Sunday, September 25, 2022

TV Medical Dramas Give Us Wrong Ideas About Minds and Death

Very many people never bothered to study scientific matters after their most recent school studies. Such people may largely get their impressions about scientific matters from social media, news stories and fictional TV shows. This leads to incorrect ideas. News stories nowadays are filled with clickbait misleading hype, much of it coming from university press offices, which these days are notorious for their exaggerations and misstatements. And a person whose ideas about the human mind and body are largely coming from medical TV shows may often get the wrong idea. 

I watched many episodes of the New Amsterdam medical drama series, and got a general impression of a hostility towards spirituality. One episode seemed to have an anti-Catholic tendency. Representatives of the pope were depicted as demanding a presidential suite in a hospital, just in case a visiting pope got sick. In the same episode, a son of a couple was depicted as telling his parents that they would go to hell if they got divorced. 

In another episode of New Amsterdam, a patient having spiritual visions is revealed to have had such visions because of epilepsy. There is little or no evidence that epilepsy produces spiritual visions. People having full "grand mal" seizures (called tonic-clonic seizures) do not remember anything that occurred during the seizures. There are other types of seizures called (simple partial seizures and complex partial seizures) that a person can remember happening. Such seizures do not produce visions or complex hallucinations (such as seeing a deceased loved one). 

It is sometimes claimed that temporal lobe epilepsy can produce mystical experiences. A scientific study had 86 patients with epilepsy fill out a questionnaire seeking evidence of mystical experience. The paper states, "none of the patients’ descriptions met the criteria for mystical experience." The quote below from the paper discusses the gap between ivory tower teachings on this topic and observational reality:

"Religious experience, though sometimes seen in seizures, is not a common feature: prior studies among patients with epilepsy have cited frequencies of 1% (Kanemoto & Kawai, 1994) and 0.4% (Ogata & Miyakawa, 1998). Mystical experiences have been linked theoretically to the temporal lobes (Saver & Rabin, 1997), and that association has been widely accepted. According to Ramachandran and Blakeslee (1998, p. 1975), for example, 'every medical student is taught that patients with epileptic seizures originating in this part of the brain can have intense, spiritual experiences during the seizures.' However, a survey of patients in an epilepsy clinic found no mystical experiences (Sensky, 1983)." 

A much eariler 1990 survey of 234 epileptic patients said that only 1% of them reported something like a religious experience during a seizure.  Referring to another larger study, the paper states, "According to Kanemoto et al's study, religious experiences have been recognized in six out of 606 temporal lobe epilepsy cases; an incidence of 1.0%." This is negligible evidence for epilepsy causing spiritual visions. A survey of spiritual experiences in non-epileptics would probably produce numbers as high.  

Another fictional medical series is the long-running series Grey's Anatomy, which has run for 19 seasons. In Episode 7 of the first season, a doctor recommended a hemispherectomy for a child suffering from very bad seziures. Hemispherectomy involves surgical removal of half of the brain. The doctor assures the parents that the child would be able to live a relatively normal life after the operation. Indeed, the results discussed here suggest that removing half of the brain has little effect on the intelligence of children.  But the explanation for this anomaly by the doctor was erroneous. The doctor stated, "The remaining neurons will compensate for the loss." Physically there is no evidence for any such compensating effect. The liver has a remarkable ability to grow new cells when damaged. The brain has no such ability. If someone has half of his brain removed in a hemispherectomy operation, the remaining neurons don't "compensate" by doubling themselves. 

What happens here is extremely important to the topic of the relation between the mind and the brain. If removing half of his brain reduces someone's neurons by 50% without damaging his intelligence, that is strong evidence against claims that minds are made by brains. We should note we are being misinformed on this very important topic whenever any neuroscientist makes untrue claims about a remaining brain half "compensating" for the loss of the other brain half. 

In one appalling part of the Grey's Anatomy show ("Can't Fight Biology," Season 7, Episode 4,  8:23 mark) a narrator incorrectly says, "Biology says that we are who we are from birth, that our DNA is set in stone." DNA (consisting of only low-level chemical information) does not make us who we are. DNA accounts for neither the anatomy of a human (which is not specified in DNA), nor the mind of a human, which is not explained by neurons. And even the structure of neurons is not specified by DNA, which does not specify how to build any of the roughly 200 types of cells in the human body. 

At the 21:33 mark of Episode 13 of Season 11 of Grey's Anatomy, we have a doctor lecturing a hall filled with other doctors. The doctor gives us some phony baloney talk that no one should believe, stating this:

"Now arguably the most important part of the brain is the part that makes us hope, dream, imagine. One singular almost immeasurable part is what makes you you and me me and everyone everyone. It's technically called the fornix, but I call it the dream box."

Brains don't make you you or me me. No neuroscientist has any credible explanation of how dreams or hopes or imagination can arise from neural activity.  When neuroscientists try to say something along these lines, they typically claim that thought comes from the cortex of the brain, located on the outer edges of the brain, not the fornix located in the center of the brain. The claim that thought comes from the cortex is not justified, for reasons discussed here

The Grey's Anatomy show does rarely have some shows that sound as if they were written by someone who has studied paranormal phenomena. In Episode 8 of Season 1, there is a psychic who seems to have some clairvoyant knowledge of things he should not know, and his case is never explained away.  In the "Some Kind of Miracle" episode in Season 3, there is a very good depiction of a near-death experience. With her heart stopped at the hospital as doctor's struggle to revive her, Meredith has a near-death experience in which she encounters a patient who previously died. She also encounters her mother. After going in one direction down a hall to hug her mother, she races back in the other direction. She then finds herself back at the hospital. She is then told her mother has died. Meredith acts as if she already knew this, having learned it through her near-death experience. 

This "Some Kind of Miracle" episode was a fine depiction of a certain kind of near-death experience sometimes called a veridical near-death experience: one in which someone having the experience seems to observe or learn something he should have been unable to have learned or observed through normal means.  You can find other examples in the post here.  In this case Meredith seems to have learned something during her near-death experience that she did not yet know through normal means: that her mother was dead. Around episodes 3 and 4 of Season 17 Meredith had similar near-death experiences.  

Near-death experiences often produce attitude changes in the person having them, but we saw not much of an attitude change in the Meredith character in episodes following the "Some Kind of Miracle" episode in Season 3. But not much later in the series we have what at first looks like a paranormal experience for one of the characters. In Season 4 we have the Izzie character start to repeatedly see and talk to an apparition of one of her patients (Denny), who she had romantic feelings for before he died.  We get several episodes in which lengthy conversations occur between Izzie and the apparition of Denny. 

Soon it turns out on the series that Izzie has a brain tumor. The series suggests that all of the appearances of Denny's apparition were just symptoms of a brain tumor Izzie had. In a Season 5 episode Denny says to Izzie, "I am you. I'm your tumor, you're talking to yourself." Izzie then has brain surgery to remove the tumor, and the appearnce of Denny's apparition no longer occur. 

The idea that brain tumors can produce visual hallucinations of the dead (with matching auditory hallucinations) is unfounded fantasy. A review of the symptoms of 200 children with brain tumors finds no hallucinations other than two primitive "flashing light" hallucinations. It is very common for dying people to report seeing deceased love ones. Such occurrences are called deathbed visions.  But there is no evidence that brain tumors are the cause of such visions, and they appear very frequently in the last days of people who do not have brain tumors. 

Some examples of deathbed visions can be found here and here and here.   A survey of family members of deceased Japanese found that 21% reported deathbed visions. A study of 103 subjects in India reports this: "Thirty of these dying persons displayed behavior consistent with deathbed visions-interacting or speaking with deceased relatives, mostly their dead parents." A study of 102 families in the Republic of Moldava found that "37 cases demonstrated classic features of deathbed visions--reports of seeing dead relatives or friends communicating to the dying person." In the classic work on deathbed visions (At the Hour of Death by Karlis Osis and Erlendur Haraldsson) we read on pages 71-72 that only about 12 percent of those having such visions died from diseases that can be associated with hallucinations. 

There is a deplorable failure of fictional medical TV shows to depict this important aspect of human experience. We have all seen on doctor drama TV shows innumerable depictions of terminally ill patients in their last days or hours. But we never see the dying patient saying something like, "My goodness, doctor, there's my mother right there near the edge of my bed!" Why do TV medical dreams never show a depiction of such deathbed vision experiences when they happen so often?

There is a huge body of evidence suggesting that mental states can have very large effects on health outcomes in ways we cannot understand. Part of this evidence involves evidence for the power of the placebo effect, and another part of this evidence is data suggesting mental attitudes can greatly affect life expectancy.  But on medical TV dramas we almost never hear about the importance of the mind in medical outcomes. 

An extremely important point regarding the mind and the body is that the mere knowledge of negative medical information can have a very harmful effect on a patient. Tell a patient that he has some  "ticking time bomb" medical issue, or tell him about some bodily issue that may inflict him years down the road, and the mere announcement of such a thing may be a kind of psychological torpedo blast causing incalculable damage to the person's state of mind, plunging him into some dark "world of worry" that may last for years. We almost never hear about such an important consideration in medical TV dramas. The idea is almost always "run ever test that might find trouble, and tell the patient about all the troubling results found."  

On TV's doctor dramas the doctors are depicted pretty much as people with all the answers about biological questions. But doctors are no such things. They don't understand how a human is able to form a memory or how a human is able to retrieve a memory. And when a person becomes depressed, they typically don't understand why that happens. 

Almost always on such shows a dying patient is depicted as terrified of dying. Almost always the dying patient is depicted as someone who wants for every measure to be taken to maximize his chance of living as long as possible. But many people who near the end of their lives are not afraid of death, and don't want to "pull out all the stops" to try to get every month out of a failing body. Many people are not afraid of death because of things they have learned and things they have experienced or seen with their own eyes which convinced them they are part of some spiritual reality never mentioned in medical textbooks. We almost never see such things depicted on TV doctor dramas.

A DNR order is an order that no attempt be made to use methods of resuscitation if a person's heart stops. Asking for a DNR order can be a quite reasonable choice for someone who is very old or in very poor health, such as someone with advanced cancer. Such a person may think in his state a cardiac resuscitation may be "buying himself months more of pain," and may prefer to let nature take its course, particularly if he believes in life after death. But typically in medical TV shows a person asking for a DNR is depicted as someone who doctors need to scold into changing his decision.  Why can't our medical TV doctors respect a reasonable patient choice when it is made?

In the fictional world of TV medical dramas, cardiac resuscitation is depicted as being more prone to success than it is.  A scientific paper tells us this:

"The public has unrealistic views regarding the success of cardiopulmonary resuscitation, and one potential source of misinformation is medical dramas. Prior research has shown that depictions of resuscitation on television are skewed towards younger patients with acute injuries, while most cardiac arrests occur in older patients as a result of medical comorbidities. Additionally, the success rate of televised resuscitations on older shows has vastly exceeded good outcomes in the real world....In this study, characters with medical causes of cardiac arrest were 4.6 times more likely to survive with good neurologic outcomes than patients in the real world while characters with traumatic cardiac arrest were nine times more likely. Medical dramas continue to misrepresent the demographics, etiologies, and outcomes of cardiac arrest." 

Seizures are often inaccurately depicted on TV medical shows. A web page tells us this:

"In the name of science, researchers at Dalhousie University watched every episode of 'Grey's Anatomy,' 'House,' 'Private Practice' and the final five seasons of 'ER' — and they found that in those 327 episodes, 59 patients experienced a seizure. In those 59 cases, doctors and nurses incorrectly performed first aid treatments to seizing patients 46 percent of the time (including putting an object, such as a tongue depressor, in the seizing patient's mouth)."

In general in TV medical shows psychiatrists are depicted as people who understand how to fix whatever mental issues a patient has. We have endlessly repeated TV stories involving patients who have some mental problem, but who refuse to acknowledge that they need a psychiatrist. Virtually never do we have realistic depictions of the severe limitations, explanatory failures and uncertainties of psychiatry. It's almost always a story line of "just find out the problem, and get the guy to take the right pills or have the right operation." The truth is that psychiatrists have for the past thirty years "bet the farm" on brain chemistry theories of mental disease, theories that have been a spectacular failure. 

In a Wired interview a former director of the National Institute for Mental Health (Tom Insel) made this confession: "I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs---I think $20 billion---I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness.” 

Talking about changes in the brain, a professor of psychiatry Kingdon states this: "No such clear causative changes exist in severe mental illnesses such as depression, anxiety, bipolar disorder and schizophrenia." After noting "25 years of research frustration," Kingdon quotes a neuroscientist who advocates that we keep at this not-getting-much-of-anywhere research approach. Kingdon then states this:

"But does this not seem, after more than 30 years of failure, more akin to a religious or, albeit culturally influenced, persistent strong belief than one based on scientific grounds? Just where is the rational justification for ploughing the same furrow again and again?"

psychiatry shortfall


We may wonder: how much better results would psychiatrists get if they followed a strategy not of "fiddle with their brain chemistry" but instead "try to heal their souls?" 

Postscript: It is reported in the science news today (September 29) that those taking pills to fight depression are subject to much higher rates of heart disease. We read this:

"People taking antidepressants were compared with those not on the drugs.

Following up after 10 years, those on SSRIs had a 34 per cent increased risk of heart disease, an almost doubled risk of cardiovascular death. They also had a 73 per cent higher chance of death from any cause. For the other antidepressants, all the risks were around double."

Is this greater risk caused by the pills, or by the depression itself? The people cited in the article sound like they don't know. We are given the impression of psychiatrists messing around with people's brains, without understanding whether there are deadly effects of the pills they are prescribing. 

Of course, we never ever hear about such uncertainties on medical TV shows. You'll never hear a TV doctor say, "I prescribed him some pill, but I don't know whether it will help cure him or help kill him." 

At this page we read of a psychiatry professor who has been trying to stop using SSRIs, through a very gradual reduction lasting years. We get the impression of some great hazard in suddenly stopping their use. But in the TV shows we never hear a psychiatrist say, "I'm going to put you on this pill, but it's pretty addictive." 

Post-postscript: I have just finished watching (as a background activity) all episodes of six seasons of the medical TV series The Resident. The series seems to always fail to depict the type of spiritual experiences that occur so often in relation to death and close brushes with death.  The show has endless depictions of medical close brushes with death, but no one ever reports a near-death experience (even though significant fractions of those having close brushes with death do report near-death experiences).  None of the dying people on the show ever report seeing apparitions, even though sightings are very common in dying people. 

It seems like anything having to do with life after death is never mentioned on the show. The show seems to depict every sick person as being terrified of death. We seem to never have an episode in which someone says that he does not want to have some elaborate expensive treatment (such as an organ transplant), on the grounds that he believes in life after death and is not afraid of dying.  

As I discuss in my post here, there are quite a few reasonable reasons why an old person might wish to turn down a doctor suggesting something such as a pacemaker, a heart valve operation, an ICD device implantation, or a medical test that might discover some previously unknown risk:  

  • An old person might want to avoid the endless complications and hassles of long medical treatment, and might want to keep things as simple a possible. 
  • An old person might be wary of causing great medical expenditures that he or his family might have to pay very much for. 
  • An old person might want to stay away from hospitals and nursing homes for fear of catching an infectious disease in a hospital or nursing home, as very many people did (with lethal results) during the height of the COVID-19 pandemic. 
  • An old person might wish to avoid the side effects that can occur from some type of medical treatments such as pacemakers or ICD devices. 
  • An old person may be afraid that some fancy medical treatment path that extends his life may actually have the indirect side effect of increasing the number of years he has to spend in a state of pain, confusion or disability.
  • An old person might wish to minimize his own medical expenses and use of the time and equipment of medical personnel, on the grounds that such time, resources and effort should be focused on younger people.
  • Knowing how often very old people suffer from pain, and knowing that he lives in a country such as the United States that does not currently make it easy for very old people to get the pain medication that they need, particularly people with low mobility, an old person might think that medical procedures maximizing his lifespan may have the effect of buying him years of unnecessary pain. 
  • An old person might hate spending time in hospital rooms, and may want to adhere to a policy minimizing his time in hospitals.
  • An old person may feel disgusted by treatments that may make him feel like a man/machine hybrid or a man/animal hybrid (treatments such as heart valve replacements that often use parts from cows or pigs).  
  • An old person might be skeptical of claims of medical benefits of some complicated procedure, and be worried about the small percentage of times in which such procedures go wrong, and result in death or injury to the patient, or cases in which people catch infectious diseases from being in hospitals. 
  • Believing in life after death, an old person may have little interest in very complicated and expensive medical procedure programs that may give him no more than a few years more of earthly life. 
  • An old person may not want to have tests which reveal risks to his health or happiness that he does not wish to worry about. He may realize that very great psychological harm can be done if he receives worrying medical information that he did not need to be told about. 
  • An old person might be worried that some treatment that reduces his chance of dying one way will in effect be a treatment that increases his chance of dying in some other way that is even worse, such as death by Alzheimer's disease or a slow painful death by cancer. 
  • An old person might very greatly prefer to quietly die at the familiar locale of his home, surrounded by his family members, pets, or personal possessions, rather than spending his last days or weeks in some noisy, unnatural and utterly unfamiliar hi-tech environment, hooked up to machines such as heart rate monitors.  
  • An old person might wish to have nothing to do with the kind of futile care that a nurse describes in this article. 
We seem to never hear about such issues on shows like The Resident. Instead we are given a kind of brainwashing in the dubious idea that every person should follow a simplistic "spend every dollar to give me every possible day of  earthly life" approach in making medical decisions. 

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