A great surgeon performs operations for stone by a single method; later he makes a statistical summary of deaths and recoveries, and he concludes from these statistics that the mortality law for this operation is two out of five. Well, I say that this ratio means literally nothing scientifically and gives us no certainty in performing the next operation; for we do not know whether the next case will be among the recoveries or the deaths. What really should be done, instead of gathering facts empirically, is to study them more accurately, each in its special determinism. We must study cases of death with great care and try to discover in them the cause of mortal accidents so as to master the cause and avoid the accidents.
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"There is a saying about surgeons, meant as a reproof: "Sometimes wrong; never in doubt." But this seemed to me their strength. Each day surgeons are faced with uncertainties. Information is inadequate; the science is ambiguous; one's knowledge and abilities are never perfect. Even with the simplest operation, it cannot be taken for granted that a patient will come through better off - or even alive. Standing at the table my first time, I wondered how the surgeon knew that he would do this patient good, that all the steps would go as planned, that the bleeding would be controlled and infection would not take hold and organs would not be injured. He didn't, of course. But still he cut."
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We spent ages... working... for child heart surgery... such a delicate area, trying to find the wording for... random error or binomial variability... [Y]ou can give a percentage... 95% . Well, am I going to be one of the 5% or one of the 95%? We don't know. It's just chance or luck, fortune. We can't... use those words in... delicate situations... operating on children... Then we came up with a good phrase... which we used and tested on parents... It's "unforeseeable factors," not "unforeseen factors," because that would suggest someone's to blame... [T]he unforeseeable factors could lead some people to... not survive the operation, and some to survive. So... we can put you in a group, but we can't go beyond that... [O]nly what develops over time, in terms of complications, or something like that, could... put... you in one group or another. "Unforeseeable factors," I really like that phrase. I try to use it all the time, I recommend it.
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A study led by the Harvard researcher Nicholas Christakis asked the doctors of almost five hundred terminally ill patients to estimate how long they thought their patient would survive, and then followed the patients. Sixty-three per cent of doctors overestimated survival time. Just seventeen per cent underestimated it. The average estimate was five hundred and thirty per cent too high. And, the better the doctors knew their patients, the more likely they were to err.
It is helpful to recall that the death of the person is a single event, consisting in the total disintegration of that unitary and integrated whole that is the personal self. The death of the person, understood in this primary sense, is an event which no scientific technique or empirical method can identify directly. Human experience shows that once death occurs certain biological signs inevitably follow, which medicine has learnt to recognize with increasing precision. In this sense, the "criteria" for ascertaining death used by medicine today should not be understood as the technical-scientific determination of the exact moment of a person's death, but as a scientifically secure means of identifying the biological signs that a person has indeed died.
According to the world's highest medical authorities, burns extending over 75 per cent of a person's body are regarded as likely to prove fatal. The burns of these two patients were not only extensive but also deep, even involving their muscles in many places. Therefore all the experienced surgeons frowned, shook their heads, and expressed their utter inability to save the lives of these men. One of them said, "It is only a matter of three or four days." Another suggested, "At most three days." Still a third one said, "Whether medicine is used or not is immaterial, for in spite of all efforts the patients will die." Everybody seemed to agree on one conclusion "death." In this way the joint consultation was concluded in a very pessimistic and hopeless atmosphere. On the basis of mortality statistics in international medical literature it seemed that these badly burned patients were doomed to die.
But the Party organization of the hospital would not agree to such a pessimistic view. The secretary of the general Party branch and the assistant secretary of the medical department branch immediately summoned the doctors treating the patients for a talk, and following that a meeting of all the responsible doctors was convened. The problem was analysed from a class viewpoint, and it was stressed that in capitalist countries it was impossible to obtain the full use of all resources to save the lives of burned workers, but that in our socialist country it was possible to mobilize everything available to save them. For this reason we should not always accept the medical statistics of capitalist countries and allow them to influence us. The Party secretary called the attention of the doctors specially to the following points: First, that they must try to rid themselves of their blind reliance on established bourgeois medical experience, and they must try to think, speak and act in bold new ways. Secondly, they must follow the mass line and depend more upon the power of the people. Finally he said, "The Party will do everything possible to save these steel workers who have created vast wealth for the nation."
Surgical Ventricular Restoration was successfully tested internationally in 1200 patients. Instead of the [typical] 50-to-75% two-year death rate... this surgical treatment showed a 70% five-year survival, with a return to near normal heart function and only very rare occurrences of dangerous ventricular rhythms.
Sadly, a faulty NIH-funded study of this groundbreaking treatment utilized physicians who were not qualified... disregarded proper selection of patients, and incorrectly performed procedures. Its erroneous findings led to... abandonment... despite a report that supports this treatment... Its dismissal... is tragic, and leads to enormous and unnecessary suffering upon... millions
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