Coming down on The Night Shift


I've been reviewing episodes of NBC's The Night Shift for EPMonthly. Specifically, I took the pilot, then episodes 5-8, while Dr. Aaron Bright handled episodes 2, 3 and 4.

It's not a good show. The plot twists are predictable. The characters are mostly caricatures. Worst of all, to me, is that the medicine is awful - it's absolutely impossible for an emergency physician to say, "We manage patients like that," or "That's what my job is like."

But I understand there are fans of the show. A lot of them. And they may want a collection of our medical impressions. So, here you go:

Episode 1 - Pilot
Episode 2 - "Second Chances"
Episode 3 - "Hog Wild"
Episode 4 - "Grace Under Fire"
Episode 5 - "Storm Watch"
Episode 6 - "Coming Home"
Episode 7 - "Blood Brothers"
Episode 8 - "Save Me"

Greg Henry also chimed in, with his opinion.



If you're looking for one episode to hate-watch, make it Episode 5, where a storm causes a power outage, a main character delivers his twins in the rain (one is breech!), another main character confronts her father in ED after he gets stabbed, and another ED doc does everything for a patient, taking her from he wrecked home, via ambulance, all the way to the OR - without ever actually working in the ED. This is a typical episode, but is notable because it was directed by "ER" alum Eriq La Salle, and because it features the most 'progress' in the show's marquee romance (an ill-advised, childish affair).

If you're looking for their best episode, make it #6, the only time a major character had a real arc, making difficult decisions, facing consequences. All the other "drama" on this show is how characters respond to the unbelievable stuff that rolls into the ED (spoiler alert: they respond with grit and determination and occasionally, flashbacks to the war).

From my ep 1 review:
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. 
From the season finale:

It’s genuinely discouraging to know millions of people are watching this show, and seeing the most outrageous caricatures of emergency care. A bunch of EPs joined me in live-tweeting the show and our impressions - mostly eye-rolling, snark and cringing - were in stark contrast to the praise coming in from most tweeters using the #NightShift hashtag. 
We used to fret that patients would develop unrealistic expectations, when in-hospital cardiac arrest survival rate on 90’s TV shows was higher than real life. Now we must contend with the expectation that any EP can perform any surgery in any setting, or the most serious and spectacular injuries are routinely encountered, and usually survivable with minimal complications after a few hours. And I’m still waiting for evidence that the job “Overnight Onsite Administrator” and “Chief of the Night Shift” are jobs that exist, anywhere. 
All this medical fiction may be worth it, if was in the service of telling good stories. But all the characters - despite their unbelievable medical abilities - are rarely driving the action. Stuff comes into the ED, and the cast responds. I can only think of one episode where a main character chose a course that was personally difficult, and grew as a result. Instead, the writers usually substitute medical feats for character development - somehow thinking that, if the doctor sweats a bit before performing a miracle, the audience will relate. 
So here’s hoping for season 2 to be more grounded in medical reality, which will give some breathing room for the characters to grow and develop - and not just react.

It occurs to me our profession, and viewers, would be better off if NBC just aired EPMonthly's own Mark Plaster reading his "Night Shift" columns.  That's as accurate a portrayal of our job as any, and the protagonist actually thinks and grows over time. But apparently that's too much to ask from a big budget network show.