As a doctor, I don’t like reading books or TV shows about doctors.
Not because I’m jaded and think I’ve heard it all before (quite the contrary) but
because often it feels like the writers just haven’t done their research. I’m not
talking about highly involved medical research—it’s
the basics that can trip you up.
pediatric resident turned writer of middle
grade and young adult fiction. She’s also a
blogger, a book lover, an identical twin,
a Tweeter and
a new mom. See her website here.
Here are a few questions to think about when writing a character’s hospital scene
(please note that some of this is for US hospitals only):
1. IS YOUR CHARACTER ON THE RIGHT FLOOR?
As many people know, hospitals are set up with different patients in different areas
of the hospital. There are pediatric floors, adult floors, surgical floors, maternity
floors, ICUs, etc. Knowing where your character/patient would be placed in the hospital
depends a lot on the type of hospital you’ve chosen for your story. Is it a small
community hospital in a small town? Or a large teaching hospital in a major metropolitan
area? The smaller the hospital, the fewer wards there will be (and often the really
serious cases would quickly be sent over by ambulance to a bigger hospital). In larger
hospitals, the wards will be more specialized so you shouldn’t expect to see mixing
of patient types (i.e., adult surgery patients in a medical ICU ward).
Why does this matter? It has to do with your setting details. For example: If your
character is in the ICU, he/she won’t see a lot of patients walking around with IV
poles in their hands. And the rooms in a maternity ward have more privacy than in
an ICU setting. If your character is the doctor rather than the patient—they won’t
be wandering around random hospital wards. Your medical intern isn’t going to be regularly
wandering around the pediatric wards and playing with kids there.
2. WHO WILL BE TAKING CARE OF YOUR CHARACTER/PATIENT?
This can be confusing and again, depends a lot on the type of hospital in your story.
Let’s say you choose a teaching hospital. Who will be taking care of your character?
I’m going to focus on the different types of doctors and doctors-in-training because
that’s what I know the most about.
Medical students: These are students in medical school. They have not
yet earned their MDs so they are not “doctors.” Medical students are often allowed
to see the patient first and ask questions—but not in an emergency situation. They
do not make medical decisions for your patients.
Resident and Interns: These people have graduated from medical school
and thus are “doctors.” They see their own patients and make some medical decisions,
but are still in training and run major decisions by an attending physician (see below).
Interns are what residents are called when they are in their first year of residency
(in some specialties, residents have to do a separate intern year at a different program
before beginning their specialty training so that’s why this distinction is made).
Fellows: These are people who have finished their residency but are
doing further specialization and are also overseen by an attending physician, though
less closely than a resident.
Attending physicians: An “attending” is the doctor who is ultimately
in charge of your patient during their hospital stay. All major decisions will have
to be run by him or her.
This hierarchy can make a huge difference to the believability of your story. For
example—a medical student or an intern will not be in charge of breaking bad news
to a patient unless they have forged some strong bond with your patient. This is generally
the role of the attending physician. Likewise, the attending physician will not be
doing “scut work” (i.e. tedious hospital work, ordering tests) unless they are in
a hospital where they don’t have interns and residents around.
3. WHICH PATIENTS WILL YOUR DOCTOR CHARACTER SEE?
This is one of the reasons I can’t watch Grey’s Anatomy. If you are a surgery
resident, you will not be delivering babies. If you wanted to do that, you would have
done ob/gyn. If you are an ob/gyn resident, you will not be taking care of babies
in the neonatal ICU. If you wanted to do that, you would have done pediatrics. And
if you are a pediatric resident, you will not be doing surgeries. Please get it right.
Your doctor characters really can’t do it all! (Sorry for the rant.)
Have medical questions about your story? Direct them at me (amitha[at]amithaknight[dot]com);
or send them to H.L. Dyer, a writer and
pediatric hospitalist who answers questions over at the QueryTracker blog.
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