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familiar song/dance

flysurg at aol.com flysurg at aol.com
Sun Apr 16 02:48:54 BST 2006

Dr Nemeth,
I do agree with this characterization. Challenging a post vigorously is not disrespectful. Has this list serve succumbed to political correctness? Should we perhaps have lawyers and sensitivity trainers edit our posts?
I would suggest a thicker dermis is the best solution.
Steve Smith 
-----Original Message-----
From: joe.nemeth at staff.mcgill.ca
To: trauma-list at trauma.org
Sent: Fri, 14 Apr 2006 23:27:12 -0400
Subject: familiar song/dance

The below exchange occured very recently on this "station"... 
It has become all too familiar: 
Dr.X posts a valid question/remark 
Dr. ERF replies with his God-given wisdom (most of the time) PLUS sarcasm and disrespect (most of the time)... 
this then degenerates into what some would call an elementary school exchange (which no one really cares for) 
Dr.X stops asking questions/posting remarks OR 
Dr. ERF becomes more repectful with fellow colleagues 
I'll take the latter, 
-- Dr. Joe Nemeth 
Assistant Professor 
Emergency Medicine 
Montreal General Hospital 
Montreal Children's Hospital 
McGill University Health Center 
Dr. Rick, 
The text is 1996, so it is a decade old. I'm very sorry to quote from the archives. It sounds like you are saying that in order to prove benifit, we need a controlled longitudinal clinical study of significant power. I agree with you, but doing the study? In Wayne County (and elsewhere), let's say you don't give A/Bs and patient gets septic and dies. Somewhere there is a retired surgeon with an impressive CV (before he began drinking and developed his gambling problem) that will testify to a jury of 6 laypersons (not peers) that the patient would have lived if A/Bs were given, facilitating a judgement against he physician. Again, you may be right in saying that simply because someone says this is so does not constitute evidence of benefit, but citing this text to the jury is enough for them. Proving that giving prophylactic A/Bs actually harms the patient, well, that's another story. We never used to give A/Bs for puncture wounds of the feet, but a generous award to a patient who d 
eveloped osteomyelitis changed that... 
One may ask why we rarely see rheumatic heart disease in this country. To prove the impact of the routine administration of antibiotics for otitis, pharyngitis, and URI to our children (which are most often viral) on the incidence of this disease would be impossible. Yet, this begs the question as to why RHD remains relatively uncommon. 
One last note: It is obvious that you are very bright and experienced, and no doubt your brilliance exceeds that of the common physician. Your words will have far more meaning if you avoid the arrogant adjectives which permeate your text. Truly, if you work in a teaching environment, compassion and tolerance of ignorance will make you a far better teacher, rather than someone whom the residents will try to avoid because of the likelihood of being humiliated by your dissertations. I mean no disrespect, as your knowledge and skill as a thinker is unimpeachable; but your crude and condescending comments mitigate against meaningful discussion. That is, of course, this is what you desire. 
"I play with microbes. There are, of course, many rules in this play...but when you have acquired knowledge and experience it is very pleasant to break the rules and to be able to find something that no one has thought of...." Alexander Flemming, 1945. 
This list is really not a place to give a primer in the basics of the scientific method, which you apparently have no appreciation whatever of--it took me several years to understand it, you must just at this point realize how much you do not know and go from there to try to learn 
trauma-list : TRAUMA.ORG 
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