TNT, NEC & the (possible) origin of a “World Leader.”
Published by Vijay September 3rd, 2006 in Medical blogs, Medicine, NEJM, Random NoiseJust some random thoughts….
This whole TNT thing has left me disturbed.
Out of respect and affection for my frient Moof, TNT is off my blogroll.
It is not to be taken lightly. I consider it akin to a summary execution or an honour killing for bringing dishonour to our corner of the medical blogosphere.
That said and done, I still find it hard to believe that she was not what she purported to be. To echo what a lot of commenters have said over the past few days, she seemed to know too much about the workings of a neonatalogy unit and her posts had a natural feel which would have been beyond the ken of a mere 18-year-old.
Last week I spent some time thinking about something that I read in one of her posts. Since I have no way of linking to it, I will have to rely on my memory. She had written something about wondering whether some of the struggling premies in the neonatal ICU were going to be hyperaggressive winners or pathetic whiners later in life because of the struggles that they went through to stay alive immediately after birth.
At about the same time I had seen this letter to the editor in last week’s issue of the NEJM. The first letter is from someone that many of us know - Dr. Gordon from Tales from the Womb. Necrotizing Enterocolitis (NEC) was also featured in last week’s Radiology Grand Rounds.
All this reminded me of something that happened about three years ago when I was in my previous job in a teaching hospital. My wife was in her Paediatrics rotation (part of her Family Medicine Residency), so I used to be ‘volunteered’ to do most of the Paediatric Radiology work.
They had an extremely premature neonate in the ICU - born at 28 weeks, weighing 800 grams. The premie had a Grade 1 Germinal Matrix Haemorrhage in the first week of life which was diagnosed and was being followed-up by cranial ultrasonography. The baby developed abdominal distension in the second week. The diagnosis of NEC was supported by the presence of pneumoperitoneum on the abdominal x-ray.
The general condition of the baby was not very good, so there was a lot of debate about the possible modes of treatment. The Paediatric Surgeon opted to operate after explaining the risks to the parents. Since the baby’s condition was bad, he decided to do the surgery right in the Neonatal ICU. He did a bedside laparotomy - the first time that I heard of such a thing - found a perforation in the ileum and closed it.
The baby made a surprisingly good recovery after the surgery and was sent home about five weeks later.
He was so pleased with the results of the surgery and the resilience of the baby that the Paediatric Surgeon took to calling the baby ‘World Leader.’
When you a patient like him, and everything goes nice (not easy) after all… is when you take a deep breath and think how wonderful is our body and how could be possible to surpass those tremendous adversities.
When all that happens, it’s very rewarding and lets me thinking in many things
I agree Jon. Thanks for visiting
About the situation with TNT…
It’s a dishonor to the community of humanity in general too.
later…
Dr. Scan Man..You know it is possible that she wasn’t an 18 year old at all. I’m certainly not going to accept anything she or anyone from her IP address might be telling us. Maybe it is someone who has great knowledge of the medical world, either by a physician parent or someone else who is equally knowledgeable about medicine. I guess its even possible that she or he could be a real medical Dr. but a very sick one.
I don’t like my friends messed with at all. I am angry about all this. Most important though, I’m afraid it will cause alot of distrust now among people who were previously friends. I hope that doesn’t happen.
Dr. Scan Man, I’m just getting to the comments on my blog … and to some of my emails … today. It’s going to be a while before I can get to all of them, because people have been so kind and supportive.
I want to say thank you for being my friend, and thank you for those lovely red roses you left in the comment. At first I was overwhelmed by what had happened, and then I was overwhelmed by the affirmation and support of my friends. The latter has definitely made an immense impression on me.
Thank you, my dear friend.