Surgeons Can Do Autopsies If They Want

Everything About Fiction You Never Wanted to Know.

Much to the apparent discomfort of screenwriters, modern medicine is a team sport. Writers naturally want their protagonists to perform all of the interesting medical work that week's cases will allow, but this understandable desire flies in the face of a reality in which a dozen different specialists may divide the tasks necessary to care for a patient. The same doctors will not likely care for a pregnant patient and her unstable newborn; surgeons are rarely seen in the Emergency Department unless called (and sometimes, as many a cynical ED doctor has been known to remark, not even then). The bottom line is that board certification in a specialty takes many years of work, meaning that the overwhelming majority of doctors have one, or rarely two, specialties. And in the large, modern medical centers where television dramas are typically set, specialists are expected to be consulted in the matters in which their expertise lies.

As a side note, the principle of specialization goes back to ancient Greece. The Hippocratic Oath forbids doctors from practicing surgery (or, more specifically, removing bladder, kidney and gall stones, the only real surgery that existed at the time), telling them to withdraw in favor of surgeons.

The title of this page is often Truth in Television. Surgeons and family practitioners may indeed be called upon to perform autopsies in smaller communities, especially on patients who died of natural causes, accident, or suicide. In many smaller jurisdictions there is no full-time forensic pathologist: suspicious cases may be sent to the big city (or even out of country - the Ontario medical examiner's office earns a lot of money performing autopsies for Caribbean police forces), but the drunk who wraps his car around a tree might instead be autopsied by the local general practitioner.

A subtrope of Economy Cast. Related to Composite Character, Omnidisciplinary Scientist, and New Powers as the Plot Demands. When this trope is taken to ludicrous extremes, it becomes Open-Heart Dentistry.

Examples of Surgeons Can Do Autopsies If They Want include:

Live Action TV

  • Most doctors on the various incarnations of Star Trek have this going on. You'd think the position of Chief Medical Officer on a massive, multispecies starship would be a largely administrative job that mostly involved delegating tasks to various specialists. Instead, CMOs in Starfleet usually seem to personally handle every possible medical complaint, from critical surgeries on members of obscure species right down to minor injuries, stress headaches and childbirths.
    • It's justified, however, in the case of the Emergency Medical Hologram from Voyager; he's only used when there's no other medical staff available, and as an artificial intelligence, it's reasonable to think he would be programmed with all the Federation's medical knowledge at his disposal.
    • It might also be considered justified for Bashir from DS9, who was genetically engineered to be super-intelligent, although it's not clear whether he's that smart. On the other hand, the fact that he's genetically engineered is supposed to be a closely kept secret...
  • Partially justified on Babylon 5; Dr. Franklin was hired specifically because he's good at nearly everything instead of having a narrow specialty, and he's stated to have a large support staff and do a lot of delegating—but what you actually see of his job mostly still looks like he's handling everything personally, even when it comes to alien species.
  • Numerous episodes of Grey's Anatomy have general surgeons sent to work shifts in "the Pit" [the ED], although they occasionally call in specialists for help. Very slightly justified by these being interns who allegedly mostly do diagnostics and sutures, but still...
  • In many episodes of House, the protagonists (non-surgeons all) are shown performing invasive surgical procedures (for example, a brain biopsy).
    • They also all seem to be radiologists, phlebotomists and lab techs. (While all of these things might be done by ordinary doctors in Real Life occasionally, that's only when there's no specialist available. There's rarely any reason that would be the case on House.)
    • On at least one occasion in season six, Foreman did an autopsy as well.
    • In the later seasons, Chase sticks to surgery and Cameron sticks to the ER...which is still problematic, actually: Chase performs a ridiculously wide variety of surgeries, and Cameron's specialty is immunology, not emergency medicine.
    • Averted in one episode when a disease is striking newborns. The couple calls the obstetrician who delivered the baby to come look; he informs them that he'll do it this time, but next time they need to call the pediatrician, as an obstetrician specializes in pregnancy and delivery. Some obstetricians also practice pediatrics, but most obstetricians who have a second specialty also practice gynecology (for reasons which should be obvious).
  • Scrubs tends to have a better track record with this one. As the series progresses, the characters all choose their specializations and then tend to stick to them.
    • This is especially true for the surgery/medical split. It's made quite clear that J.D., Elliot, and Cox couldn't perform surgery if their lives depended on it and Turk (as shown in one episode where he is temporarily turfed to medical as a resident after breaking his wrist) has (comparatively) very little knowledge of medical conditions and procedures.
  • At one point on NCIS, the Forensic Examiner, Ducky, does surgery...on a dog. In this case the dog's life hung in the balance and wouldn't have survived if they'd taken the time to find an actual vet, and the dog ended up solving the mystery for them.
  • Justified in M*A*S*H. They try to call in experts whenever possible, but that obviously doesn't always work, what with being located within spitting distance of the Korean front. This leads to surgeons doubling as vets, psychiatrists performing surgery, priests performing tracheotomies, and once pretty much the entire non-medical population of the unit muddling their way through nursing duties when the women were evacuated.
  • Body of Proof, a noted neurosurgeon manages to do become a pathologist practically overnight.
  • Despite being the ship's trauma surgeon, Simon Tam performs an autopsy in one episode of Firefly. Or rather, he tries to, but the patient is actually alive. He does mention earlier in the series that he has handled corpses before, so this presumably includes autopsies.
    • Or, y'know, basic medical training, where students practice on donated cadavers.
  • Inverted in Crossing Jordan, where coroner Doctor Macy is almost forced into performing a sick surgical procedure on a captive boy by a psycho, despite vehemently claiming he can't do it, at least not well.
  • Scully from The X-Files - ironically, her specialty is autopsy, but she does a lot of other medical areas when the plot demands so.
  • Averted in CSI: NY-Hawkes was a doctor/surgeon, but he later became a trained pathologist,making him qualified to do autopsies. (although after his departure to the field, Sid Hammerbeck handled them.)


Literature

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