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MARK FORREST trauma-list@trauma.orgWed, 8 Jan 2003 18:54:02 -0000
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This is a multi-part message in MIME format. ------=_NextPart_000_0041_01C2B747.4FA0E260 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Dear all,=20 As a mere consultant in 'anaesthetics and critical care medicine' I am = something of a 'jack of all trades' and possible a 'master of some'.=20 In the UK the training of doctors puts few others in a position to = manage trauma continuously from 'roadside to critical care'.=20 In doing so I do not aim to be an 'expert' in all areas as this is = clearly impossible, but as Nick M recently pointed out, intensivists do = know when to call for help and where to get it from, whilst = co-ordinating a global management of the patient by all specialities. I respect any doctor that attempts to broaden their horizons beyond the = historical realms of their speciality, to the benefit of the patient. = However, I hope that the surgeons do not claim to have the monopoly on = this broad range of abilities. Come on guys, look at this list, we are all highly motivated = professionals attempting to improve our knowledge and skills, whilst = respecting the skills of others. Team work is the answer to optimal = care, not building isolated ivory towers or 'silos'! Finally for Lorna, whatever your issues, as Pret has so clearly = expressed, this does not appear to be the forum or list for you. Good = luck in with your cause. Can we talk trauma again now?! Regards Mark F ----- Original Message -----=20 From: Bjorn, Pret=20 To: 'trauma-list@trauma.org'=20 Sent: Wednesday, January 08, 2003 2:48 PM Subject: RE: trauma and critical care Lorna,=20 Speaking purely for myself, as a concerned trauma-list subscriber, I = confess that I don't clearly understand you, or what you're trying to = accomplish here. Admittedly, I'm not fluent in Canadian; but I don't = really think that the problem lies there. Other, smarter people than me = seem equally frustrated by your enigmatic prose, and the list is not = known for its patience with impertinent, outspoken (presumed) = laypersons. All of which is merely to say that even if there is some language = barrier in play, it's overshadowed by your inability to make a point, = and further crippled by your lack of any concrete identity or = credentials. Please tell us--without embellishment or metaphor--who you are; or = more precisely, what you do. Vocationally-speaking. I'm after clarity = here. Then, in the same fashion, tell us what you're trying to = accomplish on the trauma-list. If the answer to both questions remains in sum that you're Canada's = Twin #1, who was at some point either a desperately-injured woman or her = desperately-injured unborn child, be aware that such entitles you only = to a sincere but finite extension of sympathy--which may have already = been tendered. =20 If you have nothing clinically informative or provocative to offer the = list, and yet continue to submit as you have, then your participation is = bound to be unsatisfying (and eventually unpleasant) for you. There are = doubtless other internet forums which would embrace your interests and = your manner, but I think you should consider whether the trauma-list is = a good fit. Regards, Pret -----Original Message----- From: Lorna Clark [mailto:squeak61@shaw.ca] Sent: Tuesday, January 07, 2003 8:18 PM To: trauma-list@trauma.org Subject: trauma and critical care Pret - Thankyou for your gracious comments and no none of it is = disrespect. Your most certainly right in that you never read messages = like mine before. I am aware of adult male surgeons, they sometimes have = loaded devices. As for change, one can only change themselves in the = pursuit of touching the lives of many in the process. As to what flies = are attracted to, that's easy, just get rid of the s. The secret is how = as you don't want as mess. Pret- Trauma I am closer to the realty then what many will ever = even come close to or ever understand.=20 Pret how do you manage a trauma patient with a massive = hematoma(1500cc) across the span of the entire liver, left lobe 4 = massive tears,another (500cc) at the dome of the liver while the baby is = inside the mother and she's bleeding to death. Critical care, the nurse = said oh that's a screamer while platelets dropped to 34 and oxygen as = well as blood was being cut off from the baby.The doctor, well he's in = the emergency because he's the surgeon. Once 4lb baby arrived in the = world compressions were done and they thought the broke every bone in = her body. What would be the course of critical care would it be derived from = opinions, see the parallel why Rick is right. Pret I came to this site for a reason and I found something special = and I'm sorry I can't let go of it. The challenge, if you could take your courses and take out what is = not really working and add in something better. Then teach again by = refocusing to save lives could you be a part of it by supporting it = directly or indirectly. Pret I leave you with a book to read. Go into Canadian Health Care = and retrieve Ray Romanov's book. Would you rather see doctors and nurses = paid 500million or billion dollars for your skills and services or for = it to be paid for the ole magic pill or devices into the hands of those = who are oblivious to healthcare in their pursuit of greed. ------=_NextPart_000_0041_01C2B747.4FA0E260 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <HTML><HEAD> <META http-equiv=3DContent-Type content=3D"text/html; = charset=3Diso-8859-1"> <META content=3D"MSHTML 6.00.2719.2200" name=3DGENERATOR> <STYLE></STYLE> </HEAD> <BODY bgColor=3D#ffffff> <DIV><FONT face=3DArial size=3D2>Dear all, </FONT></DIV> <DIV><FONT face=3DArial size=3D2>As a mere consultant in 'anaesthetics = and critical=20 care medicine' I am something of a 'jack of all trades' and possible a = 'master=20 of some'. </FONT></DIV> <DIV><FONT face=3DArial size=3D2>In the UK the training of doctors puts = few others=20 in a position to manage trauma continuously from 'roadside to = critical=20 care'. </FONT></DIV> <DIV><FONT face=3DArial size=3D2>In doing so I do not aim to be an = 'expert' in all=20 areas as this is clearly impossible, but as Nick M recently pointed = out,=20 intensivists do know when to call for help and where to get it from, = whilst=20 co-ordinating a global management of the patient by all=20 specialities.</FONT></DIV> <DIV><FONT face=3DArial size=3D2>I respect any doctor that attempts to = broaden their=20 horizons beyond the historical realms of their speciality, to the = benefit=20 of the patient. However, I hope that the surgeons do not=20 claim to have the monopoly on this broad range of=20 abilities.</FONT></DIV> <DIV><FONT face=3DArial size=3D2></FONT> </DIV> <DIV><FONT face=3DArial size=3D2>Come on guys, look at this list, we are = all highly=20 motivated professionals attempting to improve our knowledge and skills, = whilst=20 respecting the skills of others. Team work is the answer to optimal = care, not=20 building isolated ivory towers or 'silos'!</FONT></DIV> <DIV><FONT face=3DArial size=3D2>Finally for Lorna, whatever your = issues, as Pret=20 has so clearly expressed, this does not appear to be the forum or list = for you.=20 Good luck in with your cause.</FONT></DIV> <DIV><FONT face=3DArial size=3D2></FONT> </DIV> <DIV><FONT face=3DArial size=3D2>Can we talk trauma again = now?!</FONT></DIV> <DIV><FONT face=3DArial size=3D2></FONT> </DIV> <DIV><FONT face=3DArial size=3D2>Regards</FONT></DIV> <DIV><FONT face=3DArial size=3D2>Mark F</FONT></DIV> <BLOCKQUOTE dir=3Dltr=20 style=3D"PADDING-RIGHT: 0px; PADDING-LEFT: 5px; MARGIN-LEFT: 5px; = BORDER-LEFT: #000000 2px solid; MARGIN-RIGHT: 0px"> <DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV> <DIV=20 style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: = black"><B>From:</B>=20 <A title=3Dpbjorn@emh.org href=3D"mailto:pbjorn@emh.org">Bjorn, = Pret</A> </DIV> <DIV style=3D"FONT: 10pt arial"><B>To:</B> <A = title=3Dtrauma-list@trauma.org=20 href=3D"mailto:'trauma-list@trauma.org'">'trauma-list@trauma.org'</A> = </DIV> <DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Wednesday, January 08, = 2003 2:48=20 PM</DIV> <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> RE: trauma and = critical=20 care</DIV> <DIV><FONT face=3DArial size=3D2></FONT><FONT face=3DArial = size=3D2></FONT><BR></DIV> <DIV><FONT face=3DArial color=3D#800000 size=3D2><SPAN=20 class=3D090401712-08012003>Lorna, </SPAN></FONT></DIV> <DIV><FONT face=3DArial color=3D#800000 size=3D2><SPAN=20 class=3D090401712-08012003></SPAN></FONT> </DIV> <DIV><FONT face=3DArial color=3D#800000 size=3D2><SPAN=20 class=3D090401712-08012003>Speaking purely for myself, as a concerned=20 trauma-list subscriber, </SPAN></FONT><FONT size=3D2><FONT = color=3D#800000><FONT=20 face=3DArial><SPAN class=3D090401712-08012003>I confess that I don't = clearly=20 understand you, or what you're trying to accomplish here. = Admittedly,=20 I'm not fluent in Canadian; but I don't really think that the problem = lies=20 there. Other, smarter people than me seem equally frustrated by = your=20 enigmatic prose, and </SPAN><SPAN class=3D090401712-08012003>the = list is=20 not known for its patience with impertinent, outspoken (presumed)=20 laypersons.</SPAN></FONT></FONT></FONT></DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003></SPAN></FONT></FONT></FONT> </DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003>All of which is merely to say that even if = there is=20 some language barrier in play, it's overshadowed by your inability to = make a=20 point, and further crippled by your lack of any concrete identity or=20 credentials.</SPAN></FONT></FONT></FONT></DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003></SPAN></FONT></FONT></FONT> </DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003>Please tell us--without embellishment or=20 metaphor--who you are; or more precisely, what you do. =20 Vocationally-speaking. I'm after clarity here. =20 </SPAN></FONT></FONT></FONT><FONT size=3D2><FONT color=3D#800000><FONT = face=3DArial><SPAN class=3D090401712-08012003>Then, in the same = fashion, tell us=20 what you're trying to accomplish on the=20 trauma-list.</SPAN></FONT></FONT></FONT></DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003></SPAN></FONT></FONT></FONT> </DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003>If the answer to both questions = remains in sum=20 that you're Canada's Twin #1, who was at some point either a=20 desperately-injured woman or her desperately-injured unborn child, be = aware=20 that such entitles you only to a sincere but finite extension of=20 sympathy--which may have already been tendered. =20 </SPAN></FONT></FONT></FONT></DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003></SPAN></FONT></FONT></FONT> </DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003>If you have nothing clinically informative = or=20 provocative to offer the list, and yet continue to submit as you have, = then=20 your participation is bound to be unsatisfying (and eventually = unpleasant) for=20 you. </SPAN></FONT></FONT></FONT><FONT size=3D2><FONT = color=3D#800000><FONT=20 face=3DArial><SPAN class=3D090401712-08012003>There are doubtless = other internet=20 forums which would embrace your interests and your manner, but I think = you=20 should consider whether the <EM>trauma-list </EM>is a good=20 fit.</SPAN></FONT></FONT></FONT></DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003></SPAN></FONT></FONT></FONT> </DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003>Regards,</SPAN></FONT></FONT></FONT></DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003></SPAN></FONT></FONT></FONT> </DIV> <DIV><FONT size=3D2><FONT color=3D#800000><FONT face=3DArial><SPAN=20 class=3D090401712-08012003>Pret</SPAN></FONT></FONT></FONT></DIV> <DIV><SPAN class=3D090401712-08012003></SPAN><FONT face=3DTahoma><FONT = size=3D2><SPAN class=3D090401712-08012003><FONT face=3DArial=20 color=3D#800000></FONT></SPAN></FONT></FONT> </DIV> <DIV><FONT face=3DTahoma><FONT size=3D2><SPAN=20 class=3D090401712-08012003> </SPAN>-----Original=20 Message-----<BR><B>From:</B> Lorna Clark=20 [mailto:squeak61@shaw.ca]<BR><B>Sent:</B> Tuesday, January 07, 2003 = 8:18=20 PM<BR><B>To:</B> trauma-list@trauma.org<BR><B>Subject:</B> trauma and = critical=20 care<BR><BR></DIV></FONT> <BLOCKQUOTE style=3D"MARGIN-RIGHT: 0px"></FONT> <DIV><FONT face=3DArial size=3D2>Pret - Thankyou for your gracious = comments and=20 no none of it is disrespect. Your most certainly right in that = you=20 never read messages like mine before. I am aware of adult male = surgeons,=20 they sometimes have loaded devices. As for change, one can only = change=20 themselves in the pursuit of touching the lives of many in the = process. As=20 to what flies are attracted to, that's easy, just get rid of the s. = The=20 secret is how as you don't want as mess.</FONT></DIV> <DIV><FONT face=3DArial size=3D2></FONT> </DIV> <DIV><FONT face=3DArial size=3D2>Pret- Trauma I am closer = to the=20 realty then what many will ever even come close to or ever = understand. </FONT></DIV> <DIV><FONT face=3DArial size=3D2></FONT> </DIV> <DIV><FONT face=3DArial size=3D2>Pret how do you manage a trauma = patient with a=20 massive hematoma(1500cc) across the span of the entire liver, left = lobe 4=20 massive tears,another (500cc) at the dome of the liver while the = baby is=20 inside the mother and she's bleeding to death. Critical care, the = nurse said=20 oh that's a screamer while platelets dropped to 34 and oxygen as = well as=20 blood was being cut off from the baby.The doctor, well he's in the = emergency=20 because he's the surgeon. Once 4lb baby arrived in the world=20 compressions were done and they thought the broke every bone in her=20 body.</FONT></DIV> <DIV><FONT face=3DArial size=3D2>What would be the course of = critical care would=20 it be derived from opinions, </FONT><FONT face=3DArial size=3D2>see = the parallel=20 why Rick is right.</FONT></DIV> <DIV><FONT face=3DArial size=3D2></FONT> </DIV> <DIV><FONT face=3DArial size=3D2>Pret I came to this site for a = reason and I=20 found something special and I'm sorry I can't let go of = it.</FONT></DIV> <DIV><FONT face=3DArial size=3D2>The challenge, if you could = take your=20 courses and take out what is not really working and add in something = better.=20 Then teach again by refocusing to save lives could you be a part of = it by=20 supporting it directly or indirectly.</FONT></DIV> <DIV><FONT face=3DArial size=3D2></FONT> </DIV> <DIV><FONT face=3DArial size=3D2>Pret I leave you with a book to = read. Go into=20 Canadian Health Care and retrieve Ray Romanov's book. Would you = rather=20 see doctors and nurses paid 500million or billion dollars for = your=20 skills and services or for it to be paid for the ole magic pill or = devices=20 into the hands of those who are oblivious to healthcare in their = pursuit of=20 greed.</FONT></DIV></BLOCKQUOTE></BLOCKQUOTE></BODY></HTML> ------=_NextPart_000_0041_01C2B747.4FA0E260--
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