Dr D Rich

 
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  • in reply to: Debt Rattle March 7 2020 #54929
    Dr D Rich
    Participant

    “we will work aggressively with government to further develop and strengthen all necessary protocols for prevention, for detection and for care”
    Good leadership, soothing words from Carnival Cruise Lines

    in reply to: Debt Rattle March 7 2020 #54926
    Dr D Rich
    Participant

    Dr. D,
    I figured out the apt analogy. No need to thank me.
    You’re the Tenth Man that semi-saved apartheid Israel in Brad Pitt’s World War Z.
    Keep on countering the panic, propaganda and hysteria.

    in reply to: Debt Rattle March 5 2020 #54836
    Dr D Rich
    Participant

    Dr. D
    We can blame Alain Enthoven for this predicament and his personal war on physician/MD autonomous authority. It took 50+ years, but we’ve been reduced to technicians, opportunists capitalizing off the sick, frail and wounded.

    in reply to: Debt Rattle March 5 2020 #54831
    Dr D Rich
    Participant

    So Dr. D, what you’re saying is the statistics for this “new disease” do not correspond to the hyperbole and hysteria. Btw, what follows in no way detractsfm from the fact that each individual’s major illness or death is a catastrophe.
    The con man or alternately the betting man says “let’s just wait and see what happens”.
    Here’s a genuine example of how probability and statistics establish the “rigged” game in medicine, but from the other direction.

    Patient X arrived in specialty clinic with undiagnosed condition of which most humans are familiar that occurs 50 out of 100,000 times in the adult population. The expression of this not-so-uncommon condition in the specialists bodily area of expertise occurs in 2% of cases. The expression of this condition signifies a survival for the patient of 7.9 weeks, yes, as in 1.9 months.
    While counseling the aforementioned patient about the diagnosis, implications and prognosis, a second patient awaits counseling for another previously undiagnosed condition that has already resulted in irreparable sensory loss in the affected organ. This condition occurs in 1 out of 5,000 people.

    So far, what are the chances these two patients, indeed these two unrelated events happened consecutively? Well, it’s crudely the product of the individual chances Or:

    50/100,000 x 2/100 x 1/5,000 = 100/50 billion
    Or
    1 out of 500 million (rarer than winning a qPowerball lottery)

    But the story doesn’t end there. While counseling those first two patients, a very junior hospital administrator interrupts the specialist and informs her that her immediate attention is required elsewhere in the medical center to address a sensory threatening postoperative complication in a patient operated on by two other surgeon’s, a complication that occurs about 1 in 10,000 cases.

    Other than astronomical, what is the chance these 3 unrelated events landed on the same specialists lap at the same time/consecutively? A product of the chances, Or:

    1/500,000,000 x 1/10,000 = 1/5,000,000,000,000

    One out of 5 trillion

    That’s the definition of a rigged game.

    In a master stroke of logic in this scenario, the employer retained the pulmonologist who failed to order a chest CT, the neurologist who never ordered an MRI of the brain, the surgeons who failed to respond to their patient’s postop emergency, and family practitioner chief of the medical staff who failed to fill the call schedule.

    How do you think the leaders of a medical system capable of that recklessness are going to handle a bonafide crisis? They’re going to use marketing slogans, propaganda and political posturing to bamboozle their patients, patrons and general public.

    in reply to: Debt Rattle March 4 2020 #54801
    Dr D Rich
    Participant

    Yeah, decontaminate it like an operating room. You mean like an operating room at Children’s Hospital in Seattle.
    So many of the procedures we go through in a hospital under the probing supervisory eyes of the Joint Commission are just rituals. Ask a nurse how many times handwashing and BLS (basic cardiac life support) “standards” changed over the years.

    in reply to: Debt Rattle March 4 2020 #54780
    Dr D Rich
    Participant

    What good is a home nurse visit when all that profession is interested in today is “leading and managing and policing” physician behavior?
    Do folks genuinely believe the nursing profession still represents the soul of compassion in healthcare?
    Where’s the proof?
    Here comes the warnings and admonishments that a physician better treat the nurses well because they can get you 6 ways from Sunday if you don’t.

    in reply to: Debt Rattle February 29 2020 #54629
    Dr D Rich
    Participant

    “…child-of-alcoholic constant belief in known liars that will stop the system and kill hundredfold more people than the disease.”
    Another exceptionally accurate and insightful observation from Dr. D, but it doesn’t end there. It being the damage done by a veritable army of credulous ‘children-of-alcoholics’. This legion crowds out the clear thinkers almost reflexively. In many cases this Army will subject these nonbelievers (and almost never the alcoholic) to the most horrific abuse and isolation usually accorded heretics in the old church. Eric Berne labels this position The Antithesis in his description of The Alcoholic Game.

    in reply to: Debt Rattle February 29 2020 #54606
    Dr D Rich
    Participant

    As I wrote earlier, i watched Fauci argue with Robert Gallo one afternoon in Bethesda as to who deserved credit for discovering HTLV-3 as the causative agent for AIDS. They were both wrong and Luc Montagnier was correct with LAV which was renamed HIV. And Luc Montagnier has been expert in resident at a major Shanghai university in the past few years.
    The game is being rigged and the numbers do not justify the panic and propaganda, as Dr. D continues to intimate.

    in reply to: Debt Rattle February 27 2020 #54503
    Dr D Rich
    Participant

    Don’t confuse hydroxychloroquine (plaquenil) (used often for decades-long treatment of rheumatoid diseases) with chloroquine.

    in reply to: Debt Rattle February 27 2020 #54496
    Dr D Rich
    Participant

    And of course President Trump just shut up Anthony Fauci……..no small task

    in reply to: Debt Rattle February 27 2020 #54495
    Dr D Rich
    Participant

    Yes, the flu is an apt comparison and the statistics are comparable……especially when considering the case fatality ratio of the Spanish Flu. And it’s most applicable to this question about “bringing the troops home” because that’s how the Spanish flu moved from Europe to America where certain minority communities were completely wiped out.
    The whole concept of inverted isolation came from the military’s experience with the Spanish Flu during WWI. There’s nothing quite like the dual dangers of dysentery and respiratory illnesses to bog down and defeat an army more effectively than bullets and bombs.

    in reply to: Debt Rattle February 27 2020 #54484
    Dr D Rich
    Participant

    Beware vision loss from chloroquine retinopathy

    in reply to: Debt Rattle February 27 2020 #54480
    Dr D Rich
    Participant

    Drilling down into Moto’s referenced article, it reveals that Mr. Bradley Simmons as interim CEO UC Davis is being paid $732,000+ a year up from his ordinary salary of $592,000 to tell people who are expert in healthcare what do when he is unqualified to practice any aspect of healthcare.
    By comparison, I treated the most patients, the sickest patients and performed the most surgery in my specialty at a comparably sized university hospital in Washington and I was paid a fraction of what Brad is being paid taking credit for supposedly telling physicians/surgeons/doctors like me what to do. The neurologist who last protested such arrangements as Brad’s at UW was run out of town but not before the executive committee of the medical staff (ECOMS) labeled him a disruptive physician.

    These folks are the ppl leading your coronavirus response and they will be paid first.

    in reply to: Debt Rattle February 26 2020 #54457
    Dr D Rich
    Participant

    Always, another personal anecdote.

    I was front row at a nearly vacant Bethesda Maryland auditorium in early-mid 1980s as two titanic egos debated for credit over identifying the causative viral pathogen of the as-yet–to-be named disease characterized by opportunistic infections such pneumocistis carinii, oral thrush (candida) and unusual vascular neoplasias like Kaposi’s sarcoma. The two men, Robert Gallo and Anthony Fauci, settled on HTLV-III as a name for the virus was ncorrectly identified as AIDS causative agent which fell away to Luc Montagniers (currently full professor in Shanghai) Pasteur Institutes team correct Identification of LAV which we know today as HIV.
    And here’s Fauci in the spotlight again.

    But once again let Whitney Webb clarify things in a non-hysterical way and link it to the Great Economic Game.

    Is Wall Street Behind the Delay in Declaring the Coronavirus Outbreak a “Pandemic”?

    in reply to: It’s The Virus, Stupid #54437
    Dr D Rich
    Participant

    Probably counter propaganda pissing on this propaganda parade, but here goes.
    .

    GENEVA, Feb. 25 (Xinhua) — China has changed the course of the COVID-19 outbreak, Bruce Aylward, an epidemiologist who led an advance team from the World Health Organization (WHO), said here on Tuesday, noting a rapidly escalating outbreak in China has plateaued and come down faster than previously expected.

    It’s a unanimous assessment of the 25-member team which has conducted a nine-day field study trip to China’s Beijing, Guangdong, Sichuan and Hubei, stressed Aylward.

    Recalling details of the study trip in China, Aylward said he was impressed by China’s pragmatic, systemic and innovative approach to control the COVID-19 outbreak.

    China has taken “differentiated approach” for different situations of sporadic cases, clusters of cases, or community transmission, which makes a massive scale of epidemic control work without exhausting its response, said Aylward.

    Moreover, the WHO expert praised Chinese phenomenal collective action, stressing “it’s never easy to get the kind of passion, commitment, interest and individual sense of duty that help stop the virus.”

    “Every person you talked to (in China) has a sense that they’re mobilized like in a war against the virus and they are organized,” said Aylward, who was particularly impressed by thousands of health care workers volunteering to go into Wuhan, the epicenter of the novel coronavirus outbreak…………………….

    in reply to: Debt Rattle February 24 2020 #54349
    Dr D Rich
    Participant

    FISA Court judge had been provided official cover with a designated FBI patsy.

    https://www.washingtonexaminer.com/news/fbis-case-agent-1-stephen-somma-primarily-responsible-for-fisa-failures

    in reply to: Debt Rattle February 23 2020 #54268
    Dr D Rich
    Participant

    You are correct, Dr. D.

    Harkens back to the sad musings of my Hungarian great grandfather, Laszlo, whose younger brother was turned away at Ellis Island, refused entry by immigration officials because he was “too sick”. Repatriated to Hungary I suppose and never seen by family in America again.

    And Laszlo’s first daughter, a toddler age 2, died in 1919 during the middle of Spanish Flu epidemic. He blamed himself for “bringing the flu home” from the bar he frequented at the end of his shift underground in a 3.5 foot coal seam. Somehow the health authorities restrictions on public movement made it to his small mining town of 75 people and only served to cement his sense of guilt. We’ve made substantial progress in curbing the social stigma associated with infectious disease.

    So, yeah Dr. D, our peers are in it the money. If not for money, they/we fear losing their/outr jobs in the At Will workplace to Leadership who don’t have a clue that bacterial super-infection associated with viral pneumonia is a likely causative factor for the high death rate.

    But war, social upheaval and panic always help…..

    in reply to: Debt Rattle February 22 2020 #54250
    Dr D Rich
    Participant

    I suppose it’s the banks operating with World Bank, IMF impunity. I remember receiving my passport near the IMF Wash DC hdqtrs in 1985. I pointed out these monumentally arrogant shits blocking the sidewalk and not one of my fellow military medical students recognized the significance of the IMF in their lives. Here we are 35 years later.

    The World Bank, the IMF, and their Iron-clad Secrecy

    in reply to: Debt Rattle February 20 2020 #54129
    Dr D Rich
    Participant

    Come on, DrD. Explain to us common folk here at TAE how the average individual acquires the “seasonal flu” without ever being aware of exposure to any other person with flu-like symptoms?
    Then please describe what supportive care really means in the treatment for viral pneumonia and contrast it with the distinctly different diagnostics and treatment for community acquired pneumonia.
    Maybe close with an analysis of just how far the Covid treatment cost is beyond most people’s ability to pay, especially the price of these “test kits”?

    in reply to: Debt Rattle February 15 2020 #53983
    Dr D Rich
    Participant

    In France the old Chinese lady “walked around free”. Imagine that, free.
    Xi locked down Wuhan and indefinitely extended the New Year’s holiday free from work obligations but he’s a damn communist, secretive propagandist. However he didn’t do enough with the suddenly magical :test kits” (must be a European term) to personally halt a pandemic.
    Yikes!
    And those European officials are behaving like Chinese officials by failing to be candid about the gender of the dead Chinese woman/man who roamed free in France.

    in reply to: Debt Rattle February 14 2020 #53944
    Dr D Rich
    Participant

    And I will repeat the answer to my question about how their families are coping back in China. This is the answer from the Chinese woman:

    ““We are not afraid, dare to face everything”

    in reply to: Debt Rattle February 14 2020 #53943
    Dr D Rich
    Participant

    Wes: The focus, as I maintain it, should be to help and support China. The flu statistics posted by ‘zerosum’ are pertinent to this discussion. I spent Chinese New Year’s Eve in the company of my Chinese immigrant friends at a Hunan restaurant in Pittsburgh 10 to 12 ppl per table and I shared dinner with them once a week since then. I’m only avoiding my asshole American friends pretending as if they are immune to coronavirus

    in reply to: Debt Rattle February 14 2020 #53930
    Dr D Rich
    Participant

    Yeah! What are you doing confusing people with facts and pertinent statistics? Helping people to understand scale and scope is part of ongoing education. Even nurses understand the importance of ongoing education and they label it CEUs as distinct from a physician’s CME. Lest the weak minded become distracted. The message remains China .

    in reply to: China Cedes Virus Control #53905
    Dr D Rich
    Participant

    Oversight by a lawyer, nursing assistant, nurse, social worker or businessman while placing a physician unable to pass National Boards Parts I, II, or III OR his specialty boards doesn’t remotely solve problems of “antibiotic overprescribing” as an unnecessary distraction to this discussion. No wonder what these Leadership folk have to fall back on are issues of decorum, civility being the current trigger term for overly sensitive leaders who are far too conscious of their inadequacy.
    We should be helping and supportive, nothing more, nothing less.

    in reply to: China Cedes Virus Control #53894
    Dr D Rich
    Participant

    This is what you get when the system places nursing assistants, social workers, nurses, technicians, attorneys and businessmen in “leadership” over physicians with 10, 15, 30 years of experience; and then labels any physician resistant to these sick arrangements ‘disruptive’, the new Scarlet Letter A of the healthcare industry. Or near and dear to my heart, a bottom dweller classmate who managed to be Chinese and never pass the National Boards and specialty boards was just named CEO of Beebe Healthcare in Delaware. So, ask each other and then consult Dave as to how to distinguish the radiological differences between atypical pneumonia caused by a virus and, let’s say, Mycoplasma pneumoniae.
    I mean damn, just where is the sympathy and empathetic assistance for a country and people under duress, and if true as to the scale and scope, of unprecedented proportions? Y’all do know when they say the treatment is “supportive” that means there is no cure and all they can do is offer “support”, right?
    And perhaps it already occurred to many that this crisis is a manifestation of war by other means, right?

    in reply to: Debt Rattle February 9 2020 #53740
    Dr D Rich
    Participant

    197 nm safely abates the cornea without causing cancer

    in reply to: Debt Rattle February 9 2020 #53737
    Dr D Rich
    Participant
    in reply to: Corona Lockdown Fallout #53665
    Dr D Rich
    Participant

    Dr. D, how have you managed not to be blocked yet?

    in reply to: Debt Rattle February 1 2020 #53328
    Dr D Rich
    Participant

    Well, I think the battle of the viral narratives reached critical mass today. On one hand, ZeroHedge posts an article citing Sen. Tom Cotton as the source of information which condemns a level 4 virology lab in Wuhan as the creator and responsible party for release of weaponized coronavirus. On the other hand, Aletho News credits DARPA (no surprise there) with recent work on weaponizing coronavirus. Even today a reader can easily find “expert” posts reportedly from Chinese scientists/authorities credibly undermine the pandemic hysteria narrative while “western” sources ratchet up the emotion.

    In the meantime, the rest of us will be left to choose sides in warring narratives (false dichotomy) and then be condemned by our society’s Betters should we demonstrate anything less than fealty to our side.

    Knowing what it’s like to be ostracized by my people and profession, i feel comfortable putting my money on the “man in arena” where the situation and patient acuity demands a compassionate, selfless, analytical mind.

    in reply to: Debt Rattle February 1 2020 #53320
    Dr D Rich
    Participant

    Christ almighty zerosum, I spit my vitamin C dose across the treadmill.
    “Harken! The ol’ Nayvee stands ready to fashion a few pair of glasses for U.S. coronavirus victims!”

    Talk about an expansion of optometric scope of practice. You’re gonna have the American Academy of Ophthalmology hounded your ass for thinking optometrists should be doing cataract surgery AND on the front line fashioning new spectacles for coronavirus patients.
    But that’s what we need, thinking outside the box.

    in reply to: Debt Rattle January 31 2020 #53258
    Dr D Rich
    Participant

    When I expressed concern to my Chinese immigrant friend for the mounting danger from the rising hysteria, here’s her response, eloquent and simply elegant:
    “We are not afraid, dare to face everything”

    in reply to: Debt Rattle January 30 2020 #53227
    Dr D Rich
    Participant
    in reply to: Debt Rattle January 30 2020 #53216
    Dr D Rich
    Participant

    Hahahahaha!

    in reply to: Debt Rattle January 30 2020 #53211
    Dr D Rich
    Participant

    Have I detected a little objectivity and a turn away from the xenophobia to China exhibited on this blog recently?

    in reply to: Debt Rattle January 28 2020 #53101
    Dr D Rich
    Participant

    Most workers in US hospitals, that is, technicians, secretaries, nurses and non-physician hospital administrators could take a lesson from Dr. D on how critical reading skills, technical writing/reading and familiarity, if not expertise, in statistical methods are essential to understanding the news and, in fact, doing their jobs. However, even among physicians, Dr. D is a rare breed many of whom are marginalized as non-team players on the healthcare team or more injurious yet, labeled bullies for asserting their intellect against the status quo which preserves the jobs.
    Gotta improve the run on sentence

    in reply to: Debt Rattle January 25 2020 #53012
    Dr D Rich
    Participant

    “Naturally, since the disease is most active in China which is notoriously opaque especially when it comes to matters that can cause a mass panic…”
    And this: “Furthermore, since all of this is happening in China which is not known for making the most socially-beneficial decisions under pressure”
    I was marched out of a UW hospital for correctly pointing out that an unlicensed high school grad inappropriately staffed in a management position should not be be telling concerned patients and staff made sick with respiratory illnesses during a hospital demolition/construction project to “suck it up”. Ya see since at least as long as I’ve been Dr. D even OSHA directives cite the risk for both infectious and non infectious pulmonary disease. The first medical center center I ever worked in as an MD although brand new was already colonized Aspergillus in 1988.
    Fast forward to late 2019 and look at the glacially paced response, coverup and foot dragging at Seattle Children’s to guess what, Aspergillus. I suppose the opacity of the Chinese government played a role with the families and attorneys of the injured children. Then you add the conceit of purposeful ignorance to the mix.
    From Seattle Times: “Aspergillus infections that happen while a patient is in the hospital aren’t widely reported or identified across the country and little is known about Aspergillus in hospital HVAC systems, according to Jeff Duchin, public health officer of Public Health – Seattle & King County.”

    So yeah China and Putin should be demonized

    in reply to: Debt Rattle January 24 2020 #52974
    Dr D Rich
    Participant

    Damn, Dr. D!
    You got your finger on the pulse today.
    Ponzi schemes and pyramids all around.

    in reply to: Debt Rattle January 23 2020 #52938
    Dr D Rich
    Participant

    Paraphrasing Dr. D, Yale the gift that keeps on giving.
    MacKenzie BeebeeBozos, Yale degree and all, didnt become hip to Jeffrey’s! philandering until MBS Crown Prince BoboBoneSaw tapped “I created AMZN outta my garage, I say its true” guy’s cellphone. Ok, got it. That’s a difficult image to eliminate from my mind, a Bezo Yale guy tinkering around in his garage creating AMZN outta whole cloth in a sudden burst of fabulous genius.
    However, I thought we had Jeff BeBozos’s employer, the CIA/FBI/NSA, monitoring and then parallel con-structuring things to keep bozos like Bezos in his lane.
    So, when is the US Gov’t gonna go all scorched earth, Joseph Nacchio/Qwest retaliatory treatment on Ol’ Jeffrey for embarrassing The Firm/NSA and being a bad steward of such fabulous wealth? Already have our answer. The U.N. is gonna step in…right in the middle of The Impeachment of President Donald Trump.

    in reply to: Debt Rattle January 20 2020 #52827
    Dr D Rich
    Participant

    Where the author positions herself. Why else have a preface?
    The Durham article should be read as a signal to the Obama Administration that the fix is in. Why else make the announcement in ominous tones the focus of the Durham inquiry goes all the way back to the beginning of time, that is January 2017?

    in reply to: Debt Rattle January 14 2020 #52696
    Dr D Rich
    Participant

    Nah, some of us never fall for their acquisitive shit and answer back with competence another term co-opted by feckless managers and sociopaths they serve. I dont recommend choosing this path as it leads invariably to isolation and diminished self-respect no matter the inherent ego strength.
    Then there is this: “”Now friggin Lion Air might need a sim to fly the MAX, and maybe because of their own stupidity. I’m scrambling trying to figure out how to unscrew this now! idiots,” one Boeing employee wrote in June 2017 text messages obtained by the company and released by the House Transportation and Infrastructure Committee.”
    Lest anyone delude themselves into thinking this base rhetoric only exists buried deep within company emails, the official mishap reports not accessible by the public contain much worse operator/victim-blaming even when mechanical failure was determined to be the causal factor in the crash.
    And in medicine, it’s far worse.

Viewing 40 posts - 881 through 920 (of 936 total)