Grey’s Anatomy

Grey’s Anatomy, the show that gets credit for keeping applications to medical school at an all time high. The show that keeps me employed. The show that causes many medical students to realize that reality is nothing like the TV show. There are 15 seasons of this show to binge on Netflix. I personally have no desire to watch, but I will admit to watching one episode, Season 5; episode 17. It is the one that has CDH1 patients. Spoiler alert as I will recap. Briefly woven into all the drama going on around the characters, there are 3 siblings who lost several family members to Hereditary Diffuse Gastric Cancer. They all carry the CDH1 mutation and are at the hospital because they decided to have prophylactic total gastrectomy. The show does point out that with their family cancer history and the CDH1 mutation they are at a “3 out of 4” risk for diffuse gastric cancer. They also mention they all had negative endoscopes. As with most TV shows, things that usually take days or weeks happen in 1 hour, so I can forgive them telling the surgeons that they want their stomachs out and the operations happening the same day. Doubts about their decision arises when they are told the potential post operative complications. What they do not mention is weight loss, malnutrition, vitamin B12 deficiency/anemia, or calcium deficiency/bone loss. Of course, dumping syndrome is mentioned, but the deal breaker is “anal leakage”. I don’t know if this was suppose to disgust the audience or make them laugh. To set the record straight. An endoscopy and the biopsies they take only scan about 1-3% of the stomach’s surface areas so a “negative” just means, they did not find cancer and not that you are cancer free. One of the reasons the recommendation for CDH1 mutation is prophylactic total gastrectomy is because it is difficult to diagnosis diffuse gastric cancer. If you decide to have the surgery, it is likely you will have a CT scan, with and without contrast. This is another way to look for cancer, but it also lets the surgeon know if you have any anomalies in you anatomy that could complicate the surgery. Pre-surgical blood tests also on the list. One of the reasons, I respect my surgeon is that after meeting with him and telling him I decided to have the surgery, he talked to me about the procedure, recovery, and life after. He gave me some print information. Then he said, this is serious, major surgery; nothing to take likely; so I want you to think about it; we will meet again in 4 weeks and if you still want the surgery we will set a date. Not only did this give me time to think, it gave me the chance to attend a support group meeting before surgery. That meeting had my head spinning. They accurately described how awful recovery was, but they were also passed their adjustment period and all were happy they had it done. I had doubts even while I was being prepared for surgery. I guess that was one message that the show was able to relay as one of the siblings decided against surgery. It would have been nice if they dedicated an episode to focus on gastric cancer, but Grey’s Anatomy is a show about doctors not about medicine. I wonder if House ever had a CDH1 patient?

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