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The Clay Travis and Buck Sexton Show
Wellness Unmasked: Hollywood vs. Healthcare: The Pitt, Measles Surge, Obamacare Myths & Medicine’s Political Bias
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Welcome to Wellness Unmass. I'm Dr. Nicole Safire and this is your weekly rundown. Now, I did a post on X earlier this week. I was watching an episode of the Pit, which is one of those new modern medical drama series, and I was a little critical of it. Now, let me say this regarding the Pit. I watch it, I enjoy it. In many ways. It's a bit of a throwback, you know, a little nostalgic to a couple decades ago at this point where I was, you know, an active part of the trauma scene. Now, for those of you who don't know what the Pit is, it's essentially a modern day er. Remember George Clooney? Whoever else was in it, I don't know, it was a little bit before my time, which is probably why I didn't grow up with a George Clooney crush. But one of the main actors from ER is actually the lead actor in the Pit, Noah Wiley. If you know him, you know him as Dr. John Carter from Ernest. If you didn't watch ER then you wouldn't really know him. But one thing of note about Noah Wiley is he has been a long time vocal in progressive political circles. He's publicly supported Democratic candidates and progressive causes over the years, including healthcare reform initiatives. And now, the only reason I'm talking about this is because context matters. Because when you watch the Pit, the ideological lean becomes increasingly obvious. Now, I won't go into a full rant, but I will go through a few of the episodes just to kind of show you what I'm talking about. And one of them is the fact that when they reference anyone who supports repealing or weakening the Affordable Care act, also known as Obamacare, they allude to it would strip away emergency care access to Americans. The reality is that's just factually incorrect. Emergency departments have been required under the MTAH law since 1986 to evaluate and stabilize every patient, regardless of insurance status. Yes, the Affordable Care act expanded insurance coverage, but it did not create emergency access. Now, after the 2014 Medicaid expansion, in many states that came with the Affordable Care act, there were some studies published in JAMA that showed uninsured ER visits declined in those expansion states. So what does that mean? Fewer people without insurance went to the er. What that did not mean was fewer people actually went to the er because the reality is the overall ER volume increased as more people who were newly insured sought care. It wasn't that all of a sudden these expansion states, now these patients had access to Primary care and treatments. And they weren't needing to go to the er. They. No, they were just now given an insurance card and they were still going to the er. So it did nothing to solve the ER Overcrowding that's driven by staffing shortages, inpatient bed bottlenecks, chronic disease. The fact that we have more doctors retiring at a rapid rate, especially ever since COVID and there's just not enough doctors who are in it anymore because of all of the administrative bloat that was introduced following the Affordable Care Act. But that nuance, it doesn't make for strong political messaging. Now let's move on. Measles, another hot topic right now, especially as the United States is at risk of losing its eradication state. We have more measles this year than we have had anywhere in the immediate past. And it's concerning. And now why is it? Well, we have a decline in our vaccination rates. That's fact. People wanna blame RFK Jr they wanna blame the Baja movement. But the decline in vaccination rates actually happened before COVID We saw the biggest dip in 2019. Then add Covid, and all of a sudden you see a mishandling of a lot of the COVID policies. You had a growing distrust in public health establishment. And now we see even fewer people getting vaccinated because of this mistrust. And it is a huge, unfortunate mess that we find ourselves in. But this is where we are now. In the episode that I'm referring to, a child comes into the ER with a severe case of measles. Teenage boy, unvaccinated. Doctors are concerned about one of the neurological complications, which, by the way, can be fatal. It could kill the kid. The doctors are recommending a lumbar puncture to look at the spinal fluid. The mother does not want her child to have this lumbar puncture. She said, no, just treat him. I don't want the lumbar puncture. I worry about any damage that can be done to his spinal cord. I worry about risk of infection. She's essentially trying to tell them she's worried about having this procedure done. And rather than in a calm, respectful manner and having the true informed consent that we as medical professionals are supposed to have with all of our patients. Especially when you have a scared mother right in front of you whose child may be dying. She was portrayed as a caricature of ignorance. And fine. If the doctors are going to have that paternalistic, condescending way of dealing with patients, that's fine, because that exists in real Life, it's all over the place. But they only had that tone with her. Now let's look at the contrast in a different episode in, in another episode, a black woman in sickle cell crisis. By the way, one of the most scary, painful, fatal things that a human could actually go through. This woman comes in, in sickle cell crisis and there is some confusion, there's a lack of communication. But what ended up happening was it turned into an entire episode about thoughtful acknowledgement of documented bias in African American patients. In fact, the physicians go out of their way to validate her time to discuss any sort of risks, any sort of benefits. There's a lot of hand holding, there's a lot of empathy, there's a lot of love there. And by the way, I love the way that they treated her. Because this woman was suffering. The portrayal of her and how they treated her was appropriate and supported by evidence. But when the distrust comes from a vaccine skeptical mother, that empathy disappears and she became the obstacle, not the lack of information or a level of misinformation. While we wanna always focus on bias, head on selective empathy, that's also a level of bias. So moving on, the whole masking storyline, they doubled down on masking. And we all remember masking from COVID The episode showed two women in the emergency room. One of the women's son was there sneezing and coughing, I think, but he was there for some sort of allergy reaction. And so this other woman said, put a mask on your kid. And the woman with the kid, she's like, it's allergies, he doesn't need to wear a mask. And they got into a whole kerfuffle. And actually it turned physical when the mother ended up punching the woman who was telling her to put a mask on her kids. And it really just evolved from there. But what happened in this episode was really interesting. The woman resistant to masking was portrayed as like this southern stereotype. She was visually coded and verbally framed as kind of uneducated and crass. Even the physician made a condescending remark to her. What we have to remember is masking policies evolved. Universal masking, maybe for the people who were implementing it, made sense during peak Covid transmission. And maybe you could argue that it made sense. And we had no idea what was going on. But as we gained more information, as immunity increased and new infection control data emerged, you have to remember, many hospitals shifted to seasonal or just risk based masking. And so to ask one kid in the emergency department to put on his mask when he's not even there for an upper respiratory infection. Yeah, if I were the mom, I'd be upset too. I get it. Listen, there's a legitimate debate about indefinite masking in healthcare settings. I personally am not for them. But on the pit, the way that they framed it, it just. It really just equals ignorance, as though there's some form of settled science, because there's not. And lastly, I would be remiss if I did not talk about the episode where they're talking about abortion, which is. That's right. A teenage girl goes to the emergency department with a woman who is claiming to be her mother so she could get the abortion medication. Well, even the doctors noticed on the ultrasound that she was too far along in her pregnancy to be able to take some of these medications as stated by the law. So they were going to lie about her gestational age just so she can get access to these abortion medications. Because they're framing it as they're life saving for her. So the doctors are being empathetic. The woman saying she's her mother next to her at her bedside, they're all calm, they're all collected, they're all there in the best interest of this pregnant teen. Well, actually, what happens is that woman is not her mother. In fact, the mother comes flying in like, what is going on? Why is my daughter in the emergency department? So what really exposes this ideological framing is just character portrayal here. The pro life mother is irate, she's irrational, and she comes across as emotionally unstable. Absolutely not. My daughter will not do this. Blah, blah, blah. And yet the pro choice aunt, calm, articulate, and portrayed as morally centered. The contrast is not subtle. It's the one worldview framed as just like, hysterical and completely backwards, and the other is enlightened and compassionate and doing what is in the best interest of this teenage girl. And of course, there's an episode regarding medical intervention on a transgender person. And there's no discussion of, well, male, female. It was just like a settled science of this. What looked like a male dressed up in female clothes? Well, it's just a female, so we'll just treat this person as a female. In the United States, while we're seeing major organizations still supporting gender affirming care, the tides are turning and we're starting to see that long term evidence for puberty blockers and cross sex hormones and minors really may have have more harm than benefit. So this debate is ongoing. There is nothing settled when it comes to transgender in the healthcare, despite the fact that a lot of CME that we have to do continuing medical education. They're trying to, you know, shove it down everyone's throat as though it's settled, but we all know better. Better that it's not. And this last one, it wasn't really about something in the healthcare space, but I did find it interesting. You had this older Jewish woman coming in to seek a burn on her thigh, and she, if you were to look up, quote, unquote, stereotypical older Jewish woman, you know, she definitely hit a lot of those stereotypes. She was almost overbearing on the doctor, why aren't you married yet? You're too old. You shouldn't be. You shouldn't be driving a motorcycle. And I put honey and natural remedies on my burn. And some of these other things, which they weren't really negative, but they were definitely a stereotype. And as she's being gently cared for by the hijab wearing Muslim nurse, who, by the way, is one of my favorite characters, she has spunk. She has a great personality. But there was a moment of silence where the Jewish woman thanked the Muslim nurse for the Muslim community and how they came together to help raise funds for the synagogue after a shooting. Now, that was a real story. That did happen in Pennsylvania. You had a lot of members of the community, and not just Muslims, but you had Sikhs, you had Christians, you had others all coming together to raise money for the synagogue after a horrible shooting. But on the pit, they decided to just focus in on the stereotypes of the Jewish woman and the empathy and compassion of the Muslim culture. Now, they didn't directly support Hamas, of course, and it certainly didn't come out that they were pro hamas after the October 7 massacre. But it did make me think about that. Like, I'm not sure that that was really necessary. Listen, for the show, as a drama, it works as balanced policy storytelling, it doesn't. And medicine. And a lot of these topics deserve complexity because if you kind of sum it up, this is the pattern. ACA reform equals catastrophe. Vaccine skepticism equals ignorance. Mass questions equal backwardness. Pro life views equal irrationality. Gender debate equals bigotry. And the Muslim culture is caring, compassionate towards the Jewish people. Complicated issues are seriously just becoming morality plays here. And it's unfortunate because the show has a talent and the platform to explore these debates honestly. But instead, it's reflecting the worldview of Hollywood and perhaps unsurprisingly, the worldview of its leading man. Now, here's the irony. Despite the bias, I am still watching it because the trauma scenes are gripping. The pacing is excellent and remind me of the early days of my own medical training. The intensity, humanity, and the moments that stay with you forever. I can watch it and I can criticize a little bit that they've had a few errors when it comes to their radiology stuff. I don't think they have a radiologist on staff, but I'll let it go. Because you know what? As a drama, it works. As balanced policy storytelling, it doesn't. Patients deserve empathy. All patients, not just the ones whose politics aligned with the writers room. Okay? And if you're going to try and influence how Americans see health care, at least acknowledge that reasonable people can disagree. Because trust in medicine, it's not rebuilt by mocking half the country. It's rebuilt by modeling. Respect. I'm Dr. Nicole Safire. Thank you so much for listening to Wellness on Mass. Be sure to listen to Wellness on Mass on iHeartRadio, Apple Podcasts, or wherever you get your podcasts and I'll start. See you next time.
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