Bad Nurse

I’m watching ‘Nurse Jackie’ on DVD and enjoying it very much. As fiction.

Like any good soap opera, the show is all high drama and lots of quiet moments where characters bare their souls. Not like a real emergency room (and I have worked in one) where it’s more like McDonald’s at rush hour, or else you’re cleaning out the cabinets and checking inventory.

Dr. Rahul Parikh, a pediatrician, noticed a departure from reality and common sense when Jackie persuaded Dr.Coop to order a CT Scan on a child for no particular reason.

According to the study, published online in the journal Radiology, the number of CT scans performed on kids in the emergency room increased a whopping five-fold between 1995-2008, from about 330,000 to almost 1.7 million a year.

And that’s a problem, because CTs expose children to higher levels of ionizing radiation than any medical procedure, raising the risk — ever so slightly but very clearly — that some of those kids will develop cancer in their lifetimes. Here’s how one pediatric surgeon put it: “CT scans are like mini-Hiroshima bombs, four such scans on a kid are equivalent to the radiation exposure that the survivors were subjected to in 1945.”

Two serious and real-life problems with medicine today are unnecessary tests and accumulated radiation. There is ongoing research about the adverse effects of too many scans over a lifetime.

Medicare and most insurances won’t pay for any tests that can’t be justified. Good thing, because there’s pressure not to miss a diagnosis, and without some push-back some doctors would just test for everything, all the time.

A few years ago, for-profit businesses were peddling full-body CT Scans on a cash basis. I’ve written before why this is a terrible idea, and the fad seems to have passed. I thought then that the radiation exposure was not justified and might be something to regret later on. It looks like researchers are beginning to consider that possibility.

Another reason why ‘no immediate risk’ is not the same thing as ‘safe’.

Read the rest of Dr. Parikh’s article, and you’ll feel a lot less comfortable about the harmlessness of ‘a little’ radiation exposure.

And ‘Nurse Jackie’ rocks, but Edie Falco is not a nurse, she just plays one on TV.

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5 responses

  1. I remember when fluoroscopy was a routine part of a well child exam.
    It’s a fairly significant source of radiation exposure.
    I used to enjoy when my doctor,who was a terrific good man let me wear his lead lined gloves.

  2. sounds dangerous for the doctor and office staff, as well as the patients. the more we learn, the more we learn to be cautious.

  3. Yeah,Nancy-this was in the 50′s(early)-what staff-LOL?
    BTW when I was receiving inverted Y field cobalt therapy in 1981 one of the techs who operated the device was pregnant-I couldn’t believe she was in and out of the “hot”room all day.

  4. It takes compelling evidence to get people to take risk seriously. I think that the thalidomide tragedy woke people up to the dangers of prenatal exposure to toxins. There was a recent story in the NYT about cancer patients who were over-treated with high doses of radiation, and some suffered terribly and died.
    I hope that we will discover better treatments for cancer. Right now radiation is the best available choice for a lot of people, but it will become obsolete when better treatments are found. And we have to look at the economic pressures that reward doctors for over-testing.

    1. Radiation below the diaphragm isn’t TOO bad.That part of the body is much more resistant to the effects.
      I did have serious consequences from subcutaneous scarring that was surgically treated along with adhesions and an incisional hernia last year.I’m better but physically very limited.
      I’ve also had head and neck cancer(still do)and I’ve been told by three different doctors to avoid radiation if at all possible because radiation to the oral cavity/pharynx is horrible and reduces one’s quality of life considerably.
      So I’ve had a total of six operations(not counting biopsies)since 1997.
      And I’m not really impaired in any serious way.Good surgeons.:))

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