Posted in bio ethics, Medical education, Medical ethics, medical satistics, tagged best medical quotes, bmj, dr venkatesan sangareddi, first do no harm primum nocere, hippocrates, Hippocratic oath, inappropriate medcial care, jamanetwrok, lancet, madras medical college, medcial ethics, medical science future, nejm, nobel prize in medicine, over treatment, principles of practice of medicine, william osler on September 8, 2023|
Postamble
This quote is being sent for the annual meet of “Right care movement” I know ,this can sound outrageous, permissble limits of abuse ? Up to 2% or 5% ? Let it be anything . Meanwhile try to enlighten yourself , the key differences between misuse & abuse.
Posted in bio ethics, cardiology wisdom, cardiology-ethics, Cardiology-Statistics, cath lab tips and tricks, Medical education, Medical ethics, medical quotes, medical satistics, Two line sermons in cardiology, wisdom in cardiology, tagged cath lab viablity vs myocardial viablity, myocardial viablity before pci ptca, myocardial viablity study on June 8, 2023| Leave a Comment »
Pure science
Whenever possible ,before doing a coronary revascularisation procedure , check twice the segments you try to perfuse is really short of blood supply and truly needs the procedure. Don’t ever waste your resources and try to blood-feed the dead myocardium. It’ can never be awakened !
Pragmatic science
I was conversing with my colleague recently , who has grown into suave , Interventional cardiologist with a huge academic & societal repute .He owns a personal cathlab and planning to get one more.
I learnt a non-academic reality lesson from him .
When planning myocardial revasascularisation, apart from myocardial viablity status, there is one more viability issue which is done in the account books of finance mangers across big hospitals. Its Cath lab viablity. Trust me, he used exactly the same word ! He went on to explain in detail , how, every day there must be a minimum number of procedures to keep the machine alive. Which is under the eagle eyes of the guys who funded the state of the art lab !
“So, what do you say,I asked him ?”
He was frank enough to admit, he felt always happy when he is able to convert angiograms into angioplasties.He went on to add , the Ideal CAG-PCI conversion ration should be atleast 3:1 or more.
“Whenver I hear such genuine statments from real world people , it pains, as it tends to confirm my assumptions ”
Final message
I am wondering with all my lost wisdom. Why should any cardiologist after 30 years of training, fight for cath lab viablity , and get into a conflict with the very organ they are supposed to care and protect.
When did we become so Inferior beings & fight for the survival of these life less machines ?
Meanwhile, major text books , has un-intentionally facilitated this academic deciet .They have largely taken away the sting out of the snake . Myocardial viablity , hibernating, stunned myocardium , are rarely given importance nowadays and made it appear taboo concepts,in cardiology academia.
Postamble.
Will be extremely happy if what is portrayed in this post is not really true.
Reference
Nandan S. Anavekar, Panithaya Chareonthaitawee, Jagat Narula, Bernard J. Gersh, Revascularization in Patients With Severe Left Ventricular Dysfunction: Is the Assessment of Viability Still Viable?,
Journal of the American College of Cardiology, Volume 67, Issue 24, 2016,Pages 2874-2887,
Posted in bio ethics, Ethics in Medicine, evidence based cardiology, Medcal research, Medical education, Medical ethics, medical quotes, medical satistics, Two line sermons in cardiology, tagged evidence based falsehoods, evidence based lies, evidence based medicine, evidence based nonsense, experience based truths, principles of medicine on October 3, 2021|
Is there a solution?
As I understand, we don’t have any. Maybe, we can try this. No way, I can prevent it from appearing ridiculous for the mainstream scientists.
Truths often lie silently buried deep (many times intentionally). They definitely deserve an intellectual resuscitation beyond the dirty world of data and evidence. Further, why should experience be considered as enemy of evidence ?
Posted in bio ethics, Medical ethics, medical quotes, medical satistics, tagged fraud in medical research, hippocrates oath modern science, how to interpret a study, how to read a scientific paper, jokes in science, medical ethics, medical research errors, medical statistics on June 28, 2016| Leave a Comment »
Dr.S.Venkatesan MD 