“Sharpiegate”: Trump Ridiculed For Altered Hurricane Forecast

Fox News joined other networks yesterday in ridiculing a truly bizarre moment from the Oval Office where Trump appeared to show a forecast map of Hurricane Dorian with a hastily drawn extension into Alabama. Trump previously claimed that Alabama was in the hurricane’s projected path and was widely contradicted (including by federal officials). He then showed up with the map that seemed to have an extension written by a Sharpie. It was another bizarre misstep that expanded a minor story into a major embarrassment. Trump had to personally deny that he took a Sharpie to the altered map in what people are humorously calling “Sharpiegate.

The apparent Sharpie job was no clumsy and amateurish that one had to wonder if someone on the staff was being passive aggressive and intentionally trying to make Trump look ridiculous. Anyone looking at that altered map would have said that it looked absurdly altered. That obviously did not include Trump himself.

Trump’s initial misstatement over Alabama was not particularly serious. Once could see how the mistake could have been made. Trump could have just let it drop or even, perish the thought, admitted that he was wrong. Parts of Alabama was likely to get heavy rain but was not really in the path. Trump however doubled down.

Trump had already objected to the critics over his Alabama claim and returned to the subject by raising the National Weather Service’s early forecasts of Hurricane Dorian’s path. In what was clearly an effort to quiet the criticism, Trump declared “We got lucky in Florida, very, very lucky indeed. We had actually our original chart was that it was going to be hitting Florida directly… And that would have affected a lot of other states.”

Fox correctly reported that this was not the map issued by the government. In discussing the scene with Bret Baier, John Roberts noted that there was never a forecast track into Alabama and “You can see somebody with a Sharpie or some other writing instruments added a little bit to the cone of uncertainty, which was not a part of the official forecast, which included the Florida panhandle and parts of Alabama.”

This is yet another example of how this White House and this President is ignoring a fundamental rule of life and politics: when you are in a hole, stop digging.

1,082 thoughts on ““Sharpiegate”: Trump Ridiculed For Altered Hurricane Forecast”

  1. “speak to her husband…, and then get back to us, Allan.”

    Now anonymous thinks her husband is a doctor.

    __________

    That’s a leap of logic. Let’s call it AllanThink.

    1. Allan in his infinite wisdom concludes: “Now anonymous thinks her husband is a doctor.”

      First, let me refer Allan to his own response.

      “That is not logic rather a cheap retort by one that doesn’t have the intellect to respond appropriately.”

      Moving on…, it’s more likely than not that the hospital in Saint-Agathe spoke with her husband by phone to get his input and keep him apprised. Her medical records would tell us something about any communications that might have taken place.

      1. There is no doubt in my mind that both hospitals communicated with the husband in some way.

        My statement was a logical conclusion since anonymous wished me to speak to her husband. Do you really believe her husband has an in depth understanding of what happened? Do you think he read the pathology reports and all the doctors notes? Do you think he interviewed the ambulance drivers? One has to think why anonymous would tell me to speak to her husband. It sounded foolish as it is.

        1. Family members often provide valuable input. I won’t add anything else because it would go right over Jethro-Allan’s little head.

          The only one who sounds (and is) foolish is Allan.

        2. A member of the immediate family….especially the surviving spouse……is in a far better position to know the details of the deceased’s accident, treatment, and final hours than a blowhard like Allan.
          A blowhard playing Monday Morning Quarterback 10 years down the road.
          Since this was an unexpected death of a fairly young woman, there were probably a lot of questions asked by, and answered for, the family.
          As far as understanding the medical issues and the medical jargon, they would also be in a far better position to be informed than Dr.Allan Blowhard.

          1. “A member of the immediate family….especially the surviving spouse……is in a far better position to know the details of the deceased’s accident, treatment, and final hours than a blowhard like Allan.”

            Information is almost always useful, but in the case of bleeds to the head the all important factor is the time it takes to get to the OR. You sound as if you are reading off a list rather than using your brain. Then to top it off you end with an insult (blowhard) which indicates a foolish person with a small mind.

            In the coming responses to a future Anonymous I can’t tell for sure if the next anonymous is the one I am responding to here, a foolish person with a small mind, or a more mindful anonymous. That creates a problem because justified testy responses to the wrong anonymous causes a war which is in part what has happened. Your alias and icon create that type of problem so blame yourself if you are assumed to be this mindless twit while the mindless one takes credit for any of your more intelligent statements.

            1. The issue was who was in a position to have actual knowledge of the details of the medical response to Richardson’s injury.
              Allan can pretend all he wants that his 20/20 analysis and baseless accusations are based on some sort of knowledge and expertise that he clearly does not have.
              That does not change the fact that, next to the medical team actually involved, the immediate family would have the most actual information.

          2. “A member of the immediate family….especially the surviving spouse”

            Still another stupid response likely by the Brainless Wonder. It appears to be a duplicate or similar to the earlier one. Refer to the earlier response.

            1. So now Allan Blowhard is also an expert on the information available to the spouse?
              Beyond his brilliant “stupid response” ploy, he has not told us why he disagrees that the family has more knowledge ( except for the medical team itself) than a blowhard like him.

  2. This is what Dr. Sun said:

    “Since initially there was no indication that Natasha’s life was in danger, it’s unlikely that she could have been saved. She would have needed to be rushed into the hospital and into a CT scan in a matter of minutes, according to Dr. Sun

    **”…rushed into a CT scan in a matter of minutes…”***

    https://www.huffpost.com/entry/why-natasha-richardson-en_b_176665

    Burr holes work well in the early stages of EDH.

    You’ll need her medical records, including the results of her CT scan, Allan. Without them, you’ve got nothing.

      1. Get her medical records, a copy of the CT image and its interpretation, and then get back to us. More information is required.

        1. Of course the above is an ignorant reply since it will not deal with the almost 4 hour delay, rather it will deal with the system that is in place.

          Which anonymous made this ignorant reply is unknown because all anonymi hide under the same name and icon to afraid to take responsibility for what they say.

          1. When will be see the blowhard posting as “Allan” go public with his phony accusations?
            If he wants to “take responsibility” for his accusations of “multiple failures”, maybe “Allan” will debate, in an open forum, medical team that handled the Richardson case.
            THAT would be “talking responsibility”. A keyboard warrior lobbing accusations under a username is not.

            1. “maybe “Allan” will debate, in an open forum, medical team that handled the Richardson case.”

              That would be interesting and they might even agree that the present way the system is set up is wrong. They followed a system. That doesn’t mean they like the system.

            2. ‘“Allan” will debate, in an open forum, medical team that handled the Richardson case.
              THAT would be “talking responsibility”. A keyboard warrior lobbing accusations under a username is not.’

              Predictably, Allan believes that he would have something to offer.

              1. Anonymous at 10:06 PM,
                Allan does have something to offer……entertainment. He is as funny as Jethro Bodine and Theodoric of York put together.
                Whether he was actually going for a comedy act here, or it’s unintentional humor on his part, let’s give credit where credit is due.

                1. Anonymous if you are going for a comedy act you can’t forget yourself, Fido the Brainless Wonder. Don’t forget your depends as they add a bit of humor to your persona. Take a bath before you come out on stage.

                    1. Paul has come around to provide Allan with some direction and “insight.” Allan will be able to get everything sorted, now, so he’s ready for his big night in Canada.

                    2. “Paul has come around to provide Allan with some direction and “insight.” ”

                      Anonymous, Paul has come around to look a bit deeper and past the lunacy of the anonymous postings. You just can’t stand it that you are an idiot and other people can think. You don’t even try to learn. Go back in your hole

      1. This is what Dr. Sun said:

        “Since initially there was no indication that Natasha’s life was in danger, it’s unlikely that she could have been saved. She would have needed to be rushed into the hospital and into a CT scan in a matter of minutes, according to Dr. Sun

        **”…rushed into a CT scan in a matter of minutes…”***

        https://www.huffpost.com/entry/why-natasha-richardson-en_b_176665

        Burr holes work well in the early stages of EDH.

        You’ll need her medical records, including the results of her CT scan, Allan. Without them, you’ve got nothing.

        1. ***…rushed into a CT scan in a matter of minutes…”***

          But even if her life could be saved the facility couldn’t do it which brings us back to the question:

          You are driving at 100 miles per hour and a wall appears in front of you. Choose one.

          Speedometer
          Brakes

          You chose the speedometer just like you are choosing the hospital with a CAT Scan but no ability to relieve the pressure on the brain.

          You refuse to deal with the essence of the problem.

          1. One can’t deal with “the essence of the problem” (from Allan’s perspective) without having all the facts.

            And speaking of the facts, give us all of her known Glascow Coma Scores, if you would. You mention “a timeline” somewhere.

            1. This comment doesn’t make sense. The almost 4 hour delay indicates a system failure since you said the trip to Montreal was only 1 hour and 28 minutes. Of course you can now say another anonymous said that but how can we believe anything if you say that?

                1. Paul, firstly I think we should accept that a system failure doesn’t necessarily mean that there isn’t a good reason for the system failure to exist.

                  I look at this system failure as time. In certain traumatic injuries and certain diagnosis time is of the essence. Therefore, the quicker the patient is treated medically or surgically the better the chance for survival. ( The discussion actually started with Princess Diana’s death and this was just another example of where time was likely wasted and may have contributed to the death.)

                  I think they had a pretty good idea they were most likely dealing with a bleed. If that is so then they need an operating room to do a craniotomy or perhaps a faciity that could temporarily relieve pressure giving additional time for the patient to get to the needed facility.

                  Therefore since the first hospital could do neither that strikes me as a bad choice. Secondly, there may have been a neurosurgeon on route at a closer facility that could have more quickly offered some remediation of the problem.

                  Sometimes systems are set up to treat all patients as equals and that leaves certain smaller groups of patients in a system that is not optimized for their survival.

                  1. Allan – what were the qualifications of the people who first saw Ms. Richardson? Were they qualified to decide she had a bleed?

                    1. I don’t know but I am sure they had some sort of communication device and could triage a patient with a physician on the telephone.

                      Many ambulance drivers are trained to determine certain things. I don’t know the quality of Canadian ambulance drivers in that province in that location but they are coming from a ski slope. I would hope they had some training.

                    2. Allan – I checked out the hospital in the town they took her to. They have a triage team in emergency according to the ratings, however, depending on what your rating was on the triage, you could be there forever. They are in a town/city of 10k which has grown rapidly. It is a small hospital that relies on Montreal for any problems. Many of the people said their was only one doctor available in emergency. I do not know what the level of care would be for a major emergency like Ms. Richardson.

                    3. Paul, you provided insight. Their referral hospital is in Montreal. Another step would be to look and see what other hospitals exist closer and their services since they might have another hospital not that far away with an available neurosurgeon on staff. Their referral hospital would likely be the same one. Canada I believe bases its medical care on a more centralized system, however, each province is different.

                    4. Allan – according to their website, Montreal is their base hospital. I wasn’t able to do a deep dive as to which hospital they were connected to in Montreal. In general, specialists, like neurologists are centered in big cities, like Montreal rather than small towns. A small town can support a couple of surgeons and several gps, but not a neurosurgeon.

                    5. Paul, what you say sounds about right if as I assume that the care is still as centralized in Canada as it used to be. That lead to certain services to be quite limited, sometimes injurious, to patient care. Before anonymous pipes in to defend Canada while saying things that are wrong with American healthcare I want to say I am not criticizing their system, just stating a problem inherent to it. Canadians should determine their own system for many things have to be taken into consideration.

                      The question then becomes whether there is a hospital closer that can do the procedure or increase the time a patient has along the way with a burr hole or whatever procedures might help. If centralization is too strong one might want an intermediate facility for the less invasive procedures as a stopover increasing the patients time. Stopping at a hospital that can not offer the emergency treatment needed to save a life to me sounds strange because the patient’s time clock keeps running while they are there and the travel time to the primary hospital might even increase.

                    6. Allan – it is really not a question of centralized medicine, but how many people does it take to support a particular type of specialty. I grew up in a town like the one we are talking about so I have a rough idea of what a town of 10k can support. However, the closest town to us with better medical personnel was 150 miles of windy roads (pre-freeway). They had a neurosurgeon, if I remember correctly.

                    7. “Allan – it is really not a question of centralized medicine, but how many people does it take to support a particular type of specialty.”

                      Paul, It can become a question of centralization if the procedures and expensive technology are located only in central hospitals. This has been discussed at length with some interesting articles in the late 70’s and 80’s especially when CAT Scans had become popular in the United States.

                      Small towns can have a problem accessing medical care. There is no doubt about that. However, there are methods of alleviating the problem. Some smaller areas actually pay to build a hospital and pay physicians to locate there. Some will have clinics with specialists that might come in once a week or at a suitable interval. For quicker transport on our highways many areas use helicopters on a frequent basis. Some areas have very experienced paramedics that are able to do more things in the field. [Soroka Hospital in Southern Israel near the Gaza strip performs surgery right on the battlefield to save limbs etc. and then sends the patients to the hospital for more intensive treatment] We also have robotics and new technologies that can assist for quicker responses in distant areas. This is just a little bit of what has to be considered when one is evaluating a system failure.

                      Small minds consider small things and lose out on understanding what the discussion is all about. I commend your mind for the interest in expanding the discussion rather than contracting it into a barrage of insults. No agreement need be necessary under those terms since it places more information and questions into the hands of those thinking about the problem.

                    8. Allan – all of your solutions are nice, but were not in place when Ms. Richardson was in distress. And it is Ms. Richardson we are talking about. This is a very specialized case. Had she had a regular concussion, she would have been adequately treated in the local hospital. However, there is no way without scans that you are going to find that bleed and be able to alleviate it. And if I am a GP, my malpractice insurance does not cover that, pretty sure. Estovir can correct me on that.

                      This was a time-sensitive matter and Ms. Richardson foolishly decided not to be treated. I really do not blame her for that, how is she to know. However, she is the proximate cause of her own death,

                      The systems you want to be there were not or could not or never would be. The ones that were there worked like a champ.

                    9. “And it is Ms. Richardson we are talking about.”

                      Paul, coming in late to the discussion, that may have been your primary consideration and that is very understandable, however, I was talking about a system failure not one particular person who was already dead. The discussion of a failure actually was following up a different discussion pointing out another case that was TIME sensitive.

                      Things like malpractice in our country do cause system failures. Many ER’s have instituted clocking of time sensitive testing in part to prevent malpractice suits. The time from the scan in a head trauma case to action, in one hospital even in a stable patient, is 1 hour.

                    10. Allan – there is no indication that the Saint Agathe Hospital did anything wrong. They have a triage nurse in emergency, it appears that Ms. Richardson was given priority care and then shipped to Montreal with additional personnel, Now, I am not a doctor, nor do I play one on tv, however that seems very reasonable to me.

                      Yes, they have a helicopter now, which will cost the patient 50-60k to get to Montreal.

                    11. “Allan – there is no indication that the Saint Agathe Hospital did anything wrong.”

                      Paul, I believe you to be correct and I don’t blame any of the medical personal. I saw the “almost 4 hours” TIME and that was why I thought there was a system failure. Yes, on the surface it appears reasonable but the almost 4 hours makes one think differently.

                      “Yes, they have a helicopter now, which will cost the patient 50-60k to get to Montreal.”

                      Based on that alone they may have recognized the system failure was TIME and that may be the way they have attempted to solve the problem. If so, they agree entirely with my analysis.

                      I don’t know what the actual cost is to the patient, if any. I rember my spouse having a minor surgical procedure as an outpatient. The bill was $7,800 but they accepted my insurance which allowed $400. One should be suspicious of medical bills.

                    12. Allan – medical helicopters are not covered by your insurance, usually. Cost is between 45-65k for a trip to the hospital in a copter.

                    13. Paul, that is interesting. Emergency helicopter ambulance service is not covered in Canada. $45-$65K.

                      I had to do an evacuation from Dubrovnik in Croatia to the US. Initially the insurer refused to pay so transport was being set up for a private jet 2 nurses, 2 pilots and complete ambulance care. The quotes ranged between $85,000 – $150,000. The jet finally used was a luxury jet often used for CEO’s and a lot of other people. I estimate when not used as an evacuation airplance it carried 20-30+ people but no one else was on this flight. The jet came from Paris and by law stayed in Dubrovnik over night and then went to the US. It tied up the plane and 4 professionals for at least 3 days along with all the ambulance services, hotels required etc.

                      I don’t know that cost since those that we felt should handle it finally did so I never got a bill. However. the research gave a price range. Compare that to the cost of a helocopter for an hour or two and think about the comparitive prices.

                    14. The transmissions from the paramedics would indicate that they “had some training”.
                      They are not simply “ambulance drivers”.
                      It’s an open question as to which specialists (MDs) were involved at which stages; there’s no way of knowing that.

                    15. ““ambulance drivers” -Allan
                      Yep, we’re dealing with a smart one.

                      You really are as stupid as you sound. Ambulance drives can be paramedics, assigned to fire departments, simple drivers, etc. There is a variety of training. Please don’t apply for such a job. You are dangerously stupid.

                    16. “What You Should Know About Ambulance Drivers”

                      https://www.verywellhealth.com/whats-an-ambulance-driver-1298488

                      “The terms paramedic and emergency medical technician have been around for years, but there’s still a tendency by some people to call anyone in an ambulance an ambulance driver (anyone other than the patient, that is). Some emergency medical technicians — especially paramedics, which in many states are an advanced form of emergency medical technician — get quite offended at being called ambulance drivers. Nobody ever calls a police officer a police car driver or a firefighter a fire truck driver. So why call us ambulance drivers?”

                      By, hey, coming from Allan, it’s not a surprise.

                    17. But, anonymous, some are ambulance drivers and nothing else. We can’t call them medical technicians if they are paramedics so until they identify themselves or one knows what they are ambulance driver at least differentiates them from the dog waker that changes your depends. By the way some of them are firefighters that are also paramedics. Too confusing for you so carry on .

                    18. Anonymous on September 1, 2019 at 3:02 PM
                      Allan,
                      I’m not a proponent of Medicare for All or any other similar universal government healthcare delivery system.
                      But in the specific case of Ms. Richardson, it looks like she intially refused medical assistance due to the apparently minor head injury she received in her fall.
                      She felt well enough to be unconcerned, which is understandable given that she felt fine, at first.
                      When her situation clearly deteriorated a bit later….within about 2? hours, I did not see evidence of undue delays or other deficiencies in her treatment.
                      It did take a while before the ambulance arrived and then transported her to the hospital, but there was some distance involved that reasonably accounts for that time lag.
                      I think her situation deteroriated so rapidly that by the time she or her husband realized the seriousness of her injury and called for help, it was already too late to save her.

                      ***************************************************************************
                      Allan opened up the topic of Richardson’s death on Aug.31. And acted as though he knew there were “multiple failures” in how her case was handled.
                      Above I have reposted my first comment made to him the next day. I think the other anonymous had a comment before mine, indicating the fact that she had initially declined treatment.
                      I’d say that this issue has been adequately covered, to put it mildly. Sk I’m not going to review every twist and turn that convinvced me that Allan is a blowhard and a liar.
                      But since Allan brought up his feeling that I might join in “to defend Canada”, I’ll mention that I stated, cleary and from the start, that I was not a fan of a single payer heth care system.
                      There can be a separate debate on the pros and cons of that system, but this is not what the discussion has been about.
                      It didn’t take too long to figure out that Allan could not support his claim of “multiple failures” in the Richardson case; had he been able to do so, I was interested on whatever knowledge he may have had about the case.
                      It appeared that he was picking up some of the details about her case which were supplied by those challenging his claim. Then claim that they were ignorant or lying for contesting his unsupported claim.
                      At least there is a new baseless claim made by Allan to deal with, since he just spouted off about joining in “to defend Canada”. This is about the medical response in the aftermath of “a rare catastrophic event”, and unsupported claims by Allan about that response.

                    19. For all those anonymi that have yet to get the point, Mrs. Richardson is the example under discussion but her case doesn’t matter because she is dead. What matters are other cases that are time dependent and not just cases of trauma to the head. I think everyone can agree that we should constantly be reassessing care and improving systems. Some, however, get insulted when their idea of ‘good’ is observed and commented on.

                      The system needs to concern itself in what can make it better. Richardson might have died if when she called she walked right into the operating room. She is a vehicle of discussion representing a wide spectrum of cases. “Almost 4 hours” points to a system failure when part of that time might have been wasted in the wrong place. According to a list member the travel time to the major center was 1 hour and 28 minutes. The question is not how long the patient delayed treatment before the priority one rather how long the time span was once the patient became a priority one. If one focuses on the patient refusal of treatment then the only question that I see that exists is whether or not she was adequately informed of the risks.

                      It is not a matter of defended or accusing Canada. If one looks at the IOM reports on preventable deaths in the US one immediately notes that a preventable death is not malpractice and not necessarily something that requires a system change or should be prevented. It is merely a statement of a failure that in the end could be an appropriate failure. There is no need to debate the Canadian or American system as they are two different countries. The only thing to be aware of is trying to copy another country’s system without understanding the negatives that system brings with it. There is too much emotion that accompanies political discussion on this blog.

                      You can believe what you wish and be the contrarian. That is fine with me, but deal with only the specific problem that was dealt with by me. The system failure that led to a person not getting to a hospital that could treat in less than “almost 4 hours”. All the details about Richardson do not count unless one can specifically prove the “almost 4 hours” was necessary. That is something that has not been done and likely won’t be.

                    20. The above was to anonymous whose response starts with:

                      “Anonymous on September 1, 2019 at 3:02 PM
                      Allan,
                      I’m not a proponent of Medicare for All or any other similar universal government healthcare delivery system.”

                    21. DONT FEED THIS STUPID EXCHANGE PAUL. IT’S A MEANINGLESS SQUABBLE BETWEEN TWO HOTHEADS RUN OUT OF CONTROL

                2. “Rural Hospital Closings: Crisis Is Leaving Millions Without Nearby Health Care”

                  https://heavy.com/news/2019/09/rural-hospital-closings-crisis/

                  “More than 20% of our nation’s rural hospitals, or 430 hospitals across 43 states, are near collapse. This is despite the fact that rural hospitals are not only crucial for health care but also survival of their small rural communities. Since 2010, 113 rural hospitals across the country have closed, with 18% being in Texas, where we live.”

                  1. Anonymous – I am talking about a specific case. That of Ms. Richardson, which took place in Canada. What the heck does that have to do with US hospitals. The Saint Agathe Hospital was OPEN and fully operational 24/7.

                    1. The comment isn’t addressed to you, Mr. Schulte, though it may have shown up as a reply to one of your comments. I’ll address it elsewhere, as it pertains to someone else’s comment.

              1. Nonsense; AllanSpeak.

                You’ll keep beating your ridiculous “multiple failures” drum, but you might want to listen to your pal “Paul”

                https://jonathanturley.org/2019/09/26/msnbc-cuts-off-presidential-press-conference-because-the-president-isnt-telling-the-truth/comment-page-4/#comment-1886960

                Paul said, “…The moment she refused treatment she was a dead woman.
                Even if she had accepted treatment the first time and gone to the hospital, it was iffy. She was still going to get shipped to Montreal.
                If anyone is at fault it is Ms Richardson for not being treated, but even then she didn’t think she was that badly injured.
                NO ONE is at fault. Everyone acted appropriately.”

                But Allan — living in AllanWorld — knows that there were “multiple failures” just as he knows that he doesn’t need NR’s medical records, etc. to reach any meaningful conclusion.

                1. And it should be noted that Saint-Agathe is en route to Montreal. Also, CT results, etc. would have been sent to Montreal, in advance of NR’s arrival.

                  1. Given what I’ve read and know, it’s possible that she was already sunk before she left the hospital in Saint-Agathe, but without her medical records we’ll never know.

                    They did the right thing in getting her to the nearest hospital.

                    She may have been seen by a neurologist or neurosurgeon in Sainte-Agathe. We don’t know. It’s another unanswered question, I believe.

                  2. “And it should be noted that Saint-Agathe is en route to Montreal. Also, CT results, etc. would have been sent to Montreal, in advance of NR’s arrival.”

                    The stupidity continues. How would that help save a patient’s life if so much lost time was consumed in getting the CT and they could have gotten it in less time in Montreal?

                    I must note that this anonymous appears to be the dullest one. If so, the other anonymous is doing himself a disservice.

                    1. I have to admit that I am impressed with Allan Bloward’s determination to continue demonstrating what a fool he is.
                      That shows some real commitment on his part.

                    2. I am training myself to deal with stupid people that don’t have a chance of ever attaining even a minimum of intelligence. Fido, it is time for your walk.

                  3. I’d say that the Richardson case does matter, since Allan stated this “discussion” with an unsupported allegation of “multiple failures” in the response to her injury.

                2. “you might want to listen to your pal “Paul”

                  Anonymous, amid all the insults your stupidity squeezed out of that pea sized body of tissue in your cranium and you ended up becoming the definition of stupidity.

                  Much of what Paul’s said was valid or represented the usual occurrences but I believe on the point involving the system failure he made his final position more clear or he altered his position.

                  Paul said: “Allan – I will accept your point”

                  1. This drama is still going…wow. TMTH.

                    I would almost think these two are in some sort of cahoots to bring down the comment section of JT’s blog.

                    1. Wally no cahoots on my part. I am just playing with some very stupid people. I know that sounds foolish but I am curious how stupid, stupid people can get. I don’t find the opposite side of the debate that interesting anymore for almost all of those on the left seem not to know much of anything and seemed to be guided by their emotions rather than their intellect.

                    2. Gotta be frustrating for Allan Jethro Bodine, with his giant brain and 6th grade education.
                      Always having use words like stupid and ignorant for those who point out what a fraud and liar Allan is.

                  2. Allan relates that Paul said: “Allan – I will accept your point”

                    (Paul is being diplomatic, IMO, and using his powers of persuasion, etc., but be that as it may…)

                    Now, here’s more of that exchange — the part that Allan didn’t share:

                    Paul C Schulte says:October 1, 2019 at 10:21 AM
                    Allan – I will accept your point, however the ambulance here was going to the local hospital first since Montreal is 1.5 hours away.

                    Allan says:October 1, 2019 at 10:33 AM
                    “Allan – I will accept your point, however the ambulance here was going to the local hospital first since Montreal is 1.5 hours away.”

                    Thank you Paul. That of course is a major consideration that cannot be forgotten. That is why I called it a system failure rather than a personel [sic] failure.

                    Paul C Schulte says:October 1, 2019 at 11:09 AM
                    Allen – people falling on the Bunny Slope and getting a brain bleed is a system failure if we use your logic.

                    Here’s a link to the full exchange:

                    https://jonathanturley.org/2019/09/26/msnbc-cuts-off-presidential-press-conference-because-the-president-isnt-telling-the-truth/comment-page-4/#comment-1886960

                    It’s an exchange with Allan so, yes, it’s lengthy.

                3. “The point” of my last comment here was to address Allan’s comment to Mr. Schulte that Allan needed to say something to Mr. Schulte before anonymous joined in “to defend Canada”.
                  Since there were no statements by me either “defending Canada” or the Canadian single payer system, why imply that I was going to do that?
                  Allan’s word salad response to my comment does not answer that question, so I’d say that he met my expectations.

                  1. “Since there were no statements by me either “defending Canada” or the Canadian single payer system, why imply that I was going to do that?”

                    Anonymous, There were multple statements by you regarding Canada. Here is one.

                    “But it’s easier to point the finger at an outlier in Canada, rather than dealing with our own healthcare mess.”

                    This appears to me to be some type of defense of Canada and the other statements you made continued to affirm that feeling I had. Your problem is that you flail around so much in argument with extraneous facts that you have difficulty dealing with a singular point.

                    1. That was not my statement, but I’m sure a genius like Allan already know that.
                      But he fact is that the Richardson case was “an outlier”. That was confirmed by the comments of two specialists who have been quoted here.
                      You may still “bet” that she would have survived had this happened at a U.S. ski resort, but you fail to make the case of how the outcome would ha e been different.
                      One doctor that I quoted did state that she might have had a better chance of survival had this happened at U.S. ski resort, but added that she might have had a better chance as well had this happened at another Canadian ski resort.
                      Another doctor who was quoted commented that the wait times “the delay” as you call it, could have been longer in some cases in the U.S.
                      So the Richardson case is not some sort of showcase if one is trying to show “how we save lives in America”.
                      It’s neither an indictment nor a defense of the Canadian system.

                    2. “That was not my statement”

                      Really anonymous? I remember finding it under the poster named “anonymous” so it is yours. You want to blame it on another because suddenly you don’t like it? If it is under your name it’s yours. You want to have exit doors so you can leave some of what you write behind? Isn’t that the whole reason to use a generic name and ink spot called “anonymous”? Isn’t that the cowardly way to behave?

                      All you are doing in the rest of the posting is to weasel out of the mess you put yourself in.”

      1. I may let Allan get I both the first and last words on the subject, and he will continue posting until he gets in both the first and last words.
        Then again, I may not give him both the first and last words. Either way, these threads will survive.

      2. “THIS IS RUINING THE COMMENTS SECTION”

        Now that’s funny.

        One might suggest that you avoid this thread, if you’re not finding happiness. Scrolling works well, too.

        1. The anonymous demanding a “cease fire” has a point, and I mentioned that I may ( or may not) give Allan the last word in addition to his having the first word.
          IMO, the length of a thread is less of a threat to a comments section than repeatly giving a pass to someone who makes an unsupported claims and accusation.
          Or starts a “pissing match” with the expection that no will piss on him in return.
          I’m not involved in that many threads, and have never been in an exchange anywbere near long.
          But at least every now and then, I think it’s OK to call out a blowhard and a liar.

          1. “The anonymous demanding a “cease fire” has a point…”

            Yes, but there are plenty of other sandboxes (other postings and comment streams) and no one is forced to visit this particular thread.

          2. It strikes me that the one complaining about the thread is generating the most posts. We already know anonymous is a kook. What else is he trying to tell us?

            He wanted to start a fight (” I think it’s OK to call out …”) and entered into someone else’s discussion to do so.

  3. Allan sings the praises of emergency tracheotomys downthread, but let’s bring a little balance to the topic.

    Add “burr holes” to the list in the first paragraph, below.

    “Tracheotomy: Does TV Get it Right?”

    by Editorial Staff | July 14, 2016 (Last Updated: October 1, 2018)

    “We as a nation love medical dramas. It has to be a fact, as 91 shows related to the genre have been produced since 1951 in North America alone. What’s not to love? A fast-paced environment, strong characters and a little bit of health advice along the way! Except… with such popularity, a lot of writers seem to get their facts confused in order to instill a bit more drama in the story. Similar to other ill-informed portrayals of medical techniques (bad CPR, needle to the heart, using electroshock while flat lining, removing bullets, etc.) produced by Hollywood, a delicate procedure like a tracheotomy is often performed by the protagonist and without medical training (or with very little guidance). Of course, there have been plenty of doctors portrayed performing the procedures as well, but the ratio is a bit too even for our liking. Before we dive into depictions, what exactly is a tracheotomy?”

    “While it’s certainly heroic and brings with it a good life-time feeling of saving a life, tracheotomies should be treated as a last resort in a dire situation and with medical staff guiding along or on their way. Because remember: tracheotomies add drama on TV, but add a lot more than you might bargain for in real life.”

    (And the same goes for burr holes.)

    https://jonathanturley.org/2019/09/05/trump-ridiculed-for-altered-hurricane-forecast/comment-page-4/#comment-1884107

    The aforementioned comment is by Allan — a guy who watches a lot of TV, reads shit on the internet, and knows just enough to be dangerous…

    And Allan has great 20/20 hindsight — without access to medical records, medical history, the CT scan, input from those on the scene, and so much more.

    Natasha Richardson ran out of time. If she had gone to Montreal immediately after her fall, we might had seen a very different outcome. Even if a burr hole has been drilled, in Saint-Agathe — at the first hospital — Richardson might have needed a craniotomy. Sometimes burr holes aren’t enough…, and there are risks and side-effects from burr holes. There are too many variables and unknowns. And it happened back in 2009.

    Let it go, Allan. There weren’t “multiple failures” — just as there wasn’t “a four hour delay.”

    Read the transcript again: Her GCS was 12 — with a question mark — when the ambulance was 8 minutes away from Saint-Agathe. As I recall, a “crash room” was being prepped. Once symptoms appear and more than 30-90 minutes elapse, the situation often “goes south” pretty quickly. Her symptoms began around 1:45 and by this time it was around 4 pm.

    Allan will keep banging his drum from ‘AllanWorld’, but most of us live in the real one.

    1. “Allan has great 20/20 hindsight”

      That would indicate I know what I am talking about. You don’t. The emergency under discussion started when the priority one was authorized “almost 4 hours” before any life saving emergency treatment was available. By that time Richardson was already brain dead. A burr hole at a different facility might have given Richardson time to survive. Burr holes can release the pressure on the brain and that can buy more time.

      You are just too stupid to understand simple things.

      “As I recall, a “crash room” was being prepped”

      A crash room without the ability to relieve the pressure on the brain is not going to save the person’s life.

      But anonymous has determined to let the patient die based on his 90 minutes theory that she was dead anyhow so no one should try to do better. Said by a real third rate mind.

      1. So Allan falsely concluded this: “That would indicate I know what I am talking about.”

        No, Allan. It doesn’t. What follows is the full statement.

        “And Allan has great 20/20 hindsight — without access to medical records, medical history, the CT scan, input from those on the scene, and so much more.” Anonymous @ 5:30 P, upstream

        So what we can conclude — and it’s something he does all the time — is that Allan takes things out of context and reaches specious conclusions. And he doesn’t understand sarcasm.

        Get back to us when you have ALL of the information needed to make a determination about what should have happened that day, Allan.

        You’re operating with a half-deck, in more ways than one, buddy.

        1. ““And Allan has great 20/20 hindsight — without access to medical records, medical history, the CT scan, input from those on the scene, and so much more.””

          Because of gross stupidity anonymous cannot distinguish a stable person from one rapidly dying. Thus he looks for excuses not to do anything.

          Patient is dying, does one act or play the fool like anonymous?

          1. Dr. Allan Blowhard can immediately tell which patient has suffered a concussion, and which patient “is dying”.
            He can do this without any CAT Scans or X-Rays, but he does have something far more accurate; 20/20 hindsight.
            He can probably also tell us which patients with chest pains need immediate bypass surgery, without all of those unnecessary diagnostic tools.
            He is pioneering an entirely new area of medicine…..retroactive diagnosis.

            1. ” can immediately tell which patient has suffered a concussion, and which patient “is dying”.”

              Anonymous I can’t help it that you are an idiot. Since the Richardson “died” under observation I think those doing the observation could tell the difference. This can be observed by anyone with a brain without the use of a CAT Scan. Are you claiming you were on the ambulance?

              1. The transmissions from the paramedics on the ambulance are one piece of actual medical evidence we have that is documented at an exact time.
                You obviously have either seen her complete medical records, or you are a blowhard who acts as though he has.
                Everything you “know” that “should have been” diagnosed, should have been done, us based on your 20/20 hindsight.
                You like to pretend that there is some sort of instantaneous diagnosis that should have been done, when in fact there was no way of initially knowing if this was a concussion, or “a rare catastrophic event”.
                That is a direct quote from the head neurosurgeon at a major hospital, so spare us your horse**** that I “lied” about what he said.
                That just shows how low a clown like you will go, trying to bail himself out.
                So do you drill holes into someone’s skull for everyone with a concussion, before imagining, on the chance that it may instead be a rare catastrophic event?
                With 20/20 hindsight and a time machine, you can go back and tell the medical personell which category they are dealing with.
                You’ve got the 20/20 hindsight mastered, now all you need to do is to build the time machine and you’ve got it made.

                1. “The transmissions from the paramedics on the ambulance are one piece of actual medical evidence we have that is documented at an exact time.”

                  Anonymous, use the evidence you have from the transmissions to prove your case.

                  What we know what act as anchors are:

                  1) priority 1 took “almost 4 hours” to get to a place where the facility was able to save the life.
                  2) a stop was made at an institution that could not save her life. That wastes time.
                  3) she was brain dead when she got to the hospital that would have been able to treat.
                  4) her Glasgow score provided a timeline for the mental status decline

                  Your claim is either A)that there was no facility that could do a burr hole less than “almost 4 hours away” B)the ambulance and hospital personal didn’t know she was dying C)you believe a CAT scan is treatment.

                  Stick with A,B and C. Make your argument.

                  1. “You like to pretend that there is some sort of instantaneous diagnosis that should have been done, when in fact there was no way of initially knowing if this was a concussion, or “a rare catastrophic event”. That is a direct quote from the head neurosurgeon at a major hospital”

                    Anonymous, the instantaneous diagnosis was simple head trauma needing observation. When Richardson called back it was no longer a safe bet that she didn’t need a facility that could treat, and fast. That was demonstrated by making the call a priority one. The decline demonstrated that they would lose her unless they acted quickly. The fact that she ended up dead after “Almost 4 hours” validates my point of view.

                    1. I don’t think Allan Blowhard even understands parking validation, let alone validation of his medical “expertise”.

                  2. “So do you drill holes into someone’s skull for everyone with a concussion “

                    Only you would be stupid enough to drill holes for every concussion. Only you would not recognize the patient is “dead” until at “almost 4 hours” the doctors said ‘too late anonymous you fool. You should have tried to get a temporary fix (burr hole) and then bring her here for further treatment’.

                  3. “With 20/20 hindsight and a time machine, you can go back and tell the medical personell which category they are dealing with.”

                    Only a fool like anonymous can’t tell a “dead” person from a ripe banana.

                  4. To Allan:

                    Get Natasha Richardson’s medical records, speak to those who treated her, speak to her husband…, and then get back to us, Allan.

                    (Allan is not a doctor or any sort of medical professional.)

                    1. Anonymous, you believe quantity is better than quality. I provided you with four major concerns and then asked you to get back to us with the answer to a simple multiple choice question.

                      Your claim is either A)that there was no facility that could do a burr hole less than “almost 4 hours away” B)the ambulance and hospital personal didn’t know she was dying C)you believe a CAT scan is treatment.

                      Use all your knowledge of the medical records including family history and then answer A,B or C. You can’t and you won’t. Add your solution that is better than Richardson being seen sooner where she could be treated. You won’t. You don’t have basic knowledge and logic is something you never possessed.

                      When a person is dying most of the stuff you consider so important is meaningless. I can see it now. A man is pulled from the water not breathing and no pulse. An individual starts CPR and suddenly finds you dancing around like an idiot saying we can’t start CPR until we have a history, we know if he can swim, and all sorts of nonsense while the man dies.

                      That is the anonymous that we have all learned to “luv” wondering how he ever survived childhood.

                    2. “Since initially there was no indication that Natasha’s life was in danger, it’s unlikely that she could have been saved. She would have needed to be rushed into the hospital and into a CT scan in a matter of minutes, according to Dr. Sun.” -Dr. Dexter Sun, New York Presbyterian Hospital/Cornell in New York City

                      https://www.huffpost.com/entry/why-natasha-richardson-en_b_176665

                      Since initially there was no indication that Natasha’s life was in danger, it’s unlikely that she could have been saved. She would have needed to be rushed into the hospital and into a CT scan in a matter of minutes, according to Dr. Sun.

                      “If she had gone to the hospital and a CT scan indicated that there was bleeding, her skull would have been opened to relieve pressure, and she would have been given medication to relieve the pressure in her brain,” he says.

                      Only then, would there have been a chance that she could pull through.

                      Tragic.

                      ____________

                      And this:

                      With that said, Dr. Sun explained that there are three particular possibilities that could account for Natasha Richardson’s state:

                      1. “She may have a fairly rare underlying hematology condition called hypocoagulation, in which she lacks a blood clotting factor,” says Dr.Sun. This could be a genetic factor which had gone unnoticed throughout her life until now. When the clotting factor is missing, a minor bleed can become a hemorrhage.

                      2. It’s possible that Natasha could have been taking a blood thinner like coumadine, for another medical condition, that would have made it much more likely for her to bleed after any head injury, according to Dr. Sun.

                      3. Finally, and most likely, she did have a harder spill than what has been reported. Sometimes when this happens “you can have a high level cervical spine fracture or a fracture at the base of the skull,” says Dr.Sun. When this occurs, and the injured person continues to move around as Natasha did — not realizing that she was seriously hurt — the spine can touch the brain stem and cause a severe brain injury.

                      A high impact fall on the head can also cause three different types of bleeding within the brain: 1) an intracranial hemorrhage, which begins as a microscopic rupture of a blood vessel deep within the brain, 2) a subdural hematoma, which is a bleed that occurs in the dura, which is the outer layer of the brain, or 3) an epidural hematoma, which is a hemorrhage, that takes place between the outer skull and the dura.

                      ______________

                      It’s time to focus on the living, Allan.

                      A burr hole or craniotomy might have saved Richardson in the early going. She ran out of time. It was late in the game when she was finally transported. I

                      It’s over.

                    3. Anonymous claims her life was over when the ambulance left the first time. Then why did the ambulance bother to come back? Why didn’t they go directly to the morgue.

                      Some of the stuff is quoted from Dr. Sun but the interpretation of his words where Sun is not quoted means very little and likely is a bit misleading.

                      However, one can read one thing quoted from Dr. Sun “If she had gone to the hospital and a CT scan indicated that there was bleeding, her skull would have been opened to relieve pressure … Only then, would there have been a chance that she could pull through.”

                      That is exactly what I have been saying. Time was of the essence. The shorter the time span to the operating room the better liklihood of survival. Anonymous was willing to cut her chances by delaying the only thing that could save her. “almost 4 hours” was too long. Relieving the pressure was the singular most important item that Anonymous places as the last thing on his list.

                    4. To Allan:

                      Get Natasha Richardson’s medical records, speak to those who treated her, speak to her husband…, and then get back to us, Allan.

                      (Allan is not a doctor or any sort of medical professional.)

                    5. Dr. Sun’s legitimate quote told you everything you need to know.

                      Dr. Sun “If she had gone to the hospital and a CT scan indicated that there was bleeding, her skull would have been opened to relieve pressure … Only then, would there have been a chance that she could pull through.”

                      Burr hole in closer facility relieves pressure.

                      If you are driving at 100 miles per hour and suddenly a wall appears in front of you which would you pick to be working:

                      Spedometer
                      Brakes

                      Anonymous wants the spedometer so he knows exactly how fast he is going when he gets killed hitting the wall.
                      Though not certain to avoid death the brakes would have given him a chance.

                      That is how foolish anonymous sounds.

                      Of course in this example anonymous will be announcing that I am not an auto mechanic.

                    6. “speak to her husband…, and then get back to us, Allan.”

                      Now anonymous thinks her husband is a doctor.

                      Over all these postings anonymous has had about a dozen different answers, papers or quotes from physicians and none of his answers ever made sense. The papers and the quotes all placed in proper context agreed with me. I’ll quote Dr. Sun the last of your experts and you tell me how that quote differs from what I said. I already told you how that differs from what you said.

                      Dr. Sun: “If she had gone to the hospital and a CT scan indicated that there was bleeding, her skull would have been opened to relieve pressure … Only then, would there have been a chance that she could pull through.”

                    7. Allan ignores this — again:

                      “Since initially there was no indication that Natasha’s life was in danger, it’s unlikely that she could have been saved. She would have needed to be rushed into the hospital and into a CT scan in a matter of minutes, according to Dr. Sun.” -Dr. Dexter Sun, New York Presbyterian Hospital/Cornell in New York City

                      By the by, here’s a cause for you Allan:

                      “Rural Hospital Closings: Crisis Is Leaving Millions Without Nearby Health Care”

                      https://heavy.com/news/2019/09/rural-hospital-closings-crisis/

                      “More than 20% of our nation’s rural hospitals, or 430 hospitals across 43 states, are near collapse. This is despite the fact that rural hospitals are not only crucial for health care but also survival of their small rural communities. Since 2010, 113 rural hospitals across the country have closed, with 18% being in Texas, where we live.”

                    8. From the article we don’t know precisely what Dr. Sun was talking about. Was he talking specifically about Natasha Richardson or all patients? Can you answer that? I suspect he knew of the exact nature of the injury when he stated that she only had minutes of time available. However, she wasn’t dead in minutes so his answer is a bit fuzzy. In any event the pathology wouldn’t have been identified at the scene.

                      What he is pointing out is that she required definitive treatment as soon as possible (that could not be provided at the hospital she was taken to). I am sure he recognizes the death rate goes up with time. So the death rate at 1hour and 28 minutes is lower than the death rate of almost 4 hours. Logically that tells us she was taken to the wrong hospital. That would be a system failure (whether or not there were good reasons for the system failure to exist). Does that make sense?

                      I don’t know why all your posts have so much material that doesn’t pertain to the particular system failure under discussion. The basis for the initial statement made by me where you were not involved was that TIME was involved in another unrelated death and this death was another famous example. TIME to the operating room was what I was talking about in the context of the longer the time the higher the death rate.

                    9. “speak to her husband…, and then get back to us, Allan.”

                      Now anonymous thinks her husband is a doctor.

                      __________

                      That’s a leap of logic. Let’s call it AllanThink.

                    10. Why else would you ask the question when the husband wasn’t even there?

                      Some of these responses are very foolish and some not so. That would indicate a possibility of more than one responder which we all know is happening. That means that the anonymous label makes the smarter anonymous appear foolish since the certainty of who is making the foolish remarks is left in doubt.

                    11. “C You believe a CAT Scan is treatment”.
                      That is one of Allan Bloward’s more blatant lies. No such “belief” was ever expressed.
                      Maybe the Blowhard’s great powers also extend to telling people what they “believe”, because Alan wants to paint it that way.

                    12. ““C You believe a CAT Scan is treatment”.
                      That is one of Allan Bloward’s more blatant lies. No such “belief” was ever expressed.”

                      I am only following your logic and your insistance on taking her to a hospital for a CAT Scan that couldn’t treat a bleed which was the problem most dire and under consideration. If you say a CAT Scan is not treatment I believe you, but then don’t mix it up in your responses as to why she had to go to that hospital first only to be transferred to the treating hospital which could have the CAT Scan as well. That causes a loss of time which is a system failure. It was the nature of your numerous responses to a specific question that has created so much dialogue.

              2. I’ll just take #4 as an example. Since you’ve seen her medical records, or a act as though you have, what was her Glascow Score at various intervals?
                We know it was at 12 en route to the hospital, but what is the “timeline” of subsequent Glascow Scores?
                I wouldn’t ask, exept you brought “the timeline” up, and have obviously seen her medical records.
                Did your medical collegues concur with your analysis, or with the several specialists that have been quoted here?
                The other stupid points you tried to make have already been dealt with, so explaining anything to a blowhard like you yet again is just an additional waste of time.

                1. Anonymous, you haven’t seen her records. You only know what was released. We do not have full information but we do know that she was showing signs of mental deterioration and she was brain dead at “almost 4 hours”. We can assume she deteriorated during that time period. Your friend says the trip was 1 hour and 28 minutes to the trauma center. That means there was a delay of over 2 hours being taken to and from the hospital that couldn’t treat the problem she had. No one says she would or would not have survived. The only question is would she have had a better chance of surviving if she arrived sooner, even 2 hours sooner.

                  Take a fictitious poison that needs treatment in less than 2 hours. The hospital that can treat the poison is 1 hour and 28 minutes away but you bring a poisoned patient to a different hospital that then transfers the patient to the treating hospital except it is now “almost 4 hours” and the patient is dead. Does that sound logical. The only thing I am dealing with is TIME..

                  Let me here your logical explanation.

                  1. That is correct. I have not seen her medical records.
                    The key difference is that Allan acts as though he has seen her medical records, and is able to confidently declare that there were “multiple failures” in the how the Richardson case was handled.

                    1. I understand. You aren’t arguing with my logic rather you are arguing with what I know, but I never said I saw her records and I never commented on what type of education I had. I provided an opinion that there was a system failure in that it took almost 4 hours to get the patient to the place for treatment when according to one person the trip to that hospital takes 1 hour and 28 minutes. You were attacking the person, not the logic and you made assumptions that weren’t valid.

                      You enterred an ongoing discussion where Richardson was just another example of how important TIME was in traumatic injuries of significance.

                  2. Logical explanations do not work for Allan. Once things have already been explained to him multiple times and in multiple ways, there’s no point in going over the same explanations again and again.
                    He’s already proved that, in addition to proving that he is a blowhard and a liar.
                    For whatever reason, Allan has decided to belabor the point that he is a gasbag and a liar.

                    1. “Logical explanations do not work for Allan.”

                      Perhaps that is because you are a fool and you say things that just so happen to pop into your head. No thought involved in any of your comments.

        1. You don’t have access to her records. You are pretending.

          We know she died and we know it took almost 4 hours to get her to a place where treatment could be performed.

          We know time was of the essence so being able to do a remedial procedure to reduce the pressure in the cranium might have helped save her life.

          1. Anonymous, you are driving on the highway and another vehicle is about to have a head on collision with you.

            Do you turn the wheel to get away from him or do you first assess what radio station he is listening to?

            1. If you are Allan, you assume that the oncoming vehicle will swerve in front of you, so you drive the car into a ditch.
              In AllanWorld, that is being decisive and proactive.

            1. Richardson was dead unless the cranial pressure was relieved according to Dr. Sun.

              If you are travelling at 100 miles per hour and a wall in front of you appears which do you want?

              Speedometer
              Brakes

              You ask for the speedometer to know how fast you are going rather than the brakes that have a chance of saving your life.

              Your choice is stupid.

              1. This is what Dr. Sun said:

                “Since initially there was no indication that Natasha’s life was in danger, it’s unlikely that she could have been saved. She would have needed to be rushed into the hospital and into a CT scan in a matter of minutes, according to Dr. Sun

                **”…rushed into a CT scan in a matter of minutes…”***

                https://www.huffpost.com/entry/why-natasha-richardson-en_b_176665

                Burr holes work well in the early stages of EDH.

                You’ll need her medical records, Allan. Without them, you’ve got nothing.

                1. At the time she was made a priority 1 Dr. Sun would not have known how long she had to live. Therefore TIME was of the essence. In all your postings you have not dealt with the factor of time and the “almost 4 hours” You have not bothered to consider how that time could be lessened.

                  My initial premise was TIME.

                  A CAT scan cannot save her life though it is good to have. Take note Cat Scan were not available before they were invented.

                  1. Since CAT Scans have been around for about 45 years, and accurate diagnosis is essential, they need to be used before performing burr hole surgery.
                    Whatever Allan may have learned from watching Theodoric of York is not useful.

                    1. “Since CAT Scans have been around for about 45 years, and accurate diagnosis is essential, they need to be used before performing burr hole surgery.”

                      Using your numbers that means the first CAT Scans would have been available around the mid 1970’s and rare at that time. Do you think no craniotomies or burr holes were drilled before that time?

                      Skip the useless rhetoric and deal with logic.

    2. Again,

      Allan sings the praises of emergency tracheotomies, downthread, but let’s bring a little balance to the topic.

      I-can-do-these-things-in-my-sleep Allan (not a doctor) says:

      https://jonathanturley.org/2019/09/05/trump-ridiculed-for-altered-hurricane-forecast/comment-page-4/#comment-1884107

      “The throat is completely blocked for whatever reason and the patient can’t breathe. A small cut below can permit enough air to keep the patient alive. People have been known to insert things like pens into the neck to open a path for air to go in or out.”

      “Nothing to it” says our non-doctor “Allan.”

      The reality is different. There are risks and complications from emergency tracheotomies. (And the same is true for Burr holes. Sometimes a burr hole isn’t enough and a craniectomy is necessary.)

      https://www.lung.org/about-us/blog/2016/07/tracheotomy-does-tv-get-right.html

      In Allan’s world, any Tom, Dick or Harry could just make a little cut or drill a little hole. Easy-peasy. No muss, no fuss. Why would he let things like contraindications, risks and side-effects get in his way.

      1. “praises of emergency tracheotomies”

        The discussion is Richardson and a brain bleed. The subject is life and death. When it comes to matters of importance anonymous is impotent.

        That is why he plays the the part of a fool.

  4. Some dude named Allan said:

    “That is something they have talked about having the person on the ambulance do on site if such an emergency occurs.” (He’s referring to the drilling of burr holes.)

    Not true. Allan tells us that he gleaned that little bit of “knowledge” from the following article:

    ‘Emergency burr holes: “How to do it”‘

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352313/

    There is nothing in that article about “having the person on the ambulance” drill burr holes.

    In the article, non-specialists = non-neurosurgeons, but these non-specialists are doctors — not ‘the person on the ambulance.’

    Look at the references, too. The non-specialists are all doctors — doctors who aren’t neurosurgeons.

    1. Anonymous, you really are soft in the head. They didn’t say a neurosurgeon need be present either. Do some research on medical care on the battle field especially in Israel or where robotics are being used. Based on your ignorance none of those things saving lives and limbs could possibly be done.

      You sound like Fido who has to be lead around on a leash and can’t think.

      We have all sorts of non physicians doing skilled work on patients. That neurosurgeon was a general medical doctor before he became a neurosurgeon. Before that he was a college graduate and before that a high school graduate. He started off as a human which is the same species that fill the shoes of physician extenders etc. You are trying to win an argument you lost on your first posting. Try thinking instead. What is the difficulty in drilling the hole. A carpenter can drill a hole and so can many people. A neurosurgeon can even supervise on the phone and make the decisions of drive or drill.

      I brought up the development of a scan that would be done on site in remote areas per the article or didn’t you read that far. Remote is relative. If the TIME factor is too long and the patient is going to die, consider that place remote.

      1. It’s not a surprise that Allan continues to misrepresent and obfuscate. It’s what he does.

        Allan doesn’t understand that not just anyone should be drilling holes in another person’s head.

        Maybe someone should drill a hole in Allan’s head.

            1. “Allan Jethro Blowhard learned years ago that there was another way to access and view his giant brain.” – Anonymous @ 9:13 PM

              Let’s retitle that: “Allan’s giant brain.”

        1. It is not everyone that is drilling holes in people’s heads. You are lying by just implying that. It is the most qualified person possible when a person’s life is ending without such treatment. One need not be a neurosurgeon to do the procedure and with drill bits that have a clutch the process is easier. Yes, we can train people to do all sorts of emergency treatments. In fact in an emergency a patient could be taken to a skilled ER doc who might be able to drill the hole in an emergency and then send the patient to the hospital where there is a neurosurgeon on staff.

          The idea is to reduce the time so the patient remains alive without too much damage to the brain. If this is too complex for you then you probably require help tying your shoes.

          1. Allan continues to make his mark in the world by writing blog comments.

            He wants you to remember this:

            You, too, can save a life by drilling a hole in someone’s head. There may be a little ‘damage to the brain’, but no matter. A life with brain damage and disability is so much better than no life at all.

            1. It strikes me that anonymous has had personal experience with too many holes not just drilled into but through his head. They thought he was a just a dummy so they used his head for practice. They were right .

            2. To really capitalize on Allan Jethro Blowhard’s medical expertise, he should do ride- along with paramedics and tell them how to do their job.
              Then he should follow them and and the patient(s) into the ER, and tell the ER MDs that they are doing it all wrong, how Allan Jethro with the Giant Brain knows better, how they shouldn’t “delay” diagnosis or surgery by taking X-Rays or CAT Scans, etc.

              1. Rabid Fido and master don’t seem to know much about these things or much about anything else.

                I think I will just repeat a prior discussion and see if either of them learned anything.

                I wonder who will bark first, Fido or anonymous.

                Dr. Death writes: “There are established guidelines dealing with responses to a variety of acute medical issues”

                Allan responds: If you like the term guidelines that is fine. It is a good term but guidelines coexist with systems that are in place. Systems aren’t necessarily created by medical professionals and even medical guidelines can be altered by non professionals.

                (Quotes are Dr. Deaths comments.)

                “Their assessment was that she he had suffered a concussion.”

                Yes, she suffered a concussion but did she also suffer a bleed?

                “The question then is “Should a concussion patient with her symptoms be immediately rushed to a distant hospital with a major trauma unit”? I don’t think that the guidelines call for that, at least in most areas.”

                That is what I call a system failure. The bleed is the real emergency whereas the concussion would be of much less urgency and more run of the mill. Did they know she wasn’t a routine problem? Should critical conditions be handled like routine problems? (I don’t think so.) We have to guess that they recognized this patient was more critical than the vast majority of patients they treat based on a troublesome Glasgow score, a deteriorating mental status, and ‘talk and die’. Did the system appropriately account for the most serious conditions? That is the issue under discussion.

                A bleed should always be in the back of the minds of medical professionals that recognize the urgency. You seem to believe that the only facility that could relieve the pressure of a bleed is a trauma center. That would mean that Canada had no closer facilities that could both do a CT and a burr hole and then transfer the patient to the trauma hospital buying the patient’s life a little extra time. Have you checked the possible facilities in that area? A closer facility to just drill the burr hole decreases the delay for that type of patient.

                This problem is not as uncommon as you believe. You should have recognized that when you posted the article on burr holes. They were discussing doing burr holes on the site so the patient wouldn’t die on the way to the hospital or the trauma hospital.

                Since they didn’t seem to have a system to separate the sickest from the rest I wonder if the system was created based solely on the odds. That is not the way medicine should be practiced. I think their system has already been changed to account for this type of system problem. I think they now use helicopters and that helps correct the failure I have been talking about.

                This posting of yours seems like an attempt to address the systems involved. It is the best effort to date by you but I think you drew a conclusion and then looked for things that satisfied the conclusion instead of maintaining an open mind drawing conclusions after you had more information.

                We have to recognize that Canada has a centralized system of medical care and that can lead to certain holes in treatment. The specific hole that occurred here might not occur in a more decentralized medical system. There are advantages and disadvantages and they have to do with the risks and benefits.

                The risk is loss of life the benefits have to do with preserving resources. Where on the line one places their emphasis is a societal decision.

                1. I think that Alan should keep reposting comments that have already been made.
                  He has reposted some of the same comments multiple times, as if already making those comments over the course of hundreds of exchanges is not sufficient.
                  Maybe if he keeps repeated the same comments that were previously made, be can add hundreds more comments and thousands of additional words to this thread.

                  1. I’m glad you think I should repost these discussions. They show you to be an idiot so perhaps you are learning what you are and how you can change. In fact I think I should post such things everytime you post on the blog despite the fact it is regarding a different subject. Those postings are nothing more than generalities that are near meaningless and the brain that created those postings is without value.

                    1. Just be sure that since you got in the first words on this topic, that you also meet your requirement of getting in the last word.

                    2. “Just be sure that since you got in the first words on this topic, that you also meet your requirement of getting in the last word.”

                      Yes, and I will be sure to remind you of ‘almost 4 hours’.

  5. Allan says:September 22, 2019 at 4:16 PM

    “Natasha Richardson was encouraged to use a helmet that day.”

    The discussion is not about Richardson’s culpability so why do you bring it up? The answer is simple. You believe that if you pile on enough crap some of it might stick. The discussion is about an almost 4 hour delay.

    https://jonathanturley.org/2019/09/05/trump-ridiculed-for-altered-hurricane-forecast/comment-page-4/#comment-1884015

    Feel free to “discuus” whatever you like, buddy, and I’ll do the same.

    1. “Feel free to “discuus” whatever you like, buddy, and I’ll do the same.”

      That is fine anonymous or Fido. As long as you don’t lie that isn’t a big problem but you lie all the time and what you say is all too frequently garbage. Go yap at someone elses heals

      1. @Allan:

        You’ve got a problem, buddy, and it isn’t someone yapping at your “heals [sic].”

        And yes, I’m free to discuss whatever I’d like, and I don’t “lie.”

            1. You are a yapper Fido and you say nothing. They should do a brain biopsy on you and check you for rabies. The only problem is with such a small brain will they miss it?

            2. The scatalogical references are useful to Alan, since he’s been bull****ing his way through this entire discussion to try to back up an accusation of “multiple failures” in the Richardson case.

  6. It is not possible for Dr. Allan Blowhard to stand on his “own two feet” when he keeps putting his foot in his mouth.

    1. If you could show that to be true it might have some meaning. You can’t.

      Absent that it demonstrates the characteristics of a wounded animal that doesn’t have the intellect to be on this blog.

  7. There are in fact 3 different people posting anonymously in response to Allan’s comments.
    I would think that a genius like him, capable of immediately diagnosing epidural hematoma without a CAT Scan or other imaging, could figure out that 3 different sets of comments were posted by 3 different people.
    That should be a piece of cake for someone with Allan’s phenomenal analytical powers.

    1. It is not up to me to separate one anonymous from the other. You are all the same, trash. You hide your persona among many that makes the blog inefficient. One of the supposed anonymous’s is likely no different than the anonymous presently making this claim. That is your nature. Hide, be stupid, hide and be stupid again. That is fine for I believe it clear to everyone. There is no anonymous that escapes the duplicity, prevarications, or stupidity of the other anonymous’s.

      As far as “immediately diagnosing epidural hematoma without a CAT Scan “. Again you are being stupid. No one whether a doctor or a lay person is making a diagnosis. They are making a presumptive diagnosis so that if the patient deteriorates they are prepared to do what is necessary and what they can to save a patient’s life. You are too stupid to understand this so in this reply I won’t go any further.

      Understand a lot of people have knowledge of head trauma. People that are well informed and do not place their intellect in a box to be buried, nurses, hospital administrators, medics, ambulance drivers, policy makers, and anyone who has had contact with such an incident. The knowedge is widespred so that many people wear helmets when doing a whole slew of activities including todlers that ride bikes. Your brain is so clogged with garbage that you don’t recognize these things.

        1. Need I remind you that you play a major part in that goal. But I note all the cr-p you write but on the two posts that actually responded to the issue of Richardson I replied to yours with correct information and you had to shut up.

          All you are left with is the slithering and phony attacks of a snake that knows it has lost the battle and soon won’t exist.

      1. No one expects Allan to figure out which anonymous he’s mouthing off to.
        He is far too busy pretending that he knows what “should have been done” in the Richardson case, with his perfect 20/20 hindsight.
        And he’s also been occupied with lying about a non-existent “4 hour delay”.

          1. Like Allan has not repeated himself with the phony “4 hour delay, 4 hour delay!” lie.
            To the extend that I have repeated myself, detailed comments I made were repeated when Allan lied about what was in them.
            I thought at first that Allan was merely stupid and could not comprehend what was being said to him. So there was some hope that explaining things again to a dull normal guy like Allan might make a difference.
            When it became clear that he was a pompous ass pretending to be knowledgeable, that, combined with his underlying stupidity, made it pointless to try to explain anything to him.

            1. “Like Allan has not repeated himself with the phony “4 hour delay, 4 hour delay!” lie.”

              Stop lying and misquoting “almost 4 hour delay” Don’t forget the word “almost” because that is 20 minutes of an hour is impotysny yo petty guys like you who have to keep themselves straight to be able to complain.

              You keep insisting I don’t know the facts and you do after making a fool of yourself time and time again. All one has to do for a two part summary is go to https://jonathanturley.org/2019/09/05/trump-ridiculed-for-altered-hurricane-forecast/comment-page-4/#comment-1884019 Where I answered your more intelligent questions. The dumbest questions were left out of that debate. Clarrified later is that not anonymous but Allan wrote the 2 parts.

              You are just too stupid to deal with, but I guess I have to. Make sure Fido doesn’t pee on your leg..

      2. It was clear from the start that Dr. Blowhard knew little or nothing about the Richardson case.
        I have to hand it to him that it did not stop him from acting as though he did have some actual knowledge, and a basis for his accusation of the “multiple failures”.

      3. Natasha Richardson was encouraged to use a helmet that day. As with the ambulance (not just once, but twice — and while “lucid”), she refused. (That said, a head injury is still possible with a helmet.)

        She was also strongly encouraged to be seen at a hospital immediately after her fall — something that would have saved her but, again, she refused.

        Again: She refused to wear a helmet and she refused to early offers of medical assistance.

        Sadly — tragically — she sealed her own fate that day.

        If she had gone to the hospital straightaway, she would have had a CT scan, been transferred to Montreal, had burr hole surgery and/or a craniotomy, and she’d likely be fine today — because all of this would have occurred within the ideal treatment window, which is 30 to 90 minutes after symptoms appear).

        By the time, she sought help, it was too late. especially if she was to live without brain damage and/or disabilities. Without her medical records, medical history, and input from medical personnel and family, comments suggesting another more positive outcome are just ‘guesswork.’

        1. “Natasha Richardson was encouraged to use a helmet that day.”

          The discussion is not about Richardson’s culpability so why do you bring it up? The answer is simple. You believe that if you pile on enough crap some of it might stick. The discussion is about an almost 4 hour delay. whether her own delays sealed her fate or not we will ever know but what seems most odd is the almost 4 hour delay with a stopover at a place that couldn’t do what is considered the simplist of neurosurgical procedures. That is something they have talked about having the person on the ambulance do on site if such an emergency occurs.

          You are trying to justify your comments so I will repeat two two postings replying to the best of your comments while not repeating the dumbest of your comments.

          1. Allan – Richardson’s refusal of care and refusal to wear a helmet all add to the problem. The EMTs could not kidnap her and force her to the nearest hospital (which is the usual procedure).

            1. Paul, the issue I discussed was a system failure where the patient was taken to a facility that could not do the procedure that might be necessary to save her life. Anonymous responded with lies and quotes that did not pertain to that almost 4 hours. He is totally unable to focus on the issue.

              I agree she should have worn a helmet and she should have gone to the hospital but after the repeat call where she became a priority one with a deteriorating mental condition which is consistant with a bleed she should have been sent to the closest facility that could release the pressure on her brain and then treated or shipped to the trauma facility.

              1. Allan – once she refused treatment and delayed for as long as she did, there was no way to know she had a bleed until they got her to some hospital with a CAT scan. Then, sadly, the hospital was not equipped to treat her to they had to take her to Montreal. Then her husband flew her to NY, compounding the problem. Hospitals in small communities are ill-equipped for neuro-surgery. That is not their fault.

                1. Paul the judgement call is predominantly made based on neurologic signs along with the history of a skiing head injury and an initial status of normal. Her continuous decline in mental statust tells one that a potential emergency exists. The bleed causes pressure to build in the skull and is transferred to the brain leading to brain death and death. (the pressure can actually cause the brain to herniate into the spinal area throughthe foramen Magnum) A normal drill can and has been used outside of a hospital setting by non neurosurgeons to release the pressure. This is a procedure done since ancient times and certainly before the invention of the CAT scan.

                  1. Allan,
                    Please post Natasha Richardson’s medical records, or summarize what you learned after you were given access to them. You appear to know things like the rate of her decline, that she “would likely be fine” had her case been handled differently, etc.
                    When you make claims like that, there is an expectation that you have the knowledge and basis for your confident assertions.

                    1. “would likely be fine” Your words not mine.

                      “You appear to know things like the rate of her decline”

                      She appeared fine when she sent the ambulance away Glasow 15. When she was taken as a priority 1 she was at a 12 Glasgow. When she got to the trauma center she was brain dead or all but brain dead. I’d say that gives a pretty good indication of her decline.

                      You are not very bright.

                  2. It has already been pointed out that surgeries were done before the invention of X-Rays over a century ago. That does not mean that it’s wise to skip imaging when you need it for a diagnosis.
                    There are reasons why some things have to be repeated when a dimwit like Allan Blowhard continues to spout the same nonsense.

                    1. Are you trying for the record of the number of dumb posts?

                      I had to inform you that these things were done before the CAT Scan and I never said one shouldn’t use a CAT scan. I said it was of no value if the CAT Scan told you what to do and the only thing you could do was to let the patient die.

                      CAT Scans do not cure disease.

                    2. The above post starting with “Are you trying for the record of the number of dumb posts?” was from Allan.I noted more dumb posts but I don’t think I need to answer all of them. Anonymous has already proven he lies, misquotes and is as dumb as they get.

                      Geet your trousers cleaned.

                2. Paul,

                  A quick clarification:

                  Her husband didn’t compound the problem. By the time he reached Montreal, she was already there and it was too late. She was placed on life support in Montreal.

                  As I understand it, she was flown to NY so that family and friends could say their goodbyes, and her organs could be harvested there. She had already made her wishes known and didn’t want to live in a persistent vegetative state.

                  https://www.reuters.com/article/us-richardson/natasha-richardsons-organs-donated-report-idUSTRE52P15R20090326

                    1. Paul, take note when she got to Montreal she was considered brain dead. That is how we know her condition got worse something missed by anonymous. It’s a tragic story that can be used to show potential system changes and I believe those changes were made.

                    2. “…when she got to Montreal she was considered brain dead. That is how we know her condition got worse something missed by anonymous”

                      Uh, no, Allan.

          2. “That is something they have talked about having the person on the ambulance do on site if such an emergency occurs.”

            Perhaps you could provide a source for that?

                  1. I haven’t seen any article that says what you’re asserting:

                    “That is something they have talked about having the person on the ambulance do on site if such an emergency occurs.”

                    What is your source for the previous statement.

                    1. You cited it so you should prove it, but that is beyond your competence.

                      From the article you Anonymous cited. Unfortunately you don’t read what you cite, you don’t comprehend what you read, you lie and you misquote.

                      Emergency burr holes: “How to do it”

                      For many years it has been known that earlier surgical intervention is of benefit in the management of head trauma when an extra-axial collection can be removed [9]. In the future, near infra-red/ultrasound devices or mobile CT, may mean that extra-axial collections can be detected in remote locations. This will not be of benefit unless the time to surgical relief of increased Intracranial Pressure is also shortened.
                      While attempting to remove the mystique and anxiety surrounding emergency burr hole placement, we emphasise the importance of avoiding inappropriate intervention. However, when faced with a situation where mortality approaches 100%, a simple technique, using the correct equipment can be robust, safe and life-saving even in the hands of non-specialists.

            1. “That is something they have talked about having the person on the ambulance do on site if such an emergency occurs.” (This is Allan’s take on one of the articles that was posted.)

              Nope. Not in the article that you’ve referenced, Allan.

              There is zip in that article about “having the person on the ambulance” drill burr holes. Allan is reading something into the article that isn’t there.

              1. You lack total comprehension and any vision.

                From the article:

                “extra-axial collections can be detected in remote locations. This will not be of benefit unless the time to surgical relief of increased Intracranial Pressure is also shortened. … when faced with a situation where mortality approaches 100%, a simple technique, using the correct equipment can be robust, safe and life-saving ***even in the hands of non-specialists***. (The article is also talking about drill bits with a clutch to automatically stop the drill)

                It’s in the article. Read around. They talk of remote places and the use of non medical equipment such as drills as I described earlier. You apparently know nothing about robotics and how surgeons use robotics. I guess you don’t realize that even a cell phone could be used for a neurosurgeon anywhere in the world to help in the placement of these drill bits that are easier to use.

                You are an idiot.

                1. “non-specialists”

                  Yes — ER docs, doctors who aren’t neurosurgeons, other doctors in remote locations…

                  As dhlii said:

                  “dhlii says: August 13, 2018 at 1:46 AM

                  Regardless, you have this bizzare concept that people do things in blog comment sections beside comment.

                  I DO things in the largest part of my life which is not here.”

                  Get off your computer, find a cause, and get out there and actually DO something, buddy.

                  1. Tell me. A person will be dead in a very short while unelss a hole is drilled in his head. I discussed a portable machine to provide an image as discussed in the article. I discussed the clutch mechanism on the drill. The neurosurgeon anywhere in the world looks at the image sent to his phone, sees the patient on Facetime gets the data, sees the patient and has the image sent to him. He instructs a person where to place the drill and drill.

                    Is that hard for you to imagine?

                    Ever see a person that gets food stuck in his throat and can’t breathe? Does one wait for a specialist or does one do a Heimlich. A person drops dead in front of you no pulse and not breathing. Do you wait for a cardiogist or do you do cardio pulmonary recussitation?. In many places there is a defibrillator for use by lay people. Do they wait for the cardiologist or use the defibrillator?

                    The throat is completely blocked for whatever reason and the patient can’t breathe. A small cut below can permit enough air to keep the patient alive. People have been known to insert things like pens into the neck to open a path for air to go in or out

                    A person drowns does one wait until a pulmonary doctor reaches the scene or does someone try to resucitate. Are life guards medical doctors? No but they will act.

                    An allergic person who carries an epi pen has an allergic reaction does he wait for the nurse or does he inject epinephine into his body?

                    Do you think medics are medical specialists? They are on the battlefield and treat with or without MD’s. In some countries on the field they keep a limb alive by doing surgery on the field of battle and then remove the patient without the loss of a limb.

                    Are you that unknowledgeable of what is done by normal people?

        2. The comments in quotes are those made by Dr Death Anonymous:

          “They reason they did a CAT Scan was to rule out something g more serious than a concussion.”

          You are an idiot. The CAT Scan doesn’t fix the problem. It is a good thing to do if time is available but it never cured anyone or saved anyone’s life.

          “To retroactively advise the medical staff have “something more serious should be in the back of their minds” about her injury is not exactly a treasure of medical advice from ”

          Dr. Deaths retrospective method of treatment requires an autopsy to know what is wrong with the patient. By then it is too late. That is why physicians use their best medical judgement at the time. They knew her mental status was not optimal and was declining. She was brain dead by the time the almost 4 hours were up.

          “He has repeated my question about the wisdom of immediately rushing a patient thought to have a concussion to distant major trauma center.”

          Almost 4 hours is the issue. The question is could they have gotten her to a facility that could treat in less time.

          “If you are willing to clogged ERs of Level 1 Trauma Centers with concussion patients, and strain the resources of ambulances and the medical personell involved in the transportation, you can lobby to change the guidelines. By Dr. Blowhard’s reasoning, there are ””

          That was not the issue. They knew this was a more serious concussion and they saw her deteriorate meaning she required more advanced though relatively simple neurosurgical treatment. That treatment need not be in a Level 1 trauma center but anywhere closer than “almost 4 hours” that had the appropriate facilities.

          If one takes Dr. Deaths argument to its logical conclusion then everyone that is relatively healthy ends up in a place for rest that cannot treat while the very sick die. There is such a thing as triage.

          Continued

          1. The CAT Scan is a diagnostic tool, Allan as anonymous. It was never claimed that it did more or less than that.
            This also has been covered before, yet you keep repeating the same stupid lines.
            Imaging is not just “nice to have”; it is essential to get a diagnosis before boring holes into a patient’s skull.
            There was already a detailed list of contraindications for burr hole surgery presented to Dr. Allan Blowhard. One was “lack of imaging”.

        3. 2/2 The comments in quotes are from Dr. Death Anonymous

          “His initial position was that there were “multiple failures” specific to the Richardson case, and that he’d “bet” that she would have survived had this happened at an American ski resort.

          I can’t predict life or death but I would “bet” that she would have had a better chance at a 5 star ski resort in the US because the Canadian system is more centralized and the American system is more decentralized which means that likely there would have been no “almost 4 hours” to get to a facility that could treat.

          “I made the mistake of thinking that Allan knew what he was talking about when he made that comment, that he actually knew something about the case.”

          You were right at first but then became upset because you recognized that you didn’t know what you were talking about. “Almost 4 hours” is the issue but you think a CAT Scan is curative so gradually as you became more knowledgeable you had problems with conflicts of your prior statements. Instead of simply recognizing the simple problem you made all sorts of excuses and in the process made a fool of yourself.

          “Since the handling of concussion cases is not substantially different in Canada than in the U.S., who knows what he was basing that claim/ bet on.”

          We get back to guidelines and systems. Canadians are good doctors. I said there were system failures and they existed around the “almost 4 hours” along with a preliminary stop to a hospital that could not treat the likely emergency. This had little to do with how a concussion or a bleed should be treated.

          “f his objective is to change established standards, to revamp the system to deal with every “rare catastrophic event” ( as Dr. Keith Black stated), maybe be can change “the system”, and also require that a nuerosurgeon be present at every slope in North America.”

          No. The objective is to reduce the time frame to less than “almost 4 hours”. Generally people attempt to improve things. You don’t understand that principle and you don’t apply that to yourself so you remain intellectually challenged. You can’t even get it into your head that Dr. Black wasn’t commenting on the “almost 4 hours” but you grab onto that and anything else trying to maintain a failed position. I hope you don’t climb mountains because you don’t grab onto solid things.

          Had she been taken initially to a center that could have done an emergency burr hole and was then transferred to another hospital I would have said nothing. It was odd to take a patient whose mental status was changing for the worse to a hospital that couldn’t do the basic treatment necessary for her survival.

        4. “she’d likely be fine today”. Another of Dr. Allan Blowhard’s example of confidently spouting off to cover up his ignorance. His medical malpractice premiums must be exorbitant, if any insurer will cover him.

          1. To Anonymous at 5:38 PM:

            I don’t know what Allan said, but he certainly confuses matters and isn’t clear in his comments. I said this.

            “If she had gone to the hospital straightaway, she would have had a CT scan, been transferred to Montreal, had burr hole surgery and/or a craniotomy, and she’d likely be fine today — because all of this would have occurred within the ideal treatment window, which is 30 to 90 minutes after symptoms appear).

            What I should have said is this: “…she might be fine today.” With early treatment, she might be fine… — with an emphasis on “might.” It’s impossible to know.

          2. Sounds like another lie to me. I think you are copying your own words from above at September 22, 2019 at 3:43 PM.

            We already know you are a liar. You don’t have to continue to prove it.

  8. Duke Powell:

    “I have worked on ambulances since 1971 and have been a paramedic at HCMC* since 1980….Given the remote location of the accident and the subtle, slow onset of symptoms, this actress was probably doomed to die at the moment that she fell.”

    *Hennepin County Medical Center

    1. “this actress was probably doomed to die at the moment that she fell.”

      That is possible but not the question under discussion. Thin minds try and prove their case by using proofs that have nothing to do with the questions under scrutiny.

      The question had to do with the system…almost 4 hour wait.

      Your mind is very thin and we don’t decide life and death based on guesswork miles away from the scene.

      1. “…we don’t decide life and death based on guesswork miles away from the scene.”

        So it’s decided by ‘guesswork’ by some random non-medical guy named Allan?

        Feel free to ‘discuss’ the ‘the system…almost 4 hour wait’ that you’ve dreamed up with anyone who would like to ‘discuss’ it. I have no interest it it — or you.

        1. You always respond to a question with an insult but never or almost never do you try to deal with the content. I wasn’t on the scene and neither were you. Therefore the idea is to save the life not to guess whether one should let her die by delaying treatment. Dr. Death is an appropriate name for you because you seem willing to decide life and death based on what your puny mind guesses.

          “Feel free to ‘discuss’ the ‘the system…almost 4 hour wait’ that you’ve dreamed up with anyone who would like to ‘discuss’ it. I have no interest it it — or you.”

          Walk away if you have no interest. But you don’t because you want to win so badly but recognize walking away confirms the loser you are.

          1. People “win” and make a difference in real life, not in the comments section of some blog.

            Highlighting what dhlii said to Allan:

            “dhlii says: August 13, 2018 at 1:46 AM

            Regardless, you have this bizzare concept that people do things in blog comment sections beside comment.

            I DO things in the largest part of my life which is not here.”

            https://jonathanturley.org/2018/07/11/cambridge-under-fire-for-hiring-american-physics-researcher-who-advocated-monogamy-on-blog-three-years-ago/#comments

              1. Let’s repeat this one, too:

                Dhlii to Allan:

                “This type of nonsense argument just makes you look silly and nuts.

                “You would not except stupid ad hominem from other posters here.
                Why should you accept it from yourself ?”

                https://jonathanturley.org/2018/07/11/cambridge-under-fire-for-hiring-american-physics-researcher-who-advocated-monogamy-on-blog-three-years-ago/comment-page-1/#comment-1761508

                Yep. Others get it, too: “…silly and nuts”

                1. I guess you didn’t get it the first time.

                  A statement by anyone can sound and be referred to as silly and nuts.

                  I thought dhlii’s statement sounded silly and nuts. I didn’t call him silly and nuts. You are silly, nuts and stupid. There is a difference no matter how many times you repeat it.

                  You are also a loser.

                  1. Dhilli got it right, of course:

                    Allan’s “nonsense statements” certainly do make Allan seem “silly and nuts.”

                    No, Allan didn’t call dhlii “stupid and nuts” — it was the other way around.

                    Read dhlii’s comment because Allan is trying to confuse…, per usual.

                    1. Are you now trying to misquote dhlii. That would be par for the course. Liar.

                      “argument just makes you look silly and nuts.”

                      That is his opinion of one of my arguments. You are an illiterate, but you know that by now. So after saying I insulted another you went through 826 comments and could only find that I insulted no one and that dhlii insulted one of my arguments. In other words no one insulted anyone.

                      Sherlock you are schlock and I don’t want to forget, a loser as well.

                    2. Anonymous at 4:14 PM,
                      Allan does not have to try to confuse the issue. Confusion comes naturally and effortlessly to him.
                      That is one reason why an issue that could be discussed and settled in a few dozen comments can extend to a marathon of hundreds of comments, just trying to keep the record straight while Allan rambles on in the AllanWorld ” I am always right regardless of the facts” mode.
                      Now that he is within about a hundred comments of running this thread past his previous personal best, there is no reason to believe that he will change his confused style of “debate”.

                    3. Didn’t you know that directly quoting dhlii is misquoting him and lying in AllanWorld?
                      That is how exchanges with Dr. Blowhard play out.

            1. Anonymous,
              In a normal exchange with a rational individual, directly quoting someone is not the same as misquoting them, or ‘lying”. A normal exchange with someone like Allan “I am always right regardless of the facts” Blowhard is not possible, given the AllanWorld style of ”debate”.
              But he is edging closer and closer to topping his previous personal best, and maybe that is why Allan considers himself a “winner”.
              Those who do not cross over into the AllanWorld of delusion are “losers”.

              1. “In a normal exchange with… ”

                Gosh it is difficult to say if anonymous is talking to himself or Fido. He can’t prove it to everyone else so he is trying to prove it to the dog.

                What a loser.

                  1. Do you mean you didn’t notice Fido yapping at your feet? Along with being intellectually challenged you are not aware of your surroundings.

          2. Best thing at this point is for Dr. Allan Blowhard to get in his time machine, go back to the time the paramedics initially saw the patient, and tell them what he learned from his Future World perspective.

              1. Very good, Allan. You are getting closer to that 827 record breaking mark.
                “All you need to say” involves repetition of your previous nonsense to rack up more comments.
                Your normal status as one of this blogs “most frequent commentators” is always secure, but this shot at “827” is an even greater goal for you.

                1. It takes two to Tango so my guess is you want to reach that 827 mark for it will amount to your greatest accomplishment.

                  Almost 4 hours.

                  1. I had no role in your previous marathon thread of 826 comments.
                    That was you and an infrequent commentator.
                    I don’t make The Most Frequent Commentators list when it’s periodically presented.
                    Dr. Allan Blowhard does. And if that list were determined by total number of words rather than number of comments, you would be at the top of that list every time.
                    I, and the others pointing out your idiocy, haven’t been stuck on one theme like “4 hours”, and writing thousands of words saying the same thing.
                    So if there us another 800+ comment section, we will have the same Allan Blowhard topping his previous personal “best”.
                    I and the other 2 anonymouses who have been pointing out your stupidity in these exchanges will be perfectly happy to give Allan the Blowhard full credit if you run this farce up to 827.

                    1. You have a direct and causative role in the promotion of the present discussions on several of the threads increasing the numbers by your own hand. You are making yourself look ridiculous, that is if you can look any more ridiculous than you are.

                      You write junk and do not respond too content.

                      You are a loser.

                    2. https://images.app.goo.gl/ChJGAjPiGvH4C9PD7

                      Dr. Allan “4 hour delay” Blowhard has not posted anything in the way of sensible content, nor has he addressed the content of the replies to him that have sunk his idiotic “multiple failures” garbage.
                      Since he regards himself as The Great Expert on how paramedics and MDs “should have” responded in the Richardson case, his standard reply in defense of his position is to label those who don’t agree with his position as liars or ignorant orosers or stupid.
                      Because he likes that style and those tactics, the most appropriate method of communication with him can be found in this link.
                      He deserves no less.

                    3. Referring to your comment on September 21, 2019 at 2:36 PM where you say I have “not posted anything in the way of sensible content” I am reposting a comment posted more than once. This is just one example of content not responded to whereas your content has been almost totally absent recently and off topic in the past. Almost 4 hours was something you never really could get a handle on and now you are frustrated littering the blog with trash similar to that seen by the guy screaming inanities in the park where he lives.

                      “There are established guidelines dealing with responses to a variety of acute medical issues”

                      If you like the term guidelines that is fine. It is a good term but guidelines coexist with systems that are in place. Systems aren’t necessarily created by medical professionals and even medical guidelines can be altered by non professionals.

                      “Their assessment was that she he had suffered a concussion.”

                      Yes, she suffered a concussion but did she also suffer a bleed?

                      “The question then is “Should a concussion patient with her symptoms be immediately rushed to a distant hospital with a major trauma unit”? I don’t think that the guidelines call for that, at least in most areas.”

                      That is what I call a system failure. The bleed is the real emergency whereas the concussion would be of much less urgency and more run of the mill. Did they know she wasn’t a routine problem? Should critical conditions be handled like routine problems? (I don’t think so.) We have to guess that they recognized this patient was more critical than the vast majority of patients they treat based on a troublesome Glasgow score, a deteriorating mental status, and ‘talk and die’. Did the system appropriately account for the most serious conditions? That is the issue under discussion.

                      A bleed should always be in the back of the minds of medical professionals that recognize the urgency. You seem to believe that the only facility that could relieve the pressure of a bleed is a trauma center. That would mean that Canada had no closer facilities that could both do a CT and a burr hole and then transfer the patient to the trauma hospital buying the patient’s life a little extra time. Have you checked the possible facilities in that area? A closer facility to just drill the burr hole decreases the delay for that type of patient.

                      This problem is not as uncommon as you believe. You should have recognized that when you posted the article on burr holes. They were discussing doing burr holes on the site so the patient wouldn’t die on the way to the hospital or the trauma hospital.

                      Since they didn’t seem to have a system to separate the sickest from the rest I wonder if the system was created based solely on the odds. That is not the way medicine should be practiced. I think their system has already been changed to account for this type of system problem. I think they now use helicopters and that helps correct the failure I have been talking about.

                      This posting of yours seems like an attempt to address the systems involved. It is the best effort to date by you but I think you drew a conclusion and then looked for things that satisfied the conclusion instead of maintaining an open mind drawing conclusions after you had more information.

                      We have to recognize that Canada has a centralized system of medical care and that can lead to certain holes in treatment. The specific hole that occurred here might not occur in a more decentralized medical system. There are advantages and disadvantages and they have to do with the risks and benefits.

                      The risk is loss of life the benefits have to do with preserving resources. Where on the line one places their emphasis is a societal decision.

                    4. “Allan’s the one”

                      Anonymous, I think what you are telling us is that the reason you are ignorant is because the dog ate your homework.

                2. They reason they did a CAT Scan was to rule out something g more serious than a concussion.
                  To retroactively advise the medical staff have “something more serious should be in the back of their minds” about her injury is not exactly a treasure of medical advice from Dr. Allan Blowhard.
                  He has repeated my question about the wisdom of immediately rushing a patient thought to have a concussion to distant major trauma center.
                  If you are willing to clogged ERs of Level 1 Trauma Centers with concussion patients, and strain the resources of ambulances and the medical personell involved in the transportation, you can lobby to change the guidelines.
                  By Dr. Blowhard’s reasoning, there are ”
                  mutiple failures” present in “the system” every time a concussion patient is not immediately handled in the way Dr. Blowhard recommends.
                  His initial position was that there were “multiple failures” specific to the Richardson case, and that he’d “bet” that she would have survived had this happened at an American ski resort.
                  I made the mistake of thinking that Allan knew what he was talking about when he made that comment, that he actually knew something about the case.
                  It didn’t take long to find out that was not the case, hence the Dr. Blowhard title he earned. It was much later on, in his scrambled efforts to support his “bet”, that be came up with his criticism of accepted guidlines for those thought to have concussions.
                  Since the handling of concussion cases is not substantially different in Canada than in the U.S., who knows what he was basing that claim/ bet on.
                  If his objective is to change established standards, to revamp the system to deal with every “rare catastrophic event” ( as Dr. Keith Black stated), maybe be can change “the system”, and also require that a nuerosurgeon be present at every slope in North America.
                  With CAT Scans and MRIs in every ski lodge. Why stop with his recommendation to rush all concussion patients to distant facilities?

                  1. “They reason they did a CAT Scan was to rule out something g more serious than a concussion.”

                    You are an idiot. The CAT Scan doesn’t fix the problem. It is a good thing to do if time is available but it never cured anyone or saved anyone’s life.

                    “To retroactively advise the medical staff have “something more serious should be in the back of their minds” about her injury is not exactly a treasure of medical advice from ”

                    Dr. Deaths retrospective method of treatment requires an autopsy to know what is wrong with the patient. By then it is too late. That is why physicians use their best medical judgement at the time. They knew her mental status was not optimal and was declining. She was brain dead by the time the almost 4 hours were up.

                    “He has repeated my question about the wisdom of immediately rushing a patient thought to have a concussion to distant major trauma center.”

                    Almost 4 hours is the issue. The question is could they have gotten her to a facility that could treat in less time.

                    “If you are willing to clogged ERs of Level 1 Trauma Centers with concussion patients, and strain the resources of ambulances and the medical personell involved in the transportation, you can lobby to change the guidelines. By Dr. Blowhard’s reasoning, there are ””

                    That was not the issue. They knew this was a more serious concussion and they saw her deteriorate meaning she required more advanced though relatively simple neurosurgical treatment. That treatment need not be in a Level 1 trauma center but anywhere closer than “almost 4 hours” that had the appropriate facilities.

                    If one takes Dr. Deaths argument to its logical conclusion then everyone that is relatively healthy ends up in a place for rest that cannot treat while the very sick die. There is such a thing as triage.

                    Continued

                    1. “His initial position was that there were “multiple failures” specific to the Richardson case, and that he’d “bet” that she would have survived had this happened at an American ski resort.

                      I can’t predict life or death but I would “bet” that she would have had a better chance at a 5 star ski resort in the US because the Canadian system is more centralized and the American system is more decentralized which means that likely there would have been no “almost 4 hours” to get to a facility that could treat.

                      “I made the mistake of thinking that Allan knew what he was talking about when he made that comment, that he actually knew something about the case.”

                      You were right at first but then became upset because you recognized that you didn’t know what you were talking about. “Almost 4 hours” is the issue but you think a CAT Scan is curative so gradually as you became more knowledgeable you had problems with conflicts of your prior statements. Instead of simply recognizing the simple problem you made all sorts of excuses and in the process made a fool of yourself.

                      “Since the handling of concussion cases is not substantially different in Canada than in the U.S., who knows what he was basing that claim/ bet on.”

                      We get back to guidelines and systems. Canadians are good doctors. I said there were system failures and they existed around the “almost 4 hours” along with a preliminary stop to a hospital that could not treat the likely emergency. This had little to do with how a concussion or a bleed should be treated.

                      “f his objective is to change established standards, to revamp the system to deal with every “rare catastrophic event” ( as Dr. Keith Black stated), maybe be can change “the system”, and also require that a nuerosurgeon be present at every slope in North America.”

                      No. The objective is to reduce the time frame to less than “almost 4 hours”. Generally people attempt to improve things. You don’t understand that principle and you don’t apply that to yourself so you remain intellectually challenged. You can’t even get it into your head that Dr. Black wasn’t commenting on the “almost 4 hours” but you grab onto that and anything else trying to maintain a failed position. I hope you don’t climb mountains because you don’t grab onto solid things.

                      Had she been taken initially to a center that could have done an emergency burr hole and was then transferred to another hospital I would have said nothing. It was odd to take a patient whose mental status was changing for the worse to a hospital that couldn’t do the basic treatment necessary for her survival..

          3. Allan at 3 PM yesterday:

            “Walk away if you have no interest. But you don’t because you want to win so badly but recognize walking away confirms the loser you are.”

            Allan is projecting again.

            1. If Dr. Death could have told me something correct I didn’t know I would thank him or correct myself like I have done before. I don’t need to win. You do and that makes you the loser.

              1. There is a clear path to. being “a winner” in AllanWorld Fantasy Land. It involves never disputing any of his idiotic comments.
                It involves giving him the first and last words when be makes an extremely stupid set of unsupported accusations.
                It involves an admission that you are “lying” when you present direct quotes, because Dr. Allan knows that the quotes are accurate and make look like an even bigger fool.
                Just in case you no longer risk want to risk being called loser/liar/ stupid/ ignorant by a blowhard like Dr. Allan, you need to know all of the Allan Guidlines for being a “Winner” like him.
                He is still working on on his autobiography, which covers how he came to be a pretentious, pompous ass.

                1. “There is a clear path to. being “a winner” in AllanWorld”

                  Being a winner is standing on one’s own two feet and not being afraid of learning. Fido yapping at the feet of others is not being a winner. It is close to being a slave.

                  1. “It involves an admission that you are “lying” when you present direct quotes, because Dr. Allan knows that the quotes are accurate and make look like an even bigger fool.”

                    Anonymous, your quote though accurately worded did not pertain to the almost 4 hours. Since this has been explained multiple times and proven by the entire quote and question asked by Scientific American one has to assume that you are stupider than anyone can imagine or you are permanently set to lie

        2. It is not ”guesswork”. It is with perfect 20/20 hindsight that Dr. Allan Blowhard would have immediately “known’ he was not dealing with a concussion, but a hematoma caused by a severed cranial artery. In AllanWorld, imaging would not have been necessary to make an immediate, accurate diagnosis.

          1. “It is not ”guesswork”…

            In the immediately preceding post of yours were you speaking to Fido or yourself or was Fido speaking to you. We all want to know.

  9. I see that Allan is stinking up another thread, as he continues with his “multiple failures” bs r/t Natasha Richardson’s death. He’ll move on eventually, but for now he continues to obsess about something that he can’t prove.

    1. Do you have a problem Dr. Death,,known as anonymous and posts pretending to be still a third anonymous different than Fido.

      You think almost 4 hours is how one moves quickly in an emergency or when one needs to. That is why you are a loser.

      1. The “4 hour” crap repeated endless by Dr. Allan Blowhard has already been addressed comprehensively, many times, and ignored by Allan.
        So there is no point in repeating the specifics of an issue that has already been covered.
        When a person like Allan accuses people of “multiple failures” when they are fighting to save someone’s life, compares there efforts to “doing her nails”, those accusations deserve a response.
        There is an expectation that when someone makes statements like that, they would have something specific to back it up.
        When there is a case of negligence or incompetence or malpractice that costs a patient’s life, there needs to be solid reasons for demonstating what the “failures” where.
        Acting like an expert and acting like you have the medical records or a real knowledge of those records, acting like ambulance transport time is wasted time, acting like imaging and stabilization are like “doing her nails”, are not the same as providing solid reasons.
        That will not stop Allan Blowhard from running his mouth about a “4 hour delay” or “multiple failures”, but what good is the internet without frauds like Allan running his mouth?

        1. “The “4 hour” crap repeated”

          It’s almost 4 hours to get a critical patient to a facility where the patient could have a surgical procedure to buy her more time. I feel certain, someone closer than 4 hours could have been found to buy Richardson more time. After all, according the physician you quoted, Dr. Boylan, that necessary procedure was the easiest neurosurgical procedure. Also according to your burr hole article if time is running out they would like to do the procedure on site rather than in a hospital. Telephones exist to contact neurosurgeons for help or a closer facility. The equipment is not difficult. A regular drill has been used on patients successfully by non neurosurgeons. A CAT scan though preferrable is not a necessity. Such procedures have been done in ancient times.

          All the above is content that you claim doesn’t exist and you cannot refute. You are a liar. You have been in error on most of the content above and even the articles you posted agree with what I am saying.

          You keep proving you are a dope, but more than that you are a loser.

            1. It is amazing that Dr. Allan Blowhard has time to run his medical practice and still finds time to be one of the most frequent and wordy commentators here.
              He is to be congratulated.

            2. “I did not quote Dr. Boylan. As for your “certainty”, that is a joke.”

              You quoted an entire article and I believe her words were either quoted or paraphrased. You have been using her name saying what she says all along. You are a dope, not interested in content,. Using a silly style of argument seems to be your modus operande.

              1. That was the other anonymous who presented Dr. Boylan comments, which did not support your argument.
                I think most people understand that you do not immediately drill holes into someone’s skull for what is thought to be a concussion.
                A damn fool like Dr. Allan Blowhard is not most people, and no matter how many times or how many ways things are explained to him, Dr. Allan “I am always right” Blowhard will cling to an indefensible position.
                That is simply Allan being Allan.

                1. “That was the other anonymous who presented Dr. Boylan comments, which did not support your argument.”

                  Dr. Death, you are a confirmed liar so we can’t trust anything you say. You tied your persona to an alias that was not unique in order to hide your incompetence and your lies so live with it. We have to assume that you are responsible for all the comments under anonymous even the ones coming from the yapping dog.

                  “I think most people understand that you do not immediately drill holes into someone’s skull for what is thought to be a concussion.”

                  You don’t drill for a concussion. You would have to be stupid to do so for all concussions and even stupider to propose that is what I suggested. Most concussions do not lead to bleeds and bleeds can be small. You drill when it is necessary and you drill at inconvenient times when the patients’s life is being extinguished hoping to permit the patient extra time so that you can get the patient to the proper facility. None of this information is outside the scope of the normal intelligent person that reads and all of it was likely contained in the articles quoted.. That is why you seem to have so many problems with this subject. You are poorly read and poorly educated.

                  You call my position indefensible but what I say is actually what people generally attempt to do. Your comment merely tells everyone what a loser you are.

            1. David Benson is the God Emperor of Making Stuff Up and owes me thirty-six citations (one from the OED, one from the town ordinances and two from the Old Testament), an equation and the source of a quotation, after forty-four weeks, and needs to cite all his work from now on. – David, give us one of your pearls of wisdom from the BNC Discussion Forum.

              1. No, David. Fido, AKA the Brainless Wonder would become lonely again and would start yapping and grabbing at your trousers. Do you really want the bottom of your trousers shredded and left with rabid mucous?

  10. There was no 4 hour delay. There was no 3 hour, 40 minute delay rounded up to 4 hours.
    This has been covered, in some detail, several times.
    Only in AllanWorld was there a 4 hour delay.

    1. Dr Boland who you quoted thought there was a 3 hour and forty minute delay rounded to **almost** 4 hours or can’t you read?

      1. That is not what Dr. Boland daid. She said that “only 3 hours, 40 minutes elapsed” from the time a call for the ambulance was made to the time she arrived in Montreal.
        She also mentioned the imaging and stabilization at the closer hospitals, which you have repeatedly criticized as unnecessary “delays”.

        1. Correction:

          Dr. Boylan– not Boland

          And to Anon @ 5:23:

          Yep. 3 hours and 40 minutes. But Dr. Boylan is a medical professional and Allan clearly isn’t.

        2. That 3 hours and 40 minutes elapsed is the same as delayed. You are really digging in the dirt to find something to say. But you are not alone. You have your trusted dog Fido (AKA the Brainless Wonder) yapping at your feet so you must feel that you are protected by her mindless comments that haven’t added one bit of knowledge to any of the problems under discussion.

          1. “That 3 hours and 40 minutes elapsed is the same as delayed.”

            This is true in AllanWorld, but not anywhere else.

            Dr. Boylan was correct in using the word “elapsed.”

            That Allan doesn’t understand the difference between “elapsed” and “delayed”, in the context of travel time, isn’t a surprise.

            We’ll let him think on it, for all the good it will do.

            She was also correct in her precision about the amount of time that “elapsed.” She’s a neurologist and understands that when describing a medical emergency, one doesn’t round 3 hours and 40 minutes up to 4 hours.

            In AllanWorld, however, he wants the transfer time — the amount of time that elapsed — to be as long as possible, even though it’s inaccurate.

            Keep thinking on those definitions, Allan.

            1. It’s difficult to ascertain with total accuracy whether this is Fido, AKA the Brainless Wonder or Dr. Death speaking. IF it is Fido she has elevated her wrting so there is barely notable intelligence or if it is Dr. Death, his ability to write is degenerating to that of Fido’s total lack of ability.

              Since the exact times were given multiple times almost 4 hours was very appropriate.

              My guess is the above post was Fido’s and she paraphrased some of what Dr. Death said before.

      2. We can read, Allan, but you obviously can’t.

        Dr. Boylan mentioned “3 hours and 40 minutes.” She said nothing about 4 hours… — or almost 4 hours.

        She said “3 hours and 40 minutes.”

        1. “Dr. Boylan mentioned “3 hours and 40 minutes.” She said nothing about 4 hours… — or almost 4 hours.”

          Whether it be Dr Death or Fido the Brainless Wonder you guys really have nothing to say.

  11. Are we safer than Natasha Richardson?

    By Laura S. Boylan, M.D.
    Commondreams.org
    Monday, April 6, 2009

    http://pnhp.org/news/are-we-safer-than-natasha-richardson/

    In an example of the circus of fear and hyperbole surrounding the health care debate, opponents of government involvement in health care are exploiting Natasha Richardson’s tragic death from a skiing accident.

    The New York Post reports “Canadacare May Have Killed Natasha.” The blogosphere has headlines like “Canada’s Killer Healthcare.”

    Here are the bare facts: Natasha Richardson died from an epidural hematoma, a condition that requires urgent evaluation and surgical treatment. When treated early enough, this injury is rarely fatal. It is, therefore, reasonable to ask how different health care systems handle this sort of emergency.

    Ms. Richardson’s initial refusal of an ambulance cost about two hours. With 20/20 hindsight we know this was a bad decision. However, it’s also true that “feeling OK” after a minor head injury is, in fact, a powerful predictor of a good outcome. But bad things do happen. Patients with an epidural hematoma may initially feel and look well, this is referred to as a “lucid interval.”

    After the ambulance was summoned for a second time, only 3 hours and 40 minutes elapsed before Ms. Richardson arrived at a neurotrauma center in Montreal. On the way she was evaluated and stabilized at a community hospital with modern imaging facilities. Apparently, however, it was still too late.

    Many have asserted that Ms. Richardson would have fared better in the United States. This is far from certain. With epidural hematomas, it’s all in the timing. The intervention required is one of the simplest in neurosurgery.

    Helicopter airlift, or the lack thereof, has been a focus of criticism of Ms. Richardson’s care. An immediately available helicopter might have helped Ms. Richardson if used to transfer her directly from the resort to Montreal. It’s hard to know. However, it does not follow that the profusion of medical helicopter services in the United States makes Americans safer.

    As reported by the Institute of Medicine, neurosurgeons are often unavailable to provide emergency and trauma care in the U.S. Detailed data on patients referred to specialty hospitals for emergency neurosurgical evaluations is available for Cook County, Illinois. This county, which includes Chicago, is densely populated. Total time elapsed from arrival to a community hospital to arrival at the specialty hospital averaged 11 hours. The comparable time period for Ms. Richardson, who had an accident in rural Quebec, was less than 3 hours. In Cook County most patients would still be awaiting an imaging study at the first hospital.

    The Austin American-Statesman reported in 2002 that a man with a vertebral fracture after a fall waited 8 hours in an Austin emergency room before being airlifted to Temple because no local neurosurgeon was available. In Temple, he waited two days for surgery and was eventually billed over $4,000 for the helicopter. In the end, it turned out that there had, in fact, been a neurosurgeon available in Austin; however, he worked at a hospital in a competing network. This is just one case, but it does illustrate how business incentives distort quality in our health care system.

    U.S. helicopter medical evacuation services are extensive, but tend to address market rather than public health imperatives. Helicopters are concentrated in urban rather than rural areas. Alarming fatality rates due to accidents during medical helicopter evacuations have led to headlines such as in “Critics Say Emergency Medical Helicopters Are Overused and Offer Few Benefits to Patients” (Wall Street Journal 2005).

    It’s different in Canada. In Quebec, while there is no helicopter service there is a fixed wing air ambulance service. Fixed-wing craft require a landing strip but are much faster. In addition to being used for long distance emergencies in this vast province, several times a week Quebeckers from remote regions are flown to the city to obtain non-emergency medical care not available locally. All of this is free to patients, who are covered by Canadian medicare. Other provinces do have helicopter evacuation services, and these have a better safety record than their U.S. counterparts.

    A really good emergency medical system addresses the continuum of care from prevention to pre-hospital care to rehabilitation. Nova Scotia, a not-wealthy largely rural Canadian province, has created a model program of integrated services, which others have aimed to reproduce.

    Dr. Ronald Stewart, who championed the program first as a legislator and then as minister of health, engineered the replacement of fragmented private services with a unified public system in the 1990s. Innovation has thrived with a profusion of influential research papers on, for example, medically appropriate helicopter triage, head injury treatment guidelines, and detailed reports of clinical characteristics and outcomes of all surgical interventions on injuries of the sort Ms. Richardson had. The average wait time for neurosurgical emergency treatment in Nova Scotia, by the way, is less than in Cook County.

    I have worked for years in a variety of different sorts of U.S. health care facilities including inner city hospitals, private academic referral centers, rural community hospitals and the Department of Veterans Affairs. A uniform truth, alas, is that financial incentives play a major role in who gets what care and when. We have scarcity in the midst of excess, to the detriment of patients on both receiving ends.

    If you are uninsured and socially undesirable you can die in Manhattan from an epidural hematoma, despite rapid arrival to an emergency room and what must surely be one of the world’s densest concentrations of medical subspecialty care. I’ve seen it. Trauma patients are disproportionately uninsured and are considered a high medicolegal liability risk.

    Our entire emergency care system is overwhelmed, in large part, due to lack of universal access to other health care. As a result, all Americans are left to rely on a distorted emergency system. When it comes to effective clinical emergency care we should emulate Canada’s single-payer system, not congratulate ourselves on helicopter availability in Aspen.

    Laura S. Boylan is clinical associate professor of neurology, New York University School of Medicine; attending neurologist, Department of Veteran’s Affairs; and board member, Physicians for a National Health Program – Metro NY.

    1. “After the ambulance was summoned for a second time, only 3 hours and 40 minutes elapsed before Ms. Richardson arrived at a neurotrauma center in Montreal. ”

      Only 3 hours and 40 minutes? Did she deal with the possibility that Richardson could have been taken to a closer facility. After all “The intervention required is one of the simplest in neurosurgery.”

      She seems to be more interested in promoting a type of healthcare system than in truly evaluating whether or not that 3 hours and 40 minutes could have been reduced. That is the question and remains the question no matter how many people agree with your philosophy. We are talking medicine, not philosophy..

      1. Again, absent NR’s medical records and input from those who were actually there — doing the hard work of trying to save lives — Allan continues on his fool’s errand. He so wants to prove his point, but wait…: He can’t.

        (And from that article::

        “As reported by the Institute of Medicine, neurosurgeons are often unavailable to provide emergency and trauma care in the U.S. Detailed data on patients referred to specialty hospitals for emergency neurosurgical evaluations is available for Cook County, Illinois. This county, which includes Chicago, is densely populated. Total time elapsed from arrival to a community hospital to arrival at the specialty hospital averaged 11 hours. The comparable time period for Ms. Richardson, who had an accident in rural Quebec, was less than 3 hours. In Cook County most patients would still be awaiting an imaging study at the first hospital.” )

        1. WE are discussing a singular case, Richardson.

          You believe there was no faster way for her to get treatment and almost 4 hours had to pass before she could be at a facility to do what your own expert says is the simplist procedure done by a neurologist.

          What you also are saying (Cook’s County) is that a city with a leftist government for decades can’t provide reasonable access to a hospital.

          I am glad I live in a place where in less than 30 minutes an ambulance can stabilize me and take me to the ER in less than 30 minutes and whether I am insured or not, wheher I can pay or not the emergency will be managed even if I need surgery.

          1. “The Austin American-Statesman reported in 2002 that a man with a vertebral fracture after a fall waited 8 hours in an Austin emergency room before being airlifted to Temple because no local neurosurgeon was available. In Temple, he waited two days for surgery and was eventually billed over $4,000 for the helicopter. In the end, it turned out that there had, in fact, been a neurosurgeon available in Austin; however, he worked at a hospital in a competing network. This is just one case, but it does illustrate how business incentives distort quality in our health care system.”

            1. I am looking to correct those things. You on the other hand are acting like a child that complains instead of trying to make things better.

          2. Dr. Boland:

            “If you are uninsured and socially undesirable you can die in Manhattan from an epidural hematoma, despite rapid arrival to an emergency room and what must surely be one of the world’s densest concentrations of medical subspecialty care. I’ve seen it.”

            1. ““If you are uninsured and socially undesirable you can die in Manhattan from an epidural hematoma, despite rapid arrival to an emergency room and what must surely be one of the world’s densest concentrations of medical subspecialty care. I’ve seen it.””

              You can die anywhere even with the best neurosurgeon available almost immediately. What does that mean?

              The subject is Richardson and the almost 4 hour delay.

              By the way unless the hospital is breaking the law there is no wallet biapsy before emergency treatment is offered. The hospital must treat even if the patient never pays his bills.

              1. There’s “AllanWorld”…and then there’s the real world.

                (And in “AllanWorld”, problems are “solved” (or rather not solved) in a vacuum.)

                1. Does that mean you are ignorant to this fact?

                  By the way unless the hospital is breaking the law there is no wallet biapsy before emergency treatment is offered. The hospital must treat even if the patient never pays his bills.

                  Your knowledge and logic register very low on any scale.

                    1. If Dr. Boland believes that the law forcing hospitals and doctors to treat without consideration of payment doesn’t exist then she is simply unaware of the law and likely doesn’t involve herself in hospital practice.

                      Now that you know this you should recognize the fallacies of some of the arguments you are inferring. If you disagree, look up the law and the fines.

                  1. And psst, in case you can’t reach Dr. Boland:

                    She’s not saying that they won’t be treated, only that they wait…and sometimes die.

                    1. If that is what she is saying and they are making those emergency patients wait because of lack of money then she is unaware of the law as you seem to be.

                    2. I’m aware of the law.

                      You’re working hard on this, though, so give Dr. Boland a call and get back to us.

                    3. “I’m aware of the law.”

                      Then you are trying to change context which isn’t that much different from lying.

              2. “The subject is Richardson and the almost 4 hour delay.”

                Get her medical records, etc. and then get back to us.

                (But in “Allan World”, all of the facts aren’t necessary.)

      2. Words of non-wisdom by Allan: “We are talking medicine, not philosophy..”

        I’m pretty sure that Laura Boland gets that.

        “Laura S. Boylan is clinical associate professor of neurology, New York University School of Medicine; attending neurologist, Department of Veteran’s Affairs; and board member, Physicians for a National Health Program – Metro NY.”

        Let’s see Allan’s medical credentials.

        1. It’s not my credentials that presents a problem rather your inability to deal with complexity and your unwillingness to respond to what is actually written.

            1. The lack of credentials is one problem.
              The tailoring of facts by Allan, and rejection of any facts presented to him that dispute what he wants to believe, is another problem.
              Welcome to AllanWorld.

  12. Maybe we should focus on our own messes, rather than obsessing about an outlier in Canada that took place over 10 years ago.

    July 2, 2019

    “Price of emergency air lift to hospital soars to nearly $40,000”

    https://www.upi.com/Health_News/2019/07/02/Price-of-emergency-air-lift-to-hospital-soars-to-nearly-40000/3831562098098/

    Needing air ambulance transport might sound like a rare event that couldn’t happen to you, but more than 85 million Americans live in rural locales where a helicopter is their only chance of reaching a trauma center within an hour or less, according to the AAMS.

    This is a prime example of “surprise billing,” since most of these air ambulances are not covered in-network by a person’s insurance, said Shawn Gremminger, senior director of federal relations at Families USA, a health consumer advocacy group.

    “Surprise billing is one of those things that has been recognized by at least some consumer advocates that there’s a real problem here,” said Gremminger, who noted that such surprises usually spring up in a hospital’s emergency services, where a life is on the line and the options are limited.

    In one recent case, 35-year-old radiologist Dr. Naveed Khan rolled an ATV while scooting along the Red River in Texas, according to Kaiser Health News. His left arm was mangled, and the hospital at Wichita Falls decided he needed immediate helicopter transport to a trauma center in Fort Worth if there was any chance of saving the arm.

    The 108-mile flight cost $56,000, Kaiser Health News reported. Khan’s insurer paid about $12,000 of that, leaving him on the hook for the remaining $44,000.

    RELATED Study: Dialysis provider charges private insurers four times more than Medicare

    1. $40,000 I’d like a breakdown of that.

      Helicopter and pilot: Ridden by people and news crews all the time.What is that cost? Certainly not $40,000 everytime a helicopter takes off.
      Medical personal with communication
      Equipment

      Tourists take helicopter rides in NYC for less than $300.

      I’m not saying this in argument and I am not disagreeing with the article. I am just saying that service to those people in those areas can be provided at a lot less than $40,000 a trip.

      1. From the recent NY Times Parenting article, below:

        Excerpt:

        The Airline Deregulation Act of 1978, which bans the government from controlling fares and routes, has prevented states from regulating air ambulance charges. And if these operators don’t have a contract with a commercial insurance company, they can essentially charge whatever they want.

        As the industry has grown, the number of air ambulance helicopters has risen. But the cost has not decreased: Air ambulance prices doubled between 2010 and 2014, according to a 2017 Government Accountability Office report.

        “There is no infrastructure set up to handle this,” said Donna Rosato, a senior editor at Consumer Reports who has examined air ambulance charges. “And more importantly, there’s not really any recourse for consumers” who feel they have been unfairly charged.

        1. What is the point you are trying to make, that things associated with healthcare are too expensive? I don’t think there is much disagreement with that point.

            1. I don’t think I brought that up because of Canada. Just one post earlier I brought something up about something that happened in France. You read more into what was said than existed and focus on tangential items rather than the item under discussion.

              That is your problem.

              My entry point into the discussion had to do with what you find to be a dirty word “time” Time it takes to get definitive treatment.

              ” one of the major things that counts is the time it takes to get to the operating room the ability or to to stop blood loss on site”

              Take note, again I am interested in the system or guidelines of the situation.

              Then I said “There was a study on trauma with bleeding and the best results correllated with how long it took to get to the hospital.”

              Then Natasha Richardson was brought up for the same reason, ***time***. In this case I believe the centralized system failed and the decentralized system would have succeeded but that is a societal issue and at the time I said these things the point involved *time* not the incidental differences between countries.

              1. “But it’s easier to point the finger at Canada, rather than dealing with our own healthcare mess.”

                Correction:

                But it’s easier to point the finger at an outlier in Canada, rather than dealing with our own healthcare mess.

                Richardson’s case is an outlier. And you’re looking at it with 20/20 hindsight, ten years down the road. Toss in the fact that we’re missing Richardson’s health history, her medical records and pertinent/necessary information from doctors, family, and other people who were involved? It leaves one in the position of having to speculate and guess at possible outcomes. As others have said, it’s a fool’s errand.

                1. You have a real problem focusing. The discussion I entered into and that you later commented on involved time. I provided the quotes and you continue to discuss another subject. Why at the beginning you didn’t state your intention to discuss Canada vs US healthcare is unnown to me except for your focusing problems. You still can’t focus on my concern Time because you are too involved with that hot poker up your behind. That led to you making a lot of statements that made no sense and that led to you misquoting people.

                  These are two different countries that have different systems of operation. One is more centralized and one is more decentralized. That is more to the issue than what you are now discussing. Time was the issue and in cases like this too much centralization becomes problematic.

                  It is up to the people of Canada to determine what system they wish and it is up to the people of the US to determine the type of system they wish.

                  Both countries are paying a steep price for their healthcare systems when one looks at the triad access, cost and quality.

                  If you want to point to a solution for either country go ahead but at least deal with the triad instead of throwing out the classic sh-t and hoping some of it sticks. I am not interested in that type of shallow discussion.

                  1. This was the majority of that comment:

                    “Richardson’s case is an outlier. And you’re looking at it with 20/20 hindsight, ten years down the road. Toss in the fact that we’re missing Richardson’s health history, her medical records and pertinent/necessary information from doctors, family, and other people who were involved? It leaves one in the position of having to speculate and guess at possible outcomes. As others have said, it’s a fool’s errand.”

                    (Any “discussion” with Allan is by definition “shallow.”)

                    1. ““Richardson’s case is an outlier.”

                      Your entire argument disputed my statement that time was of the essence in the Richardson case and the almost 4 hour delay was too long. Are you now agreeing with me on that issue?

                      20/20 hindsight? Do you really believe that it is good to delay definitive treatment in a head bleed for almost 4 hours?

                      “ten years down the road”? Do you believe that Candaian doctors were stupid 10 years ago and didn’t know that time is of the essence where a head bleed is concerned?

                      “we’re missing Richardson’s health history,”? Do you believe that the health records makes the essential element, “time” disappear?

                      You talk about other people being shallow, but look at your statement and look at the questions being asked. Do you think your statement answered the question of “time”? It didn’t. It merely put forward a lot of words without defining the problem or the solution. Go back to the literature and read what was known at the time.

                    2. I would not say that “discussion ” with Allan I’d shallow. Any discussion .with Dr. Allan “I don’t need no stinking knowledge ” Blowhard is pointless.
                      He has this incredible gift, drawing definite conclusion with knowledge, or regard for facts. Disagree with that fool, and he will say it is because you are ingnorant, stupid,ying, etc.
                      In his own mind, Dr. Allan Blowhard is always “right”, even when he is shown to be wrong. Peddling his lamebrained conclusions on the internet is a good opportunity and outlet for him.

      2. The helicopter services that provide regular shuttle-type service have a much more predictable volume of passengers.
        And if a pilot is carrying 4 to 6 passengers per trip, the cost per passenger will be much lower than picking up a patient for a medical emergency.
        If it’s 75 miles out to the site of a patient, that will be at least a 150 mile trip.
        The commercial shuttle services carry departing passengers to one site, pick up more passengers on the return trip.So if it’s a 20 mile round trip, they can have passengers going both ways.
        MediVac service will also has the expense of having medical personell on standby, or out on the calls for a medical emergency.
        You could have 3 or 4 people transporting one patient, not one pilot carrying as many as 6 passengers.
        There may well be price gouging going on as well, but one can’t go by the fare for a helicopter ride in New York in guessing what a reasonable price for medical AirVac should be.

          1. Some interesting info, here:

            Understanding Air Ambulance Insurance Coverage

            https://www.naic.org/documents/consumer_alert_understanding_air_ambulance_insurance.htm

            “Air ambulances most commonly transport patients with traumatic injuries, pregnancy complications, heart attacks, strokes and respiratory diseases. The Association of Air Medical Services estimates that more than 550,000 patients in the U.S. use air ambulances each year. However, using air ambulances is expensive and might not be covered by the patient’s health insurance policy.

            How much does an air ambulance flight cost?

            The average air ambulance trip is 52 miles and costs between $12,000 to $25,000 per flight. The high price accounts for the initial aircraft cost which can reach $6 million as well as medical equipment and maintenance. Also factoring into the price is the cost of round-the-clock availability for specially-qualified medical personnel and pilots to take flight at a moment’s notice.

            Depending on the severity of the medical condition, the number and type of medical staff on board can vary, further impacting the flight price. If you undergo a medical emergency abroad, the cost of medical evacuation back to the U.S. can reach six figures.”

            When traveling abroad, it’s a good idea to purchase medevac insurance.

            https://www.forbes.com/sites/everettpotter/2017/06/06/5-reasons-why-you-need-medical-evacuation-coverage/#199ed8084153

            1. “Some interesting info, here:”

              It would be far more enlightening if we knew the marginal prices and if we could place a $ value on such care. Using resources for one thing takes resources away from another.

              1. Well, he have “a dollar volume” estimate for the charges for a tourist helicopter ride and a taxi fare.
                In “AllanWorld”, these would appear to be valid factors in determining the “right” cost for ground or air medical transfers.

                1. “In “AllanWorld”, these would appear to be valid factors in determining the “right” cost for ground or air medical transfers.”

                  Again we see a failure of reading comprehension.

                  That only provides some information on marginal costs. I’m waiting for you to explain why there may be a 40 times difference in costs if the proper systems were being used.

                  (Again I note the word system that you don’t seem to understand. You probably think I am saying taxi cab drivers are bad drivers but that is a totally ridiculous idea in the context of this discussion.)

                  You react with shock to any type of innovation. I think you should leave any sort of policy making or complex thinking to others.

                  1. “I think you should leave any sort of policy making or complex thinking to others.”

                    We certainly wouldn’t want to leave it to Allan. “Complex thinking”? That ain’t happenining in “AllanWorld.”

                    1. “We certainly wouldn’t want to leave it to Allan.”

                      That is why you never address content. Previously you responded and I replied. You provided no evidence of the ability to deal with complex issues.

                      “If Allan does not understand the difference between a commercial helicopter service that regularly transports tourists and others, and a Medevac service that has a complete different objective and set of requirements,”

                      I do, but you are oblivious to all the things under discussion and refuse to delve into the actual differences. If it were up to you we would be using an abacus and telling people to die rather than figuring out how to keep people alive.

                      You won’t even take the example of a $200 bill for outpatient treatment of dehydration vs a $2,000 -$4,000 bill for doing so in a hospital. Thus you believe that helicopter must cost $40,000 for a hundred mile ride when the cost for thousands of miles across an ocean and several days of a private jet with physicians and medical equipment might cost only double.

                      You can’t explain what you don’t know and you don’t even try to work things out. I have provided realtime numbers and you respond with silly juvenile frustration. That is what causes a person to be unintelligent.

          2. How much do you pay for your annual medivac insurance? Sometimes that involves a private jet that is able to fly thousands of miles over oceans. It’s a far cry from $40,000, right? How are they able to do such evacuations if a 100 plus mile trip costs $40,000?

            I am not unfamiliar with air evacuations or travel.

            Things to consider before trying the shotgun approach.

            The competitive market provided you with reasonable air evac service.

            Insurance aided in the transaction because you might not be able to afford the cost but you can afford the insurance.

            During the depression when few could afford hospitals Blue Cross was born.

        1. “The helicopter services that provide regular shuttle-type service have a much more predictable volume of passengers.”

          Do you just make up things as you write? I provided you with some numbers so that you could understand the marginal price of a basic helicopter trip ($200-$300) for the trip . Marginal prices give one an idea of a base price. You don’t think in terms of marginal cost rather you just search the Internet for pricing that is unrelated to what they would be in a well thought out system. (What happened to Richardson was part of a thought out system but failed her and others.) You face the same problem here as you did with Natasha Richardson. You think small and don’t realize a telephone call might have revealed a facility much closer than both of those facilities she was brought to and that facility might have been able to do all the things you mentioned like stabilization, and CT scan but it would also be able to do the definitive treatment.

          Think small and you end up with a case like Richardson’s.

          1. An ambulance run might cost $1500, and a taxicab ride of the same distance might cost $15. Most would understand why these are apples/ oranges types of comparisons.
            I suppose that the one who commented earlier about the cost of a helicopter ride for tourists thought he was making some sort of a point; otherwise, why was it brought up?

            1. “An ambulance run might cost $1500, and a taxicab ride of the same distance might cost $15.”

              This is not an apples to oranges example because there are a lot of similarities between the two rides but they occur in two different systems. (Ah that word system that perplexed you so much in earlier postings.)

              One can go to a cash only clinic for dehydration or a hospital ER. Both will receive fluids and be sent home. One might cost a couple of hundred dollars while the other can cost thousands. Why? The same diagnosis and the same treatment with prices that may be 20 times higher or more at the hospital ER.

              You are too set in your thinking process and can’t seem to take things down to their marginal costs and utility. Why do you think you get so much in your computer today for relatively low dollars when many decades ago it would have cost millions to get a fraction of the computing ability?

              What is the point of all your postings? That things are too expensive? We all know that. That there are failures? We all know that as well.You are interested in hyped stories, but I am looking at how to create better systems for the public at large with costs that are affordable.

              1. “I am looking at how to create better systems for the public at large with costs that are affordable.”

                …one comment at a time. Allan is working hard, here, solving the world’s problems.

                .

                1. Anonymous, if you wish to act stupid, act stupid. Some of us are better educated and some like you pretend. You can’t respond with content so you act stupid like a child.

                  Take note how befuddled you are that treating dehydration in a clinic might cost $200 while in a hospital it might cost $2,000 -$4,000. That is why you become so confused when helicopters are brought into the picture.

                  1. I never mentioned the cost difference between treatment at a clinic compared to the same difference at a hospital.
                    Is Allan now presenting his hallucinations as one of his ways of trying to make a point?

                    1. No, I attempted to demonstrate the difference in costs from one facility to another which demonstrates that all of your content lacks the realistic ability to deal with problems.

                      You prefer stupidity to thinking so you think hallucinations are involved. What a dummy you are.

                    1. Anonymous, I don’t know if Allan is dehydrated, or just gathered and consumed the wrong kind of mushrooms on an outing.
                      Whatever the cause, Allan is not firing on all cylinders.
                      AllanWorld is one strange land, and logic is not accepted in his world.

            2. “I suppose that the one who commented earlier about the cost of a helicopter ride for tourists thought he was making some sort of a point; otherwise, why was it brought up?”

              To demonstrate marginal costs.

              Why don’t you take the $200 helicopter ride and look at its marginal costs to compare it with the costs of using a similar helicopter to take a dying patient quickly to the hospital.

              Show us where the dollars mount up in the latter’s costs until you get to $40,000. I am not saying that the charges to a patient aren’t real, sometimes they are. What I am questioning is the costs and how to get them down.

              You have medivac insurance where an entire private jet with two pilots a doctor and a nurse might have to fly you across the oceans to get you to your hospital in the states. That isn’t costing you $40,000 should that event happen. That type of transport will probably cost the individual $85,000 to $150,0000 from places in Europe and will include all sorts of services including ambulances. That ties the plane and personal up for several days, but is only 2-4 times as expensive as a 100 plus mile trip by helicopter which lasts hours. Don’t you wonder why?

              1. Here in the U.S. @ Burning Man:

                https://burningman.org/event/preparation/health-safety/medflight-evacuation/

                From the site:

                Medflight Evacuation

                Did You Know It Costs $30,000 If You Get Transported Off Playa Via MedEvac?!?

                The most expensive ride on the playa is the one you never want to take: an emergency medical transport to one of the Reno hospitals. Even if you have insurance, it still might leave you with a bill for several thousand dollars, since most insurance doesn’t cover 100% of medical costs. Of course it is considerably worse if you have no insurance at all!

                Every year, it seems, we hear a story or two of a Burner who gets airlifted off playa only to practically need to be resuscitated again when they receive their bill months later. Given that only an unlucky few get airlifted each year, chances are good you’ll never need it, but if you have a complicated pre-existing condition or you are a good little scout and believe in preparedness, it’s worth considering a $50 membership from CrowdRX.

                1. “Here in the U.S….”

                  “If Allan does not understand the difference between a commercial helicopter service that regularly transports tourists and others, and a Medevac service that has a complete different objective and set of requirements,”

                  I do, but you are oblivious to all the things under discussion and refuse to delve into the actual differences. If it were up to you we would be using an abacus and telling people to die rather than figuring out how to keep people alive.

                  You won’t even take the example of a $200 bill for outpatient treatment of dehydration vs a $2,000 -$4,000 bill for doing so in a hospital. Thus you believe that helicopter must cost $40,000 for a hundred mile ride when the cost for thousands of miles across an ocean and several days of a private jet with physicians and medical equipment might cost only double.

                  You can’t explain what you don’t know and you don’t even try to work things out. I have provided realtime numbers and you respond with silly juvenile frustration. That is what causes a person to be unintelligent.

              2. To get a true picture of the contrast between a regular helicopter shuttle service and a Medevac service, one would need to look at a revenue/ expense ledger.
                For example, if a shuttle service costs $1,000,000 a year to operate, and brings in $1.1 million in revenues, there is a 10% profit margin in that business.
                Is a Medevac helicopter services shows the same numbers, that would also be a 10% profit margin.
                Those are only examples, and I don’t know the actual numbers.
                The point is that the operational costs for a Medevac helicopter service are, on a per passenger basis, gining to be a heck of a lot higher than a shuttle service with much higher passenger volume.
                And one helicopter pilot transporting 4-6 passengers is far less expensive, per passenger, that a pilot and 2 or 3 medical specialists transporting one patient.
                So to even mention a $300 charge for a tourist on helicopter ride is ridiculous if one is trying to use that as an argument that Medevac transport is overpriced.
                It may it or may not be overpriced, but bringing up a $300 fare for a tourist helicopter makes no sense in in trying to determine what a Medevac transport should cost.

                1. Again you have lost track of the discussion. The question is why the costs are $40,000 and if the costs have to be $40,000. Apparently too complex for you to discuss.

                  The private jet equiped for a medical evacuation with a doctor, a nurse, a pilot, and a copilot that involves about 3 days to go across the Atlantic Ocean can only cost twice as much as a helicopter going about 100+ miles. With a brain one can see a disparity. Without one a person jumps around making all sorts of statements that doesn’t direct his ideas towards a solution or a rational. That is the state you are in.

                  Then add to the fact that you, a person that can’t understand these events, can buy relatively inexpensive medivac insurance that will guarantee ,if needed ,a plane to take you much further than my example.

                  I think unless one doesn’t exist you should start using your brain instead of playing your foolish games.

          2. If Allan does not understand the difference between a commercial helicopter service that regularly transports tourists and others, and a Medevac service that has a complete different objective and set of requirements, I don’t see any point in trying to explain it to him again.
            He would bring out his big debating guns of “stupid” “ignorant”, lying” etc. we’re that attempt made.
            In AllanWorld, normal regard for basic facts and logic are suspended. That’s why trying to reason with a damn fool like “Allan” is pointless.

            1. “If Allan does not understand the difference between a commercial helicopter service that regularly transports tourists and others, and a Medevac service that has a complete different objective and set of requirements,”

              I do, but you are oblivious to all the things under discussion and refuse to delve into the actual differences. If it were up to you we would be using an abacus and telling people to die rather than figuring out how to keep people alive.

              You won’t even take the example of a $200 bill for outpatient treatment of dehydration vs a $2,000 -$4,000 bill for doing so in a hospital. Thus you believe that helicopter must cost $40,000 for a hundred mile ride when the cost for thousands of miles across an ocean and several days of a private jet with physicians and medical equipment might cost only double.

              You can’t explain what you don’t know and you don’t even try to work things out. I have provided realtime numbers and you respond with silly juvenile frustration. That is what causes a person to be unintelligent.

              1. Real time numbers? You have “provided” nothing that is relevant.
                You are a fraud who has no limits when it comes to ignoring basic facts presented to you.

                1. You provide only the thoughts of a child. I will give an example of factual numbers used in our discussion.

                  “If Allan does not understand the difference between a commercial helicopter service that regularly transports tourists and others, and a Medevac service that has a complete different objective and set of requirements,”

                  I do, but you are oblivious to all the things under discussion and refuse to delve into the actual differences. If it were up to you we would be using an abacus and telling people to die rather than figuring out how to keep people alive.

                  You won’t even take the example of a $200 bill for outpatient treatment of dehydration vs a $2,000 -$4,000 bill for doing so in a hospital. Thus you believe that helicopter must cost $40,000 for a hundred mile ride when the cost for thousands of miles across an ocean and several days of a private jet with physicians and medical equipment might cost only double.

                  You can’t explain what you don’t know and you don’t even try to work things out. I have provided realtime numbers and you respond with silly juvenile frustration. That is what causes a person to be unintelligent.

          3. “part of a thought system” !? This guy gets more entertaining with each doubling down comment.
            AllanWorld is bizzaro world.

            1. Can’t find the quote. Are you lying again, misquoting or what? Did I make a typing mistake?

              You really have difficulty thinking.

    2. Families Fight Back Against Surprise Air Ambulance Bills

      When a seriously ill child needs air transport, parents don’t hesitate to take the flight. Then comes a bill, sometimes upward of $50,000.

      By Christina Caron
      Sept. 4, 2019

      https://parenting.nytimes.com/childrens-health/air-ambulance-bills

      “Tyler Silvy
      @tylersilvy

      So it turns out this – this helicopter flight my 5-month-old daughter is being prepared for here in early February at McKee Medical Center in Loveland – was not medically necessary, according to @AnthemBCBS. The bill is $56,000, and insurance is covering nothing.”

    3. The article states that the median cost of an air ambulance trip was $39,000 in 2016.
      That indicates that these huge bills are not uncommon.
      Up to a point, at least, there is some cost shifting involved because of Medicare reimbursement rates.
      If the rate of Medicare reimbursememt is artificially low, the companies can make up for that by charging many times the Medicare rate.
      One of the Democratic candidates, John Delany, said in the first debate that if hospitals had to accept the Medicare rate of reimbursements, there’s be a large number of hospitals closing down.
      Part of Sanders’ Medicare for All plan is to for e a 50% price reduction for prescription drugs.
      Even in an industry with high profit margins like the pharmaceutical industry, a 50% drop in revenues will have disastrous consequences.
      If the other feature of Medicare for All is to force all health care services to accept the rates set by Medicare, there will be a lot of fallout from that.

    1. Dr. Death, you continue to be an A$$ and a dumb one at that. The only tracks that have to be covered are yours after you schitt in your pants. What is your problem with either OT story posted below?

        1. Yes, Dr. Death you lied about what the neurosurgeon was talking about and you demonstrated phenomenal ignorance. I know it is hard for you. Lacking the ability to think puts you at a disadvantage.

          1. The words of the neurosurgeon would be clear enough to almost anyone but a moron, are a fool doing backflips to distort them.
            When he said he thought everything was handled appropriately, that means that he did not concur with Dr. Allan Blowhard’s claim that there were “multiple failures”.
            He also described the Richardson case as “a rare catastrophic event”.
            That is one indicatation, among others, that they paramedics who initially thought she had a concussion could not have been expected to diagnose an epidural hematoma.
            Any clown with 20/20 hindsight can act like an expert and claim “they should have known” it was other than a concussion.
            I will once again remind Dr. Blowhard that directly quoting someone is not “lying” about what they said.
            He can repeat that stupid accusation as often as he likes, but it does not make his false and idiotic claim any truer.

            1. You are a liar Dr. Death. I quoted the statement and the question both of which referred to the period of time when Natasha refused treatment. Our disagreement starts when she is considered a priority 1.You lied and said it pertained to the later period of time after the ambulance made her a priority 1. You are a liar. He was asked only about the time wasted by her refusal and only answered that time period. He did not talk about the later time period at that time.

              “He also described the Richardson case as “a rare catastrophic event”.” One reason, you fool, that she was considered a priority 1 might have been because of the talk and die syndrome previously discussed. All educated medical professionals that deal with patients of this kind should be aware of the gravity of the situation when a patient has a head injury where the patient is inititally OK but then suddenly becomes ill with a rapidly deteriorating mental status. You are an idiot. You want to forget about any patient injured that needs treament and only treat those that need rest and observation. I can’t believe how stupid you sound. If her mental status remained stable she wouldn’t have died, but that is not the case. Her mental status deteriorated and that points to a more serious injury than a concussion.

              Medical providers are expected to know what can happen so they don’t have to blame 20/20 hindsight when a patients life could have been saved. You are unable to integrate complex facts so this goes way over your head.

              “quoting someone is not “lying” about what they said.” Intentionally quoting someone out of context is most definitely a lie. I provided both the question asked and the answer given (more than what you initially posted) but you refuse to recognize your quote was out of context even though you had several opportunities to review the more complete statement. That makes you a liar and if you don’t see it, it makes you a stupid liar that cannot ever be trusted or rehabilitated.

                1. Actually Dr. Death my favorite words have to do with charity and goodness. I can’t help it that the most accurate words that describe you are stupid and liar. What else am I supposed to say when I twice posted a larger portion of an interview that showed you were wrong. You didn’t bother addressing those posts and continued being stupid and lying.

                  You are not to be trusted. You have existed under another alias and were embarrassed then and changed to anonymous with a possible alias used for a shorter time period in the interim.

                  1. Your “favorite words” show that you a sleazeball who likes to make baseless accusations to cover up your foolishness.
                    Dr.Blowhard can not always count on his assinine claims going unchallenged, but maybe he’s been spoiled here and is shocked that someone actually challenged statements he could not back up.

                    1. “but maybe he’s been spoiled here and is shocked that someone actually challenged statements he could not back up.”

                      Not at all, but I am shocked by your stupidity and the lies you make. You still haven’t shown why there wasn’t a potential system failure with an almost 4 hour delay.

                2. Repeatedly squealing “liar” and “stupid” is about all that Dr. Allan has to work with. I don’t think he really expected to be challenged on his idiotic declaration about ‘multiple failures”, and he has been squirming and flailing to try to justify that comment ever since.
                  I don’t think there is really a limit as to low far a sleazeball like him will go if he thinks he might score some points by distortion and exaggeration.
                  He is a real piece of work.

                  1. No, I have shown you with the neurosurgeons own words why your comment was stupid and by you repeating something the neurosurgeon never said you are lying.

                    Tell us why an almost 4 hour delay was necessary in a critically ill patient. You have been “been squirming and flailing ” trying to avoid responding to the probable system failure.

              1. The “complete statement” was actually consistent with the neurosurgeon’s quoted statements ( everything handled appropriately, and a rare event).
                That was pretty hard to miss, and yet you presented a longer version that supported his statements, then claimed that I took the statements “out of context”.
                You also lob wild accusations in an attempt to prop up your claim about “multiple failures” and throw out the baseless “liar” claim.
                Since you’re slimey enough to do that, I suppose you’ll go for another few hundred comments to top the thread you helped top 800 comments.

                1. The questions had to do with Natasha’s initial refusal of treatment and what effect that could have had. It had nothing to do with the almost 4 hour delay in getting the patient to the hospital that would be able to treat the problem. The almost 4 hours is what is under discussion. Rare and life threatening events are taught in medical schools even if the physician never comes across a case. That is part of the reason medical school is so difficult.

                  Find the statement and show where he talked about the almost 4 hours. That was one of the potential system problems I was talking about.

                  You don’t bother to correct your mistakes but intentionally repeat them making you a liar and stupid.

                    1. I’m not limiting the discussion. I claimed there were probable systemic failures in the system. It is my claim and for the most part the claim has to do with that almost 4 hour time period unless you believe the medics didn’t appropriately inform Richardson the first time they came.

                      You are arguing against my claim so it has to be within my time frame where I felt system failures existed.

                      This is probably too complex for your small mind to understand. The question is whether you are as stupid as you sound or you are too intent on not being proven wrong.

                    2. “Allan needs to recognize that it’s time to move on.”

                      No, it is you who have been proven a liar that should move on. I am just defending my comments regarding a system failure and you are attacking them. You didn’t have to attack them. You didn’t have to enter the discussion. You are creating the mass of needless posts because you are too arrogant to believe you are wrong or too stupid. You can stop the foolishness at any time but you keep it going. Why is it always someone elses fault? Are you unable to look critically look at yourself? Apparently the answer is yes and that is one reason you hide behind an anonymous alias.

                      Just recently you tried to start a new bout of endless postings. Why do you start something you are incapable of finishing? You don’t have the adequate knowledge. You post other peoples ideas but you do not comprehend the words and meanings. Go back to ditch digging or whatever you do.

                    3. Not projection but fact. You are arguing with my claim of system problems within a certain time frame. You want to prove you are right on a completely different subject and a different time frame. How much stupider can one get? You complain about the number of posts but it is you who continues to post and doesn’t bother to even check out the facts

                      There was a system failure within the almost 4 hour time frame. That is what you are arguing against but you have a problem. Your claim of what the experts said do not deal with that nearly 4 hour period. What will you do? Lie of course.

                    4. It’s all he has to make it “his call”. A slimeball like Dr. Allan ” I am always right” Blowhard will try to slither his way out of accusations that he can not support.
                      He pretends to know about “multiple failures” in the medical response to Richardson’s injury, can’t back it up, do he just keeps repeating the same accusation of “multiple failures”.
                      If opinions of specialists in the field state that this was “a rare catastrophic event”, or “very unusual”, or that her case was handled appropriately, Dr. Slimeball will claim that it’s “lying” to directly quote them.
                      It is amazing how far an ignorant clown like Dr. Blowhard will go to try to support baseless accusations against others.

                    5. Dummy, my claim is that she needed to go to a hospital that was able to do the needed procedures. It took almost 4 hours to get there with diversions. Prove the diversions were necessary. Prove they couldn’t have found a closer place.

                      I think it is now recognized that speed is of utmost importance and they may be airlifting this type of patient. If that is so then that is the correction of the system failure I was concerned with and demonstrates that it existed.

                    6. Wrong! Dr. Allan Blowhard is “tailoring” the discussion, and he thinks it IS “his call”.
                      Therefore, your comment must be flawed, with “multiple failures”.
                      Brace yourself for when Dr. Blowhard brings out the big guns, and calls you a liar.

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                      What is “talk and die” syndrome?
                      After a seemingly minor fall on the slopes, actress Natasha Richardson is reportedly suffering from a potentially deadly head injury

                      By Brendan Borrell on March 18, 2009

                      ADVERTISEMENT
                      Last night, British-born actress Natasha Richardson, 45, was rushed from Montreal to New York City in critical condition after a seemingly minor fall on a Quebec ski slope apparently led to bleeding in her brain.

                      Richardson, who won a Tony for her role in the Broadway play Cabaret and has also starred in a string of films including The Parent Trap and Maid in Manhattan, is the daughter of actress Vanessa Redgrave and the wife of actor Liam Neeson, 56, with whom she has two sons, ages 12 and 13. She was reportedly taking a skiing lesson on a beginner slope at the Mont Tremblant resort some 80 miles (130 kilometers) northwest of Montreal when she took a spill.

                      “It was a normal fall,” Lyne Lortie, a Mont Tremblant spokesperson told The New York Times, “She didn’t show any signs of injury; she was talking and she seemed all right.”

                      Still, her instructor summoned the ski patrol to transport her to the bottom of the hill in accordance with the resort’s safety policies. Richardson reportedly refused medical care when an ambulance arrived and went back to her hotel room. About an hour later, however, Lortie said that Richardson complained of a severe headache; she was rushed by ambulance to Hôpital Sacré-Coeur in Montreal, where Neeson met her after flying in from Toronto where he was filming a movie. The actress was then flown by private jet to Lenox Hill Hospital in Manhattan, where she and Neeson have an apartment on the Upper West Side.

                      The family had not issued a statement at deadline and no reports on her condition had been confirmed. However, some media outlets, citing anonymous sources, claim that the actress had been on life support but was removed from it today and was not expected to survive. “It’s so sad. Vanessa, her sister Lynn, everybody is gathering in New York to say goodbye,” a “close friend” of the family told London’s Daily Mail. “No one can believe what has happened, that this once vibrant woman, full of love, of life, is lying there brain dead.”

                      The tragic story, if confirmed, is a reminder that even minor blows to the head can lead to devastating bleeding that can cause strokes or otherwise damage brain tissue. One possibility, sometimes called “talk and die” syndrome, is that the actress had delayed bleeding between her skull and her brain stem, which sits at the top of the spinal cord and regulates consciousness, breathing, and the heart and connects the brain to many of the body’s sensory and motor nerves. Another possibility is that there was a tear in the inner lining of her arteries, causing blood clots. To find out more about Richardson’s potential injury, we spoke with neurosurgeon   Keith Black, chairman of the Department of Neurosurgery at Cedars-Sinai Medical Center in Los Angeles.

                      [An edited transcript of the interview follows.]

                      Based on Richardson’s symptoms, what kind of injury do you think she suffered?
                      The possibilities range from what we call an arterial dissection to a preexisting condition that might have been triggered by the event. An arterial dissection is where patients have a very mild injury tear the inner lining of the arteries of the neck, either the carotid or vertebral arteries, and that can occur with even minor trauma that one may not believe to be significant. That tearing in the artery can cause clotting, which can set up a stroke (an interruption of the brain’s blood supply caused by a blockage or a rupture of a blood vessel). If that clot is in the vertebral artery system, it can cause a stroke in the brain stem, which can be devastating.

                      The other possibility is delayed bleeding in the brain. That can be from either a tear in a vein or an artery in the brain tissue itself, and that can be either an epidural hematoma (between the skull and the dura, the membrane that surrounds the brain) or a subdural hematoma (between the dura and the brain).

                      Another possibility is that she had a condition that predisposed her to having a more catastrophic event. This could be an abnormality in how fast her blood clots after a bleed. Or if she’s been on any aspirin, blood thinners, or, supplements like omega-3 fish oil, that can make things worse.   The other thing one has to worry about is whether she had a vascular abnormality in the brain like an arteriovenous malformation (an abnormal connection between high-pressure arteries and low-pressure veins). If an AVM tears one can get a more significant bleed.   

                      I think the two most likely conditions would either be the arterial dissection in the neck or the delayed bleeding within the brain itself.

                      What is “talk and die” syndrome?
                      That refers to the fact that we always worry about people with head injuries that don’t show up immediately, which is why we like to observe people after a head injury for 24 hours. Generally when we talk about “talk and die” it’s usually a delayed bleed like an epidural hematoma.

                      How would you assess a patient after a fall like this?
                      The most important test would be a CT scan (a 3D X-ray that can provide cross-section images of anatomical structures), which would tell you if there is bleeding in the brain itself. If there is bleeding, it would tell you if it needs to be relieved with surgery or with medication. It would also give you an indication if she’s had a stroke, and whether she’s had one of these arterial dissections that may be showering blood clots into the brain.

                      How would you treat her?
                      If there’s bleeding in the brain, if it’s causing pressure and if it’s an area that’s accessible, one may think about surgery to remove the blood clot. Usually, that’s done on an emergent basis, and since we haven’t heard reports that she’s going undergoing surgery then that’s probably not the scenario she’s facing.

                      Another possibility is that the clot is in an area that you cannot safely operate on like the brain stem. That’s because the structures of the brain are very compact in that area, and it’s very risky to operate on. One may then try to manage the clot with medications (such as hypertension drugs like labetalol).

                      Did the fact that she delayed treatment for an hour put her at further risk?
                      Obviously, when it comes to treatment—the earlier, the better. If she had gotten a CT scan right away, doctors likely would have seen the bleed. From what I understand, however, she was examined by a medic, and she was doing fine. We don’t typically scan patients unless there has been a more significant type of trauma. It sounds like everything was managed appropriately and this was one of these rare catastrophic events. Even for patients that do have delayed bleeds, most of them tend to do very well, particularly younger patients. They normally don’t deteriorate that fast, and one has time to stabilize the situation, control the swelling and operate to relieve the blood clot if necessary.

                    8. Now that you pulled up the entire article I note you didn’t bother to focus in on the question. Here is a direct quote from the article that preceded the answer you provided.

                      “Did the fact that she delayed treatment for an hour put her at further risk?”

                      Take note how it deals with Natasha’s refusa not the almost 4 hour delay. You cannot explain that because what you said is not true. You are a liar.

                    9. Dr. Allan Blowhard has strained and twisted himself into impressive evasiveness and distortions to claim that actual assessments and quotations from specialists were presented as “lies”.
                      Does this guy even understand English? When there is a tragic medical outcome, that can happen when there is “a rare medical catastrophic event” and when the response was “handled appropriately”.
                      He has sunk about as low as he can go in claiming that it is a “lie’ to present that opinion by a specialist. Then again, maybe that fool will find a way to sink lower, to claim that Dr. Allan Blowhard must be right.

                    10. The almost 4 hour delay is what troubles me.

                      Deal with the almost 4 hour delay. Does it sound reasonable to you. If it were an 8 hour delay would that sound reasonable?

                  1. It was clear from the chief neurosurgeon’s comments that Richardson’s initial refusal for medical attention caused a delay.
                    It is even more clear, except to a clown with 20/20 hindsight like Dr. Allan Blowhard, that he stated his opinion that everything was handled appropriately, and that this was a “rare catastrophic event”.
                    Dr. Black’s comments SPECIFICALLY have to do with the medical professionals response to her accident. From the time that they were called back to the scene two hours or so after her accident.
                    So specifically, what aspect of Dr. Black’s comments were “taken out of context”? What part of quoting Dr. Black was the “lie” that the sleazebag Dr. Allan Blowhard refers to?
                    It is the hallmark of a sleazebag like Dr. Bloward that HE keeps doubling down on his own set of lies to squirm his way out from reckless and unsupported statements he made when he was running his mouth.

                    1. Did the fact that she delayed treatment for an hour put her at further risk?
                      Obviously, when it comes to treatment—the earlier, the better. If she had gotten a CT scan right away, doctors likely would have seen the bleed. From what I understand, however, she was examined by a medic, and she was doing fine. We don’t typically scan patients unless there has been a more significant type of trauma. It sounds like everything was managed appropriately and this was one of these rare catastrophic events. Even for patients that do have delayed bleeds, most of them tend to do very well, particularly younger

                    2. “Did the fact that she delayed treatment for an hour put her at further risk?”

                      That deals with hour one not the almost 4 hours. Show us where the doctor is dealing with the almost 4 hours. You can’t.

                    3. The cut and paste of the neurosugeon’s comments did not completely post.
                      The remainder of Dr. Keith Black’s statement should appear below, if these comments ard in sequence.
                      He states that Richardson’s case was handled appropriately, and that this was a rare catastrophic event.
                      He was specifically referring to the medical response to her injury.

                    4. “Richardson’s case was handled appropriately, ”

                      For the first hour which is not under discussion. The almost 4 hours is.

                    5. “It was clear from the chief neurosurgeon’s comments that Richardson’s initial refusal for medical attention caused a delay.”

                      We agreed on that from the beginning. What is disputed is whether or not an almost 4 hour delay was a system failure. The doctor did not discuss that time period so his words tell you nothing about whether or not there was a system failure. The question being answered was: “Did the fact that she delayed treatment for an hour put her at further risk?” Once Richardson was made a priority 1 the question of how things were done first come to light.

                      You seem to think medical professionals aren’t trained in rare catastrophic events Head injuries are not rare and bleeds in the head though not a frequent event with a head injury occur. With head trauma a bleed is one of the things a professional would worry about.

                      Now get back to the issue of an almost 4 hour delay. Your reading comprehension skills are near negligible.

                    6. “It sounds like EVERYTHING was handled appropriately”. The “EVERYTHING” was capitalized by me, in case somebody missed it.
                      The other part of Dr. Black’s commemt, about this being a rare catastrophic event, is an indication that the paramedics should not be second guessed on their initial assessment that they were dealing with a concussion.
                      That is not the only reason that it is unfair to Monday Morning Quarterback the paramedics.

                    7. Referring to the question asked about the first hour the doctor felt that hour was handled OK. There was no question about the subsequent treatment or delay of almost 4 hours. Show us where that answer is without using the answer to the question about the first hour. You can’t.

                      Answer the question. Would an 8 hour delay been appropriate? If not, why not?

                      You continue lying.

                    8. Had they just “been doing her nails”, as was suggested earlier, a 4 hour delay would be an obvious “failure” in the medical response to Richardson’s injury.
                      The time it took for the ambulance to reach the ski resort, the paramedics initial treatment and assessment, the travel time to a nearby hospital, the diagnosis (CAT Scan, etc.), the stabilization were all part of the so-called 4 hour delay.
                      I think the ambulance was called at 3PM, and she reached Montreal by about 6:45 PM. Even if one choses, with the benefit of hindsight, to criticize the decision to take her to a nearby hospital, how does an immediate decision to rush Richardson to Montreal “ssve” 4 hours.
                      An ambulance called at 3PM is not likely to arrive at the ski resort at 3PM. There is the transport time even if an immediate decision was made to bypass the closer hospital and race off to Montreal, they paramedics need some time to at least load the patient in the ambulance.
                      So where they to skip an intial assessment to save time? Forget about setting up oxygen and IVs?
                      Delay a CAT Scan because a trip to Montreal takes 3 times as long as the trip to the closer hospital? Forget about stabilization that was available and closer at the nearby hospital?
                      There was no “4 hour delay” in responders’ efforts to save Richardson’s life.

                    9. You are unable to stay on focus and keep jumping around. I am talking about a system failure which I believe occurred whether Richardson lived or died. You are talking mostly about whether or not Richardson would have survived.

                      Look at the time lines you have mentioned (I don’t know if they are totally correct or not) If our idea is to save a life of a person that will bleed into the head killing them then time is of the essence. You saw that in the article you posted regarding burr holes where the idea was to shorten the time by possibly providing immediate surgical remediation on site. That by itself is recognition that time is of the essence.

                      I won’t go through all the explanations again but time didn’t seem to be the most important criteria in her care. Thus there was an almost 4 hour delay. To correct the systemic problem one has to reduce the delay and that means removing an intermediate step.

    2. Absent Natasha Richardson’s medical records, as well as input from the medical personnel involved, Allan has nothing. Without this additional information, one can’t conclude that there were any “delays.”

      1. Without this additional information, one can’t conclude that there were any “delays.”

        Or “multiple failures.”

        Allan isn’t a doctor, and doesn’t have enough information, but that hasn’t stopped him from reaching his baseless conclusions.

        1. All one has to do is look at the almost 4 hours it took to get Natasha to a hospital that could treat her. They can then check to see if the problem was rectified which I think it was to some extent. That proves my case and leaves anonymous outside naked for everyone to see the wretched individual he is.

          1. “They can then check to see if the problem was rectified which I think it was to some extent.”

            What the eff is Allan blabbering about?

            1. I think they are now using a helicopter to transfer to the trauma center for cases like Richardson. Not sure but I think they are doing so.