Category Archives: Medicine

Centrifuge of Infinite Rage – Part 1 – Fracking Secrets > Health

I’m going to spin up the Centrifuge of Infinite Rage(TM) and leave it running for a while because there is some Grade-A bullshit I need to vent about.  Item the first.  The proprietary nature of the chemicals used in Fracking are so, “fracking” (HA!), important that Pennsylvania now has a law which prevents doctors from sharing information about those chemicals with their patients.  Because, why the hell would the patient need to know about it?

Here’s the actual wording of the piece in question:

(10)  A vendor, service company or operator shall
identify the specific identity and amount of any chemicals
claimed to be a trade secret or confidential proprietary
information to any health professional who requests the
information in writing if the health professional executes a
confidentiality agreement and provides a written statement of
need for the information indicating all of the following:

(i)  The information is needed for the purpose of
diagnosis or treatment of an individual.
(ii)  The individual being diagnosed or treated may
have been exposed to a hazardous chemical.
(iii)  Knowledge of information will assist in the
diagnosis or treatment of an individual.

(11)  If a health professional determines that a medical
emergency exists and the specific identity and amount of any
chemicals claimed to be a trade secret or confidential
proprietary information are necessary for emergency
treatment, the vendor, service provider or operator shall
immediately disclose the information to the health
professional upon a verbal acknowledgment by the health
professional that the information may not be used for
purposes other than the health needs asserted and that the
health professional shall maintain the information as
confidential. The vendor, service provider or operator may
request, and the health professional shall provide upon
request, a written statement of need and a confidentiality
agreement from the health professional as soon as
circumstances permit, in conformance with regulations
promulgated under this chapter.

Full text of the bill (for those of you into masochism)

…so…according to that, an oil company could legally withhold vital information regarding exposure to hazardous chemicals needed to treat a patient if the doctor doesn’t first promise to keep whatever they’re told secret.  I presume the presence of nurses and/or other hospital staff could complicate those matters somewhat?  Do they all need to pinky swear that they won’t tell?

The equation is all fucked up, it is not:

Corporate Secrets > Health

It is:

Health > All-the-other-things!

The health and well being of the populace must come first, how is this even a story?  How backwards do we have it if we can’t get this most basic of ideas correct?

The mind reels.  Someone actually wrote that bill.  Worse, a bunch of other people said “Okey Dokey!!  It’s now a fucking LAW!!??!!” – there is no rage face sufficient to express how completely fucked up and evil that is.  No amount of “F”s or “U”s in any combination can properly describe how vile this is.

Dear Pennsylvania,

May I, politely, suggest that you round up your elected representatives and remind them whose interests they’re supposed to be protecting (without pitchforks, torches and firearms…ya know, if possible).

Actually, fuck that.  Drag them out into the street and demand answers.

You’re entitled to them.

Original Story/Rage Source: For Pennsylvania’s Doctors, a Gag Order on Fracking Chemicals – The Atlantic


Reprint: A Doctor on Transvaginal Ultrasounds

This is a reprint of a guest post originally published on Whatever.  Because of their position the author is known simply as “An Anonymous Doctor”.  The progress this kind of legislation is making in the US is staggering and depressing all at once.

For me the hope is that a country founded by rebels still has the will and ability to rebel when it counts.  There are a myriad of issues they’re currently wading through and there always seems to be a “trickle up” effect on Canada, which boils my blood to no end…but this isn’t the time for that rant.

Unfortunately, everyone has the right (politicians included), to be stupid, ignorant and bigoted.  Such is the burden of living in a free society – you need to be able to tolerate shit you don’t agree with, thick skin can be essential equipment at times.  However, those rights end where the rights of another start and this legislated-transvaginal-ultrasound-nonsense is one of those lines.

But I’ve said and mangled this introduction enough – time to hear from someone who’s a much better writer than I and whose stance I fully agree with and support.

Where Is The Physician Outrage?

Right. Here.

I’m speaking, of course, about the required-transvaginal-ultrasound thing that seems to be the flavor-of-the-month in politics.

I do not care what your personal politics are. I think we can all agree that my right to swing my fist ends where your face begins.

I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise.

In all of the discussion and all of the outrage and all of the Doonesbury comics, I find it interesting that we physicians are relatively silent.

After all, it’s our hands that will supposedly be used to insert medical equipment (tools of HEALING, for the sake of all that is good and holy) into the vaginas of coerced women.

Fellow physicians, once again we are being used as tools to screw people over. This time, it’s the politicians who want to use us to implement their morally reprehensible legislation. They want to use our ultrasound machines to invade women’s bodies, and they want our hands to be at the controls. Coerced and invaded women, you have a problem with that? Blame us evil doctors. We are such deliciously silent scapegoats.

It is our responsibility, as always, to protect our patients from things that would harm them. Therefore, as physicians, it is our duty to refuse to perform a medical procedure that is not medically indicated. Any medical procedure. Whatever the pseudo-justification.

It’s time for a little old-fashioned civil disobedience.

Here are a few steps we can take as physicians to protect our patients from legislation such as this.

1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on.

2) Reinforce patient autonomy. It does not matter what a politician says. A woman is in charge of determining what does and what does not go into her body. If she WANTS a transvaginal ultrasound, fine. If it’s medically indicated, fine… have that discussion with her. We have informed consent for a reason. If she has to be forced to get a transvaginal ultrasound through coercion or overly impassioned argument or implied threats of withdrawal of care, that is NOT FINE.

Our position is to recommend medically-indicated tests and treatments that have a favorable benefit-to-harm ratio… and it is up to the patient to decide what she will and will not allow. Period. Politicians do not have any role in this process. NO ONE has a role in this process but the patient and her physician. If anyone tries to get in the way of that, it is our duty to run interference.

3) If you are forced to document a non-indicated transvaginal ultrasound because of this legislation, document that the patient refused the procedure or that it was not medically indicated. (Because both of those are true.) Hell, document that you attempted but the patient kicked you in the nose, if you have to.

4) If you are forced to enter an image of the ultrasound itself into the patient chart, ultrasound the bedsheets and enter that picture with a comment of “poor acoustic window”. If you’re really gutsy, enter a comment of “poor acoustic window…plus, I’m not a rapist.” (I was going to propose repeatedly entering a single identical image in affected patient’s charts nationwide, as a recognizable visual protest…but I don’t have an ultrasound image that I own to the point that I could offer it for that purpose.)

5) Do anything else you can think of to protect your patients and the integrity of the medical profession. IN THAT ORDER. We already know how vulnerable patients can be; we invisibly protect them on a daily basis from all kinds of dangers inside and outside of the hospital. Their safety is our responsibility, and we practically kill ourselves to ensure it at all costs. But it’s also our responsibility to guard the practice of medicine from people who would hijack our tools of healing for their own political or monetary gain.

In recent years, we have been abject failures in this responsibility, and untold numbers of people have gleefully taken advantage of that. Silently allowing a politician to manipulate our medical decision-making for the purposes of an ideological goal erodes any tiny scrap of trust we might have left.

It comes down to this: When the community has failed a patient by voting an ideologue into office…When the ideologue has failed the patient by writing legislation in his own interest instead of in the patient’s…When the legislative system has failed the patient by allowing the legislation to be considered… When the government has failed the patient by allowing something like this to be signed into law… We as physicians cannot and must not fail our patients by ducking our heads and meekly doing as we’re told.

Because we are their last line of defense.

Author: An Anonymous Doctor

Originally posted: 20 March 2012

Plan B!

Malaria, scares the crap out of me – my fiancé and I recently took a trip to the Dominican Republic and stayed at a resort where the risk of malaria is pretty low.  We took malaria medication anyway, “better to have it and not need it, than need it and not have it” being the mantra.

Now it appears we were double inoculating ourselves against the scourge known as malaria – HUZZAH!!

I’ll take my medicine in beer form thank-you very much!

NCBI ROFL: Want to cure your malaria? Get wasted! | Discoblog | Discover Magazine.