Medical Bullshit on TV: Orange is the New Black


Featuring: Orange is the New Black Season 5 Episode 2 and Episode 13 (No spoilers)

There is a HILARIOUS stroke scene.

Gunshot wound to the leg. Hours later, the guy suddenly develops slurring of speech, altered consciousness, and speech repetition. Medical personnel dives in and shines a torch into guy’s eyes. “Looks like cerebral ischaemia. Get me some tPA STAT!”

(tPA is tissue plasminogen activator, a clot-busting drug used to dissolve confirmed blood clots causing stroke)

LOLOLOLOLOLOL. No observations. No physical examination beyond shining the torch (airway? breathing? etc. etc.) No CT scan. Not even an aspirin, which is what you give in (confirmed ischaemic) stroke.

They’re also in the medical unit of a PRISON. Where the hell would they get tPA? Or a CT scanner? Or ANY medical intervention beyond an IV??

The commonest cause of the above symptoms? Hypoglycaemia (low blood sugar). Stroke-related causes of the above symptoms? Ischaemic (blood clot-related) stroke. Haemorrhagic (burst blood vessel) stroke.

Is he going to thrombolyse the patient and make a possible hypoglycaemic episode or intracerebral bleed just haemorrhage all within the guy’s skull?

*a few seconds later*

Convict: sometimes it’s good to use what’s available. Like blowing oxygen bubbles into his IV.


Oh my GOD. Is she saying she gave the guy an oxygen embolus LARGE ENOUGH to give him a STROKE but NOT large enough to lodge into the MANY TINY CAPILLARIES in the lungs (which is en route peripherally BEFORE going to the brain — hello, veins to the heart, and then the lungs for oxygenation, then back to the heart, and then to the rest of the body like the brain?) and give him a pulmonary embolism (PE) instead? And considering you need like at least 20ml (that’s a fat syringe) of air to give someone ANY health compromise, how much must she have given to give him a stroke??

Oh, but not a PE, though.

And the guy’s stroking out like he’s having a tonic seizure.

ALSO you can’t thrombolyse an air embolus! tPA busts CLOTS, not air bubbles!

ALSO ALSO good luck busting his non-existent brain clot — AND the very existing clot stemming his gunshot wound to the thigh! There is a reason there is a list of contraindications to thrombolysis (in confirmed ischaemic stroke!) for good reason and that includes recent major surgery and major wounds.


And a few minutes later, the patient’s hoisted into a chair (for the sake of plot drama) without medical treatment, airway protection, post ‘stroke’, with a downward droop on the left side of his face. But he’s fine. So has he been thrombolysed?

I can’t. Jeez.

*later — on Episode 13*

You do not treat lithium overdose with IM adrenaline. You can absolutely become comatose from lithium overdoses — that is a medical emergency requiring organ support (at least the airway), IV fluids, and probably dialysis. IM adrenaline doesn’t do SQUAT aside from in anaphylaxis. How ridiculously poorly-researched is this show?!

Tell me ridiculous medical errors you’ve seen on TV!


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