Is Dhadkan Zindagi Kii, a real-life hospital-based show or is this a TV melodrama? The new Indian medical drama aired on Sony TV is very popular. I watched Episode 20 overcoming the past and what I saw shocked me!
Let’s jump right into it.
- How does Dhadkan Zindagi Kii Ep. 20 start?
- What happens next in Episode 20 (Overcoming the past)?
- What is PTE (Pulmonary Thromboembolism)?
- What happens after this in Dhadkan Zindagi Kii?
- What does the Anesthesia Doctor Do in Dhadkan Zindagi Kii?
- How does the monitor work?
How does Dhadkan Zindagi Kii Ep. 20 start?
Show Information: The episode starts as a conversation presumably in a hospital supply room. The conversation seems to be between a doctor and the supply room manager. The doctor seems to be getting ready with their drugs and other materials. There is a person in the background who appears to be stealing medicines. The conversation is about how junior doctors are not helpful.
My View: Every year during medical training be it MBBS, MD, MS, or any type of training, there is a general thought that their batch or people senior to them was excellent. On the contrary, the juniors are not good. Don’t get me wrong. This is a general feeling that I have seen and heard but is this true? I don’t think so.
Bottom line: This type of thinking is true but it is not possible to verify if this is factually true.
What happens next in Episode 20 (Overcoming the past)?
Show information: There are two doctors discussing a patient. This seems to be a complex patient. The discussion is regarding a patient who presents with multiple symptoms. This appears to be a senior doctor testing a junior doctor and does not seem to be very friendly. Essentially, this is a patient who presents with a fracture of a leg bone. The senior doctor checks the junior doctor’s knowledge on the presence of what he calls PTE.
My view: This is accurate information.
A senior doctor frequently questions junior doctors to check their knowledge and help them learn. The senior doctor here appears to be rude. The interaction really depends on a few things:
- The person’s personality
- The country they are working in
- The type of hospital
- Culture of workplace
The second point is accurate. Fracture of the long bones of the leg can predispose someone to PTE.
Bottom line: The interaction of doctors depends on many factors. The fracture can predispose to pulmonary thromboembolism (PTE).
You can watch this information in this video along with my reaction.
What is PTE (Pulmonary Thromboembolism)?
PTE is pulmonary thromboembolism and this is a clot in the lungs.
- Fracture of the legs. With a fracture, the legs cannot be moved. This causes venous stasis in the leg veins and this can predispose to clots of the leg veins. These clots can then migrate to the lungs to cause pulmonary thromboembolism.
- Fat embolism. The long bones of the legs like the femur contain fats in them. These fats can come out with a fracture and then can migrate via veins into the lungs predisposing to PTE.
- Oral contraceptive pills
- Hormone replacement therapy postmenopausal
According to American Lung Association, the symptoms include
- Chest pain
- Difficulty breathing
- Back pain
- Increased sweating
- Feeling tired
- Dizziness, giddiness
- Feeling of doom
- Leg pain and swelling that may indicate clots in the leg veins
- Blue lips, nails, fingers, toes
- Coughing out blood
- Clinical examination
- Chest X-Ray
- Blood tests
- CT scan of the chest
- Ultrasound of leg veins
- MRI of the chest
- Pulmonary angiogram (considered the best “gold standard” test)
- Blood thinners (anticoagulants)
- Clot busters (thrombolysis)
- Treatment based on symptoms
- Clot retrieval from body using devices
- Long term prevention
- Physical therapy
What happens after this in Dhadkan Zindagi Kii?
Show information: There is an operation theater scene. They sound like there is an emergency problem and they summon the help of an additional surgeon. The Anesthesia Doctor suddenly turns around and says, anastomosis is leaking and the patient can have peritonitis.
My view: The Anesthesia Doctor is the most important person in the operation theater. He/She keeps the patient safe. The Anesthesia Doctor makes sure, all the vital parts are functioning fine by monitoring heart rate, ECG, oxygen levels, breathing, temperature, and other physiologic variables.
(Some places may have other a person other than a Doctor giving anesthesia).
As surgeons are focused on the operation, any problem to the patient is brought to attention by the Anesthesia Doctor which is what is happening in this case. Although the leakage of anastomosis is not what is seen in the monitor, many other changes can be seen. As soon as the change happens, the Anesthesia Doctor immediately communicates this to the person.
Bottom line: Anesthesia Doctor is the most important person during operation who makes sure the patient is alive and safe.
What does the Anesthesia Doctor Do in Dhadkan Zindagi Kii?
Show information: The Anesthesia Doctor tells the surgeon the cardiac output is falling. The surgeon refuses to budge and they decide they have 90 minutes to complete the case. They start a timer clock. The anesthesia doctor says I will push more “NORAD”. Anesthesia Doctor at one point asks to stop operating. The surgeon refuses to say he has 90 minutes. The scene proceeds in a melodramatic way and is finally completed when the surgeon says anastomosis is complete, Done.
My View: There are many points in this. Let’s break this down:
- Cardiac output is falling: Cardiac output is the amount of blood the heart pumps each minute. It is commonly determined by the formula Cardiac output = stroke volume × heart rate. As noted before, the anesthesia doctor tells all important information to the surgeon. This is exaggerated and incorrect. To comment on cardiac output, there are separate cardiac output monitors. This is not shown. With the monitor shown in the scene, only blood pressure can be commented but not cardiac output.
- NORAD: The use of this term is wrong. Abbreviations should not be used. The doctor is probably referring to the medicine called Noradrenaline or norepinephrine. This medicine is used in cases of low blood pressure due to sepsis. In this scene, perhaps there was an infection of the abdomen (peritonitis) that may have caused low blood pressure which is why noradrenaline is used. The doctor goes on to say I will give more NORADR. This is not correct. Noradrenaline is used as a continuous medication using specialized devices called infusion pumps and not pushed whenever. Pushing noradrenaline can be dangerous.
- Anastomosis: This is essentially the joining of two pipes. In this case, the joining of two ends of the intestines. If a part of the intestine has to be taken out for a health problem, then the other two parts can be joined. If you imagine a water pipe and have a hole, you cut that part and then join the other two parts.
- Clock Timer: A timer is used in certain types of procedures. The concept of using a clock timer is correct. However, the conversation related to this is not correct. If the anesthesia doctor says you have to stop, the surgeon does not argue and continues. The surgeons try to wrap this up quickly. Both surgeon and anesthesia doctor have the same goal: the best for the patient. A part of the body will be open and a team decision is made to keep the patient safe. An example is if an artery,
Bottom line: There are some parts that are accurate. Using abbreviations is strongly discouraged. If you are a medical student or a trainee doctor reading this, develop a habit of not using abbreviations.
Is the emergency shown in Dhadkan Zindagi Kii accurate?
NO. This is shown in a funny way. This part is completely not accurate. There are no changes in the blood pressure on the monitor. See the picture below.
To me, the heart rate is 65, which is normal. The oxygen saturation is 100, normal. The blood pressure is 85/53 which is normal. It’s not normal in an awake patient but under anesthesia, it’s not abnormal. I cannot see anything else, so to me, the monitor looks normal. They could have changed the monitor to show something better. After all, it is a TV show, will they go that far to be accurate?
How is the monitor working?
These are all demo monitors, and they always keep running. You know these are monitors that the company uses to sell them. So, when they show it to us as doctors, they turn it on. This is like checking if a TV works when you want to buy them. These monitor display all this information even without being on the patients.
This edu-tainment piece is my personal view. If you are reading this far, ping me to share your experience.
Interested in more? Check this out for Reaction to shock treatment in Bollywood.
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