THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Thursday, December 29, 1994 TAG: 9412290039
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: BY LARRY BONKO, TELEVISION COLUMNIST
LENGTH: Long : 143 lines
AT THE ENTRANCE to the emergency room of Virginia Beach General Hospital are these large, wide doors made of glass. Impressive doors.
``When they slide open, you have to be ready for anything.''
That was emergency room physician Dr. Charles A. Rula speaking, but his words could have been a line from ``ER,'' the wildly successful Thursday-night series that has climbed as high as No. 2 in the ratings its first season on NBC.
It also has given a shot of adrenaline to primetime drama.
Rula, an emergency room physician since 1976, gives ``ER'' a passing grade, even if the series at times is mock medicine.
Junior residents patching aortic aneurysms? On one episode, a woman hired as a custodian took charge during a crisis - patients were everywhere because of a pileup on the interstate - and saved a man in cardiac arrest. She cracked his chest and massaged his heart back to life just like that!
Seems the woman had been a doctor in Europe but didn't have a license to practice in the United States.
Even after seeing that improbable event unfold in NBC's emergency room, Rula still likes the show. It's nothing for emergency room staffs to be ashamed of or to laugh about, he says. In fact, ``ER'' kind of glorifies his profession.
Dr. Suzanne S. Love, a colleague who was working the night shift with Rula at Virginia Beach General one Friday not long ago, shares that opinion. She's one of six women who are members of the Emergency Physicians of Tidewater.
At the emergency room of Sentara Norfolk General Hospital, ``ER'' is also winning friends. Doctors and nurses there award the series no less a grade than B.
There are some technical goofs on the show - a nurse at Norfolk General said she was appalled to see the actors treating a patient like a tag-team partner when they were removing a cervical collar - but that hasn't stopped ER professionals here from endorsing the series.
Tracy Lebel, 25, a nurse with four years' experience in the ER, said that as far as she can tell, the actors do the right thing at the right time, including administering the right care and right medication.
The American College of Emergency Physicians is less enthusiastic about ``ER,'' issuing a statement recently that said the series created by physician-turned-author Michael Crichton is good drama but that it's 20 years behind the times.
``Rather than being staffed by moonlighting physicians, part-time practitioners and unsupervised residents, the vast majority of emergency departments are staffed by full-time, trained emergency physicians with a career commitment to the practice of emergency medicine,'' the statement read.
From the time your humble columnist spent hanging around the emergency rooms day and night in Norfolk and Virginia Beach, I concluded that on ``ER'' the doctor talk is pretty accurate - ``I can't find a pulse. He's in arrest!'' - but there are some major differences between real life ER and television ER.
For one thing, the local emergency rooms are busier than those on TV. Yes, on ``ER,'' you see rush-rush, bam-bam shots of victims being hustled into the trauma bays.
``This kid has stopped breathing!''
``I can't stitch you up if you don't settle down.''
Emergency rooms look real busy on TV.
But in fact, the doctors and nurses in those green scrubs on ``ER'' (George Clooney, Sherry Springfield, Eriq LaSalle, Julian Marguiles, Noah Wyle and Anthony Edwards) don't handle nearly the volume of cases that pass through the sliding doors in Norfolk and Virginia Beach.
Norfolk General, a Level I trauma center equipped to handle burn patients, treats 41,000 cases a year. Virginia Beach General, located in the state's largest city - and a resort to boot - logged 46,000 cases last year, including about 18,000 cases of heavy trauma such as gunshot wounds and horrible injuries from auto accidents.
The ERs here buzz around the clock.
Typical scene at Virginia Beach General: a 76-year-old man with a long history of heart trouble checks in with chest pains. Chuck Smith, 57, arrives, also complaining of chest pains.
``Right here in the middle of the chest . . . ''
Also treated is Dixie Jones, who fell and hurt her ankle, pulling ligaments, while stringing Christmas lights on her porch. There's a 7-year-old in the ER with a big toe that was almost severed in an accident.
That's how it went on the evening shift with Rula and Love on duty, supported by charge nurse Vicki Gehring and four other nurses.
One moment it's calm and quiet, the next paramedics are calling in to alert the team that they are bringing in the victims of an automobile accident. ``At times, we get stressed,'' Rula said.
But not as wiped out as the actors playing doctors on ``ER.''
Those doctors complain about working 24 and 36 hours without a break. They catch a nap anywhere they can, even in broom closets. In Norfolk and Virginia Beach, Rula, Love and the other emergency room physicians generally work eight-hour shifts.
There are surgeons and other members of the trauma team on call 24 hours a day, but they don't hang around the ER.
``When the patients in trauma arrive, when the big crunch happens, the trauma team is already there,'' said a spokesman at Virginia Beach General.
At Norfolk General, a teaching hospital that includes two residents on every ER shift along with seven nurses, three technicians, two clerks, one secretary and one attending physician, it's unlikely you'll see a resident reaching for a textbook before making a diagnosis.
That's pure Hollywood, said one local residents.
It's also pure Hollywood when the doctors and nurses on ``ER'' hardly ever wear masks when treating badly injured patients. Body liquids squirt all over the place.
It's pure Hollywood when the nurses steal the doctors' coffee. In real life, it's the other way around, I'm told.
It's pure Hollywood when patients are operated on at the drop of a scalpel.
``Not such a good idea,'' said a member of the Virginia Beach ER team. ``Why operate in the emergency room when the sterile operating rooms are right next door?''
Because that is more dramatic. And because that is how Crichton remembers the emergency room from 20 years ago when he was a medical student. Emergency medicine has been a recognized specialty only as far back as 1979. Today, the pros treat 9.2 million people a year in the United States.
In one shift, the ER team in a typical trauma center might be called on to treat 60 emergencies of every kind, says the American College of Emergency Physicians. In real life, the trauma teams are real cool about how they do it.
``ER'' is Crichton's trauma center, the way it was in 1974. To see it as it really is, catch an excellent syndicated series, ``Trauma Center,'' on WTVZ Saturdays at 10 p.m. ILLUSTRATION: Color photo
Top: Anthony Edwards has the lead role as an emergency room doctor
on "ER," the season's highest rated new show.
Color staff photo by Tamara Voninski
Above: Paramedic Lincoln Thomas helps bandage an accident victim's
hand at the Norfolk General emergency room.
by CNB