“Flatliners” gets almost everything wrong about doctors
A few weeks ago on Reddit, I shared our episode discussing “The Injury” episode of The Office, which manages to gets everything right, from the actual symptoms of a concussion to the mistakes people make when self-treating injuries. This week we talked about the 1990 horror film “Flatliners,” which gets almost everything wrong. Last week we talked about “The Human Centipede,” which was arguably more medically accurate.
I thought this was an episode worth sharing with r/screenwriting because the mistakes this film makes are more than just technical; for example, nitrous oxide isn’t a good choice when you want to put someone under, but that’s a quick fix, and it can be excused because most of your audience knows what “whip its’ are — in 1990, probably from first-hand experience. The main issue my physician co-host had with this film is that the characters do things that doctors — even med students — just wouldn’t do. Some examples:
The film opens with Keifer Sutherland, a prodigious med student, performing an emergency operation on a patient without a resident present and without permission. In the film, this leads to a 4-month suspension from med school. In reality, this is practicing medicine without a license and is a felony. (Apparently, Keifer is also “confined to quarters” at med school and has to break out of his dorm room. That’s… not a thing.)
These characters have all made it into med school, which means they’re arguably intelligent, but definitely driven and career-focused. Just as importantly, they’ve probably taken at least some courses on medical ethics. They should know that there’s no way for their careers to come out of this unscathed, even if they did all sign an “it’s okay for my friends to murder me” letter.
The game of chicken the med students play, where each “flatline” lasts progressively longer, is incredibly dangerous, and the characters would know it. If you’re brain dead, there’s likely going to be brain damage. The longer you’re brain dead, the more sever the damage is going to be. The film does get something right in lowering the flatliner’s body temperature. It’s said that “you’re not dead until you’re warm and dead,” meaning that patients have a better chance of surviving losing blood flow to the brain if they’re hypothermic.
Defibrillation — shocking the heart — doesn’t restart a stopped heart. It’s used when the heart is beating irregularly — it’s basically turning the heart off and on again. This IS a technical issue, but given that the whole premise of the movie is bringing someone back from the brink of death, it’s a big one. It also doesn’t STOP the heart, at least without doing severe damage to the rest of the body.
This is the first film or show that we covered that my co-host Dr. Jackson Vane absolutely didn’t like, and it’s because at no point did he buy that these characters were aspiring physicians. “These people will all be horrible doctors,” he says, “because they think way too highly of themselves. No one will ever want to be their patient, because they’re going to talk down to everyone that they see. They’ll be horrible.” That’s something more than a technical flaw. It reflects, in my opinion, a film that’s been poorly researched and developed from day one.