The poor people of the American Society of Anesthesiologists. They were just minding their own business when suddenly they had to weigh in on the drama of "The Real Housewives of Beverly Hills."
The brief backstory: Annemarie Wiley, a certified registered nurse anesthetist, joined the cast this season. She's one of several Bravo stars in the medical field (there's even a show called "Married to Medicine"). Over recent episodes, Wiley has questioned a fellow cast member's diagnosis with an esophageal disorder, insinuating she may actually have an eating disorder. In these conversations, Wiley has invoked her medical knowledge, saying at one point in a confessional, "as a nurse anesthetist, I'm, like, what she's saying as stated just doesn't make sense. Period." One cast member even claimed that Wiley introduced herself as a doctor rather than a CRNA when they first met.
It's all very dramatic, and the American Society of Anesthesiologists apparently felt compelled to publish an Instagram post comparing the education that anesthesiologists receive with that of nurse anesthetists. Now Wiley seems to be at war with the association and with two Bravo stars who are practicing physicians — one of whom, Nicole Martin, is actually an anesthesiologist in Miami. I assume this is the first time that the American Society of Anesthesiologists has made the New York Post's Page Six with a headline involving the word "slams."
Why am I telling you this? As a Bravo fan, it's been exciting for me to see a new kind of argument play out on shows that are getting a little tired.
More importantly: This storyline speaks to a topic First Opinion and STAT have covered: the challenges to the medical hierarchy. One of my favorite essays of 2023 argued that no patient should call their provider "doctor." I am fascinated by the vitriol on the Reddit sub r/noctor, where physicians discuss "midlevels (NP, PA, CRNA, CNM, etc.) who pretend to be doctors." The sub — basically a forum — even has a highlighted post about the storyline.
I love it when the debates we cover on First Opinion end up in unexpected places. So, consider this a plea: If you see a discussion about your area of expertise playing out in a TV show, movie, podcast, any cultural phenomena that surprises you, please let me know. Maybe we can turn it into a great First Opinion. And if you're an anesthesiologist or CRNA with Thoughts (with a capital T) on "The Real Housewives of Beverly Hills," let's talk immediately, before this storyline is put to sleep.
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This week on First Opinion: I can't say enough good things about James Sulzer's incredibly touching and persuasive essay. When his daughter was almost 4 years old, she suffered an injury that changed their family forever. Sulzer, as he writes, had spent two decades working in rehabilitation research. "But as we struggled to help Livie to recover from her injury, my professional background turned out to be less of a boon than I had expected. In the end, the whole ordeal was more revealing of my academic field than vice-versa: It showed me that rehabilitation engineering was, and is, utterly unaware of the real problems of families affected by neurological injury," he writes. It's a must-read.
Ben Hoffman, president of the American Academy of Pediatrics, writes that Congress must pass an expanded child tax credit for the sake of kids' health. Why defunding liberal arts education for undergraduates is a threat to medicine. The Apgar score needs an update. Patients should keep getting physical printouts of prescription information. New Jersey is now a state leader in reforming prior authorization. And it's time for the FDA and FTC to team up to crack down on social media influencers pitching prescription drugs.
Recommendation of the week: More than a week after reading "The Women Who Walked Away," from New York magazine's Elizabeth Weil, I'm still thinking about it. It's a deeply troubling story about two sisters who, after falling down conspiracy theory rabbit holes, decided to live off-grid without the proper equipment or skills. One of the sisters brought her teenage son with them. The article touches on themes of mental illness, social isolation, Covid misinformation, and so much more.
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