The show wasn’t as bad as I was expecting, but it certainly wasn’t good. It was…bland.

James Bell is a techie wunderkid who opens a private hospital catering to the most intriguing and desperate cases (by invitation only, of course). Maverick — yet world famous — surgeon Dr. Walter Wallace is invited to join the faculty. The rest of the faculty are young more-or-less interchangeable doctors and engineers and only two or three show any spark of characterization at this point.

This is a difficult show to review medically, as the medicine — such as it is — bears more resemblance to Star Trek than reality. Additionally, the patients are all two-dimensionsal and cliché: there’s coma girl, there’s pregnant-woman-who-has-to-make-a-difficult-choice, etc.

Krissy Ramirez is a 16 year-old girl who’s been in a coma for unknown reasons for over six months. The show gets points for correctly shows her breathing through a tracheostomy tube, because patients who need long term mechanical ventilation, such as coma patients, are transitioned from an endotracheal tube to a tracheostomy because it is better for the body long term.

To see if Krissy still “inside,” James hooks her up to her Mother through an experimental brain-to-brain communication device (FDA approval? Who needs that?). The team is excited that while hooked up the her mother, Krissy’s EEG shows increased brain activity. Then, when Krissy’s father speaks to her, she responds through her mother, “Hi dad.”

I’m sorry, but brain activity does not correlate with consciousness. From their description of the device, that brain activity could just as likely be the mother’s thoughts in Krissy’s head.

An EEG gives results like sine waves — which we did see off to the side. What the team was looking at was fMRI results — which show which areas of the brain have increased blood flow — which again, does not equate to consciousness. (Plus there was no MRI machine)

The mother “interpreting” her daughter’s “thoughts” seems an awful lot like facilitated communication, a discredited technique that was once all the rage. I would think it more likely the mother “heard” what she subconsciously wanted to hear rather than anything real. A disinterested third-party should have been wearing the helmet, not Mom.

They never did tell us why Krissy was in the coma, or how they are going to cure her.

A second patient is Margo Beyer, who is 20 weeks pregnant. She also has lymphoma — in this case, a mass growing on her heart. Because she was pregnant, she declined chemotherapy and radiation therapy to treat the lymphoma — a legitimate choice as those would have been fatal to the fetus. Unfortunately, now the mass has gotten so large it is causing tamponade (limiting how much the heart can expand — a surgical emergency) and requires surgery to remove. At 20 weeks, the team does not want to deliver the baby yet, so the plan is to put it off as long as possible, which turns out to be maybe a day instead of the two weeks they were shooting for. Dr. Wallace goes ahead and operates and — surprise, surprise — both the mother and baby survive.

Critically, the show never explained why operating on Margo’s heart required delivery of the baby. Operations are performed on pregnant mothers all the time without having to deliver the baby. It seems to me a truly expert surgeon would have operated on the heart without risking the child or requiring delivery.

There was a bit with spousal abuse tied in as well, but that was all wrapped up too neatly and I feel it did a disservice to real-life abuse situations that are always more complicated to handle.

There is no magic way to tell when a premature fetus has the best chance of surviving outside the womb. There are some tests that can suggest it, but there is no black and white line — and certainly nothing you can see by having the patient swallow an experimental (there’s that word again) “fetal monitoring ingestible.”

It was nice they 3D-printed dozens of plastic hearts for Dr. Wallace to practice on, but they really shouldn’t have colored the tumor blue — that’s like having the cheat codes turned on. It’s not that easy to tell good tissue from bad tissue in real life and that’s one of the main challenges of tumor surgery.

Even if the team did have to deliver the baby prematurely, there are steps you can take to give the baby the best chance of survival, such as giving steroids before birth to improve lung maturity. These were never mentioned but should have been a key component of the plan.

Margo’s feeling of ants crawling on her skin was a hallucination, not a delusion. I think the writers were confusing it with delusional parasitosis, which is a different entity.

A young patient is given a wrist band that is a fancy monitoring device tied in to the hospital’s computer in order to better manage his asthma. At one point, an alarm goes off indicating sudden drop in lung function — but wait! The kid put the monitor on the dog, and the dog’s lungs (which are smaller than a humans) were what was detected. Later, the alarm goes off again, this time showing a heart attack. It turns out the skeptical paramedic who lectured our doctor about his monitor not being ready for use had the device in his pocket and he was the one having a heart attack. The irony!

The paramedic has an ST-elevation heart attack confirmed by an elevated troponin (a chemical the heart releases when it’s injured), and the doctor does nothing to treat the heart attack or prevent the next one? This guy needs some stat treatment such as a cardiac catheterization and stenting, thrombolytics (”clot busting” drugs), or worse case scenario, a cardiac bypass. The guy needs to be admitted, not a cordial slap on the back.

Yes, you can technically pronounce troponin that way, but nobody does. I’ve been to dozens of conferences and head hundreds of specialists talk, and nobody every pronounces it like that. It reminded me of the old SNL skit with Alec Baldwin as the soap opera doctor who mispronounces everything.

It’s amazing the experimental (again!) wrist device thrown in the right front pocket and forgotten about is able to get an EKG reading accurate enough to determine an ST elevation through two layers of clothes and on the wrong side of the body. Seriously, lead placement is very important when reading EKGs — a lead misplaced by an inch or two can miss a heart attack entirely.

In the end, James Bell admits to Wallace that he has an as-yet incurable neurological disease known as GSS (Gerstmann–Sträussler–Scheinker syndrome) — and that’s the real reason he founded the hospital: to find a cure for himself.

Final thoughts:
This hospital is a HIPAA/patient privacy disaster on every level, plus there’s that whole “practicing medicine without a license” aspect.

For someone who states he wants a level playing field where everyone is equal, it’s telling that Bell frequently refers to Wallace as “doctor.”

At this point the show is cliche and unexciting. It’s not good, and not bad enough to be enjoyable in a car-crash sort of way. It needs to go one way or another if it wants to stay on the air (or at least if it wants me to keep watching it).