Casualty, Morquio syndrome and incest

A couple consisting of a young white man and an older white woman in a hospital bed. Yet again, Casualty gets the medical facts wrong in one of their plotlines. This time the condition involved was Morquio syndrome (pronounced Morkio), a genetic disorder which results in dwarfism, spinal defects and visual impairment. The condition is recessive and both parents have to carry the gene for the child to have the condition, but Casualty extrapolated from that to imply that the parents were usually related, and in this story the parents turned out to be brother and sister and not know it. (More: Normal Plus Wheelchair, written by someone with Morquio which gives far more detail than I have.)

The story was that a couple was caught in a car accident with their son, and suffered a couple of broken bones each (the accident was caused by a drunk driver, a footballer who had just forcibly ejected his girlfriend from his car, then drove back and crashed when he saw an ambulance tending to her; he suffered a spinal cord injury which was exacerbated by his refusal to have his neck immobilised). A young doctor noticed some symptoms of Morquio’s syndrome on the child, including clouding of the cornea, and told his colleague that in every case he had seen, the parents were related and thus they would have to break the news very carefully. When they told the couple that both parents had to have the gene for the child to have Morquio’s, both of the parents were offended, as if that fact automatically meant that they must be somehow related, something that they had no reason to think was the case as they came from different parts of the country. However, further inquiries revealed that the couple were in fact brother and sister.

A young white boy with ginger hair, who supposedly has Morquio's syndrome, taking a football from a man (off the picture to the right)Although conditions inherited this way (called autosomal recessive traits) are more common in children of consanguineous marriages, such as between cousins (and a couple from the same village may well be distant cousins — rarely first or second cousins in this country, although such marriages are fairly common among South Asians), they do in fact occur in families in which there is no known relationship and Morquio’s occurs in children from families with no known history of it — the coming together of two carriers of the trait was a coincidence beyond their control. The suggestion that the condition must be to do with inbreeding is obviously hurtful to families of children with Morquio’s (and adults with it) and exposes families and children to false assumptions and bullying. I also found it extremely odd that everyone assumed that the son’s condition meant that the parents had to be closely related, rather than the more likely scenarios of coincidence or them merely being distant cousins, and staff began to think up ways in which a brother and sister could become a couple.

Casualty and Holby City have a history of playing fast and loose with medical facts — I have been following both for several years and have noticed two storylines during that time which contain serious errors about the facts of a condition which could be offensive to people affected by it. (Previous examples were the guy who apparently had ME but beat his wife, and the girl with the skin disorder Epidermolysis Bullosa who was offered a bone-marrow transplant as an apparent cure, which is in fact an early experimental treatment for a different form of EB to hers.) I complained about the ME story, and was given the excuse that “drama productions … aren’t always best served by meticulous attention to detail and accuracy”. Surely they could afford the services of some sort of medical expert they could run stories by to make sure they don’t make glaring errors with medical facts?

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