We have another case of an alleged horrific injury due to the ever-present delays at emergency rooms in the United States. Malyia Jeffers, 2, was left for hours in the ER at the Methodist Hospital in Sacramento as her Strep A devoured her body. She ultimately lost both of her feet and one of her hands to amputations and she is fighting for her life at Stanford University’s Lucile Packard Children’s Hospital.
The family arrived in early December when Malyia had developed a fever and was lethargic. She also had visible bruise-like splotches on her cheeks. They sat there for five hours despite the pleas of the parents.
She was in septic shock from a Streptococcus A infection. She is now on life support.
While Malyia’s parents have medical insurance, many of their bills are not covered, including the $26,000 bill for a helicopter ride from Sacramento to Palo Alto.
I am unclear why the helicopter ride is so expensive or why it would not be covered given the medical emergency. Moreover, I do not understand why Democrats and Republicans cannot agree that the current delays in the emergency room are nothing short of a national scandal. We have all experienced these waits in ER rooms. Putting aside the current debate over the health care program, it remain a national disgrace that citizens routinely wait for hours for care. Yet, these same legislators who refuse to do anything about these lethal days are often those supporting caps on recovery for families in tort cases.
Obviously, there is a tort case in the making here for negligence. However, it could turn on factual causation question of whether Strep A would likely have resulted in the same amputations even if properly diagnosed. It would make for a poor jury case, however, for the hospital if this should go to trial.
Source: SacBee
Jonathan Turley
PatricParamedic:
I checked back here while working away at words in reply to Otteray Scribe, and noticed your comment, to which I will reply now, so as to not lose track of what else I am working at learning.
While I expect such would be different for someone not me, I do not have any way to evaluate whether what I lose in one way at one time in one place is of lesser,equal, or greater value than what I gain in another way, otherwise, elsewhere.
Were the way the world is entirely up to me, surely much would be very different. Your dad would be with you, along with your grandparents, great-grandparents, and more. Only, I have little difficulty, using system dynamics approaches, in discovering that a world in which everyone gets what they want when they want it would quickly become a world in which no one ever gets anything.
Establishing value without error is a problem within a problem, infinitely nested, as I can best imagine. This is an aspect of the concern of Otteray Scribe, on which I am working. It is of the form, “If not this, then what,” in a decision space of unfathomable complexity. One can separate out one component of a system and isolate it and conjecture what that one component would do in a hypothetical situation which will never actually happen.
Alas, the way my life works, neither what I lose nor what I gain are nebulous as I experience them. For me, it is child-like simple. I can affirm the life I am able to live as I live it, or I can reject the life I am able to live as I live it. The latter takes me toward the agony of despair, the former accords to me an affirming integrity.
There was that Twilight Zone clip. If the law serves man, did the spaceship ramp just close? If man serves the law, who is served, and who serves?
One among many of my reference books is H. L. A. Hart, “The Concept of Law,” Oxford at the Clarendon Press, 1961.
From page 71:
…Certain provisions of the United States constitution have been held to raise ‘political questions’, and where a case falls within this category the courts will not consider whether a statute violates the constitution.”
As it appears to me that funding for medical care and medical care facilities is a matter of public policy formulation, and therefore, political, what is the relevance of the art of law-making and law-enforcement upon whether medical blunders become more or less probable in the future?
“Every time I lose an aspect of the struggle with yet another egregious situation, I seem to win an aspect of understanding the meaning of the enigmatic tragedy of existence itself.”
Well & good & as valid a point as can be made – in the objective.
But I strongly suspect that oftentimes the two parts are not of equal value at all. In the subjective, I’d far rather have my father back, than the nebulous understanding of why that can’t happen.
eniobob,
wisdom
“Every time I lose an aspect of the struggle with yet another egregious situation, I seem to win an aspect of understanding the meaning of the enigmatic tragedy of existence itself.”
J. Brian Harris, Ph.D., P.E.
” … yet each way of hoping, loving and trusting life is of a unique pattern, not only in each person, but also in each moment of each person’s life.” (Dr. Harris)
And this unique pattern that is not only the person but also each moment in the person’s life can account for that person’s reaction within the moment and why one individual’s reaction differs from another’s experiencing the same moment? i.e Why condemnation/praise of another should be suspended until the unique pattern of the individual is determined (if it is possible to do so at all)?
(I am attempting to understand the philosophical points you have raised in your texts … or … playing them back in my words to see whether or not I have caught the gist.)
As best I now recall; memory is sometimes reconstructive…
One Friday, my father-in-law, Allen Hamilton, P.E., was feeling poorly and went to see his physician, who practiced at West Suburban Hospital, in Oak Park, Illinois. Nothing wrong recognized by the medical people, Allen was sent home.
In the evening, Allen felt more poorly yet, and called the hospital and described his experienced symptoms. He was told to call the next Monday for an appointment.
Allen and his wife, Margaret, went to bed. About 3:00 on Saturday morning, our phone rang, my wife and I awakened and answered it. Margaret said to us, “Allen is very cold, and I cannot wake him.”
Cremation, memorial service, memorial garden.
In that memorial garden are names, names of people who died in the presence of medical care which contributed to their deaths. Allen J. Hamilton. Margaret R. Hamilton. J. Don Harris. Lillian L. Harris.
Not always medical mistakes. In a cemetery in Chicago, Michael Harris, Shelly Dukes. Mercury Sable. Welding mistakes.
When the writing was originally finished, May 29, 1914, the last word of Joseph Conrad’s “Victory” was “victory.” From “Note to the First Edition,” page vii:
“The last word of this novel was written on the 29th of May, 1914. And that last word was the single word of the title.
Those were the times of peace. Now that the moment of publication approaches I have been considering the discretion of altering the title page. The word Victory, the shining and tragic goal of noble effort, appeared too great, too august, to stand at the head of a mere novel. There was also the possibility of commercial astuteness deceiving the public into the belief that the book had something to do with war.”
I do not have the first edition; rather the second, copyright 1921. Public domain, nonetheless. The second edition ends not with “Victory.”
The last page of the novel, page 412, reads:
Davidson took out his handkerchief to wipe the persperation off his forehead.
“And then, your Excellency, I went away. There was nothing to be done there.”
“Clearly,” assented the Excellency.
Davidson, thoughtful, seemed to weigh the matter in his mind, and then murmured with placid sadness:
“Nothing!”
Now, approaching a hundred years since Conrad’s “Victory” was first finished, subsequent events, unknowable by Conrad because they had not happened, re-frame his book in my heart, mind, spirit, and strength.
I find the writings of Joseph Conrad to be very much about war. “Victory,” however, is, with me, not exactly about the human tradition of war among and between nations; it is about the inner war of experiences and their meanings which society endeavors to teach us to hide from ourselves as we hide it from others.
I cannot lose what i never had. I have never had the future, as it is always at least one moment away from where I am.
From my copy of “Victory,” page 410, the Excellency:
“Ah, Davidson, woe to the man whose heart has not learned while young to hope, to love–and to put its trust in life!”
Were I asked of my understanding of what Conrad had the Excellency say, it would be that it is not really necessary to learn to hope, love, and trust life; such was the way every newborn I have ever observed, as I have been able to observe, is born, yet each way of hoping, loving and trusting life is of a unique pattern, not only in each person, but also in each moment of each person’s life.
Every time I lose an aspect of the struggle with yet another egregious situation, I seem to win an aspect of understanding the meaning of the enigmatic tragedy of existence itself.
And…
Otteray Scribe:
The question you asked of me in your comment of January 4, 2011 at 6:51 am is one I find as profoundly significant as any ever to come my way. I will reply. However, I will need to be diligently careful in my choices of words and word sequences, and will first write my reply using WordPerfect, as it has tools that I will find helpful which are not available within the blog “Leave a Reply” text entry box…
eniobob,
Your story underscores the importance of carefully listening to “the patient.” Someone in the medical profession once told me to “listen to (my) patients, because the patient usually knows…”
Too many times, medical professionals believe that they “know best” — arrogance gets in the way. Thanks for sharing your story. Maybe it will help someone else somewhere down the road… Having said this, it doesn’t make it any easier for you. I’m sorry for what happened — it’s all the harder when one knows that there could have been a different outcome, if only…
eniobob,
My condolences as well. It is never easy to loose a loved one, but egregious circumstance is a compound injury.
mespo,none taken.And to all thanks again for your expressions of concern.
Swathmore Mom I came in with my mother to the er after calling all night telling them something was wrong with my mother,they told me since she had just been there that day all they would do would be to send her back home since the doctor found nothing wrong.
Finally after my calling all night they sent an ambulance,Like I said I went in with her and came home with out her.
And to really make matters worse after the funeral and we had friends and family at the repass,the doctor called to apologize.
anger and disbelief.
Thanks again for the concern.
The unending cycle of rage and despair contained in a singly word: “why?”, in this case followed by a soft reply of consolation.
Take it or leave it as one is capable of.
The only constant in life is beauty. The continual change keeps it forever new. -That’s the seat in the universe I’d like to occupy… and share.
Dr. Harris:
You have described the almost indescribable. That is a great explanation and description of the kind of synesthesia of words and mental pictures experienced by persons with certain kinds of autism. I have a relative who thinks in pictures but cannot tie them together. When he was working on his Master’s Degree in education, he had a class assignment to design an elementary school building. He drew some very beautiful plans, showing the classrooms, offices and utility areas. There was only one thing wrong. While he could visualize each classroom and knew in his mind where each fit in the total scheme, he could not connect them together on paper. So his plans consisted of a group of classrooms, none of which were contiguous on the paper. In other words, several rows of block-like rooms, none touching each other. That had to be the strangest set of plans I ever saw, but somehow they were beautiful in their isolated simplicity.
Perhaps you would like to address your understanding of that phenomenon, from your unique worldview as an engineer who has to deal with working drawings on a daily basis, and who is at the same time, autistic.
PatricParamedic,
You wrote, please allow me to quote,
“Are we supposed to die today, at the hands of an egotistical maniac?
To argue “yes” wreaks of manifest destiny.”
To me, and perhaps to no one else in an infinitude of eternities, I am saddened by the way that question and its given answer portend of assuming the consequent. Why I write that may be more usefully understood if I do a little dance on the side, with me, you may abide if you will.
Dr. Temple Grandin, who wrote “Thinking in Pictures” has described how she has awareness of the way non-human animals think, and that this is a necessary ability in her engineering work in designing animal-soon-to-be-human-food handling systems. When I first read her book, I wondered what it would be like to be able to think in pictures. Then it struck me like a mythic Zeusian thunderbolt. Some people may be able to think in words.
My parents were autistic, my mother much as I am, my dad, like my brother, of the Asperger’s Syndrome form; thinking in words was possible for them; my mother understood how I experience life vastly more fully than anyone else I have ever encountered.
My parents started out with the belief that I would be how I could be, and how I could be would be good enough. And, therefore, when I was very young, and during the first two years after being born, I did not encounter people who were able to convince me that I ought not be as I was.
For about the first four years of my life after being born, we lived in Butte, Montana, where my dad was the minister at United Congregational Church. While some members of the congregation and some people I met other than at home or church clearly deemed me in need of repair, and I recognized their view, my dad was able to talk with people at church and get them to let me be me.
When I was around a year and a half from birth, my dad observed that I was not going through one of the traditional developmental milestones — those words were not what he used with me — yet he did share his concern about my not learning that I had done something wrong when other people so deemed me to have done.
Told that I had been told to do or not do something and that I had not done as I was told, I had words enough to state that I had not understood what I had been told until after I had attempted doing, or not doing, it, and therefore had no way to do otherwise than to avoid what I had done or do what I had avoided doing.
In my iatrogenic psychosis saga, some of the psychiatrists remarked that I was talking about what is supposed to be pre-conscious (Sigmund Freud, anyone?) and that what I was doing was supposed to be impossible. It turns out, and Quantative Electroencaphalography confirms (I was given the original computer printout), my center of consciousness is far back in the brain, and not in the cerebrum. While the QEEG software is proprietary, the statistics given suggest to me that it ought to take quite a bunch of galaxies, with most stars having humans on planets, before frequentist statisticians would expect to find anyone like me.
One psychologist asked me why I “wanted to be so rare.” I replied, in effect, “I am one-of-a-kind-in-forever, just as is everyone else. I am exactly as rare and unique as everyone else is. I only want to know what happened to me.”
From Benjamin Hoff, “the Tao of Pooh,” Penguin Books, 1982, “The Pooh Way,” page 77 (Benjamin Hoff is talking with Pooh):
…The animals in the Forest don’t think too much; they just Are. But with an overwhelming number of people, to misquote an old Western philosopher, it’s a case of “I think, therefore I am Confused.” If you compare the City with the Forest, you may begin to wonder why it’s [italics on]man[italics off] who goes around classifying himself as The Superior Animal.
“Superior to what?” asked Pooh.
“I don’t know, Pooh. I’ve tried to think of [italics on]something[italics off], but I just can’t come up with an answer.”
“If people were Superior to Animals, they’d take better care of the world,” said Pooh.
“That’s true,” I said.
For the rest of the story, please read the book.
Pain? The nurse said I was experiencing “unbearable” pain. Then it was as though an order of magnitude greater. Not a day at a time, not an hour, not a minute. I could manage the pain of one breath, then another. Then as though an order of magnitude more yet. I could manage about a hundredth of a breath, more pain than that, I could not imagine surviving. Spasms at the ileo-rectal anastomosis and more.
Pain that took away my capacity to say words. The University of Illinois Pain Clinic. Second opinion at Mayo, Rochester. Transecting nerves might stop the pain, but I would not likely be very functional. I set out to see if I could use biofeedback to regulate what is usually autonomic. Yes, but it took time and, if spasm start,I need to stop every thing else and lie down, quietly, to get the biofeedback to work. Over the intervening years, I have become increasingly aware of the prodromal indicators of spasms, and can usually arrest them if I can lie down soon enough and be undisturbed enough.
Sobibor, Bergen-Belsen, Nagasaki. The death penalty. I complain not of the pain of my life. Perhaps I have yet to know real pain…
I do what I am able to do, as an animal and perhaps sometimes as though a person, to do what I am able to do, to take care of the world.
The term manifest destiny, as you probably know, came about in the mid 1880s & referred to the Anglo-Saxons “mission” to sweep across & dominate the continent. To Hell with the natives or anyone else. Some equated it to “Divine Right.”
But the concept is thousands of years old, and has been expounded upon in the writings of royal families, from Siam’s King Indraditya, Roman historians, and even further back than that.
Regardless, the essential concept of any earthly mission being preordained, in any context, is far older than the phrase itself.
Former Fed,
Only 5 that we know of!
FFLEO,
Exactly!
From BBB’s Wiki link:
“The belief in an American mission to promote and defend democracy throughout the world, as expounded by Abraham Lincoln and Woodrow Wilson, continues to have an influence on American political ideology:
_______________
The illogical “belief” that has us in about 5 foreign wars today.
eniobob,
🙂 … with love
BBB,
But that is exactly the beauty of the phrase … “To argue “yes” wreaks of manifest destiny.”
I despise the Manifest Destiny concept … self-righteous bullying and imperialism … it’s a beautiful phrase for certain uses so I will steal it or adopt it. (I like your use of “adopt” … makes me sound more law abiding. 🙂 )
To put the phrase back into the context Patric used:
“Are we supposed to die today, at the hands of an egotistical maniac?
To argue “yes” wreaks of manifest destiny.”
Beautiful!
Blouise –
Points well taken. I will.
eniobob:
I,too, extend my sincere condolences. My post about the generous donor of a kidney in honor of his grandmother certainly was not meant to cause you to relive old pain.