The Top 5 Ways 90's Simpsons Helped Shape My Medical Practice

The Simpsons television show debuted on the 17th of December, in 1989.

My childhood from beginning to end, just about, had every single Sunday evening spent at church -- this was in addition to Sunday morning, and Wednesday and often Friday nights and sometimes Saturdays. Sunday nights we would usually be home before 8 pm and would, like most other nights, watch television as a family.

The Simpsons very first episode was a Christmas episode and is where Santa's Little Helper -- a (presumably) a greyhound race dog is adopted by the family after they lose all their Christmas money on said dog.

While I could run through all the episodes and regale everyone with my favorite parts and aspects but I'm only going to do that with a very select few instances.

Through the teenage years, there were many influences from pop-culture -- how many remember the years where teenage boys across the land would speak in the cadence and vernacular of the venerable Beavis and Butthead.

Years of this echoing in the hallways of every high school in America. It was quite the time to be alive.

In my early teen years I began to forsake much of the popular culture and the zeitgeist of the skateboarding world had my circle of friends and I focused on less widely known cultural influences.

I've written of this before but I did not have the slightest notion of being a doctor until my mid-20's, but undoubtedly my perspective of what it means to be a doctor is and was shaped by the Simpsons.

I've come to learn that I do well with some background noise while focusing on any given task. Some call it ADHD driven, some say it is because I grew up with the TV on from morning to night, well, I may be the only one that says this, but whatever, I am what I am.

And what I am is a person who often has the Simpsons playing softly in the background of when I'm working (not at work, but working at home) and often fall asleep to it playing in the background, again, softly, but it is, at this point just a comforting process I'm accustomed to.

Here are the top 5 ways the Simpsons has influenced my medical practice.

• Number 5

Dr Julius Michael Hibbert, MD first appeared on an earlier episode than the clip above and it was from (Bart the Daredevil, S2E8, for those who care) and has consistently remained a part of the television show since. I've always loved the line where he apologizes for making Homer wait so he now only has 22 hours to live, vs the 24 he had from when he ate the blowfish.

I've worked with doctors who regularly run hours late. Hours. Things come up, and life happens -- sometimes a patient needs more time and attention that a visit allows for, and sometimes that attention cannot wait for a follow-up appointment.

Sometimes a patient is running late -- and this is often the reason why I am running late. So how does one work to mitigate this? Expectations is a large part of this -- most patients know that doctors run on strict schedules; some perhaps, just don't care. Knowing that being 20 minutes late for a 15 minute appointment, will usually result in a reschedule is key. I really struggle with this aspect of my job, in that it affords very little flexibility in this manner.

Having a "late" policy is brutal -- I understand that patients (me included) have waited for our appointments in the past. Sometimes, for significant amounts of time. Some doctors just operate in this fashion every day. I can't and won't do this, so, I may run on the harsher side of enforcing a "late" policy but it is in efforts to keep those that did arrive on time, leaving on time, as well.

The 5th most impactful way the Simpsons have influence my medical practice is by me fighting to have patients wait as little as possible for their appointment. I want my patients to get as much of the 24-hours post blowfish ingestion as possible.

• Number 5

Is this not one of your favorite pieces of television ever? There is so much to unpack in this episode at large -- in the video clip we see Homer undergoing medical experiments to make extra money (which I did as well in medical school) and then, they find a crayon has been smashed into his brain. They remove it and he becomes much more intelligent, and because of this, he is able to have a meaningful relationship with his daughter Lisa in a manner unavailable to him when he is with crayon.

In a heartbreaking move, at the end of the episode, Homer puts the crayon back into his brain as he struggles with the isolation and ostracization, amongst other presumed afflictions, that came with his sudden increase in intelligence. Much could be written about this alone. Novels and whole philosophic machinations have been based on this idea -- to know is to suffer.

The tree of the knowledge of good and evil -- the famous tree in the Garden of Eden from which Adam and Eve were forbidden to partake from, because partaking would mean certain death. In other words -- to know is to die which is to suffer.

Dr Hibbert makes an appearance, briefly explaining that because he always held the XR films the same way, his finger blocked out the crayon in previous imaging studies. Much could be extrapolated from this that works as a metaphor for outdated medical protocols, or, doing something, simply because this was the way it has always been done. Danger zone.

The 4th most impactful way the Simpsons has impacted my medical practice is by recognizing that my knowledge of the disease process, dying and just general suffering is an issue and burden if not properly digested. Being a doctor can be quite lonely, and not only for the reasons as above. There is something to be said, as well, about the idea that Homer's bafoonery is due to a brain injury -- this blog post has a take that speaks to considerations with those who are, indeed, wont to act as a bafoon.

• Number 3

The MA (medical assistant) I usually work with has experience, in his younger years, working at a children's hospital. While I don't have a parade of children all day coming through the clinic, we do have many times where we are administering vaccines to children.

There are many approaches on how best to give a child a vaccine -- and this generally doesn't have much bearing on how loudly the child may scream or how fiercely they may fight back. If only we were regularly trying to manifest "terror sweat" for any good reason -- many children will have provided an ample amount before the visit is over.

The 3rd most impactful way the Simpsons has impacted my medical practice, is by providing a low-key private joke (that is, it exists in my mind only) that when I hear the child screaming in the room (that's right -- I generally don't actually give the vaccines!) I chuckle to myself and think -- 'if only we needed a supply of terror sweat!' But, we usually don't need any.

• Number 2

Three Stooges Syndrome -- first described in S11E12 where it was found that Mr Burns has all the diseases in the known world (and a few newly discovered in him) and they are all acting in perfect balance allowing Mr Burns to live.

At one point Mr Burns tells the doctors that he wants all the tests done.

On a regular basis, I get a request to do just that -- order all the tests.

This will often spark a discussion about what should be done and is paid for, what could be done, and isn't paid for and then, perhaps the most contentious -- what I don't think needs to be done and why it won't be paid for.

One of the things I really enjoy with my current position and location of my practice is that I have patients from all over the world. The big tech companies have a workforce that comes and goes on a regular basis -- people come and stay for a number of years and often move back home and some stay and settle down here.

Patients who have recently moved from Taiwan and South Korea are accustomed to annual preventative exams where every test, just about, is actually ordered. Patients who are coming from India are often used to paying for a variety of tests, such as MRI and cardiac stress tests for a tiny fraction of the cost of the same testing here in the states. I am often in the role of introducing people to American Healthcare. I feel as if I need to prepare them for some of the major frustrations that often arise. Wait times. Surprise bills. Insurance denials. Truncated visit times. Late policies. Did I mention the cost of care? I feel as if I'm preparing them for disappointment and hardship whenever they are engaging the healthcare system in the US.

The 2nd most impactful way the Simpsons have influenced my medical practice is by being able to warn patients about "Three Stooges Syndrome (TSS)" and inform them that we don't want to upset the balance of all the diseases trying to make it through the door at the same time. That we need to work to not upset this balance and the full body MRI may only have us endure a flare of TSS.

• Number 1

There is not a doctor, clinic or hospital involved with this clip. There is simply the fact that our health (and in this case, dental) insurance is tied to our employment. The same big tech companies mentioned above, have all gone through some layoffs this year, and some continue to do so. In my short three plus years at my current position, I've had more patients coming to me with their insurance coverage ending at the end of the given month because they have been "downsized." Follow up plans must be shaped with this in mind; long term approaches, such as rehabilitation, appropriate repeat labs, medication checks, blood pressure checks, q3 monthly controlled substance visits -- all of these become very difficult to do, due to financial considerations. Many of these people have children and they too are losing their insurance coverage.

When we look back at the dawn of modern medical insurance, the country was a vastly different landscape. Careers were lifelong affairs. Companies provided pensions (for those under 60 years of age -- a pension is a fund into which amounts are paid regularly during the individual's working career, and from which periodic payments are made to support the person's retirement from work. Imagine that -- a company running a service like this for it's workers. Now, it is more likely for a worker to have such a low wage and insufficient medical coverage that they need food stamps and medicaid -- effectively shifting the burden of our nation's well being to the greater public. Profits are privatized and liabilities, expenses and losses are public.

The most impactful way the Simpsons has impacted my medical practice is seeing, with crystal clear clarity that the private insurance companies (some call them 'payers,' I refer to them as 'takers') are ruled by the spirit of Mammon and the wolves (or, since this is a Simpsons tribute post, the hounds) have been released upon our heads and we are due for a revolution in how we, as a society, take care of ourselves and each other.

Lastly, I think my political philosophy could be summed up by the following, which is a rare moment of insight from Homer himself -- here he is spitting some real truth:

You've made it to the bonus material part of the post -- congratulations!

I had a hard time believing that I didn't choose even one of the Dr Nick (Hollywood Upstairs Medical School alum) and I couldn't just let that go unaddressed. Here are some of my favorite Dr Nick clips.