When doctors get called on the carpet by other doctors, it's productive but not always pretty, as neurosurgeon Sanjay Gupta describes it.
Closed-door meetings in which physicians candidly dissect cases that went awry can verge on "dignified versions of street fights," said CNN's globe-trotting correspondent.
He drew on such sessions — commonplace for hospitals, if little publicly known — for his first novel, "Monday Mornings," and is a writer-producer on a new TNT series based on the 2012 book.
The drama, from veteran producer David E. Kelley ("Boston Legal," ''The Practice") and with a heavyweight cast that includes Ving Rhames, Alfred Molina and Bill Irwin, debuts today (10 p.m. EST). That's also the day the show's fictional Chelsea General Hospital holds its weekly reviews.
In the real world, such meetings to scrutinize complications and mistakes in patient care can lead to new guidelines, Gupta said.
"They can be simple, like never sedate a patient until they're strapped in on the table," he said, the outcome of an unrestrained patient having taken a tumble. "Some changes are big, some are small, but they are always important. We are always redefining medicine."
In the first episode of "Monday Mornings," brash but dedicated neurosurgeon Dr. Tyler Wilson (Jamie Bamber, "Battlestar Galactica") is grilled for failing to check a patient's medical history. Gupta said he learned his own "searing" lesson, about carefully reviewing lab results, without any harm to the patient.
Do the forums ever become a stage for office politics?
"People do jockey for position in these situations," Gupta replied. "If someone's at the lectern (under scrutiny), anyone can ask questions, not just the chairperson of the department. So the nature and tone of it can change pretty quickly."
The most disturbing inquiries involve an apparently reckless M.D. with "a disregard for the person on the operating table or in the hospital," he said. "You can imagine your own mother or loved in the position of the patient, and those are the most indelible ones of all."
The meetings make for gripping drama on "Monday Mornings." But is a show that focuses on medicine's failures as well as its triumphs potentially a hard sell for audiences?
"ER," TV's once-reigning hospital drama, aired a powerful first-season episode in which decisions by Dr. Mark Greene, the caring, steady lead character played by Anthony Edwards, cost a pregnant woman her life. The story line was a rarity on the show that routinely focused on medical heroics.
The key to making the TNT series work is the "likability" of its physicians, said Bill D'Elia, a producer on "Monday Mornings."