Althouse: "Start on clavicle. Remove middle third. Control and divide subsc art and vein."

December 5, 2008

"Start on clavicle. Remove middle third. Control and divide subsc art and vein."

"Divide large nerve trunks around these as prox as poses. Then come onto chest wall immed anterior and divide Pec maj origin from remaining clav. Divide pec minor insertion and (very imp) divide origin and get deep to serrates anterior. Your hand sweeps behind scapula. Divide all muscles attached to scapula. Stop muscle bleeding with count suture. Easy! Good luck. Meirion"

12 comments:

Bissage said...: What?

No smiley face?

:); 12/5/08, 9:50 AM
Joan said...: Fantastic example of the importance of vocabulary. I always tell my students that if we don't understand the words, we won't know what we're talking about. I love that such a complex surgery could be summarized into such a compact paragraph and yet still be declared "crystal clear."; 12/5/08, 9:57 AM
KCFleming said...: LOL

Lop Off Limb; 12/5/08, 10:10 AM
Prosecutorial Indiscretion said...: That's just mind-blowing. Seriously - holy freaking cow. That surgeon is the stud of all studs.; 12/5/08, 11:18 AM
kjbe said...: Fascinating. It's amazing what heights people can rise to.; 12/5/08, 11:45 AM
David said...: This is one of the most amazing stories I have seen in a while. Thank you for posting it. I plan to send it to some physician friends who have done various volunteer work overseas.

I also second Joan's comment on the importance of technical vocabulary. There is of course a huge amount unsaid in these simple instructions, but the sender, Dr. Merion, knew that the recipient could fill in the blanks.; 12/5/08, 11:47 AM
cardeblu said...: This comment has been removed by the author.; 12/5/08, 11:59 AM
One Fine Jay said...: Having dissected human cadavers for a living for a short period of five months, I have a great appreciation for surgeons. Dismembering and cutting is easy. Keeping someone alive while doing it? Not really.; 12/5/08, 12:16 PM
cardeblu said...: Being a medical transcriptionist, I understood what the instructions were even without going to the link.

What I don't understand is why the copied/retyped text that Ann has and that is shown at the bottom of the link, they have misspelled what the doctor originally spelled correctly. The word is "serratus," not "serrates." He also used "cont" suture for continuous, not count. Did they think he was wrong?

Picky, yeah, and it's really cool that this was done using txt abbrevs, again, correctly, but those things tend to stand out to me--can't help it.; 12/5/08, 12:18 PM
KCFleming said...: "Did they think he was wrong?"

Nope, but Microsoft did.; 12/5/08, 1:27 PM
jaed said...: "The quality of life in DR Congo is so poor, and he was so alone, that I wondered if it would not be better off for him to die. But the local staff gleaned from him that he wanted to live – which is unusual in the region. The Congolese do not mind dying."

Is anyone else kind of scared by the thought of having anyone - but especially any Congolese person - helpless in the hands of a doctor who thinks like this? (And who not only thinks like this, but is unashamed enough of his "their lives are worthless" attitude to publish it in a major newspaper?)

He seems to have done well and professionally by this patient, but still.; 12/5/08, 4:39 PM
Darcy said...: Wow...stud is right!

And jaed, I didn't take it that way at all, and I consider myself pretty sensitive. I read deep compassion and understanding in those words.; 12/5/08, 7:33 PM