Thursday, November 28, 2013
Okay, I admit it. I've been beating up on the CBS drama Hostages. So-- since it is Thanksgiving and we're to be thankful I'm going to give a shout out to Hostages for one accurate story line.
Then it will be back to a hard medical critique as there is MUCH to discuss in some of the most recent episodes.
Accurate portrayal #1: Teens presenting for care related to reproductive issues or sexually transmitted diseases are treated as adults in the sense that they don't have to have a parent present to consent for treatment and should be seen privately by the physician.
During the exam, the physician asks her what all the bruising is about. And, the teen girl does have a suspicious bruising pattern.
Accurate portrayal #2: Suspicious bruising patterns are those that:
1. Can't be explained by the history given (I fell down the stairs.)
2. Are located over non-bony prominences. This teen presented with bruising to her upper arm (from being grabbed) and to her back (from cutting out a tracking device.)
3. Are numerous and extensive.
The doctor becomes suspicious and notifies social services.
Accurate portrayal #3: A physician is a mandated reporter under most state statutes to report a suspicion of abuse. They don't have to know beyond a shadow of a doubt that something is happening but if, in good faith, they are concerned by what they see then a report is necessary.
In a few days the teen is approached at school by a county social worker for questioning.This occurs in episode seven.
Accurate portrayal #4: There would definitely be an evaluation of the teen in private-- away from the parents. The social worker also interviewed the brother, who also had a black eye. Alone. In psychiatric situations involving teens the family is generally interviewed together and at some point-- each member is interviewed alone to get what's really going on.
So on this Thanksgiving Day-- thank you Hostages for accurately portraying management of a family when there is concern for abuse.
Now everyone-- have a safe and great holiday. I'll be working the ER and I don't want to see you ;)!!