Nearly 30 years ago, we showed that CPR worked much better on TV than in real life. This was true both on the shows that focused on medicine as well as in dramas like E.T. and Star Trek that include medical subplots. On TV, most people survive CPR. Most survivors are neurologically intact. We suggested that this misinformation could distort the way people think about real-world medical decisions. It would encourage them to believe in miracles The paper launched a curious little academic field that has carefully monitored trends in the portrayal of CPR on television. More recent studies show that CPR outcomes are better than real-life on House, Grey’s Anatomy, Chicago Med, and Code Black. They are worse on European shows than on American ones.
Who cares? TV dramas aren’t expected to be accurate portrayals of reality. They certainly should not be educational. As highly acclaimed Hollywood producer and director Robert King noted, “If a show tries to teach me something, all it teaches me is to change the channel.” We watch television to escape reality, not to have our noses rubbed in it. A producer of ER acknowledged that “these television programs do not accurately reflect the use of CPR in the United States.”
But television shows often claim to accurately portray medical realities. Many of the most popular, including ER, House MD, and Grey’s Anatomy proudly tell the world that doctors review scripts for medical accuracy. A show’s pizazz depends upon the promise that they are lifting the curtain, taking viewers behind the scenes, and showing how medicine really works and to learn what doctors really think and feel.
Is this a problem for bioethics? Absolutely. But the solution is not to ask or expect television to change. Instead, it is to recognize that these scripts speak to people's deepest longings and most powerful feelings. We only want so much reality. Cardiac arrest in medical dramas is like the killer in horror movies. We know it is there, lurking in the shadows. We know it is deadly. We want to be frightened and sad. But then we want relief and triumph. The most memorable CPR scenes, like the resuscitation of E.T. or Worf the Klingon tease us with the possibility of failure then reassure us that there are mysteries that even the best doctors don't understand and that love is stronger than death. Doctors need to acknowledge those longings, not as true but as a jumping off point. Instead of trying to reform TV, we should learn from it