The well-known TV drama, Grey’s Anatomy, is, without a doubt, incredibly successful. Currently, 15 seasons strong, Grey’s Anatomy continues to be one of my favourite binge-worthy shows. The show takes place in a hospital and is about a group of interns and their journeys towards becoming doctors. Grey’s Anatomy is famously known for its drama surrounding the members of the hospital, but also its focus on medicine. Over its 321 episodes some pretty incredible and weird medical cases have emerged. Shows like this are often criticized for their accuracy within their field, especially when very rare and unknown medical procedures, diagnosis and treatments seem to take the spotlight. A specific incident stuck out to me while I was re-watching the series in the third episode of the third season.
In the episode, a young female patient, named Megan, is introduced into the emergency unit. She is covered in bruises and has a large cut on her leg. Initially, the doctors assume she is being abused by her foster parents, but later on in the episode, they discover through a CT scan that she had a large amount of bleeding in her abdomen. Using all the evidence of bruising, scarring and injuries with no complaint of pain from the young patient, they suspected it was more complicated than what they originally thought. They ran a few genetic tests and diagnosed her to have an extremely rare disorder called congenital insensitivity to pain with anhidrosis (CIPA).
CIPA, also known as hereditary sensory and autonomic neuropathy type IV, is a genetic disease, meaning it is created by a mutation in the patients autosomal chromosomes. It is recessive, it must be passed on by both parents to be expressed in the offspring’s’ genome.It results in the inability to sense pain or changes in temperature. This is from the mutation in the NTRK1 gene which is responsible in the coding of proteins necessary in the production of nerve cells (neurons). This mutation results in the death of neurons including sensory neurons that transmit pain temperature, and touch sensations.
Pain is important because it tells us our limit or when something is dangerous. Not being able to have that indicator results in people with CIPA constantly and accidentally hurting themselves, much like the girl in Grey’s Anatomy. Those with CIPA often have to live a careful life and children with the condition are often taught to recognize signs of pain, such as blood and bruising, even when none is felt.
Sweating is the body’s natural cooling agent. By sweating we release some of the heat within our body, lowering the body’s overall temperature. However, those with CIPA are unable to detect temperature making them unable to sweat which can cause the body to overheat and have fevers and seizures. A scene in the episode highlights this, as the girl is asked to place her hand in ice cold water, to see how long she can withstand the freezing temperature. To their surprise she does not take it out until one of the doctors forces her to, claiming she does not feel anything.
Despite the episode only quickly mentioning the use of genetic tests to diagnose Megan, I found the use of biotechnology in medicine incredibly interesting, especially for a rare genetic disorder like CIPA. It allowed me to apply my preliminary knowledge of biotechnology, learned in school, to a real scenario in which involved an astonishing disorder.
Although the show does a good job in presenting some of the symptoms of CIPA, it fails to show some of its other predominantly common symptoms including intellectual disability, emotional instability and some of the very gruesome physical characteristics that can result among people with CIPA. While CIPA is most commonly diagnosed at a young age and typically accompanied with other symptoms, the show somewhat accurately portrayed the disorder. After all, it is just a show meant for entertainment and overall Grey’s Anatomy tries its best to be is medically accurate despite its occasional romanticization of a medical disorder.
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