Category Archives: Medical Horrors

Lyme Disease Superstition

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A blog called Science-Based Medicine recently had a post on ghastly naturopaths chatting on Reddit about injecting people with hydrogen peroxide! Diluted yes, but still. It’s a poison. And no, injecting people with hydrogen peroxide has zero medical benefit. Ever.

But within this rather blandly stated exposé the writer, a surgeon, made a sneering throwaway comment about “chronic Lyme disease”. Now, Lyme disease is a real disease, no one disputes that. (What kind of world are we living in where that sentence needs to be said or even makes sense?) But a small group of Assholes Doctors (and I don’t mean proctologists) have convinced themselves, in defiance of rational thought, that some people who get Lyme disease after treatment still think that they have it when they don’t. Here’s the thing: the people who “think” they still have Lyme disease still have symptoms and are still positive for it on the Lyme disease test.

Seems the Asshole Doctors have decided the wimpy two weeks of antibiotics that are the standard treatment for Lyme (a duration some doctor pulled out of his ass when the disease was discovered 30 years ago) is for sure, enough, for everybody. Even though infection treatment doesn’t work like that. Drug treatment for TB is given until the TB is gone. Drug treatment for AIDS is given for life. The drugs we have are supposed to be used in a way that is effective not that conforms to some timetable in a book.

The people who, quite sensibly, believe they are still ill have positive Lyme tests. What do the Asshole Doctors say about that? ‘The test isn’t very good. It has all these problems… ‘ Now, for all I know these problems are real. Or made up. But the Asshole Doctors don’t dispute the test results when it’s finding new cases of Lyme. Only after the magic two weeks. Then it’s’oh the test is poor!’ So we know what kind of docs we are dealing with here. (Hint: Assholes.)

I think one (only one?) objection to the Lyme test was it can be positive if you have some other microbe. Fair enough. Cross-reaction. That’s a thing. But as is typical in Medical Bad Reasoning the Asshole Doctors don’t realize that went two things are possible: Lyme not cured yet or cross-reaction, that doesn’t mean you (Asshole Doctor) get to choose one. This isn’t shopping! It means either could be true and you need something else to tell you which. That’s logical reasoning 101. But then the MCAT (the med schools’ LSAT) is the only test of that sort, which include the GRE and engineering and management ones, that does not have a test of logical reasoning. And it shows.

If I was a doctor with a patient who after a wimpy two weeks antibiotics wasn’t all better I would be utterly unsurprised. If after three months they were still infected I’d wonder if their immune system was buggered in someway. But I certainly wouldn’t reach for the idiotic “all in your head” explanation. A non-medical, unscientific myth no better than astrology. With MDs like this who needs a naturopaths? (To have hideous superstitious weirdos providing “medical” care.)

Some patients are treated till cured, even when it takes years. And guess what? When the symptoms go, the lab tests are negative. This is completely straightforward. Get the disease, have the symptoms. Get test. Test positive. Given drugs. When they have worked, no symptoms, test negative. It doesn’t get any simpler.

The Asshole Doctors are in the grip of a nonrational myth. Patients “imagining” they are ill. The “imagining” is undefined and cannot be made to make sense. The uncomprehending zeal of the doctors who promote this myth makes them appear disturbed. This sort of superstitious nonsense is not something we can afford in medicine. And especially not in what wishes to be Science Based Medicine.

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Filed under false knowledge, Lyme disease, Medical Horrors

EBOLA FUCK UPS, CANADA AND DALLAS

imageYou heard it here first. If you read my earlier post https://thebrainsciencecritic.wordpress.com/2014/10/03/ebola-in-dallas-sars-in-toronto/   In Ontario we’re now hearing from the head of the Nurses Association and you can read the story http://globalnews.ca/news/1616000/potential-ebola-patient-horror-stories-in-canada-concern-nurse-union/?utm_source=Homegnca-toronto&utm_medium=MostPopular&utm_campaign=2014 about the lack of preparedness in our hospitals for an actual ebola patient. There have been some suspected cases, they’ve been reported on the news, with all kinds of happy talk about the person was put in isolation, blah, blah, blah. Now it turns out that at least one of them sat in the waiting room with seven other patients. For some period of time. That is exactly how isolation is NOT supposed to work. That is how the SARS epidemic happened. It spread in the emergency room waiting area. Nurses all over the country are reporting that they either don’t have the protective equipment, disposable plastic suits, gloves, special masks. Or they have it but it’s too small. But here’s the thing, if they’re finding out now that it’s too small that means they haven’t put it on before. There’s also mention in the above news story about “having seen the video”. That shows how to put on and take off the protective clothing. Now, what’s the protective clothing protecting you from? What it’s doing is making a barrier, think  barrier birth control, between the nurse or doctor and the person who has the virus. The virus is coming out of that person. So the medical personnel have to not just not get that virus on their skin, they have to not carry it out of the isolation room (remember isolation is just the new term for quarantine). The virus riding on their clothes then gets on the countertop and somebody leans on it and it’s on their arm and they scratch their arm and they touch their eye and  BOOM! they have ebola. That’s how it spreads. So once you are ready to leave the isolation room you have to do something with all this protective gear you’re wearing. The plastic suits are like coveralls. There’s a special way to take them off just like there’s a special way to take off plastic gloves. I don’t quite know what it is but you pull off one halfway, then pull off the second glove with your fingers still in the glove fingers of the first one. Is that clear? Yeah exactly, it’s fiddly and counterintuitive and complicated. Watching the video is not how you train medical personnel to do these procedures. There’s a whole academic specialty, Schools of Public Health, that deal with this stuff. We know what the correct procedures are. And if you actually intend to prevent disease spreading then you drill. Yes drill. Like pilots in flight simulators. But you don’t need fancy equipment you need a room, you need a doorway, you need the protective clothing. And you need the nurse and somebody shows the nurse how to do all this complicated suiting up and especially the unsuiting. Remember when you’re taking it off it’s shmutzy. It is presumed to have the deadly virus on it. So, special way to remove it. And the way you’re taught how to do something complicated like that, think of it on the same level as how to make a cheesecake or how to drive a car, the instructor watches you. So the instructor watches the nurse put on the special clothing, she pretends to do some patient care and then comes back and takes it off and the insrtuctor watches how she does everything and tells her when she’s doing it right and when she’s doing it wrong. Then she does it over and over and over again. Like firefighters. That’s what Mr. Singh in the Global news story (link at start of post) is referring to when he mentions muscle memory. It needs to become second nature to do each little movement in the exact right way. That’s training. Nothing else is. Watching a video is not training. The nurses in our hospitals have a friggin right to this. They may even have a legal right to it in their contracts with hospitals. And in Canada today our government is not doing it. The minister for health in Ontario went on TV and said some vague stuff about we are committed to doing the whatsit thing. This is what you say at the beginning of the planning process. We’re way after the planning process now. The planning process happened and the buying the stuff happened, in some hospitals in Toronto, but not in others in Nova Scotia. The handing out the equipment part has already happened. But it sucked. They buggered up. They didn’t train them the way I describe above. And the protective clothing doesn’t fit. Which is how I know that they didn’t drill. If they had drilled, and they were supposed to before the epidemic in Sierra fucking Leone even began, they would have found that out. It sounds from the reports that they found out the equipment didn’t fit ie didn’t work when they had a suspected ebola patient. Who ultimately tested negative, thank God. And not just for them. Because we are unprepared. It’s getting ready to be SARS all over again. 44 people died, over 100 were in intensive care. If everything had been done properly and again the textbooks tell how to do this, it ain’t rocket science. If everything had been done correctly two people would’ve died of SARS, not 44.

Ebola was discovered in the 1970s, I think 1976. We’ve had since then to prepare for this year’s epidemic. We knew it was coming. And we knew it was coming to North America on airplanes. Jet spread. I learned that term in the 90s. Right now this is idiotic, but it could easily become a disaster. And it will be a disaster born entirely of governmental incompetence, unwillingness to prepare in the proper way, and to a very great extent the fact that medicine is completely unregulated. Yeah the boneheads who screwed this up are not the ones who we would want to have regulating it. But it needs to be regulated. So that someone who has learned how you do infection control out of those wonderful textbooks would, with the authority of the government, go and check in advance that the hospitals were actually doing the stuff to be prepared. I mean for chrissakes the actual term for it is preparedness! But they didn’t get ready.

Hats off to the nurses and Nursing Association for blowing the whistle on this. Well done. Next time, do it sooner.

Let’s go to Dallas. So far two nurses who looked after the ebola patient in Dallas have contracted ebola. So yeah we’re a first world country and we don’t screw things up so bad. You catch ebola looking after an ebola patient by not keeping yourself fully covered 100% of the time that you’re in contact with their body or with stuff their bodily fluids have leaked out onto. Doing that and providing patient care is extremely difficult. And as a prize if you mess up even briefly, even a tiny bit, you get a potentially fatal disease. And you have to stop the epidemic by stopping the spread of the virus by doing everything in your job correctly. With absolutely zero mistakes. And when they do it right it works like magic. This is the only thing to stop the spread of infectious diseases. There’s no drug. There’s never a drug for these kind of diseases. Vaccines yes. But once the epidemic has started we need these excellent people to do this work. Stopping the epidemic with basically plastic sheeting. Sure it’s made into all kinds of stuff gloves and masks and those plastic jumpsuits. This, for all epidemic diseases, before a vaccine is created, is how they will be fought forever. This is the super expertise that our ancestors didn’t have. It doesn’t look like much, plastic sheeting, but it works.

You know what’s not as effective as plastic sheeting (made into clothes)? The CDC. Two nurses so far have contracted ebola at the Dallas hospital. One of them took a trip to Cleveland and when she was due to come home had a fever and called the CDC and asked if it was okay for her to fly and they said yes. The next day she was diagnosed with ebola. So more fuck ups. Now the flight crew has to be in quarantine for 21 days. The airplane is out of commission until they disinfect it. And there’s all the people who were on the airplane too. Now they get to be really really terrified. This is an example of the economic impact of an epidemic. When it’s screwed up. You have to put people in quarantine and then they can’t do their jobs, or be an airplane that flies around. This is costing the airline money. And it didn’t have to if the CDC hadn’t fucked up. They didn’t just guess wrong they didn’t follow the normal protocols. Err on the side of caution. Okay so two nurses caught ebola from Mr. Duncan, the now deceased ebola patient in Dallas. Another nurse there describes a “chaotic” scene when the ebola patient first arrived. I don’t know specifically what happened but I have to wonder if it’s like SARS. Where someone with a fever and clearly severely ill with an infectious disease arrives in the ER. They know that they’re supposed to put this person in isolation but there is no isolation room. Those went out with polio. So everyone freaks out and runs around. And during that whole time the patient is shedding virus. Preparedness means having isolation rooms that just sit there being isolation rooms when they’re not being used for that. The hospital administrators just will not get it through their heads that they need to do that. They need to be required by law to do that. They also need to have a separate entrance to the isolation area. During SARS a hospital in Western Canada where there was no SARS realized that they were not ready for fatal contagious diseases so they created a new doorway directly into their (newly created) isolation area. That’s what you do. There’s no shortcuts. During SARS in Singapore they took one of their hospitals and moved everybody out of it, and made it into their all SARS hospital. And the medical personnel wore moon suits. That’s slang for the kind that have their own air supply and look all puffy like you’re walking around inside a balloon. Those are the best kind. But even those you have to have special training and drill, to take them off safely. So that you don’t get the shmutz on the outside of them on your hands and then go put it on the countertop or the elevator button or in your eye. I dare say we shall hear more detail about how the Dallas hospital screwed up. To be fair the protective clothing that the CDC told them to get did not cover the nurses necks. That’s absolutely insane. As you can easily see based on what I said above. The shmutz is on your glove, you touch your neck, the shmutz is on your neck. The shmutz is the virus. That ain’t a moon suit. So when you see stories on the news with people saying “oh I’m much more afraid of the fear that of ebola itself”, snicker. It’s bullshit. You don’t need to panic about ebola, but you should be really pissed off at your government whether in the US or Canada for sucking so bad at this. Again, not rocket science.

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Filed under ebola, Epidemics, Medical Horrors

THE WOMAN WHO HAD TO VIDEO HER STROKE

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So a woman having a stroke walks into an ER. And you’ll never guess the punchline. Yeah, they said it was stress.

In April 2014 a woman, Stacy Yepes, had one of a series of small strokes called a TIA (more on those below) and she went to the ER, described her classic textbook stroke symptoms. And was told it was stress by what are supposed to be competent doctors. Apparently she was also told that she needed to deal with her stress better (Now “all in your head” isn’t just a dismissal, it’s a guilt trip too!) And given instruction on how to manage her stress. With slow deep breaths. So, real jet age stuff. 40+-year-old woman in our society, yeah, she’s probably never heard that before. Interesting to me is that it’s a relaxation technique. Like for when you’re freaking out. Say at the dentist. So, the Bad Hospital people told her she had stress but clearly were thinking panic attack (stress, ripe piece of false knowledge, is normally portrayed as a pervasive force not a specific super noticeable event. This makes it less than useful when you want to use it to excuse inaction in the middle of a crisis! So now we have the panic attack.) Now, panic attacks may or may not exist. Certainly panic, the feeling, exists. Which begs the question what’s different about a panic attack versus a moment of panic? We’ll take that up another time. (Brief preview: it’s a mess.) Subsequent events will show Stacy’s not a panicky gal. So, if the doctors asked her about panic and she said no, what did they think? That she was a lying? “No, I feel perfectly calm. Get me the fuck away from these imbeciles!” So “stress” is now a panic attack and panic attacks have developed a deceit characteristic? “Oh, these panic attack people, always lying about the panic they feel.” Yeah. Right. Another problem: she’s having a fucking stroke! She knows it! That could make anyone panic, plus her doctor is AN IMBECILE!!!!!! Who doesn’t know the signs of a stroke from a flippin public-service commercial on TV! What kind of shithole hospital is this? she must of been thinking.

A word to medical people: if you bully, act crazy or really, really dumb – all common occurrences in hospitals – you will scare the living shit out of your patients, and yes that could make them appear panicky. So let’s not dismiss patient’s physical symptoms just because they are having an emotion (everyone always is) and especially one that you and your creepy, awfulness have induced. On top of which Ms. Yepes may have been perfectly calm. All we know is the doctor decided to say it was stress.

So the Bad Hospital sent her on her way. I cannot even imagine what that night was like. Ms. Yepes isn’t a stupid woman. (And no, in a situation like this, in a hospital you cannot just throw a tantrum and insist on seeing someone better. They just call security and might even have you arrested. Hospitals are well practiced and getting rid of their mistakes.) So Yepes is at home, goes to bed. Next morning another TIA. (No she doesn’t die in this story.)

This is what she experienced: the left side of her face drooped. And felt numb and tingly. Her talking movements were wonky. She still could but clearly not normal. And her left arm and leg got heavy and hard to move.

This is what happened inside her: a blood clot, which are not the little red spheres I used to picture but rather a long squishy piece of liver like thing, formed. So it’s in a vessel (blood pipe) in her brain. She had several of these TIAs (Transient = intermittent versus one big stroke where you go unconscious and you live or don’t. Ischemic, just means no blood so no oxygen to the tissues. Same thing as in a heart attack where heart muscle tissue is destroyed. Strokes are when that happens in the brain. The brain tissue is dying a.k.a. brain damage at all the thrilling problems that causes. And Attack is just redundant. Transient tells us it’s an event in time and can repeat. Oh wait, attack tells us it’s noticeable including by the person it’s happening too. Versus a transient event you don’t notice like some heart arrhythmias. So yeah Attack tells us it’s important!) Okay so a clot is in Ms Yepes’s brain, it could be short and stubby or really super long. And pieces of it are breaking off and stopping her blood supply, like someone standing on a garden hose, from getting to bits of her brain. This is a massive medical emergency. 1) because even a couple small clots that stop the blood supply briefly then dislodge (foot off garden hose) can cause life-changing and unpleasant brain damage. 2) but if the”mother clot” keeps shedding baby clots or breaks up completely, leaving the hunk of blood vessel lining it’s stuck to, it could kill her. Quick. That Yepes’s whole left side was affected, not just her head or vision or a weird skin sensation in a single big hunk of skin, means the middle cerebral artery was involved. (No, as I write this I haven’t seen Yepes’s medical records. Literally hundreds of thousands of people know those of the signs of a middle cerebral artery a stroke. This is not the hard stuff in medicine. And yet the Bad Hospital…) So Yepes is having little strokes that could build up to a big stroke that kills her. She goes to work. Yes, after a second TIA that morning. Why? Because the doctor at a hospital told her it was stress! This is why we can’t have nincompoops or any moronic blunders in hospitals.

After work Yepes is driving home and it happens again. She clearly has decided “screw the stress hypothesis” because she pulls her car over, gets out her phone and videos her stroke! Holy fuck! 1) she’s a genius, 2) WTF is wrong with our society and with our medical profession that something this evil is necessary? That’s a question I really want answered. How did the Bad Hospital fuck up so badly?

Then Yepes drove to a different hospital. She lives in a bedroom community north of Toronto but she drove to Mount Sinai Hospital in Toronto. The Toronto Star story on this doesn’t say if she needed the video at the competent hospital, or if they just listened to her textbook description. But they transferred her at once to the special stroke unit at Toronto Western Hospital. (Remember this is Canada so everyone has all the insurance they need for any in-hospital thing. And every test. And the Bad Hospital still booted her with a BS excuse.) At Toronto Western they did look at the tape but just to see it happening. And they treated her. Either with a clot dissolving drug. Or manual removal of the clot. With a kind of blood vessel rotorooter thing. And Yepes’s life was saved! And she was doing rehab at time of the Star article in June 2014. Hooray!

Now, here’s the thing, the article tells her story but never even names the Bad Hospital. There are no questions about an investigation at that hospital. Let alone what government agency now swoops in like the Transportation Safety Board does after a transport truck loses a load of watermelons on the freeway, to investigate this phenomenal stroke diagnostic balls up. Nothing. Nor any discussion of the lack of an investigative agency. The whole second half of the article is the stroke doctor (named, unlike whoever Yepes saw at the Bad Hospital) basically repeating all the points of a how to spot a stroke pamphlet.

One or more person at the Bad Hospital fucked up, big time. And Yepes could have died. You can watch: https://m.youtube.com/watch?v=SUzqLeC6XTQ She’s in her car doing the deep breaths the imbeciles “taught” her. And she could’ve died right there. That TIA was a little one. But it could have been a big one. How bad a failure of competence did the Bad Hospital personnel commit? 1) they should have immediately recognized when Yepes said that one side of her face drooped that this was a stroke. Why? Because literally nothing else affects only one side of the body, and is sudden onset. (Versus all the head colds we ever had: gradual onset.) The only other thing I can think of that affects just one side of the body is shingles. Also neurological. That’s how both can. ‘One side’ is a diagnostic gimme. So did she see a doctor? Or was she turfed by the triage nurse. Nurses are highly skilled. A nurse who didn’t know one side meant stroke would be an idiot. But triage in lots of hospitals is bullshit. It’s supposed to be a fast but real medical assessment. Often it’s no better than a) a check if you are bleeding and b) a time for staff to decide they hate you because you supposedly don’t have any ER worthy medical thing. Did Yepes see just triage or a doctor? Did the triage nurse write down that Yepes’s was a bullshit patient? Even give a bogus made up psych “diagnosis”: panic? I met a woman once who had started having convulsive seizures. Went to the ER, told: it’s panic. (Panic = leave the ER.) It was a brain tumor. Her husband had to pitch a fit to get her seen by a neurologist. Another person I knew had a long history of atopy: allergic with anaphylactic shock (which is fatal) to everything. Horrible condition. And asthma! Having an attack, goes to ER and once again: panic. So who decided Yepes’s problem was panic and not medical? Triage nurse? Or a doctor? A doctor hearing the one side thing should’ve just sent her to Toronto Western at once. Remember: at that point doctor or nurse, they knew she’d had a TIA, they knew that’s a small clot, they know clots are are like a long piece of liver and that the TIA could have been it, or just the beginning. Of a lot of small clots, so five or seven TIA in two days? Bing! Crippled. Or the “babies” of a huge fatal clot. They knew that. Because everyone in medical school is taught that. The doctor did the bedside neuro exam. (It is a defective, no-tech Stone Age piece of crap test for brain damage, but I will talk about in detail in another post. It is rubbish.) This includes having the patient move their face in various ways, supposedly to show weakness of the muscles. You can see Yepes doing those movements in her TIA video. (It makes me so sad. To a competent doctor her description of the face droop and numb-tongue way she was talking on the video is enough. It doesn’t matter how weak the weakness is. She should never have needed to do that. She described it fine in the first place. And Americans reading this remember: insurance for all the procedures and in-hospital drugs was 100% not an issue. Her government insurance covered all of that.) And because this was a TIA = transient, the very low sensitivity – meaning weak and crappy – bedside neuro exam would have been negative. Showed nothing. At which point the doctor should have said “are you having any of the symptoms right now?” She says no and looks at him like he has five heads. And that’s it. It’s a TIA. She described a TIA, she knows she is not having the symptoms when she clearly isn’t, ergo her account of the symptoms can be taken at face value. The only reason to do a bedside neuro in that situation is in case her degree of impairment is way worse than she’s saying. Like she’s 80% paralyzed on one side. If she’s seated how do you tell? This doctor clearly (since we know he did the bedside neuro tests, she’s repeating them in the video the next day) took the negative bedside neuro results to mean she did not have a TIA. So sharp he cut himself. The very nature of the TIA is that between the attacks there are no signs or symptoms. So the Bad Hospital is employing someone that incompetent. How that happened, would be one of the questions the Medical Fuckup Investigators would try to answer. If there were any. Does the hospital check their ER doctor’s references? If so, do they have any means by which to find out if they are turning their ER over to a joker like this? Was the doctor that Yepes saw a family practitioner i.e. a GP. Not an ER doc? If so, probably the problem. Undereducated for the job. (For any medical job?) But also may not be up-to-date on what to do with patients needing specialized care. This is probably a community Hospital outside the University of Toronto medical school’s network. But the main conclusion the investigator would draw is that this doctor is incompetent. Or weird. The doctor may have, for his or her own bizarre emotionally disturbed reasons, decided that Yepes had a psychological condition and that the doctor knew that. How? He just did. And thus she got her creepy stress counseling with the breathing crap. We will probably never know how appalling this doctor is. Or if he/she was responding to pressure from the administration to not have ‘too many’ patients. Because there is no Transportation Safety Board-like thing for medicine. There can and should be. And because even when the newspapers (including the crack mayor exposing excellent one!) do a story on a life-threatening medical fuck up they don’t dig. They don’t ask how did this happen?

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Filed under Bad hospitals, Medical Horrors, Medical mistakes, Strokes

EBOLA In Dallas, SARS In Toronto

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First we hear there’s an Ebola case in Dallas. The man is in hospital, in isolation and everything is fine. Today, October 2 we hear when he first went to hospital he was turned away. And I thought oh my god it’s like Toronto.

In 2003 SARS hit Toronto. And everything fell apart. The first SARS case in hospital was the fortyish son of the elderly patient zero. She got it in China came back to Toronto, passed it to her son. And died. First screwup, she got a sign out autopsy. That’s where if you’re old and have multiple diseases when you die they don’t do an autopsy they just pick one of them and call that the cause of death. This is considered completely acceptable. So her son is in the emergency room coughing all over everybody the doctor he saw, an intensive care doctor, thought he had tuberculosis. Funny thing, tuberculosis is a reportable disease. To public health and you’re supposed to isolate the person. Like immediately. (Isolate means put the person in a room by themself where the air from that room can’t mingle with the air from the rest of the hospital. It’s very clever and it stops airborne diseases from spreading.) Did they isolate him? No, didn’t have the facilities to isolate people at that hospital. Because hey the age of epidemics is like over right? So he coughed on a guy named Pollock, Pollock then passes it to his wife and they both died.

Before people die from SARS they have trouble breathing so they get intubated, the people who do that are anesthesiologists. Anesthesiologists got sick with SARS and passed it to their family members and at least one anesthesiologist and his teenage daughter were both on respirators in the hospital. But did not die. An entire hospital Westpark IRCC was taken over for just nurses and doctors who were sick with SARS. A lot of people were on respirators all at once. This actually helped lots of places prepare for the and H1N1 outbreak in 09. They were ready with the respirators because they knew they might have to, and would be able to deal with, an epidemic of people needing help breathing. Please be aware, the hospital in your town does not have 30 respirators just sitting around in the basement. They may well have used them many during H1N1. They had to order them. That’s one good thing that came out of this and where people showed that they had their head screwed on right. During SARS, and planning for what came in 09.

Two family doctors died because patients were sick with a cough went to see the family doctor. The city didn’t have adequate protocols or places to put people with suspected SARS. No isolation rooms.

Except for Sunnybrook hospital, the major trauma center in Toronto. The guy in charge there as soon as he heard about the SARS thing rented compressor units that allowed him to turn regular rooms into isolation rooms. They’re called negative pressure rooms. They’re used in treating cancer too when the patients’ immune system is all buggered. In cancer they keep everybody else’s germs away from the cancer patient. They worked. None of the other hospitals did that. Not right away anyway. Two infectious disease doctors at another hospital both got SARS. They lived.

In an epidemic like this the public health department of the city government is one of the most important agencies in keeping it from being an even worse disaster. What a thrill. They are in charge of tracing contacts. Anybody who came into contact with the person who has in this case the respiratory-cough-the-germs-all-over the place disease. We’ve all heard about contact tracing when there’s an outbreak of foodborne illness. At a banquet or from a store. Whatever. This is a little more complicated. It’s some individual person’s trail through the city. Okay so public health departments did this all the time in the era of polio. They do it now for sexually transmitted diseases. The city of Toronto was completely unprepared. Their computer crashed. They were reduced to using tiny slips of paper with peoples names on being stuck into little charts on for floor. Well you might say nobody expected SARS. Everyone knew it was coming for a fact. They didn’t know what the disease would be but they knew that an epidemic like that and like Ebola now, was coming. They’ve had a name for it since at least the 90s and that name is jet spread. Okay you may say but if they didn’t know what disease was going to be spread by the jets then they couldn’t prepare for it. BULLSHIT. The way you fight epidemics of air- or sputum-borne diseases is with barriers. With the negative pressure room. With gowns and masks and gloves. It doesn’t matter what the microbe, the germ, is. What the microbe is matters for the drugs you give the person who is sick. But the keeping it from being spread is a whole other critter. They didn’t preplan they didn’t prepare they were fuck ups.

People were in quarantine, now it’s s called isolation in, their homes. They had suspected SARS and some of them did, some of them didn’t but nobody could tell until a certain period of time had passed. So they had to stay in their homes in a different room from the other people in it and wear masks. And they had to change the masks every so often and they had to take Their temperature. And they were checked on by an organization that was monitoring them, the Salvation Army? I think. Lots of quarantined people to monitor. They had to call in volunteers. Like during a hurricane or something. So that sounds pretty good right? And it would’ve been if they had been able to do it competently. They kept calling to check their temperatures of people who had already died of SARS. Competent planning, competent administrative stuff in a crisis would have completely prevented that. This stuff is doable. But you have to spend the time and money before the crisis to prepare for it. You do drills. They didn’t drill. Is that on the Salvation Army? It’s on the city of Toronto public health department. Let’s hope the Dallas one is more competent.

It gets better. The epidemic was slowing, maybe it had stopped. But with epidemics you have to wait until there have been no new cases for some period of time. Depending on the incubation period for the disease. Okay so one hospital in the north of Toronto said oh it’s over we’re going to stop doing our special procedures with the gowns and masks and gloves. We’re going to stop isolating people in the hospital who have pneumonia when we don’t yet know that it’s SARS. You know, the proper precautions. So they stop them. And there was a secondary outbreak of SARS in that hospital. Old people died who were in there to get joint replacements. Even though the outbreak was in a completely different ward. Why did it affect them. Weaker immune systems. That’s medicine 101. They had all the information they needed to do a good job. And this secondary outbreak was in the media for days before the goddamn hospital administration brought back the gowns and gloves and masks. Everyone knew what was going on and some idiot in charge managed to keep the right thing from being done for days or weeks. So elderly people in for joint replacements died. So did a young woman who was in having a fibroid removed from her uterus. Something you can wait six months or six years before you have done. Absolutely elective surgery. If the hospital had told her the truth about this possible SARS outbreak, that in fact was one, she was simply have had it done later and she would be alive today.

This is why the level of governmental that is in charge of fighting epidemics in our society can’t fuck up on every possible point.

Let’s just hope they don’t do this in Dallas.

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Filed under Bad hospitals, ebola, Epidemics, government, Medical Horrors, Medical mistakes, public health, SARS