Science in Media Roundup: Artistic License with Medical Safety and Loaded Terminology

More science in TV, and as expected, most of it has issues. So, what in recent television is not quite as portrayed?

(video)

The Catch: In a case of the week episode, the private investigation firm goes up against a pharmaceutical company being sued for a clinical trial gone wrong. A drug trial ended with 16 patients in the ICU, and the firm’s client suspects that the previous trial must have had adverse reactions as well, which were covered up. In the end, it turns out the the lead clinician in charge of the trial deliberately sabotaged it because the medicine wasn’t working and he wanted to start from scratch to develop something that would work (as his wife suffered from the condition the drug was meant to treat, MS.)

The show does seem to understand a few things about drug trials, but either doesn’t understand others or freely uses its artistic license. (Disclaimer: I’m not a clinician, so I don’t have personal experience with drug trials–we learn the overview in classes.)

The episode does do something well. The drug would be tested in people who don’t have the condition first. This will often be the first time the drug is tested in humans, and in the rare instance where something goes horribly wrong, it generally happens here. Which is why it’s so strange that the first test showed no adverse reactions, while the next one landed 16 people in the ICU. This arouses suspicion in the characters, and that’s reasonable.

But here’s where the dramatic license gets absurd, because even after those people end up in the ICU, the drug trial continues. It should have been immediately discontinued. And not only that, but despite delivering a drug that had previously landed people in the ICU, the clinicians let people leave immediately after being dosed, with nothing but a complimentary sugary beverage on their way out.

I used to volunteer in a blood bank, so I know the walking-out-with-the-sugary-beverage thing is standard procedure after donating blood. (The fact that the drug is delivered by IV instead of an ingestible pill also evokes the image of a blood bank.) But there is a huge difference between donating blood and taking a mostly-untested drug that’s already caused problems. In one case, something gets removed from your body. In the other, something is added, and that something is meant to cause changes within your system. There’s also a difference between doing a procedure that’s been done thousands upon thousands of times already and one that hasn’t even been approved yet. I have no personal experience with experimental drug trials, but I doubt the protocol will much resemble blood donation.

Then there’s the villain of this piece, the lead researcher who tanks his own clinical trials because the treatment isn’t working and he wants to start anew so he could find a treatment for his wife. His motivations make no sense.

  1. How does he know it’s not working? Because if there was good evidence that it wasn’t working, the pharmaceutical company would probably stop working on it–they don’t want to waste money on a dead end. Is his wife in the trials, and he sees that she’s not responding to treatment? Because if so, him knowing whether or not she was on a placebo would compromise the integrity of the experiment.
  2. Starting from scratch is somehow supposed be a viable option for helping his wife? Clinical trials alone can take almost a decade, and that’s not even counting the amount of time the pre-clinical drug discovery process takes.
  3. How would it help his wife if he moved on to another study? Creating a drug isn’t a one person job, it’s a massive endeavor. He’s a clinician, so he would only be participating in the clinical aspects of the drug development process. If there was another promising project, someone else would already be working on it.

Granted, it’s hard to see how The Catch could have left the plot of this episode intact if it’d gone for more accuracy–at least not without a longer, more drawn-out story.

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Image: Marvel 

Agents of SHIELD: Inhumans are people who get powers when exposed to a certain substance. Lincoln (a medical doctor and Inhuman) explains to Gemma (a biochemist) that Inhuman powers aren’t distributed randomly, but rather they fill some evolutionary need or create balance ala yin and yang (which in itself is vague as hell as a description). And Gemma responds with, “an actual intelligent design.” Wow, did the show decided to step into a quagmire it clearly doesn’t understand, or what?

So first off, Lincoln’s vague-ass description is more of a philosophical explanation than anything from which an actual mechanism might be derived, so jumping to design as a conclusion is a huge intellectual leap. And next off, I really don’t think a biological scientist like Gemma would casually throw around the phrase “intelligent design” given how contentious a topic that is. Not to a scientific audience, not to a lay audience, and not to a medical professional like Lincoln (who didn’t even give her a weird look for using the phrase, for some reason). The only time I’d expect her to use that phrase is to specifically address the issue in question. I have literally never even heard the phrase used in an academic setting that I can remember.

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Image: CW via Hypable

Arrow: Curtis gifts Felicity (who’s currently in a wheelchair) with untested medical technology that she’s supposed to implant in her spine to enable her to walk. He called it an implantable biostimulant (no details on what exactly it’s supposed to stimulate, or how). And as this technology has undergone no regulation or approval, it’s safety and efficacy is completely unknown.

What could possibly go wrong? Well, let me think.

  1. The stimulant has unforeseeable side effects. The technology could do what it’s supposed to do, but also do other stuff that causes a serious adverse reaction in Felicity. The possibilities are endless, but could potentially result in further injury or death.
  2. The technology breaks often or simply doesn’t work–as it requires surgery to remove or replace, the risks of surgery apply.
  3. Whatever the technology is made out of might end up in Felicity’s system, with unpredictable risks. 

That’s just off the top of my head. I’m sure there are more.

Also, her recovery happened like magic. She suddenly noticed her legs moving, then she stood and started walking like it was nothing. Even walking out of her apartment altogether and leaving her wheelchair behind–which, I’m no expert, but that seems like a terrible idea. She has no idea how far she’ll be able to go. She literally hasn’t used her legs for, I don’t know, weeks. That’s not the kind of situation where you want to up and walk out of the apartment without having any idea of what you’re capable of. Or what the experimental technology is capable of, for that matter. She could get herself hurt.

Not to mention that this is probably bad disability representation.

And that’s my science in the media roundup for today.

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2 Responses to Science in Media Roundup: Artistic License with Medical Safety and Loaded Terminology

  1. Kourosh says:

    I think every specialist notices bad portrayals of his craft in media. You, working in biotech, notice mistakes specific to that field.

    This phenomena doesn’t even imply that scriptwriters are idiots. It’s just not possible for ALL of them to be accurate ALL the time. There are small mistakes, all the time, in every show depending on how good the research is. If you see one in otherwise good show, it will stand out like a turd on a vanilla cake, and you’ll remember it for months.

    Still, interesting perspective.

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    • That’s not what this is about, actually. I’m not trying to call anyone stupid and at no point use that word or one like it–I even mention that I understand why The Catch used its artistic license. I’ve chosen to add my perspective on the things I’ve noticed because I think there’s a lot of misunderstanding of science and how science works outside of the field, and I wanted to put some information out there in an accessible way.

      In fact, seeing what is done right and wrong in media helps me figure out what misconceptions are out there, since its hard to see it from inside the field.

      That said, sometimes misinformation can be harmful. Even that isn’t necessarily the fault of anyone creating the media–not everyone can know everything, and sometimes we don’t know what we’re missing. Again, that’s not the point. But that doesn’t mean we shouldn’t talk about the mistakes media might have made. That doesn’t mean we shouldn’t comment from our perspectives or expertise.

      I truly believe it’s important to promote understanding in the world, and that means opening up lines of communication. It doesn’t mean writers not doing anything for fear of making mistakes, because everyone always will. But it also doesn’t mean everyone else keeping silent about what they know about the topic because we’re afraid of acknowledging other people’s imperfections.

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