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What we don't know does hurt us.
I am deeply suspicious of my surgical colleagues. Why? Because for (some of) them, anesthesia can be the convenient scape goat for their own agenda. I've seen examples of this now and again over the last ten years, but I'm beginning to think it's more prevalent than I expected. Much like seeing one cockroach only serves to betray the 10,000 behind the wall. Let me give you some examples.
An orthopedic surgeon in a place I used to work told the patient and family that he couldn't do the orthopedic surgery their family member needed until 9 a.m. on a Saturday morning . Why? Because anesthesia wasn't ready until then (I was ready at seven and annoyed at not being able to start until 9). He told me the surgery couldn't be done until 9 a.m. because the family was waiting for someone from out of town. He didn't count on the fact that I would actually talk to the patient and inquire socially whether he'd had a chance to see the family member he was waiting for. His response? What family member? Anesthesia as scapegoat.
A second example (with many in between omitted) happened just this New Year's Eve. My mother-in-law fell in her apartment and significantly injured her left eye to the point of needing surgery. After admission to the hospital at which I am currently on staff, she was incidentally found to have a pneumonia. In discussing the timing of her surgery with her, the ophthalmologist (I don't know if it was residents or an attending) said they couldn't do surgery right away because anesthesia would refuse to but her to sleep.
Now, I know something about anesthesia, and that's just not true. Further, they could have called the anesthesiologist and asked for a definitive answer, but didn't. So why would they say that? Because they didn't want to operate just then, or the next day, for that matter, because their favorite operating room wouldn't be open until Thursday, January 2nd. Their favorite operating room with their special instruments (which are moveable) and their favorite nurses to assist them (tough).
What's my point? For the patient or their family, if someone tells you anesthesia does or doesn't want to do something, don't believe them unless they're an anesthesiologist. If you feel like being confrontational (I always am), ask them if they actually asked an anesthesiologist or whether <strike>they pulled it out of their ass</strike> it's just their guess. For the surgeon, you're being unprofessional. For the anesthesiologist, get out there and set the record straight. The only reason people get away with this sort of thing is becuase we're not there to set them straight.
L.M. Orchard writes the DecafBad weblog (which I'll admit I subscribed to initially because of the name). In a post entitled Pushing Envelopes and Mining the Hills he says:
"Of course, the problem with the way so many webmonkeys learned to apply some semblance of web standards was the web browser. If it showed up nicely in the browser, it was Good. If ugly, it was Bad. If invisible or without apparent effect, it was Ignored. And this mindset worked great for the busy page builder up till 4:30am trying to cobble together the latest brochureware site."That term brochureware caught my attention, because it describes what the powers-that-be want from me. I don't do brochureware. I can't do brochureware. I don't have the graphics skill, nor do I know the <table> tricks to make the page lay out nicely. Funny thing is, they don't want to pay someone who is good at those sites to do one for us. The result? A FrontPage site: http://www.hmc.psu.edu/anesthesia/ (yuck).
ProtectFairUse.org
From The Shifted Librarian, a pointer to http://protectfairuse.org . The site is dedicated to maintaining the right to copy personally owned DVD's, but the outcome of what studio executive propose will affect our ability to access medical content digitally. The site has a nice feature which enables one to send e-mail to members of Congress on the issue.
Pretty Good Privacy is a Public Key Infrastructure (PKI) implementation that is, well, pretty good. Very good, in fact. The recent 8.0 release brings the full feature set to MacOS X in a commercial package (although GNU Privacy Guard, an open source implementation, has been available for a while). A free version is also available. I'm learning about this technology myself, and have made my public key available on this site (as well as on the PGP key servers).
