Oil Field Engineer Case

[liselin@planetx.bloomu.edu (Louis H Iselin)]

The following is a message from the Occupational Health Physician who posted 
the original request for information in this case.  I asked him for permission 
to post this to RadSafe as it is a clear reminder that MDs don't operate in 
the same fashion as HPs.

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    Thank you for forwarding your comments regarding the cased-
hole logging engineer.
    I must confess that I have discovered the two edged sword of the 
Internet.  On the one hand, I have received invaluable insight into 
how an industry operates that I really don't think I could have found 
in any other way.  I couldn't even spell the isotopes used correctly! 
You and others have pointed out important considerations (the 
dosimeter, whether or not the isotopes were sealed) that I simply did 
not think of and probably never would have.
    However, I have new found appreciation for the perils of an 
unregulated forum like the Internet.  I am sure my post has been read 
by several thousand individuals by now.  The initial (and intended) 
readership was a medical one.  A medical audience is used to a case 
presentation like the one I gave.
    Part of a case presentation is the patient's history of his or 
her illness.  A common mistake that physicians make is not to 
record verbatim key parts of the patients history, often because it 
doesn't look professional.  For example if a man tells his doctor he 
felt "like the floor was moving" then that is what the physician 
should record (not that the man says he has vertigo which has a very 
precise medical meaning).  The man may indeed be experiencing vertigo 
but in a case presentation you present the history as close to what 
the patient told you as possible even if some of terms sound silly.    
    A medical audience is used to case presentations.  So when they 
read my post, they listened to the history with appropriate 
scepticism.  They realized that the story I was giving was what was 
related to me by the patient.  I myself drew no conclusion and simply 
acted to relay the information given to me as objectively as possible.
I certainly want to reiterate that I have never said this man's 
cancer was attributable to his work in this industry and made no 
comments on the pratices of the industry generally.
    Normally, the last two parts of the medical history are 
"Impression" and "Plan".  It is considered poor practice to include 
any sort of opinion or interpretation of the patients history, 
physical or investigations until you reach your impression.  You just 
describe until that point.
     The reason I go to such lengths to explain this is because many
seem to have misconstrued my post.It was a description of one patient's
problem together with how he described the work he performed. Nothing
more.
  Judging by the responses from several different people that I have
received I feel comfortable in saying that cased-hole engineers seem
to be generally extremely safety conscious and indeed very proud of
their work.
   Do I believe this man's story?  He has a terminal cancer, can't find
work, has two young sons and is seeking compensation.  He certainly
would have a motive to exaggerate his practices.  This is a problem we
face frequently in medicine, especially as you can imagine in my line of
work (Occupational Medicine).  I'll search the library, speak to many
people, seek corroboration of his story, and follow the leads that you
have provided.  In the end I'll come to an opinion, which will be mine
alone and, no matter what I decide, will make me enemies.
    Anyway, thanks for the reply and here ends the lecture.
Chris

Christopher Martin
Resident,Occupational Health Program
University of Alberta
Edmonton, Alberta
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_____________________________________________________________________
Louis H. Iselin, Ph.D.           * Go Gators! *                   <*>
Assistant Professor of Physics (Health Physics Program)
Bloomsburg University of Pennsylvania              liselin@bloomu.edu
Bloomsburg PA  17815-1399                             lhi@poboxes.com