Surgeons Can Do Autopsies If They Want
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
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- Doctor Mid-Nite of the Justice Society of America is frequently portrayed as being the only actual physician in the DC superhero community, and as such he did everything from fix broken limbs to doing the autopsy on Sue Dibny in Identity Crisis.
- Similarly, because The Mighty Thor has Dr. Donald Blake as his alternate identity (sometimes), Blake is called in to do all sorts of medical things, including rebuilding Iron Man's mind and being the general physician for Broxton.
- Lampshaded at one point in the Dresden Files: when the mortician Butters has to do surgery to remove a bullet, he explicitly points out that he wasn't trained for this.
- In Death Star, conscripted surgeon Uli Divini is called on to perform routine checkups. He's not happy about it - he's a surgeon, not an internal meds doctor! — but he's fully capable.
- Pocket in the Sea:
- Jensen does autopsies and even dentistry. This is justified by the fact that he's the CMO on a Submarine of 80 men — he has to be able to do it all.
- Later in the book he appears to take over as a recovery nurse as well. However, he's shown to be overprotective of the men he views as 'his' so he may have pushed the actual recovery nurse out of the picture.
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...
- A reason for that behavior might be that the Chief Medical Officer is the most experienced or the most trained member of the team. Being the CMO might mean being on-call 24/7, even with other specialists to handle diseases and minor issues. Plus, in the original Star Trek McCoy was one of two named doctors and several nurses - perhaps the chief medical officer is the doctor in charge over lab techs, interns, residents, nurses, and other medical staff.
- 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. This gets Deconstructed eventually when it's shown he takes on more than his fair share of the workload, and it leads to him becoming addicted to stims.
- 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... Grey's plays this trope so straight that you often wonder if there are non-surgeon doctors in that hospital. To the point where the Chief of Surgery is the boss of the entire hospital and the board only deals with problems relating to the surgical department. Seattle Grace Mercy West Grey Sloan Memorial has also never had an ER doctor or an internal medicine specialist on staff since surgeons do all that work. One might wonder how small the hospital really is since it seems to have only one attending per specialty and each doctor only deals with one patient at a time, often for several days.
- In many episodes, 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. Even the line between medicine and psychology is not safe. In the episode "One Day, One Room" House asks members of his team for advice on how to deal with a rape victim. Instead of, you know, asking an actual therapist about that.
- 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 good 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. Also, Ducky assisted his assistant Jimmy Palmer, who did spend time working in a vet and knew how to do surgery on a dog.
- Justified in Mash. 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 the non-medical population of the unit muddling their way through nursing duties when the women were evacuated.
- Body of Proof, a neurosurgeon becomes a pathologist practically overnight.
- Firefly: Simon Tam trained to be a trauma surgeon. However, in an early episode, he makes it clear he's used to handling dead bodies and in a later episode states he can perform autopsies. As the only medically trained professional on Serenity, he has to perform ad hoc medicine by circumstance which gave the writers an excuse to give him any medical skills the plot demanded. Somewhat justified in that he's "Gifted" and can thus be expected to pick up things quickly, especially in medical skills.
- Crossing Jordan:
- Inverted when 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.
- Played straight in another episode when two of the coroners had to fix a punctured lung in the autopsy room on a teenage girl. Justified as there was a massive riot going on in Boston at the time, and even if the ambulance crew was able to get to the ME office it would be far too late.
- 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.)
- Averted on regular CSI with Langston, who often ended up helping Doc Robbins in autopsy. He, too was a pathologist.
- Justified on Battlestar Galactica: Doc Cottle is perhaps the last doctor in the universe until we learn there's also a neurologist in the fleet late in Season 4.
- A favorite Soap Opera trope, where doctors are seen to be doing just about everything. An especially bad example on One Life to Live, where throughout his time on the show, Dr. Larry Wolek was seen practicing as as an internist, a cardiologist, an ob/gyn, a pediatrician, a neonatologist, an oncologist, and yes, a coroner.
- This has been mostly averted on General Hospital, where the doctors' specialties have been specified—cardiology, internal medicine, pediatrics, neurosurgery—and stuck with. That said, there have still been some slip-ups—the legendary Steve Hardy was seen practicing various types of medicine, and despite the fact that most nurses specialize as well, they too are seen doing various things as well.
- ER of all shows fell victim to this. One of it's signature episodes, "Love's Labor Lost" had ER residents Mark and Susan grossly mishandling a routine delivery (possibly deconstructing this trope, as it's possible that the very reason they screwed up was because they didn't have the necessary ob/gyn experience). This gets a callback when surgeon Benton panics when a woman goes into labor, "I haven't delivered a baby since medical school!" But even though many surgeons sub-specialize, he and fellow surgeon Elizabeth are seen doing things that range from cardiac surgery to abdominal, to neurosurgery, etc. Additionally, ER chief Kerry had OB/GYN nurse Abby abruptly reassigned to the ER. Aside from the fact that Kerry would have no authority whatsoever to do this, even if this were something Abby wanted—she vehemently objected before being told she had no choice—an OB nurse would have been out of her element in the ER. This is especially glaring in light of the fact that during the show's early years, a major storyline involved the ER nurses being sent to departments that they weren't trained for.
- In the Heat of the Night: The local doctor was frequently seen practicing all types of medicine—in the midst of performing an autopsy on a woman, he mentions having delivered her two children and having been the family doctor. Though this might be justified as (a) given the doctor's age, he probably became a doctor in an era where doctors did practice all types of medicine, and (b) Sparta is a small town unlikely to be teeming with medical specialists.
- Hannibal may have the strangest, as CSIs who are stated to specialize in latent fingerprints and fiber analysis respectively have not only been seen performing autopsies, but also tracing cell phone calls. They do it all!
- Elementary has former surgeon Joan Watson performing autopsies from time to time. First time, it was because Sherlock Holmes attempted an autopsy, was going about it the wrong way, and Joan's exasperation got the better of her and she stepped in. In the later cases, she's performing them of her own accord.
- In The Glades, Carlos is always at pains to point out that he is the chief medical examiner for the FDLE. However, this does not stop him being posted to a hospital to perform emergency medicine during a hurricane in "A Perfect Storm".
- Averted in Umineko no Naku Koro ni where doctor Nanjo says that he isn't trained in doing autopsies and is only able to state basic things about the murder victims.
- Subverted in Trauma Center: New Blood. When the heroes have to do a surgery on a dog...they have no idea how to do it, and all they can do is INCREDIBLY basic stuff.
- As you might expect from a game called Theme Hospital your doctors can do everything. Although there is some lip service to the specialists as they will need to learn titles (such as surgeon) but it only takes ~10mins in a classroom to gain these.
- An adaptation of Murder on the Orient Express has an interesting variant - Veterinarians Can Do Autopsies if they want. Although this is justified - Dr Konstantine originally trained to become a doctor of humans but then his family went into hard financial straits. The only way he could finish his training and paying off the debts was by becoming a vet. Note, however, that since he was originally trained to treat humans that his autopsy is still valid.
- Dr. Julius Hibbert on The Simpsons is an example of this. Over the show's 20-plus-year history, he has been portrayed as a general practitioner, hospitalist, cardiologist, orthopedic surgeon, neurosurgeon, OB-GYN, pediatrician, radiologist, anesthesiologist, and psychiatrist, amongst other specialties, as well as being proprietor of the local HMO.
- Dr. Nick Riviera also fits this trope. Although since he is supposed to be a quack doctor, showing him performing procedures that he is severely unqualified for is usually intentionally Played for Laughs.
- Dr. Hartman on Family Guy is not only a family doctor, he does sex change operations, leg transplants, and plastic surgery among other things.