Category Archives: rights

WEAKLY HUMERUS NEWS 12-08-07

TOP QUOTES OF THE WEEK

According to the latest numbers, our country’s national debt is growing by $1 million every minute. The Bush administration called its best economists and came up with a solution to save money: A 23-hour day. (Pedro Bartes)

December 7 is Pearl Harbor Day. Senator Ted Kennedy always commemorates the occasion in a fitting way. He goes out and gets bombed. (Alan Ray)

A man who claimed to have a bomb strapped to his chest, took hostages at Hillary Clinton’s campaign headquarters in New Hampshire and demanded to talk to Senator Clinton. This was the scariest time for Hillary since the night Bill mistakenly took Viagra instead of Lipitor. (Alex Kaseberg)

In a bold move that could dramatically alter the playing field of the 2008 G. O.P. presidential race, former Arkansas Governor Mike Huckabee today named Jesus Christ as his vice-presidential running mate. “This could be huge for Huckabee,” said Stenson Partridge, a veteran G. O.P. consultant. “Among Republican voters, Jesus Christ is even more popular than Ronald Reagan.” The Reverend Pat Robertson, a supporter of former New York mayor Rudolph Giuliani, said “I talked to Jesus last night and He didn’t mention anything about it.” (Andy Borowitz)

Rudy Giuliani billed New York for police protection for both his wife and his mistress seven years ago. He was sleeping with two women while recovering from prostate surgery. The Mitchell Report is expected to name sixty-four ballplayers and one mayor. (Argus Hamilton)

Porn star Mary Carey, who ran for governor of California against Arnold Schwarzenegger, is auctioning off her autographed, recently removed breast implants. It is not an uncommon idea; boobs in politics have been on sale for years in congress, ask lobbyists… (Pedro Bartes)

Ted Kennedy has signed a deal to write his autobiography. Although Kennedy is a little sensitive about including the word “auto” in his “biography”. (Jim Barach)

The Pope, is purging all modern music from the Vatican. The Pope is especially adamant that the priests give up their two favorite bands Boyz II Men and the Backstreet Boys. (Alex Kaseberg)

Hillary Clinton attacked Barack Obama during her speech in Iowa. The frontrunner is fading, the challenger can’t win, and the guys with all the talent can’t get any votes. This isn’t a presidential race, it’s the college football rankings. (Argus Hamilton)

On a feral cat which survived 19 days with its head stuck in a jar: That’s nothing. President Bush has survived living in a bubble since 2004. (Pedro Bartes)

New Jersey is preparing to scrap the death penalty next week. It makes sense, they’ve been outsourcing the death penalty to the private sector for years. (Alex Kaseberg)

Britney Spears again tops the list of the most frequent searches on Yahoo, but it’s not because she’s popular — it’s just that the confused performer keeps trying to find herself. (Scott Witt)

The government in Brazil is putting condom dispensing machines in public school restrooms to combat AIDS. If it works, it may be tried in the U.S., only they will be placed in the teachers’ lounge. (Jim Barach)

Continue reading

IS THE NEJM A LEFTIST MAG?

The New England Journal of Medicine has published, today, a few leading articles on the subject of child obesity, especially its implications for heart disease and the costs thereof to society. For more on childhood obesity, see my previous post.
The Journal pontificates on the subject and calls for action:

Unfortunately, the U.S. government has thus far invested only a fraction of a cent in research for every dollar that obesity costs society. And although broad consensus exists regarding the dietary and lifestyle habits needed to prevent and treat childhood obesity, we lack anything resembling a comprehensive strategy for encouraging children to eat a healthful diet and engage in physical activity. Such a strategy would include legislation that regulates junk-food advertising, provides adequate funding for decent lunches and regular physical activities at school, restructures the farm-subsidies program to favor nutrient-dense rather than calorie-dense produce, and mandates insurance coverage for preventing and treating pediatric obesity.

In other words, what it is saying is that the responsibility for some kids becoming fat should be shared by all of society, and that no kid should be exposed freely to a Macdonald’s burger or French fries. Not even an ad of the same.

It is, therefore, suggesting that tax money be spent on providing nutritious lunches in schools, and providing gyms and playgrounds for the kids. In addition, it is advocating insurance for all kids. The question I have for the learned journal is: Who is going to pay for it? And why?
Can one dare ask the high-and-mighty Journal, “What gives you the right to assume that State-funded care is all that is possible to tackle healthcare issues? As far as the issue of taxing people for these services, may I ask: By what right?”
What gives an obese kid (or anyone else, for that matter) the right to be a recipient of a part of my hard-earned money, unless I choose to do so?

The Journal assumes a Socialist position on healthcare rather casually.

Elsewhere in the same issue, it thunders on the cough preparations for children (that have been scientifically proven to be useless) and calls for banning them or, at the least, banning the ads. In other words, if your child has a persistent cough, and you want him or her to just take a bit of cough syrup and sleep it off, you don’t have the right. They have the right to stop you. You, the user, can do nothing. You see, you don’t have the brains to know which is good for your kid, or which ad to believe and which one to dismiss as crap. The Government will do this thinking for you.

To get back to the issue of child obesity, the most important things are for each of us to choose consciously what we need to do: watch less television, avoid junk food, and play or work out every day, for example. I accept that all this is easily said, but not done. The responsibility and the outcome squarely rests on the individual, his parent and his doctor.

The NEJM would have none of this. It would want everyone to be deprived of their choices (ads and junk food) just so that some of society would benefit. It is a moot point if any of these interventions will ever work on a large scale in society.
It gets shrill as it raises its political voice:

But why should Mr. and Ms. G.’s efforts to protect their children from life-threatening illness be undermined by massive marketing campaigns from the manufacturers of junk food? Why are their children subjected to the temptation of such food in the school cafeteria and vending machines? Why don’t they have the opportunity to exercise their bodies during the school day? And why must Mr. and Ms. G. fight with their insurance company for reimbursement to cover the costs of their children’s care at the OWL clinic?

Hello, did we hear right? We are all subjected to temptation. I want to be subjected to temptation: do I have a right or not? The NEJM says no, because temptation is bad for kids, at least some kids.

Isn’t a defence against rape to the effect that “she tempted me, it wasn’t my fault!”? So where is the concept of free will here? Where is the parental or school responsibility for the health of the children? Who, gentlemen, are going to pay for those ‘opportunities’ that you demand?

Every modern health problem seems to inspire Statist solutions, irrespective of the fact that State control in anything has not worked anywhere as well as capitalist solutions. Unfortunately, people living in First World countries and occupying prestigious chairs in the NEJM have not (possibly) seen the ground reality of Socialism in healthcare. They need look no further than India.

I wish to ask one final question to the Editors of the NEJM: Is the NEJM a leftist journal mag?

MEET ANIL, MY CELL-MATE!

Hello. Meet my new cellmate: Anil. He works in a small cell phone company. You know, those companies that bill you for those times you keep saying ‘hello, hello? Damn network!‘? He also runs the marathon, and plays the stock market a bit. Just a wee bit. Getting along in life, get the picture? Sitting next to him: Me.

About the latter: Does not work in a cell phone company. Does not run anywhere. A younger and (arguably) sexier ass than Anil’s does not, somehow, help achieve that kind of mobility. Keeps saying “hello, hello?” to a lot of the PYTs that swarm over him like flies over crap honey. In the stock market, Me was once found looking at other customers more than the listings of the scrips. Obvious neophyte, obvious looser-blogger.

The two of us are going to be cell mates in Tihar Jail, where India’s most notorious criminals and high profile legal guests are hosted by the State. Only that Anil does not know it. I have my side of things planned to a nicety. I will commit a nice little crime, like posting Sardarji jokes in this blog, and get arrested for hurting the sentiments of the poor Punjabis, just like Anil. Alternatively, I will solicit to do surgery on a well known Sardarji like Daler Mehendi, and remove the wrong testicle during a complex brain operation, thereby getting arrested. Clearly, the Court will be bowled by my legal No Ball! Arresting news this will make, too!!

Once in Tihar, Anil and I will be mates (I will arrange that, with my contacts in Cellular Jail).

Now, you, dear reader, must be wondering why I am plotting the destruction of my own career to become the cellmate of an Anil. And why he will be jail-bound. Wonder on!

I wish to take some stock tips from Anil. [Aside:Talking of which, I would be willing to share the same cell with his chauffeur as well, in case it is proven that Anil’s chauffeur, and not Anil, was actually responsible for sending dirty, ethnicentric SMS-jokes over the Reliance network.] Even if I make small change, it will be a few million dollars. After this, I plan to retire and spend my time in leisure. You know, like going to all the doctors’ conferences and looking these hard working asses in the eye and shouting “HA!” at them, before getting swept off in a BMW (notice how controlled my greed is, that I have no wish for further elevation and prosperity) by a couple of young but well-inflated girls with blond teeth, blond hair. As an Ambani, he has the qualifications to give me some advice. I shall certainly try to accomodate his. After all, “India mein muft ki advice bahut milti hai” (In India, you get a lotta free advice- an ad line of a popular cell phone ad of Reliance Mobile).

I know, you want to give me worshipping looks, saying, “What an Idea, Sirjee!”

So, here is my part of the bargain. Enjoy a couple of these Sardarji jokes, and get more at one of the many sites in Planet Google:
Click here for more.

Mr Harpreet Singh Gulati is traveling from Moscow to Turban Pore [Capital of Khalistan] by Kithe Pacific.

Seated besides him is Gary Kasparov. Gary asks him whether he would like to play chess to kill time.

Gulati : “Oye Gar(r)y. You think I don’t know who U are?. I can’t compete with a world champion”

Gary : “How about if I play left handed ?”

Gulati : [Think.. Think..] “OK!”

Gulati is demolished in 4 moves… and is very upset through-out the rest of the journey. On landing he meets his friend Manpreet Singh.

Gulati : Hey! U know what! I played Chess with Gary Kasparov and he defeated me in spite of him playing left-handed…

Manpreet : Oye ullu-de pathey!! He sure did fool you!! U know what!! Gary IS LEFT-HANDED!!

* * *

Sardars Hari Singh and Gani Singh are in a railway station.

Hari Singh asks the clerk: “Can I take this train to Ludhiana?”.
“No,” answers the Railway man.

“Can I?” asks Gani Singh.

Oye, Chak de phatte, yaaru!

CAN INDIA AFFORD RELIGION?

Religious India tramples individual rights repeatedly:
1. Taslima Nasreen is browbeaten in a supposedly civilized, free country.
2. MF Hussain is driven out of India.
3. Aaja Nachle (a new Hindi movie) is banned by a number of Indian states.
4. The movie, ‘Da Vinci Code’ was banned in several Indian states.
5. The Shiv Sena attack Valentine’s Day celebrations, as well as Orkut, the Indian social networking site.

Actually, all these are the mischief of the religious, though the purist will claim that the Dalit protectors who banned Aaja Nachle are atheists. Ah, that’s the catch! Atheists can subscribe to a form of belief that can only be called religion. Look at the BSP brand of belief: is it any less orthodox, rigid, or irrational than religion?
India is one of the biggest acts in the global stage. It pretends to be democratic and free, while it has been instrumental in oppressing the individual for decades in the name of ‘public interest’ or ‘protecting religious sentiments’. It bans books. It allows women to be beaten and stripped in public, as in Assam recently. It bans sex determination, but witnesses female feticide calmly. It celebrates religious festivals, but does not allow freedom of expression if it is perceived to be against a religion.

Religions are taking India to the level of a parody of a modern nation. It looks more like a medieval circus, where women are chased by some men, while the rest are clapping and cheering in thirst of real blood. Ultimately, all the vitriol of religion’s protectors seems to find a just conclusion in the act of stripping females naked or gang-raping them.

Purely in social terms, India will have to pay a heavy price for its religiosity. Its society is doomed to be in turmoil forever, with one wound after the other ripped up by the passage of time. I fear that this society will perhaps be irretrievably torn apart.

The contradictions of having a society that embraces Western-style civil liberties and economic freedoms along with an avowed betrothal to a rag tag of communists, environmentalists, social scientists, feminists, Islamists, and casteists will be exposed periodically. The educated class will perk up at each instance of atrocity and tut-tut about how things are going from bad to worse.
The answer to why things are going from bad to worse lies in our continually giving short shrift to individual rights. There simply cannot be collective rights anymore. In a multi-religious society like India, religion is merely the most glaring example of a collective.

THE ORIGIN OF RIGHTS

I don’t normally write a blog post on an article without having my own say, but here is an exception.
Amit Varma of India Uncut writes a splendid article on rights.
Check it out.

BLOODY LAWS!

The Indian Government has now slapped a punishment of imprisonment for professional blood donors. Anyone who sells his blood for money will be sentenced to three months imprisonment. What is more, the license of the blood bank will be forfeited. Full story here.
The rationale is that professional blood donors often are the worst sources of blood. They donate repeatedly, within days of the previous one, with their own body running short of the life-source. They do this simply because they need the money for sustenance. Many a time, they need the extra cash for drugs or alcohol. Blood from these people is liable to be tainted with HIV or hepatitis viruses.
So, all in all, this looks like one good move by the Indian Government, doesn’t it?
Not really, no. I think this is another idiotic act.
Professional blood donors may contribute as much as up to 30-40% (figures of uncertain veracity) of donated blood. India is chronically short of blood. People die because of lack of blood, following blood loss in accidents, shootouts, and surgeries. Is attacking the existence of these people going to do Indians any good when they need blood?
Around 6% of HIV and hepatitis cases are said to be due to transfusion of tainted blood. Is donation by professional donors the problem? Or is the failure of the Blood Banks in detecting these infected samples the problem? It is clearly the latter. The failure of the State in enforcing its own laws and the judgments of the Supreme Court have led to this mess. As it is, the country suffers from a major shortage of blood products. How has the decade-old ban on professional blood donors helped the problem? Have transfusion-related complications come down?
The problem with tainted blood is underlined by several other major deficiencies of Indian society. One is the abysmal standards of education, resulting in a huge lack of trained technicians to man the Blood Banks. Another is the poor state of the legal defence system, because of which unscrupulous private blood banks are left scot free even after failing in their duty to provide for safe transfusion.
A trade is a voluntary activity between individuals. One’s body and its components are one’s own property. If one cannot dispose of them or treat them as per one’s conscious choice, then who has the right to do so? The Courts? Whom are the courts protecting, and why? From the looks of it, this ban on organ trade seems to be a case of the Law deciding to protect the citizen from his own self!
Not surprisingly, countries the world over are squeamish in acknowledging the property rights of the individual to his organs. Take the recently publicised case of donor eggs in the ‘surrogate motherhood’ issue. It is illegal in the US and UK to sell your egg, though you are free to donate it.
Here is a Wikipedia entry on organ trade:

In compensated donation, donors get money or other compensation in exchange for their organs.
In the United States, The National Organ Transplant Act of 1984 made organ sales illegal; regulation by the OPTN has probably eliminated organ sales. In the United Kingdom, the Human Tissue Act 1961 made organ sales illegal.
Recent development of web sites and personal advertisements for organs among listed candidates has raised the possibility of selling organs once again, as well as sparking significant ethical debates over directed donation, “good-Samaritan” donation, and the current U.S. organ allocation policy.
Two books, Kidney for Sale By Owner by Mark Cherry (Georgetown University Press, 2005); and Stakes and Kidneys: Why markets in human body parts are morally imperative by James Stacey Taylor: (Ashgate Press, 2005); advocate using markets to increase the supply of organs available for transplantation.
In 2006, Iran became the only country to allow individuals to sell their kidneys, and the market price is US$2,000 to US$4,000. The Economist and the Ayn Rand Institute approve, and advocated a legal market elsewhere. They argued that if 0.06% of Americans between 19 and 65 were to sell one kidney, the national waiting list would disappear (which, the Economist wrote, happened in Iran). The Economist argued that donating kidneys is no more risky than surrogate motherhood, which can be done legally for pay in most countries.
Two European conferences in 2007 recommended against the sale of organs. In Pakistan, 40 percent to 50 percent of the residents of some villages have only one kidney because they have sold the other for a transplant into a wealthy person, probably from another country, said Dr. Farhat Moazam of Pakistan, at a World Health Organization conference. Pakistani donors are offered $2,500 for a kidney but receive only about half of that because middlemen take so much. In Chennai, southern India, poor fishermen and their families sold kidneys after their livelihoods were destroyed by the Indian Ocean tsunami two years ago. about 100 people, mostly women, sold their kidneys for 40,000-60,000 rupees ($900-$1,350). Thilakavathy Agatheesh, 30, who sold a kidney in May 2005 for 40,000 rupees said, “I used to earn some money selling fish but now the post-surgery stomach cramps prevent me from going to work.” Most kidney sellers say that selling their kidney was a mistake.

Clearly, vultures exploit the miseries of the poor people who are cheated in this transaction. That, in itself, does not mean the trade is unethical. The cheating of the donor is what is unethical. However, these examples are often the reasons public sentiment is stirred up to implement bans of the kind in question.
David Holcberg argues in The Economist article:

If the law recognises our right to give away an organ, it should also recognise our right to sell an organ (as long as there is no coercion involved). Those who could afford to buy organs would benefit at no one’s expense but their own. Those unable to pay would still be able to rely on charity, as they do today. If the government upheld these rights, many of the thousands of people now waiting for organs would be spared hideous suffering and an early death. How many? There is only one way to find out: set these people free.

Blood donation for pay is one example of trade in body parts. The larger ethical issues seem to be all solved, and the world seems to have embraced the philosophy of control of the individual’s rights to his own decisions. Therein lies a deep malady!

Lateral reading:
1. Nita’s article on autotransfusion.
2. Mine on Immaculate Conception.

CAN UNIVERSITIES HELP TERRORISTS?

Assume we are living in a free country that protects its own rights diligently. It also does not tolerate any infringement of the rights of any individual. No censorship, no discrimination, and no laws to favor one religion or the other.

In such a wonderful country, which by its very nature becomes the fountainhead of civil liberties, education, research, and economic power, a foreign national comes in and wants to acquire higher knowledge like say, nuclear science, microbiology, particle physics, etc., it would not be a surprise, would it? The US, for example, serves as an example by attracting millions of students for its educational and research facilities.

If such a foreigner (who may belong to a hostile country) actually takes back the knowledge this free society provides him, and goes back to use that same knowledge to attack it, what a travesty it would be!

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The current example of the Iraqi who was refused admission to a chemistry course brings this issue to focus.

According to a Nature News Alert:

A British resident who is under surveillance for suspected terrorist activities is being prohibited from taking secondary-school-level science courses by the government, Nature has learned.

The man, referred to as A.E., is contesting the decision in court, in what is believed to be the first case of its kind. The preliminary hearing over whether A.E. should be allowed to take AS-level courses in human biology and chemistry took place on 16 November at London’s High Court. The UK Home Office, which has an order restricting A.E.’s actions and affiliations, argues that such coursework could be turned towards terrorism. His solicitors counter that the knowledge is public, and that the furthering of A.E.’s education poses no threat.

At the heart of the case is a simple question: should basic courses in science be treated as potential tools for terror when in the wrong hands?

To protect the suspect, A.E.’s name and much of his personal information have been withheld from the public. What is known is that he is an unemployed Iraqi national in his mid-thirties who studied medicine at university in his home country. The government suspects him of terrorist affiliations, and he is the subject of a ‘control order’ — a special legal instrument that places limits on his freedoms.

While this issue pertains to a basic chemistry course, what would the issues be in more clearly dangerous and sensitive subjects like nuclear science or others that could potentially advance a terror outfit to develop biological, chemical or nuclear weapons?

On the face of it, an individual should not suffer from discrimination because others in his country are terrorists. Then again, no society should advance the cause of its sworn enemies.

What do you think: does the individual freedom of foreigners within a free society encourage the ultimate loss of its own freedom? What is the moral and practical thing to do?

This post is yours: comments please!

IN BAD TEST, DON’T MIND!

Loud Disclaimers:
1. This post was not written by me.
2. It is entirely hypothetical. Therefore, it is likely to be truer than the real news you read in the papers.
3. The blog owner, unlike his moniker, is not really a doctor.
4. If he is, he is one mean son-of-a-bitch (a Rambodog), who will likely be condemned by the honorable medical profession for besmirching its fair name.

Read at your own risk.

So you are unwell, and your doctor has ordered some tests? No? Maybe you need to take an executive health checkup or a pre-employment checkup: a clearance that will take your career to the next level?

Whether or not you hate hospitals, doctors and needles (for few are able to hate the nurses), you are going to be subjected to some tests one of these days.

This post is not meant to be a detailed exposition on medical labs. I will merely reveal some of the lesser known aspects of tests.

* Comprehensive health checkup, something that has been popularised by many leading hospitals, is a big rip-off. Not only do the hospitals make money doing so, but the down side is that diseases are revealed, when they probably would not have needed treatment at that time, if ever. In other words, not all abnormalities need to be detected or treated.

Let me give you an example:

Ajanta was a 26 year-old executive who was asked to undergo a health checkup at one of these modern Indian hospitals. An x-ray of the chest revealed a spot like a coin in one of the lungs. The doctor asked her to go for more tests to diagnose it.

“Is this cancer?” she asked, trembling.

“I can’t say, but it could be in some cases”, replied her doctor.

A CT scan of the chest was done, and the lesion was biopsied with a needle. Unfortunately, the needle went into a blood vessel, as well as into some airsacs, and Ajanta started getting faint and breathless as the blood and air kept leaking into her chest cavity and compressing her lungs.

Rushed to the emergency room, a tube drain was placed surgically into her chest to evacuate the blood and air. As she recovered from this mishap, more bad news came in. The biopsy was inconclusive. Another one would have to be done.

Alarmed, Aparna Ajanta left town for the best center in the country. Another scan-guided needle biopsy was done. The biopsy was again inconclusive.

Now she was heading towards surgery to remove and biopsy the coin lesion. The job was done cleanly by an experienced thoracic surgeon, and Ajanta recovered. The biopsy result?
Hamartoma, it said.
“What’s that?” she asked. Her doc replied that it was really not much except some abnormal tissue that was not a cancer.

If she had not known of this, she would possibly not have ever needed surgery for it.

Aparna was a Victim Of Medical Imaging Technology. VOMIT, in short.

VOMIT syndrome is now a well known complication of fruitless testing that throw up diagnoses that would often have been better left alone and unknown. This is one major reason why ‘let me find out if everything is okay in my body. Doc, I want all the tests, including the scans” is NOT a great idea. Treatment of many conditions is undertaken only because tests (like the chest x-ray in Aparna’s case) are done without indication, and doctors feel obliged to treat the newly diagnosed ‘disease’. Indeed, why do the tests if we are not going to treat what is found?

Other aspects of medical testing include:

* Poor standardisation of labs results in wrong reports that are sometimes dangerous.

Most labs are run with poor equipment. The tests are often done by unqualified technicians, and the pathologist or biochemist comes in only to sign the report. These doctors are rarely paid well enough for them to give much time at a lab. They, therefore, rush out of the lab after signing reports. Another center, same story. End of the day, some money has been made, but a bunch of useless or misleading reports are sent out.

* Labs, usually the ones not doing particularly well, give a hefty cut to the referring doctor, usually a medical specialist (internist). Of course, any one, from a general physician to a neurosurgeon, may avail of these ‘interpretation charges’ (‘IP’ in marketing jargon). Unfortunately, they might refer the patient to the highest bidding lab rather than the best one. Many doctors have their own lab, which could be another glorious example of the above prototype.

* In many Indian cities, of which Mumbai is a particularly obnoxious example, labs cheat patients, as exemplified by the Cheaterjee Labs. Look at this:

The marketing exec of the Cheaterjee Labs is telling the GP:

“Sir, we will cater to all your patients, rich or poor.
Please follow our system for the best results:
If you don’t really need the test, write out the tests in blue ink; we will just type a report and not waste our resources doing the test. In this case, we will give you 50% of the costs.
If you need us to give you a favorable report (for example, a higher blood sugar report, or a positive test for syphilis), please write in red ink. We will give you 40% of the costs of the tests.
If, however, you actually need us to give you accurate results, write in black. Your IP charges will be 30%.
Sir, here is a compliment from Mr. Cheaterjee, our Director. Please accept this set of three pens!”

Our GP is one smart cookie. He mainly treats the migrant laborers of Kurla, a Mumbai suburb. The Biharis and Bangladeshis are his patients. Illiterate, these poor, unsuspecting idiots think there is only one answer to their ailments: injections and glucose infusions.
For any problem, the GP admits them in his local hole-in-the-wall nursing home, and gives them the expected ‘treatment’. If the ‘customer’ is possessed of a little more cash, then tests are done. Now, the three-ink plan comes in handy. If the doc wants to squeeze some dough out of the patient, he can get a positive report for, say, syphilis, and then keep giving regular injections of penicillin, making a buck every week. A few such patients, and he has his sight on his next mutual funds investment.

* Most Government labs are horribly run. Exceptions are some of the good teaching hospitals in major cities.

* Most of the top private hospitals have decent facilities, but reports may vary. In case of cancers, it is the skill of the pathologist that makes the difference between right and a grievous wrong.

* Almost all healthy young patients below 40 years who need a routine surgery need NO pre-operative tests (useless, expensive, and wasteful). This international recommendation is zealously ignored by 99% of doctors.

There, I said it. Will I be a leper in the community of doctors now? Oh, I forgot, I am only a virtual one!

THE HIV-POSITIVE SURGEON AND YOU

It was a hot summer morning of 1992 when a bright young surgery resident stood up to address the Department of Surgery. The venue was a Government Medical College auditorium in Bombay, and the young resident was going to talk on a new subject: ‘AIDS and the Surgeon’. Listening with curiosity (for AIDS was only just beginning to register in Indian minds) were students, postgraduates and teachers of the Department of Surgery.

The resident talked of the HIV virus and the disease, and turned the topic to something far more interesting. “Given that the risk of getting AIDS through a contaminated needle prick during surgery is very low, how much lower are the chances of an HIV positive surgeon transmitting the disease to his patient? Should an HIV positive surgeon be allowed to operate on patients?, he asked.
That resident was me. Those questions were unanswered then. Today, prompted by Ergo’s post, I will try to answer them.

Look at the issue from a rights perspective. A patient deserves to be informed about his or her risks to be incurred during or after a surgery. For example, if you undergo a bypass surgery, you should know before you sign the papers that there is a risk of a lung infection or bleeding or dying from something else. Would you not like to know if the surgeon you are getting operated on by is HIV positive or not? Not unlike your wanting to know the HIV status of the guy (or girl) you are going to marry.

Looking from the perspective of the surgeon or dentist, any disclosure of a positive HIV status would spell the end of his career, and a major chance of starving to death. Because surgeons are generally not good for anything besides their own craft. Now, how reasonable is it to expect a man to condemn his existence by being honest and truthful to his patients, saying “I would like to operate on your prostate tomorrow, but I would like you to know that I am HIV positive. Don’t worry, I will take care….hey, where are you going? Please come back, lissen, will ya?”
Surprisingly, this has happened in real life. Professor George Browning, an ENT surgeon, was allowed to operate on his patients at a hospital in Glasgow back in the 1990s. His patients were considerate and understanding, and signed consent forms where his HIV positive status was clearly mentioned. He was the first known HIV positive surgeon to be allowed to operate. But would others be as well treated as he was?

The risk of the virus going from the surgeon’s body into the patient’s is said to be very, very small. However, the case of American orthopedic surgeon Dr. Scoles comes to mind. He was thrown out by his hospital because, as an HIV positive surgeon, even though the risk of his transmitting the virus to patients was very low, he was still a “significant risk”. Allegedly, there was a significant chance of his blood coming in contact with the patient’s.
Scoles lost his career, though he won a court case against the corporation owning the concerned hospital.
It is interesting to note that while he was discriminated against on the grounds of the principle that “the only acceptable answer is: no risk”, the hospital concerned had a significantly high death rate when cancer patients were admitted into their intensive care units. So did the hospital inform its patients before admitting them that they were twice as likely to die of pneumonia than in some other center? You bet not!
Scoles’ defendants asked: “With this in mind, who faces the greater risk: [..the hospital’s] cancer patients, or those seeking orthopedic surgery from an HIV-positive surgeon with an unblemished record?”

As a patient, you expect your surgeon to possess certain skills and standards. However, as a human being, is he a risk-taking type? Does he do drugs? Does he get drunk sometimes? Does he abuse people when agitated?

Would every patient be entitled to such personal information about their surgeon, because in specific cases it may be life-saving? Where does a surgeon’s right to privacy end and the patient’s right to know begin?

I have known of ‘great’, macho surgeons being absolute drunkards outside and inside hospitals. They have operated while being piss-drunk, or sniffed anesthetic gases before and after surgery, and no one really knows how many they have killed.
Therefore, these questions do have a valid, rational basis, though they may have sounded far-fetched at the outset.

My opinion is that an HIV positive surgeon, while maintaining his own confidentiality, should shift to mainly consultation, or do minimally invasive procedures, where there is minimal risk of his coming in direct contact with his patient’s blood. He should also keep a back-up surgeon in case something goes wrong and an invasive, open procedure is needed.

In recent years, the issue of HIV positive surgeons is being tackled in a pragmatic way. Various UK Government Health bodies have opined that “…it is no longer necessary to notify every patient who has undergone an exposure prone procedure by an infected HCW because of the low risk of transmission and the anxiety caused to patients and the wider public.”

I started off by talking about a young surgeon, back in 1992, giving a talk on ‘AIDS and the Surgeon’. He ended his talk by advising the audience to wear double gloves to protect themselves against accidental inoculation with HIV-tainted blood. His Professor then took the mike for expert remarks. The Professor said, “…He has given us new issues to deal with. However, one thing I must tell you: as a surgeon, you must do everything you can to prevent getting AIDS from patients. And the best way to do that is….USE A CONDOM!”

*General disclaimer: this blog and its owner have been certified as HIV negative*
*For a fascinating account of the Scoles case, read this article.*

THE DAY OF THE BANDHIT QUEEN

Today, I am reading and writing more than usual. Today, after all, has been declared as a day of collective rest. The declaration has been decreed by the Bandhit Queen of India, Mamata Bandhopadhaya.
In case you are not an Indian, a Bandh is a general strike, and you can have a glimpse of how it is in India, especially in Kolkata, the Bandh Capital of India.

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I have around 14 patients in three hospitals, all operated upon in the last forty-eight hours. Three of them had operations bigger than the routine stuff.
I am, naturally, obliged to see these patients and, therefore, had to leave home. I would normally have left early to escape any strife on the roads. However, I got lazy delayed for some important work, and left later, around 10 AM.

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I took some pictures of the roads for you. These pictures hint at the successful marketing of the ‘Strike or Strike’ method.

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In other words, if you are seen to disobey the strike, you will be open to attack, and I hear even Insurance companies won’t cover you for it.
I had to drive here and there along serpentine routes to escape gangs of goons. These gentlemen went about battering cars, and deflating tyres. The police were very helpful. They did not actually take the trouble of confronting the vandals, but generously warned drivers which routes not to take!

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Somehow, I managed to come back home with half my work done. I will have to wait till the evening to visit the rest of my patients. Fortunately, they are all doing fine.

The cause of calling the bandh is immaterial: there have been countless such strikes in recent times. The only effect has been the deterrent to foreign investors, the mileage extracted by the politicians of the gutter, and the humongous loss in financial and human terms.
I want to cook some Oriental food today, but can’t, because I can’t get spring onions and peppers from the (closed) local market.
However, people have more important concerns: countless surgeries have been postponed, many people have died because they have been unable to reach hospitals on time, and even the dead have to wait till the next day to be cremated.
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However, even these vultures of the diseased Indian polity cannot come in the way of true love, as can be seen above!
Nor can it stop the alcoholic from having a binge!

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In case you live on another planet, like the White House or the Karolinska Institute, that is a rickshaw!

Officially, the crucial service sectors, including healthcare, are exempt from the strike. On the ground, in real terms, the vandals spare none, unless you are lucky, and have ‘PRESS’ or ‘ON HOSPITAL DUTY’ written all over you. However, there have been occasions when this has not helped. I speak from personal experience.

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So, not having much option, I hope to enjoy the rest of the Bandh at home, and I wish you ‘Happy Bandh’. And, you too, Miss Bandhopadhyay, if you can elevate yourself to the level of reading a blog.