Adelle Coffin

Comments on Nip/Tuck Season 1, Adelle Coffin

Remember in the episode, Megan O’Hara when Dr. Christian Troy said he had to get his life back on track and stop sleeping with his patients? Who could forget? Well, he had another Zen moment this week when he said, “I’m going to pass the recertification; I’m going to work harder, and be less complacent; and, I’m going to apply myself and not coast by anymore on ‘slick.'” That’s what they all say. Anyway, that’s what he’s learned about himself. Well, here we are, episode 10, and what have we learned about the man? He wears Gucci briefs. Check. He wears Gucci suits. Check. He sports a Rolex. Check. He’s obsessed with Lamborghinis. Check. He’s addicted to sex. Check. What else? Oh, yeah, we know now that he was also in the bottom 10% of his class. Check please! And, he doesn’t know much about Microvascular Surgery. I’m going to call this episode…

THE FINGER.

I know it’s out of character, but believe it or not, Dr. Troy gave someone the finger – a plumber who had lost several digits to a garbage disposal. Hey, who hasn’t given a plumber the finger? I don’t have to tell you – the viewer of such a high-quality, reality-based television show as nip/tuck – but if Dr. Troy’s reattaching digits, he’s obviously trained in the aforementioned Microvascular Surgery. Believe it or not, he isn’t, as evidenced by the fact that Dr. McNamara had to take over after Christian refused to admit that he gave the man the wrong finger (interchanged the index and middle fingers). The error was staring him right in the face! Maybe he’s used to it.

Maybe we ought to cut Dr. Troy some slack. After all, he was nervous about having to perform a facelift (rhytidectomy) on a cadaver’s head for his 10-year recertification. I don’t know why he’s so worried. I mean, while recertification is a requirement for a board certified plastic surgeon, performing plastic surgery on a cadaver isn’t. Oh, wait, that’s right… he’s a character on a television show; he isn’t real… and neither is requirement that a doctor perform surgery on a cadaver’s head for recertification.

The American Board of Plastic Surgery (ABPS) exists to “promote safe, ethical, efficacious plastic surgery”… just like the kind you can see in these actual videos of plastic surgery. So, yes, there is indeed a recertification process for those surgeons certified in 1995 or later who wish to maintain their certification. Known today as maintenance of certification (MOC), here’s how it works… in the real world:

• Requirements of Professionalism: the surgeon must submit a case list must to the ABPS, as well as a valid license, verification of hospital privileges and recommendation of peers.
• Continuing Medical Education (CME): every three years, the plastic surgeon must choose from one of 20 procedures, evaluate 10 consecutive patient records, enter on a Web site data specific to the procedure, review educational articles on the topic and finally answer questions relating to the articles. During this time, the surgeon is able to assess his/her performance in practice and to compare patterns and outcomes to those of his/her peers.
• Isolated Exam: every ten years, the surgeon must take a computer-administered test consisting of 150 specialty questions and 50 general questions produced in the public domain as question in the Plastic Surgery Educational Foundation (PSEF) In-Service Examinations.

Of course, this process doesn’t make for “must see cable TV,” but it does ensure “safe, ethical, efficacious plastic surgery.”

So, what else happened? Well, Mrs. Grubman – the practice’s number one patient and the only woman Dr. Troy ever slept with but didn’t “sleep with” – was back and she brought her fiancé. He wants a scrotal lift to “spruce up the cousins.” She wants vaginal rejuvenation (vaginoplasty). And, she doesn’t want Dr. Troy’s hands anywhere near her vagina. Not only rich, but smart as well!

See you next time.

Charlie Sheridan

Medical Editor and Consultant