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Opiates & the Acute Abdomen

caesar ursic trauma-list@trauma.org
Sat, 12 Apr 2003 10:47:36 -0700 (PDT)

You are making absolutely no sense, I'm afraid. Are
you post-call? I think you should go back and read
some of my posts.  What does the phone interview of
one study have to do with the methodology of another
study that purports to determine the influence of
narcotics in a surgeons ability to diagnose a surgical
abdomen?  Nothing, but somehow you have made this
connection and are unwilling to let go.  Gimme a

I stand by my original statement, your rant
notwithstanding.  How about criticising my rationale
for rejecting the conclusions of this paper instead of
your perception of my motives for doing so.  Or do you
not think that their method was inherently biased?  I
wonder if you've even read it.

I simply cannot understand why some people justify
their clinical practices by quoting faulty literature.
 At least they should have the honesty to say:  "I do
what I do because I think it's the right thing to do
based on my experiences and based on common sense, and
it works for me and my patients."  But don't quote me
articles to defend your position when these articles
do not stand up to even basic scrutiny.  That's jsut
intellectual laziness.  Dr. Wangensteen would not

By the way, I examine opiated abdomens all the time,
and I feel that it really DOESN'T significantly affect
my ability to make the right call.  But I don't just
reflexively bow down before the altar of peer-reviewed
articles, especially bad ones, to prove that I am
right.  Pseudosciene indeed!

C.M. Ursic,M.D.
Dept. of Surgery
UCSF-East Bay
Oakland, California

I--- DocRickFry@aol.com wrote:
> In a message dated 4/12/2003 12:53:16 AM Eastern
> Daylight Time, 
> cmursic@yahoo.com writes:
> > And I base this opinion on
> > the methodology used, which allowed for the
> examining
> > doctors to examine each patient before AND after
> > narcotics were given.  Think of the bias that
> > introduces and how it differs from how we examine
> > patients in real life - i.e we don't have the
> benefit
> Oh--and a telephone survey of 5 questions to 60 ER
> docs is somehow more 
> scientifically rigid, more realistically attuned
> with how we examine patients 
> in real life??????  I get the feeling, Caesar, that
> you are going to beleive 
> what you want to believe, what your heart and mind
> are already set upon, no 
> matter what.  And--there is plenty of room for doing
> just that with the scant 
> firm data in existence on this issue.  But don't try
> to make your clear bias 
> the right one, and everyone else's wrong, using
> pseudoscience to make it seem 
> more valid--just admit to yourself that is what your
> opinion is, everyone 
> else be damned.
> "There are two groups of surgeons--those who see
> what they believe, and those 
> who believe what they see"-----Owen Wangensteen

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