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After flashing back to Afghanistan, Dr. T.C. Callahan wakes up in a jail cell in the late Texas afternoon. He's hungover and bruised after a bar fight, but gets on his motorcycle to ride to work. On the way, he sees an ambulance by the side of the road, and pulls over to help EMS. They're helplessly gathered around a patient in shock, impaled through the abdomen by a tree branch. By the roadside, TC quickly pulls the branch out, clamps the patient's renal artery, and begins peritoneal lavage to collect blood for autotransfusion. The EMTs are amazed by this brilliant but troubled doctor who doesn't play by the rules. 

That's the first minute or so of NBC's new medical drama, The Night Shift. The rest of the hour is very similar: character development that hits you over the head, and medical scenarios that go well past the point of straining credulity. 

 
wrestling with patient
 

After the smoldering TC arrives at work, he clashes with his ex-girlfriend, a caring but ambitious physician who's angling for "Chief of the Night Shift" (is that a thing somewhere?). After he starts dialysis on an infant, he punches out the hospital administrator who reprimanded him for treating the patient instead of transferring. Apparently TC didn't realize how lucky he was to have an overnight administrator readily available. TC then goes and rescues a kid trapped in a car with craniocervical instability, taking him to the OR where, in a dramatic twist, the administrator (who turns out to be an MD and wannabe surgeon) walks him through an experimental procedure that involves grafting bits of rib to the "neck bone." TC and the administrator reach a truce, cemented after the administrator punches him back in the face. 

 
night shift punch
 

Some things rang true in this pilot episode: The ED doc bargaining with a bored radiology tech to do a scan, a lack of specialist availability, the drunk driver who emerges from a car accident relatively unscathed. There are interns who compare each others' test scores but get squeamish about death -- and testicles. 

The staff is so busy that there's an irate patient complaining about the wait, yet the docs have enough time to pull pranks, juggle, or spell out their feelings for each other in obvious, expository ways ("I know we're not together anymore, but that doesn't mean I've stopped caring about you."). Other situations made the doctors look cruel -- practicing defibrillation on a dead patient, pulling the PCA button away from a wounded criminal, depriving a woman of sedation when her ICD kept inappropriately firing (thankfully another leading character stepped in, with a magnet). 

Sadly, however, it's been twenty years since "ER" debuted on NBC, and this show seems like a giant step backwards for medicine on television. It probably won't do much for public perception of emergency medicine either. Sure, ER had some unbelievable scenarios, particularly in the later years, but there was always a healthy volume of bread-and-butter cases, and it was clear the writers took pains to portray the medicine, procedures and specialities accurately. On "ER" you'd take it for granted that the doc would call out the right meds, do the right procedure, and hand-off to the right specialist if needed. On "The Night Shift," everyone seems trained to do everything (because, Afghanistan?) and very little feels right about the resuscitations. And the characters on "ER" had more depth and nuanced relationships than the broad brushstrokes we saw last night. 

Still, it's just the premiere, and we'll give "The Night Shift" a chance to prove itself. And if not, there's still entertainment to be had in picking it to pieces. If the Tweets were any indication, a lot of people seemed to like the show's over-the-top cases, simple relationships and attractive cast. The show may be around for a while, so come along for the ride, and enjoy EPMonthly's continuing coverage!

 

Follow along on Twitter @epmonthly during the show, and then read the review the following morning at www.epmonthly.com

 
 

Comments   

# RE: EPM Reviews NBC's "The Night Shift"Steve Acosta, MD 2014-05-28 15:43
Editor:

The last medical drama I thoroughly enjoyed was St. Elsewhere. The action , and series, was character based , with the continuity thread provide by medicine and resident status. The recent ones, including ER, evolved into situation based. They resembled actual ED practice about as well as L.A.Law resembled legal practice: a smattering of situations and terms interspersed with 'Wait! There's more!'
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