Doctor injects realism in TV show

When he's not consulting on TV shows, Dr. Irving Danesh treats patients such as Crystal Pichardo in the emergency room of Lawrence General Hospital. (Mark Wilson/Globe Staff)

In between long shifts working amid blood and broken bones at Lawrence General Hospital's emergency room, Dr. Irv Danesh is jet-setting to television film sets, arranging medical props, and teaching actors how to use a stethoscope and perform a basic physical exam.

As a medical consultant for a TV show in development for the USA Network, the 52-year-old New York native uses his knowledge from 25 years of experience in the emergency room to help the writers and producers make the faux medical backdrop and plot lines as close to reality as possible.

Last October, Danesh, the associate director of emergency medicine at Lawrence General, met Hollywood script writer Andrew Lenchewski while attending his sister-in-law's wedding on the West Coast. Lenchewski was writing the script for a medical drama, "Royal Pains," and asked Danesh to help him with some of the medical jargon.

Most television script writers, like Lenchewski, don't know what the standard treatment for a hemophiliac is, what hospital nurses wear in a catheterization lab, or how to perform a pericardial window for a cardiac patient. That's why they hire a behind-the-scenes doctor, like Danesh, to proofread.

"It was an excellent script but the medical stuff needed work," Danesh explained. Over the next six months the two exchanged e-mails, writing and rewriting scenes and tweaking the medical details until they were just right. Danesh called upon cases from his years as an emergency physician at hospitals in Massachusetts and California for ideas to use in different episodes.

The ER at Lawrence General sees 65,000 cases every year. For Danesh, that's a lot of material. He has seen everything from antifreeze poisoning in a 17-month-old to a man whose chest was sliced open with a machete.

Lenchewski was so impressed by his experience that he asked Danesh to help out on the set. During filming at a bankrupt hospital in Brooklyn, the ER doc picked out scrubs, strategically placed fake IVs, and advised makeup artists on the correct skin tone of a patient feeling faint. He even took photos on his iPhone of the Lawrence nurses to show the costumers.

Danesh tried to avoid mistakes like those made in other medicine-based TV shows. For example, in the opening montage of "Scrubs," he says, a chest X-ray is shown upside down, and in most of the popular medical dramas, such as "ER" and "Grey's Anatomy," the on-screen doctors can't even perform a simple physical exam.

According to Danesh, "Royal Pains" draws its stories from real diseases and medical maladies but gives them a twist, much like his own personal favorite TV show, the Fox series "House." However, unlike "House," "Royal Pains" is not your typical hospital-doctor based medical drama.

"When you watch something on TV you want something different," Danesh said.

The show, which is waiting on a decision from USA to determine its future, follows the endeavors of an emergency room doctor who has been thrown out of the hospital for making an ethically questionable decision. After crashing a party in the Hamptons, the young doctor, Hank Lawson, finds work as a concierge doctor, making house calls and catering to the medical needs of the rich and famous.

Lawson, played by Mark Feuerstein, of "What Women Want" and "Good Morning, Miami," has to treat his patients without the comforts of a fully stocked hospital. "He's a little MacGyverish," explained Danesh, referring to the TV character known for using common items to survive desperate situations.

During his time on the set, Danesh has learned a few of TV's behind-the-scenes secrets. Those prescription pills from the fictitious pharmacy are actually Tic Tacs. The needles are fake, but the scalpels are real. And the actors portraying patients suffering from nausea are convincingly regurgitating oatmeal.

Danesh said working on the TV show has made him recognize all the small roles and minor details that work together in the real life emergency room. Having to analyze every small detail on set has given him a greater appreciation for the nurses who take care of those details in the hospital. "Our nursing staff is superb. They take care of stuff I don't have to notice," he said. "Nothing is mundane."

It has also helped him expand his own medical knowledge, he said, by digging through textbooks and medical journals and reading up on treatments and different diseases for cases on the show. "Even with 25 years, you only see so much," Danesh said.

While helping out on set, he snagged an on-screen cameo as a cardiologist during the pilot episode of "Royal Pains." But he says that after his one-line debut, he's decided to stay behind the scenes. In fact, at home in Marblehead, the father of four has just finished writing his own script for a television show loosely based on his own experiences attending medical school in Mexico in the 1980s.

Erin Cahill's e-mail address is ecahill@globe.com.