reboot would be like. Many of the people in the D-OC have been worried about how diabetes would be approached in the movie. Rightly so, as the original basically made it look like if a woman with diabetes had a baby, she was doomed to die and leave her child motherless.

First off, let me say (in case you didn't read what I've written previously), I adore the original version of Steel Magnolias. I cry every time I see it. Secondly, let me say that the Lifetime reboot, with an entirely African-American cast, was handled very well.

I don't get Lifetime, so I went to my mom's on Sunday night to watch the movie. She typically wouldn't watch the movie, just because she's the mother of a daughter living with Type 1 diabetes (ME!) and what mom wants to watch a movie that a person with said disease dies? But my mom watched it with me, cause she's super awesome like that. If you don't believe me, go read THIS.

Overall, the "updated" version of Steel Magnolias was nearly IDENTICAL to the original. There were a few exceptions. The cast is the first and most obvious of the changes. There are a plethora of cell phones and newer technology devices, along with the occasional pop-culture reference in the script. The line dancing at the wedding reception was replaced by some more updated, and culturally appropriate music and dance for the "new" cast. But so many of the things were exactly the same. The lines, the infamous armadillo cake, the pink wedding with a ton of bridesmaids. Sometime it was the same right down to the camera angles.

Is it weird that I'm glad that they stuck so closely to the original? I am. The areas that were improved were the areas of diabetes information. It was pointed out very early in the movie that the reason Shelby shouldn't have a baby wasn't her diabetes, but her chronic kidney condition. It was never mentioned if the two were related, but most of us can assume it probably was.

When M'Lynn is arguing with Shelby's decision to have a child, it's pointed out by Shelby that her medical records were an issue in the adoption process. This is something I was glad to be brought up because I've looked into it. While diabetes isn't a flat out "no," any chronic health condition is a serious hurdle to get past. I'm sure if you added in the kidney issues, a "no" would be likely. Shelby did say that she was tightening her control, checking her blood sugar 10 times a day, and seeing doctors specializing in high risk birth; all of these are things we can relate to and I'm GLAD they brought it to light.

Also, we actually got to see Shelby check her blood sugar. Only once, but it's an improvement over the first movie. Though there was never any mention of an insulin pump, CGM, or any other treatment. I can't complain, really. Diabetes was kind of glossed over (though not as much as in the first film), but the movie, in my opinion, is about the relationship between the women in the story more than it's about Shelby and her diabetes and kidney issues.

One of the things that most people wouldn't notice, unless they'd seen the staged play, was that M'Lynn's famous break-down was changed to more closely reflect the play. In the original movie, her break down happens at the grave-side. In this version, it happens in the beauty shop, as it does in the play. I appreciated that because I feel like it would be more likely to happen that way. The difference? I still like Sally Field's breakdown more than Queen Latifah's. Don't hate me. I love Queen Latifah, but the fact remains I was more moved by Sally's performance.

Same goes for Julia Roberts' low blood sugar performance in the original versus Condola Rashad's. The one thing about Rashad's low that WAS better was the guilt she felt when she began to come back to herself after drinking the juice. I've been known to do nothing buy cry and say, "I'm sorry." after a low like that. And the brought in the cold sweats as well. They never said it, but Queen Latifah was fanning Rashad. Someone without diabetes may not have noticed it or even understood what it was. But as a person who has suffered major cold sweats after a severe low, I did notice it and appreciated the attention to detail.

Honestly, the movie made me cry. I was expecting that. I didn't hate it. I wasn't expecting that. I truly enjoyed getting the chance to "live tweet" the movie with several other members of the D-OC. And I really appreciated getting to watch the movie with my mom.

The moment that will live in my brain forever, though, was something my mom said to me. We were both crying on the couch as Shelby had her low. Me, because I know what that's like. I've felt that. I hate that. My mom because..... well, let me just quote her. She said it so well. "It's so easy to forget what it's like when you aren't around it anymore. It's not fair that I can forget and you're still dealing with it all the time."

Final judgement, out of 10

Respecting the original: 10

Updating diabetes info: 10

New cast: 8

Overal: 9

The "New" Steel Magnolias Movie

I know information about the new version of Steel Magnolias has been floating around on the 'net for more than a while now. I've had mixed feelings about the movie, but I'm pretty sure they aren't for the same reasons that most of the D-OC has. I've been a fan of the movie for years. My mother doesn't care for it, but I can't remember a time when I didn't love it.

Even as a child, I remember having a sense of understanding that Shelby had many problems going on that weren't just related to diabetes. And I've always been aware that having a child would be difficult for me, though not impossible.

As I grew, I became more aware of the fact that diabetes wasn't as cut and dry as the movie made it. I understood that having diabetes wasn't a death sentence, and it wasn't a death sentence to have a child while having diabetes. But I also understood that the movie didn't exactly give a true look at life with diabetes.

It was strange for me. Shelby was the only person I'd seen on TV or in a movie that had diabetes. I felt a connection to her AND the movie because of this. Much like I felt a connection to the character Stacey in The Baby-Sitter's Club books.

When the news about the new, all African-American cast version of Steel Magnolias was coming out, I couldn't help but think it would be messed up. Partly because I really dislike remakes of movies. Like really, really, really don't like them.

But...I can't help but be curious. I'm a die-hard Queen Latifah fan, so that's almost enought to make me watch it by itself. But I'm curious, like many of us, as to how they will represent diabetes in this movie.

They've recently released a trailer for the movie, as well as a scene from the movie on youtube. I plan on watching it at some point (I don't get Lifetime, so I'm going to have a friend record it for me) and I'll probably blog about what I think. Until then, I leave you with the youtube clips...