I Landed a Medical Fellowship in the Grey's Anatomy Writers' Room

My experiences on the show, accuracy in medical dramas, and where to watch Season 20

I love Grey’s Anatomy. Unironically. When the show is mentioned at the hospital, I often see eyerolls, and sometimes a comment or two involving the word “trash.” I don’t take it to heart (although maybe now that I feel personally involved, I might). Ever since I first watched the show back in college, I have loved the drama, high stakes, life-or-death decision-making, and emotional turmoil.

Grey’s Anatomy is not overly ambitious or pretentious in its set design, dialogue, or scenes. It is not trying to be hyperrealistic (it’s not a documentary). A patient’s death might get just as much screen time as an illicit sexual encounter. But it is really good television.

And last fall, I had the incredible opportunity to work on Grey’s Anatomy as a medical fellow in the writers’ room. I spent weeks with the writers, sharing my thoughts on surgical residency, talking about my experiences, fact checking, researching and writing medical cases, and contributing to the upcoming season.

When I say that everything I have done as a doctor - going to medical school, starting surgical residency, and everything that has entailed - has led to this, I am only partly joking.

Back in college, I never thought I’d be a doctor; I wanted to be a writer, then a journalist, maybe a public health advocate, or perhaps a museum curator? What I realized much later was that the thing that motivated me, and always captured my interest, was the human experience: stories and questions about who we are, how we got to be this way, and how we interact with one another.

And over time, I’ve realized that as much as I love operating, and learning about science, what I really value is talking with my patients. Stories are what bind us - they are how we learn about others, how we empathize, and how we understand who we are. I’ve tried to highlight some of this through my personal writing, but working on Grey’s Anatomy gave me the chance to be a part of a much bigger story.

During my time in the writers’ room, I learned an incredible amount about storytelling, writing, and media. As I absorbed the writers’ ideas, and investigated my own, I became more adept at recognizing common threads in past episodes - moments when the patients’ stories or diagnoses echoed the doctors’ emotions. I started to see, with increasing clarity, how these thematic arcs deeply affirmed the interconnectedness of our lives.

And, though I feel foolish thinking about it now, I had no idea how many hours, weeks, and months of work go into each second of an episode. The people on this show - thoughtful, talented writers, and dedicated artists - truly care about their work, and spend tons of time and resources not only on crafting interesting stories, but also devoted to public health messaging.

Almost every story and subplot, as far-fetched as it might sound, comes from a doctor’s personal experience, a news article, or medical case report. The details are ironed out with meticulous attention to detail, often including phone calls with experts in the field.

But. There will always be things that people point out as “not accurate.”

Accuracy in medical dramas

The way I see it, there are two ways to look at this.

On the one hand, medical dramas have a huge platform for public messaging.

In Season 4, Episode 13 of Grey’s Anatomy, Izzie Stevens (Katherine Heigl) meets a young woman who is terrified to learn that she is pregnant, because she is HIV positive. By the end of the episode, Izzie is able to convince the mother that, despite being HIV positive, not only is it possible for her to have a healthy baby - it is probable. I later discovered that this subplot had been included as an experiment in conjunction with the Kaiser Family Foundation, and in a pre- and post- survey of viewers about attitudes towards HIV and pregnancy, the answers changed from 15% to 61% of people believing a healthy pregnancy with HIV was possible. I was stunned.

Graphic from Kaiser Family Foundation Report on Grey’s Anatomy Case Study

Since then, Grey’s Anatomy has done public messaging work on sexual assault, racial biases, and the Covid-19 pandemic, among many other topics.

I, along with the other fellows, consultants, and full-time physicians on the show were constantly working to make sure we were accurate in our information and portrayals of healthcare. Of course, this exists within the confines of a cable television series - the surgeons do everything from transporting their patients to performing their own MRIs, because if we included every staff member that worked at an actual hospital, we’d have to expand the story to many more characters, and hire many more actors, shifting the focus away from the real stars of the show: the surgeons.

But there are times when certain storylines can send the wrong message in a way that’s dangerous - for example, Grey’s Anatomy loves to highlight rare diseases and experimental technologies, and there are stories of patients thinking you can easily 3D print organs for transplantation.

Even more alarmingly, a survey of CPR occurrences in medical dramas found that 69.6% of hospitalized patients on television immediately survive after CPR. The real number is closer to 25%.

Throughout my time on the show, I shared my perspectives and knowledge of palliative and end-of-life care, a topic which many of the writers agreed was important to portray on the show. Though the shortened timeline made it difficult to fully explore these ideas (the writers’ and actors’ strikes brought the usual 24 episodes down to 10), there are a few moments in Season 20 that allude to these themes, and I’m hopeful that we will see more in upcoming seasons.

So when looking at medical dramas as a tool for public education, accuracy is incredibly important.

The Spirit of the Story

But the other way I watch medical dramas, putting aside my technical knowledge of disease and procedures, is as a resident, who spends countless hours in the hospital, interacts with other healthcare staff, and takes care of hundreds of patients. The lived experience of being a resident is unique, and difficult to capture.

There have been many times in the past when, in watching certain scenes, I’d almost roll my eyes at how unrealistic it seemed - an intern would never skip their annual exam to spend more time with a patient. Patients come and go. Exams can dictate your future.

But then, I started thinking: it doesn’t bother me when I’m reading a fantasy novel and I am told that humans coexist with dragons. When I’m watching The West Wing and senior White House staff make egregious mistakes that should, in reality, get them fired, I don’t obsess and lose sleep over it. Instead, I take in the story the way it’s presented to me, and I think about what these imagined worlds are trying to tell me about the one that I live in.

As I spent time with the writers, constructing scenes and rewatching old episodes, I started thinking about Grey’s Anatomy in the same way. Maybe in real life, I would never skip a test to finish up patient care, but in my head - in my heart - don’t I believe that an hour spent caring for a patient is more important than a test score? Haven’t I worked to build my future career around a focus on palliative care and communication skills, because of how important I think they are? And don’t I believe that if I can change someone’s life, help them through difficult times, then I have done something more valuable than anything listed on my resume?

Of course I do. And that is the spirit of the show.

So now, when I watch medical dramas, I won’t be nitpicking the correct size for an ET tube, or the fact that you need to tie your mask before you scrub, otherwise you’ll break sterility¹ - instead I’ll be paying attention to the characters and their emotions, and the spirit of the story being channeled through.

Season 20 of Grey’s Anatomy airs tonight, March 14, on ABC. You can also find it streaming on Hulu.

For those who are curious (read: friends and family) - I was the medical fellow in the show’s first stages, just after the strike ended, so I was involved in framing the whole season arc. And on a more granular level, I helped construct the medical stories in episodes 1-4.

If you want to catch up before starting season 20, I commend you, but that is a lot of TV to watch. Instead, I’d suggest watching season 19 to get to know the new interns - or, if you are really just want the highlights, watch the season finale for season 19, so you know exactly where season 20 picks up.

Also, if you look closely in episode 1, you might just see me in the background.

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References and Further Reading:

Public Awareness for a Sexual Assault Hotline Following a Grey’s Anatomy Episode published in JAMA

Survey Shows ‘Grey’s Anatomy’ Viewers Gained HIV Knowledge from the Kaiser Family Foundation

I've spent the past 9 months talking to healthcare workers as a reporter. 'Grey's Anatomy' gets the pandemic right from Business Insider

The Grey’s Anatomy Effect: When TV Warps Perception, Proactive Communication is Key on Clinical Advisor

Cardiopulmonary Resuscitation on Television — Miracles and Misinformation published in NEJM

Grey’s Anatomy effect: television portrayal of patients with trauma may cultivate unrealistic patient and family expectations after injury published in Trauma Surgery and Acute Care

The effects of viewing Grey's Anatomy on perceptions of doctors and patient satisfaction published in the Journal of Broadcasting & Electronic Media

1. Because if their masks are tied the whole time, we can’t see their faces or their expressions, and we all know - because of Covid - how frustrating and painful that can be