Johns Hopkins Pathology, Surprising development

(My usual long rant, as in days of old. Here is the TLDR version: maybe he did wrong, maybe his accusers are doing wrong. We probably will never know. If you are willing to go even further, perhaps just read the areas emphasized in bold)
What a very interesting thread. I spent age 18 to 20 as an OJT lab tech( coincidentally, working for a very rich and powerful pathologist as ultimate boss ), then a few years as a military medic, then nursing school and a few years as an ER nurse, and finally anesthesia school and 36 years in surgery and OB as a CRNA. I administered between 30K and 40K anesthetics for various surgeons and occasionally non-surgeons.

I could tell some tales. Tales related to mind boggling egos and some amazing bullying of underlings and sometimes even patients. Tales of amazing displays of rage and temper tantrums. I'm not going to, but I could. My oldest grandson is in 1st year med school. I have cautioned him more than once to avoid becoming an arrogant ego maniac who views every one he works with, and indeed even his patients, as far beneath him in intelligence and most other areas.

I will say that I have also observed the opposite of this. Where MDs who are just as skilled and brainy as any other that I have worked with are almost saints. Sometimes these MDs find themselves in serious conflict with their ego maniac colleagues. Though that may be the wrong word. Sometimes they are not colleagues so much as competitors. The "saints" are often taking the patients side. Their opposite side is taking the side of money and power.

As for Doc Epstein, I could not possibly say. He might well deserve what is happening, or he might be the innocent victim of some sort of coup or rebellion staged from below or even above. I have seen that last one happen as well, where someone from below threatened money and/or power and was run out. It can come from either direction.

Though I do know that they can often, thank God, perform near miraculous deeds that keep us alive and sometimes even well, my already partially negative view of our medical system suffered a serious blow during the recent national and worldwide difficulties. I watched as several highly esteemed critical care doctors, from various hospitals, who were saving lives at much higher rates than at competing hospitals, had their careers absolutely destroyed. When their hospitals insisted that they stop doing the very successful things they were doing, and start doing more of the "approved" things. Things which, coincidentally, were vastly more profitable for the hospitals.

One of these destroyed doctors was the most published critical care doctor in the USA. And Chief of Critical Care at a prestigious medical school. He still has his license, but he no longer runs a critical care unit. He no longer teaches medical students how to save lives in the CCU. He was just one of many. He claimed he was fired because he refused to let his patients die, something that was happening at much higher rates at competing hospitals. (I think it was 5% mortality vs 15 to 30%) No doubt, the involved hospitals have a different story. Who is correct?

Also during that time, I watched MDs being interviewed on TV, warning against a certain medication which is still on the WHO's list of essential meds, which has been given in billions of doses over decades and saved so many lives. A medicine whose discoverers won the Nobel prize in 2015, for this medication, before the recent troubles. I watched as these MDs on TV warned against the dangers of this "horse medication" and ridiculed the idea that even when prescribed by a doctor, it could have benefit, and rather it was dangerous. Seeing these things further eroded my ability to believe these people.

So, is Doc Epstein deserving of what is going on, is he guilty? If so, that is a further example of the corruption of an individual doctor, such as I have seen more than once in my life, nothing new. If not, then it is maybe an example of the systems rail roading(sp?) a good doctor, for who knows what reason(money and power usually at the top of the list). Which is it? I have absolutely no clue, and probably never will have.

Bill

BillyBob@388 said...

Also during that time, I watched MDs being interviewed on TV, warning against a certain medication which is still on the WHO's list of essential meds, which has been given in billions of doses over decades and saved so many lives. A medicine whose discoverers won the Nobel prize in 2015, for this medication, before the recent troubles. I watched as these MDs on TV warned against the dangers of this "horse medication" and ridiculed the idea that even when prescribed by a doctor, it could have benefit, and rather it was dangerous. Seeing these things further eroded my ability to believe these people

I'm surprised that you're still flogging that dead horse, Avermectin.

Important reminder note to self about responding to "loaded" posts: "If you don't grab the bait, you won't get reeled in."

Tim G said...
Important reminder note to self about responding to "loaded" posts: "If you don't grab the bait, you won't get reeled in."

Apologies for the offense, Tim. None was intended.
Bill

It can be surprising sometimes where 'the best in the business' are located. In the rural small town in Illinois where I lived there was (I think he may have retired) one of the premier hand surgeons in the world.

I recall reading another time that one of the best places to go for unusual cases of blindness is the University of Iowa.

I had my PC treatment at Barnes-Jewish/Washington University St. Louis. My outcome speaks for itself.

Bottom line: there are great, and near-great medical practitioners everywhere. I also recognize that all of the top names know each other, and in unusual cases, they talk to each other.

Mumbo said...
Nice to be perfect all the time but not possible in the real world from my experience.

I was a carrier pilot in the Navy, and also an LSO (guy who stood at the back and talked to pilots landing on the carrier). Landing on the carrier was very unforgiving of error.

We all had days better than others, and days worse than others. Maintaining a uniformly high level of performance was hard.

I think of that before undergoing medical procedures. How is the doc’s game today?

Looking around I found a lot of different numbers for medical doctors who have substance use problems, with alcohol by far being the main concern. The following sorts of numbers seemed to come up often:

"Studies report that at least 10 to 12 percent of healthcare professionals will develop a substance use disorder during their careers, including at least 1 in 10 physicians, and 1 in 5 nurses."

Those number are thought to be lower than reality. Surgeons clock in at about 15%. For the general US population it's about 6%. For pilots it is claimed to be only 0.2% Maybe a bigger sense of responsibility for so many lives?

about 25 years ago my flight was landing in Dallas/Ft. Worth in the daytime with a massive thunderstorm right over the airport. I was seated near the back and the plane was bucking pretty hard, everyone in front of me were being thrown left and right in unison. A few people screamed and children were crying. Just as we were very close to landing the engines spooled up and pilot did a go-around. As we headed back around the First Officer came on and said they would get us down on 2nd try. I'm thinking really, you're going to try again? The 2nd try was just as rough but the pilot got it done. After the landing most passengers were clapping and clapping. I remember thinking that a diversion might have been wiser. I don't know if the flight was in any real danger, but I really have disliked flying ever since..

TJ123 said...
..............................And is it any wonder that MD's have a higher rate of alcoholism with the burdens and responsibilities they carry. And these days some guy who owns a small plumbing business can make as much, if not more, than a general practice MD. Is it worth the cost of a medical degree, and the time put in for a low-paid internship and residency? I've spoken to several MD's about it. Let me put it this way. The majority told me that they would never encourage their children to pursue a career in medicine.

Oh, and Billy Bob. You certainly don't need to apologize to me for your opinions. I learn the most from diverse opinions and I welcome them with open arms. I've read many accounts of alternative medications used in the third world during the covid crisis with moderate to good success. I never take opinions at face value. I do my own research and come to my own conclusions. But all opinions are helpful in stimulating my own interest in certain topics. Thank you.

Thanks for that, TJ.

And, I can personally attest to the kind of stress most MDs are under. Even as a CRNA, I had a good bit of it myself, particularly when I did not have an MD anesthesiologist(MDA) to back me up. Just me and a surgeon or an ER doc who could not get the ET tube in, in some rural locations. But, I think my stress would have been even higher had I been the MDA backing me or others up. Since the buck would stop with him/her. 3AM emergency C-sections, baby is crashing and mom has a full belly: now that will raise a blood pressure I'm here to tell you! (plus a hundred other situations) With my Grandson in 1st year medical school, I do worry about the effect all of that will have on him. Lord help him!
Bill

Thank you, TJ. Yes, #1 Grandson is indeed a sharp cookie, as well as a hard worker. A good thing since he is working his butt off. And #2 Grandson, 3 years younger, appears to be progressing right behind him, on the same path.

Stephen S said...
Its good to see you BillyBob388!

CentralPADude—>TopGun!

Thank you, Stephen!