Paying the Price for Speaking Up

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island doc

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Looks like we aren't the only ones who have "Paid the Price for Speaking Up".
Check out the September 2006 issue of Emergency Medicine News (www.EM-news.com) letter to the editor by John A. Carroll, MD of Peoria, IL entitled "Paying the Price for Speaking Up".

Dr. Caroll also has his own web log at www.peoriasmedicalmafia.com

I know this is not exactly a military medicine item, but we do have a soul mate in Dr. Carroll who was railroaded by his organization, much like some of us(usafdoc, medicalcorpse, island doc, etc) in this forum were by the military, for voicing his concerns about quality of care problems.

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Looks like we aren't the only ones who have "Paid the Price for Speaking Up".
Check out the September 2006 issue of Emergency Medicine News (www.EM-news.com) letter to the editor by John A. Carroll, MD of Peoria, IL entitled "Paying the Price for Speaking Up".

Dr. Caroll also has his own web log at www.peoriasmedicalmafia.com

I know this is not exactly a military medicine item, but we do have a soul mate in Dr. Carroll who was railroaded by his organization, much like some of us(usafdoc, medicalcorpse, island doc, etc) in this forum were by the military, for voicing his concerns about quality of care problems.

It is pathetic and sad to see good docs who care about patients being tarred, feathered, and run out of town because they speak up, while less-caring, less-honest, and less-qualified docs stay in large, bureaucratic systems (like military medicine and many civilian conglomerates) to make rank, get bucks, and kill people dead.

By the way, I saw this story online; maybe the current tragic state of (civilian and military) emergency medicine can be improved by a few good criminal convictions: http://abcnews.go.com/US/wireStory?id=2449287

...now, when I refer to military emergency medicine woes, I must adduce the following evidence:

Metropolitan Guatemalan Medical Center Emergency Department
Difficult Airway Algorithm For Trauma Patients
As Demonstrated In July, 2003:

I am asleep 20 feet away from the ED through the floor, 50 feet away as the doc runs. Gunshot victim with bullet in head brought in. ED Staff, led by Captain M.D., implements the following Malcolm Grow "Medical Center" Difficult Airway Algorithm:

1) Try to intubate
2) Fail
3) Try to intubate
4) Fail
5) Try to intubate
6) Fail
7) Try to intubate
8) Fail
9) Try to cut the neck
10) Fail
11) Call anesthesia.

I arrive 1 minute later. One tech holding ABD pad on neck to prevent exsanguination from lacerated neck tissue, one tech holding ABD pad on forehead to keep patient’s remaining brains in. Sats in 90s, so at least some ventilation by mask occurring (amazing, that...must have had a heck of a respiratory therapist helping the patient ;) ). I ask for MAC 4 and 8.0 tube--> handed MAC 3 and 7.0 tube (unstyletted); quickly throw stylet in 8.0 tube and take look with MAC 4; suction; MP grade 1 view (easy intubation); no blood in distal airway (the maroons didn’t even hit the patient's trachea); easily intubated; general surgeon not called until 45 mins after trauma arrival; helicopter team quibbling about air-evacing patient. I wrote note and left after confirming intubation and overseeing ET tube security. The surgeon on call, Dr. "Skippy" *****, was furious, with good reason.

Of course, this is the same ED that gave me the following quote a few months before, when yet another unfortunate shot in the head was dragged into Malcolm Slow's Pit of Death, er, Emergency Room:

"If a person gets shot in the head right outside our gate, the best place to go is MGMC"
--E.D. physician (Dr. Scary), 9 Oct 02 (despite our lack of neurosurgeon to fix patient). Sadly, our system proved this contention permanently wrong several times.


--
R
http://www.medicalcorpse.com
 
I remember that. *cringes*

Were you involved with the now infamous clamshell thoracotomy incident? That was one of my first cases at MGMC.....I knew I was in for a rough ride when the words out of the surgeon's mouth were "Where the hell is all this blood coming from?"
Voice in my head: "I'm no doc, but I'd guess the big hole in the right ventricle would be a good place to start?"
 
I remember that. *cringes*

Were you involved with the now infamous clamshell thoracotomy incident? That was one of my first cases at MGMC.....I knew I was in for a rough ride when the words out of the surgeon's mouth were "Where the hell is all this blood coming from?"
Voice in my head: "I'm no doc, but I'd guess the big hole in the right ventricle would be a good place to start?"

Wasn't involved, but the vascular surgical maroon who was lauded for his heroic efforts to save the life of the 1Lt victim of a love triangle stabbing is the same one whose incompetence resulted in my "fear" that something bad might happen to the hospital VIP's relative if he committed surgery on her without everything being done "by the book". A few months later, the vascular surgery program at Andrews was shut down; he was sent to WRAMC to kill patients there (first AAA wasn't good for the home team, I was told); yet, on paper, he was promoted to be "Professor" at USU (PCA from Andrews to USUHS).

Ironically, Col. "Rusty", as I have said, took credit for "Improving liaison between MGMC and WRAMC with regard to vascular surgery" in his change of command ceremony. This is analogous to my claiming credit for "improving liaison" between my stool and the Potomac River every morning. Yes, Virginia, to any who attended: that *was* me loudly whistling "Ding, Dong, the Witch is Dead" while he was doing the obligatory grin and grip at the end.

Ah, the memories...now where did I leave my portable ECT device, the better to remove them with...oh, there you are, my preciousss....ZZZZZZZZZZZT!

Much better now.

A few hundred more treatments, and I'll be ready to re-up.

--
Rob
http://www.medicalcorpse.com
 
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