[HSF] medicine is not practiced in vitro (OT)

[Tea Acuff]

My point is not partisan politics,even if I readily admit I loath Congressman Stark's inability (for the past 20 years) to address a rational discussion of funding for medical care without scorching the motives of the protagonists in action be it military or medical.
 
My point encompasses all attempts to proscribe or describe the flow of events that we observers encounter as "reality", that is, to make sense of the data that we select as important.Since this is the HSF I am trying to understand and discuss medical practice and disease processes. When we consider what we do as defining say coronary artery disease, we exclude whole populations that make other choices perhaps to die in their sleep or die of other processes in old age. When we apply a RCT to a population, as Mr. Taggert has so aptly noted of the PCI literature, we make tremendously biased selections before and after the trial. I doubt, despite Hal's perspective, that we differ that much our cardiologist colleagues. We just have a slightly different tangent, but still a largely uni-dimensional slice through reality. Think about many of our discussions where we think that nature of disease processes can be sorted out on the basis of what technique we
 choose! How monomaniacal is our view of reality! What hubris is endemic in our views of pathophysiology and its treatment!
 
To use a different analogy than politics to express my view consider this. We think that we walk through a forest looking at the stationary trees and begin to describe the "nature" or "reality of the forest. I would submit that we are more likely doing is to akin to dragging a net through the ocean. When we pull up what is in the net, we proclaim that we understand the nature of the ocean. If we look back at our walk through the forest we can see that we made the same mistake in the forest which is certainly more complex than our careful pass even in just whether we look up or down as we made the pass. Even when we see compelling patterens reality remains more rich than we ever imagined if we are studying more than simple test tube reactions. Doubt me? Ask Bob how things looked fifty years ago?
 
I just used Stark's comments because his analysis is both contextually stupid and pertinent to our situation. (I will say nothing about the facts.) But imagine if our discussions on the mechanisms on mitral repair or coronary bypass centered on the presence or absence of the idiotic motives of cardiologists....???...do they?
 
None of this relieves us surgeons of the necessity from choosing a particular patient for a particular technique, but it does alter the relevance of that choice for everyone. Conversely it alters the (ir)relevant view that "everyman" (whether Nietzsche's or Stark's)  should determine the particular.
 
tea


----- Original Message ----
From: psimha <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Saturday, October 20, 2007 7:35:24 AM
Subject: Re: [HSF] medicine is not practiced in vitro (OT)


This seems to be getting into a Republican Vs Democrat debate that keeps 
raging on in CCML medevents. Seems to always be polarized and gets ugly. 
I think it is better done off line as I have seen it very often gets to 
become personal/hurting.
Prasanna
Hgrmd at aol.com wrote:
> Tea and Murtaza,
>   I guess Pete Stark's only defense for his grossly appalling and  callous 
> remarks that insult the families of our fallen and injured soldiers is  that he 
> resides in "La La Land" (California).  I believe he should  definitely be 
> censured and forced to apologize.
>   It is ironic and unfortunate that his name is the face of the laws  that 
> govern the relationship of American medicine and business.  My  overseas medical 
> friends find it hard to believe the contortions performed by  American 
> physicians trying to participate in revenue streams traditionally  solely owned by 
> big business.
>  
> Hal
>
>
>
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