Re: No sternum

["Gibbs, S Julian" <s.julian.gibbs@vanderbilt.edu>]

I would be the last to defend poor medical practice, which 

obviously goes on.  However, in the case cited, the patient's 

problems are common complications from appropriate treatment. 

Unfortunately, medicine is not exact.  Biological variation is 

everywhere, and the precise response for a given patient to a given 

treatment, unfortunately, is variable.  The physician frequently 

must deal with a very thin line between inadequate treatment, which 

allows disease to progress or recur, and overtreatment, which 

results in complications.  He must deal with probabilities.  For 

example, the best known treatment for some cancers allows a 

recurrence rate of about 10% and a serious complication rate of 

5%--all from the same treatment.  If the patient treatment (dose) 

is reduced slightly, complications disappear but recurrence rate 

skyrockets.  Conversely, if the dose is increased slightly, 

recurrence rate is reduced but not eliminated, and complications 

skyrocket.

I think the major problem in this area is inadequate information to 

the patient, so that an intelligent choice of treatment can be 

made.  Sometimes that is no treatment.



--On Sunday, November 02, 2003 5:33 PM -0800 Ted de Castro 

<tdc@xrayted.com> wrote:



>

>

> "Gibbs, S J" wrote:

>>

>> RADSAFErs:

>> There may have been an injury to the sternum related to previous

>> medical treatment.  However, before placing any blame, please

>> remember that the patient is still alive after at least two

>> potentially fatal diseases.  I don't like to sound crude, but an

>> intact sternum would be of little benefit six feet underground.

>

>

> With all due respect - that argument is used to excuse all sorts

> of malpractice!  It just doesn't wash.

>

> My sister is nearly blind due to errant treatment in an OR - to

> the extend that the hospital has even modified records to cover

> it up and most recently my mother was being treated by a most

> arrogant doctor who made her last two weeks a time of suffrage

> instead of a time of comfort because he wanted to either play god

> - or couldn't stand to be corrected by a woman/nurse (my sister)

> and coerced her into futile chemo torture.

>

> In the first case my sister survived the OR experience - but is

> now nearly blind - my mother had little time left - her cancer

> was first discovered after it had fully metastasized to the lungs

> and pleural cavity and was discovered when large quantities of

> fluid had to be drained from both areas.  She wanted dignity and

> didn't want tubes etc.  She got exactly what she didn't want.  My

> sister called the prognosis exactly - but the doctor didn't

> tolerate that when and galvanized his position to my mothers

> discomfort - and turned her against my sister and that was not

> resolved before her death.  In fact - my sister's prognosis not

> only made total sense and was supported by the literature - but it

> also turned out to be very right on.







***********************************************************

S. Julian Gibbs, DDS, PhD              Office: 615-322-1477

Professor, Emeritus

Dept. of Radiology & Radiological Sciences

Vanderbilt University Medical Center     Home: 615-356-3615

209 Oxford House        Email:s.julian.gibbs@vanderbilt.edu

Nashville TN 37232-4245     or alias:j.gibbs@vanderbilt.edu

***********************************************************

Committee: A group of the unwilling, picked from the unfit,

to do the unnecessary.

                                --Richard Harkness

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