Things are going from bad to worse. In engineering we have the KISS principal. KISS stands for Keep It Simple, Stupid. The principal simply put, in accordance to the principals teachings, is that simple things are safer to administer/operate/use.
The helicopter is, perhaps, the most complicated single device in the world, “10,000 parts flying in close formation”. I have heard that for every hour that some models fly they spend two hours in the shop. It is their lack of simplicity that makes them so unreliable. More parts means more things that can go wrong.
It is the health systems lack of simplicity that makes it more dangerous to your health than it needs to be. It was recently stated to me, by an Emergency Room doctor, that “The ER is one of the most dangerous places you can be.” The reasoning is that if you are there it is because you need help. But in the ER you may not get help for 10 to 12 hours if it is crowded!! Emergency is not usually defined as “needed in 12 hours”, it means needed NOW.
Ten days ago my wife and I were traveling through Colorado when she was stricken by an intestinal blockage and we had to go to an ER for help. Emergency surgery was indicated as her kidneys were going into shutdown! Several hours later she was out of surgery and all was well…..until……they decided to do an ultra sound exam of her legs and found a superficial clot in the right leg. Now she needed to have blood thinners to prevent the clot getting to her lungs. But having just had surgery this was contradicted! She was started on blood thinners and they were watching her blood levels to control the level. Apparently Cumadin is not easy to control. A week later she was discharged and flew to Austin to recover at our daughters home. Two days later the blood thinners struck!! She started bleeding in her intestines and, again, we headed for an ER. The ER didnt have the needed equipment to handle the case so she was transported by ambulance to ANOTHER hospital. So, now its a new staff with new concerns and just a sketchy view of the past. Stop the Cumadin, insert vitamin K, insert clotting factor, stop the bleeding! Ok, now the bleeding is stopped, redo the sonogram. Guess what the clot is now in the left leg and the one in the right leg is GONE and the new one no longer superficial!!! So, quickly insert a “filter” into the return vein to the heart to catch any clot that breaks loose. But “they” say that if a clot breaks loose and plugs up the “filter” the lower body becomes painful and swollen and you cannot walk. So which is worse, death quickly by pulmonary embolism or slowly and painfully by lower body deterioration and kidney failure?? If the filter is inserted and nothing is caught it was a waste of time inserting it, but if it works you die slowly instead of fast. Is that a decision you need to make? If you want to avoid both methods of death you dont insert the filter and you hope nothing breaks loose. Ok, the filter is now inserted so we dont have to start the Cumadin again, right? Wrong, the Cumadin needs to be restarted to make sure the clot is dissolved…OR…that if it breaks loose it will be dissolved in the filter before it blocks the filter. So now we worry about slow death from blocked lower body blood return, or death by bleeding to death.
This whole episode is an engineers nightmare. The KISS principal was not used in dealing with this situation. Everyone pulled out his/her tool kit and hit the line running. The prognoses is, from best to worst, clot dissolves within three months and the filter is removed (after three months the filter cannot be removed!!!!) to some form of disability or death as noted above.
But can you imagine how it would have gone under ObamaCare? With committees deciding at each step of the way whether this was financially reasonable. Whether, at 73 it is reasonable from a life expectancy viewpoint? How long for each step even if decided in favor?
“You shall know the truth and the Truth shall set you free.”