OT: I raged at Holby City

Holby City, I should explain, is a British medical drama/soap set in a fictional NHS hospital, the likes of which you will not find if you comb the depth and breadth of the UK. The wards could feature in a Woman & Home catalogue, they look that nice. That alone manages to wind me up every episode, since every ward I've stayed in has been grim beyond belief. Actually, no: I did spend one night in a bare but spacious and fairly pleasant room, before being whisked off to spend another week in a stifling sideroom with a migraine-inducing overhead light that would make a prison cell in a Texan summer seem airy and cool by comparison.

But anyway: this particular episode featured a patient who had to have a colectomy. Holby City does occasionally feature Crohn's patients, but this is the first time I've seen somebody faced with a colectomy. But the writers may as well not have bothered, they got it so wrong - should have just stuck with the usual heart attacks and so on.

The backstory revolved around a young Jewish lad who'd collapsed in the gym, with symptoms of abdominal pain, bloody diarrhoea, and cramping. Crohn's was suspected at first (far too confidently), but an x-ray showed a dilated colon and the diagnosis was changed to extremely severe UC with imminent toxic megacolon if they waited a second longer. A colonoscopy was performed. (Why?) The lad was told he had to have a colectomy: no wonder he looked so bewildered, he looked and sounded utterly well. He was upset about having to 'go into a bag for the rest of his life'. Then some bright spark finally thought of steroids! Wah-hey!

Now here comes the one part I'm really not sure about: the lad's father didn't want him to take steroids, because the lad had been training for a massive race and steroids would count as cheating. Ridiculous drama aside, are corticosteroids actually outlawed in sporting competitions? I feel a bit dumb for not knowing. All I know is that corticosteroids are catabolic steroids and break down muscle, rather than build it up, but on the other hand they give you more energy, so I dunno.

Anyway, back to the story. Mysterious tests showed that the lad wouldn't be able to walk - or run - if he took steroids, so those were conveniently ruled out; at the end you saw the lad signing the consent form for surgery and appearing to give up all his dreams of being an athlete.

If you can't be bothered reading this post (and I don't blame you), then here's a handy list of everything I thought was wrong:

1) UC not even being thought of by the bright young doc, despite bloody diarrhoea. Of course bloody diarrhoea can appear in Crohn's but it's far more common in UC

2) The patient getting a colonocopy in 10 minutes. I had to wait a week in hospital for a CT scan or flex sig. Forget getting a colonoscopy any sooner than 4 weeks!

3) The patient getting a colonoscopy in the first place despite imminent toxic megacolon. It's almost like they wanted to rupture his colon and really risk his life.

4) The patient being well. That aggravated me. I've been in his shoes, and I can't exaggerate how ill having a toxic colon makes you. You would not be able to joke around.

5) The bright young doc suggesting a 3-week course of steroids. The big race was in 3 weeks' time. The patient would be back in hospital before the race was over.

6) Have never, ever heard of being pre-tested for steroids.

7) The patient talking about going in a bag for life - and no doctor correcting him. Wrong, wrong, wrong. As a young and otherwise healthy UC patient, he'd be a perfect candidate for a j-pouch. There would be no going in a bag, except for a few months.

8) The implication that you can't be an athlete with a bag. No. Just no. If you want to run competitively with a bag, you can run with a bag. (Or a j-pouch; whichever.) There's enough outdoorsy ostomates who do marathons and things to prove that.

I know nobody else watching will take it 1% seriously as I did, but... :-/

I know you are irritated with the stupid show, but much like Kazbern, I found myself smiling....you really are a wonderful writer with great wit and personality. I DO seriously think you should write to the show's producers. Nothing may come of it, but you would at least entertain yourself. It does sound like a poorly written plot!
Even more off topic, I'm sorry the hospital wards in the UK are so dismal. In the US, it is kind of the "haves" the people with decent insurance, and the "have nots" who get dismal or no care at all. If you have decent insurance, most of the hospitals are pretty nice. I don't know what's worse! Glad to see you found a TV focus to rage at:)

I've thought of a few more things wrong with the show! >_>

Just kidding; although I was wondering if Remicade could have been given instead of steroids. It's a fast-acting antinflammatory; not as fast as steroids, but probably fast enough for the situation. Keep the patient on fluids, decompress the bowel, wait a few days for the Remicade to (hopefully) kick in, and, hey presto - one saved colon.

Should be a doctor, I should, with this sheer amount of medical knowledge :p

As for the plot, there is such a thing as dramatic licence, but Holby City was just taking the piss with it. I am actually almost tempted to write to the show's producers to explain this to them. It was poorly-researched. I am reasonably certain I could provide more accurate information on a condition I didn't have the first clue about with the aid of wikipaedia and medical websites.

@gumby - I imagine US hospital wards are a lot nicer than UK ones. That said, if you have the money, you can go private here. But even people who take out a healthcare plan usually end up going back to the NHS for various things, because going private is so horrendously expensive and, oddly enough, some things can be done faster/better on the NHS.

Also, to be fair to my hospital, the wards were at least clean. You may think that that's very least a hospital could provide, but I've heard some horror stories about other hospitals. Not sure how much I believe them, though, considering that most of the people I know who tell them are not exactly known for their meticulous adherence to truth at any cost.

Cheers, folks :p

I've never seen Holby City but I used to watch Casualty and now have the dang music in my head - or maybe it's the music from The Bill...

Wow. This reminds me of an episode in the first or second season of Private Practice (a medical drama here in the US).
A desperate pregnant woman shows up at the doctor's office insisting that she's sick, and needs answers. (if I remember correctly, her only remarkable symptom was that she was losing weight during her pregnancy rather than gaining it). Shortly after, the woman's mother and psychiatrist show up - seems she had escaped from a mental institution, where she had been hospitalized for Munchausen's syndrome (basically, making herself look ill to get attention) because other doctors have run tons of tests and all of her results have been normal. Of course, our doctor heroes believe the pregnant woman, and they have a limited amount of time to figure out what's wrong with the pregnant woman. So they go into a conference room, shuffle around a bunch of papers, and ta-da! The woman has Crohn's disease. Because she has issues with weight loss and symptoms that come and go and don't show up on tests. And then the doctors send the pregnant woman on her way, telling her that she and the fetus will be fine (nevermind that she's been losing weight her entire pregnancy). UGH. Television.

You have got to write the the producers.......... (I like to pick the killers in my husband's shows. I have a pretty good %, too!)