Re: GPs might take flight in bird flu crisis

[Guest guest]

Readers of Laurie Garrett's " Betrayal of Trust " will remember that in

the recent Bubonic Plague epidemic in India, private physicians did

more than stay home: they hopped on airplanes and fled the nation,

leaving India's public health physicians to fight the battle alone.

Since India's public health service was kept small due to budget

constraints and it was felt that private physicians could be called

upon to help, this was a public health disaster for India.

[Guest guest]

Right. GPs, RNs, LPNs, RTs, PTs, administrators, clerical staff,

maintenance crew, and anyone who has the slightest notion of the

seriousness of the situation. In the event of a full-blown high-path

influenza pandemic, the hospital will probably be the worst place you

could go. Besides the near total lack of any chance of getting

treatment, the presence of thousands of sick people and their families

scratching and fighting for scarce or non-existent resources like

ventilators and Tamiflu will make it highly dangerous on every level.

Better to be prepared to treat yourself and your family at home.

>

> Readers of Laurie Garrett's " Betrayal of Trust " will remember that in

> the recent Bubonic Plague epidemic in India, private physicians did

> more than stay home: they hopped on airplanes and fled the nation,

> leaving India's public health physicians to fight the battle alone.

> Since India's public health service was kept small due to budget

> constraints and it was felt that private physicians could be called

> upon to help, this was a public health disaster for India.

>

[Guest guest]

A good model for understanding how human behavior changes when the

situation becomes seriously life-threatening is the group of climbers

who died on K2 last week. There are few better examples of people who

use cooperation to achieve their goals than mountain climbers. Yet

when the ice sheet fell and it became suddenly clear that they might

very easily die on that mountain, cooperation and altruism went out

the window. It became an every-man-for-himself, dog-eat-dog display

of non-cooperation, stealing, and treachery, according to the one

survivor. When it sinks in that one's life and the lives of one's

family are seriously at risk, you can forget all the altruistic

professionalism, years of training, and Hippocratic oaths. Survival

instinct takes over. It is human nature. Or rather, animal nature.

And health professionals will be among the first to realize that the

situation is extremely life-threatening because even those who aren't

already aware that influenza is exceptionally contagious when a

completely new strain like H5N1 appears, will realize it in very short

time as they see first hand the contagion and the death it causes

spreading like wildfire.

So yes, I am pessimistic, but I believe my pessimism is rooted in

reality and it informs my decision to prepare. Better to be

pessimistic and prepared than optimistic and therefore unprepared.

> >

> > Readers of Laurie Garrett's " Betrayal of Trust " will remember that in

> > the recent Bubonic Plague epidemic in India, private physicians did

> > more than stay home: they hopped on airplanes and fled the nation,

> > leaving India's public health physicians to fight the battle alone.

> > Since India's public health service was kept small due to budget

> > constraints and it was felt that private physicians could be called

> > upon to help, this was a public health disaster for India.

> >

>

[Guest guest]

Well, that is what the free market physicians did when bubonic plague

hit India: they hopped on planes and flew away.

But the India Public Health Service physicians stayed to fight the

epidemic alone despite the danger.

Sometimes people do live up to the best ideals. It just depends upon

the people and their personalities and their training.

Do some looking and you will find many instances of both sorts of

behavior.

>

> A good model for understanding how human behavior changes when the

> situation becomes seriously life-threatening is the group of climbers

> who died on K2 last week. There are few better examples of people who

> use cooperation to achieve their goals than mountain climbers. Yet

> when the ice sheet fell and it became suddenly clear that they might

> very easily die on that mountain, cooperation and altruism went out

> the window. It became an every-man-for-himself, dog-eat-dog display

> of non-cooperation, stealing, and treachery, according to the one

> survivor. When it sinks in that one's life and the lives of one's

> family are seriously at risk, you can forget all the altruistic

> professionalism, years of training, and Hippocratic oaths. Survival

> instinct takes over. It is human nature. Or rather, animal nature.

>

> And health professionals will be among the first to realize that the

> situation is extremely life-threatening because even those who aren't

> already aware that influenza is exceptionally contagious when a

> completely new strain like H5N1 appears, will realize it in very short

> time as they see first hand the contagion and the death it causes

> spreading like wildfire.

>

> So yes, I am pessimistic, but I believe my pessimism is rooted in

> reality and it informs my decision to prepare. Better to be

> pessimistic and prepared than optimistic and therefore unprepared.

[Guest guest]

The India Health Service physicians had no choice but to stay in India

because their paltry salaries didn't allow for escaping. And who

knows what percentage of them actually saw infected patients. But

regardless, even though there certainly some people who will put their

own lives at risk to provide comfort for dying strangers, my point is

that if you count on business as usual in the hospitals during a

raging, highly lethal pandemic, I think that you should re-evaluate

your assumptions. Once such an event is going full roar, all bets are

off and it will be better, in my opinion, to assume that the very

worst of human nature will surface and prevail. So sure, hope for the

best. But prepare for the worst. That's all I am saying.

> >

> > A good model for understanding how human behavior changes when the

> > situation becomes seriously life-threatening is the group of climbers

> > who died on K2 last week. There are few better examples of people who

> > use cooperation to achieve their goals than mountain climbers. Yet

> > when the ice sheet fell and it became suddenly clear that they might

> > very easily die on that mountain, cooperation and altruism went out

> > the window. It became an every-man-for-himself, dog-eat-dog display

> > of non-cooperation, stealing, and treachery, according to the one

> > survivor. When it sinks in that one's life and the lives of one's

> > family are seriously at risk, you can forget all the altruistic

> > professionalism, years of training, and Hippocratic oaths. Survival

> > instinct takes over. It is human nature. Or rather, animal nature.

> >

> > And health professionals will be among the first to realize that the

> > situation is extremely life-threatening because even those who aren't

> > already aware that influenza is exceptionally contagious when a

> > completely new strain like H5N1 appears, will realize it in very short

> > time as they see first hand the contagion and the death it causes

> > spreading like wildfire.

> >

> > So yes, I am pessimistic, but I believe my pessimism is rooted in

> > reality and it informs my decision to prepare. Better to be

> > pessimistic and prepared than optimistic and therefore unprepared.

>

[Guest guest]

I agree with you entirely. It is always better to assume the worst

and to be prepared for it. And usually, you will not be disappointed.

[Guest guest]

I'm a nurse and I believe it would be against every nursing principle I hold to turn my back on the sick and the dying just to save my own skin. I could not die in peace knowing I had walked away from people who needed help and care. If that means I might die as a result, well that's the way the dice roll.

Do one thing every day that scares you.

Eleanor Roosevelt

From: Lee <jackalope_lepus@...>Subject: [Flu] Re: GPs might take flight in bird flu crisisFlu Date: Wednesday, August 13, 2008, 12:47 AM

Well, that is what the free market physicians did when bubonic plaguehit India: they hopped on planes and flew away.But the India Public Health Service physicians stayed to fight theepidemic alone despite the danger. Sometimes people do live up to the best ideals. It just depends uponthe people and their personalities and their training.Do some looking and you will find many instances of both sorts ofbehavior.>> A good model for understanding how human behavior changes when the> situation becomes seriously life-threatening is the group of climbers> who died on K2 last week. There are few better examples of people who> use cooperation to achieve their goals than mountain climbers. Yet> when the ice sheet fell and it became

suddenly clear that they might> very easily die on that mountain, cooperation and altruism went out> the window. It became an every-man-for- himself, dog-eat-dog display> of non-cooperation, stealing, and treachery, according to the one> survivor. When it sinks in that one's life and the lives of one's> family are seriously at risk, you can forget all the altruistic> professionalism, years of training, and Hippocratic oaths. Survival> instinct takes over. It is human nature. Or rather, animal nature.> > And health professionals will be among the first to realize that the> situation is extremely life-threatening because even those who aren't> already aware that influenza is exceptionally contagious when a> completely new strain like H5N1 appears, will realize it in very short> time as they see first hand the contagion and the death it causes> spreading like

wildfire. > > So yes, I am pessimistic, but I believe my pessimism is rooted in> reality and it informs my decision to prepare. Better to be> pessimistic and prepared than optimistic and therefore unprepared.

[Guest guest]

Some people will always try to do the right thing because it is the

right thing. And even if they cannot, some will try to right things

when they can.

Former leprosy patients hear long-awaited apology

By Audrey McAvoy, AP Writer / August 13, 2008

KALAUPAPA, Hawaii—The state delivered a long-awaited apology to former

leprosy patients forcibly confined to a remote peninsula on the island

of Molokai.

" We're sorry. We're sorry for the treatment. We're sorry for the

suffering that you've been through, " state Sen. J. Kalani English told

about a dozen former patients gathered Tuesday at a meeting hall. " The

entire state is with me today as I say this. "

English then read aloud a resolution the Senate and House passed in

April apologizing to the former patients.

It said many patients were torn apart from their families when they

were sent to Kalaupapa Peninsula. It acknowledged the sacrifices the

patients made, noting they thought of the public more than themselves,

and gave up freedoms and opportunities the rest of society takes for

granted.

The Hawaiian Kingdom, and then later the republic, territory and state

of Hawaii, together banished 8,000 people with leprosy, also known as

Hansen's disease, to Kalaupapa for over a century after 1866 in an

attempt to control the illness. Drugs to cure the disease were first

administered in the 1940s.

Patients were no longer required to remain at Kalaupapa after 1969 but

many have chosen to live out the rest of their lives there because it

had become their home.

Former patient Gloria Marks told English the apology was way overdue

but she appreciated it.

" We're very grateful for you to come here and give us this message, "

Marks told English.

But she was sad that Harada, her brother-in-law and former

patient who pushed hard for an apology resolution, was not alive to

witness the event. Harada died Jan. 4.

After English spoke, Makia Malo visited the grave of his younger

brother, Earl D.K. Malo, who died at Kalaupapa in 1968 when he was 35

years old.

Malo, who is blind, held his cane on top of his brother's gravestone

while a health aide read the resolution. Malo, 73, said he thought

everyone buried at Kalaupapa heard the statement.

" I know they're watching and nodding. All of these people. They're all

agreeing. They're just saying 'at last,' " Malo said.

Edwin " Pancake " Lelepali, 80, said he believed the apology should be

made to the earliest residents of Kalaupapa more than anyone because

they had to scrounge for shelter and food and were given little

medical care.

But by the time Lelepali arrived in 1941 at the age of 14, he said

patients received food rations, allowances and health care. Then in

1969, patients were given the opportunity to leave if they wanted.

" Those people up there, they had nothing, " Lelepali said. " They really

suffered. "

http://www.boston.com/news/nation/articles/2008/08/13/former_leprosy_patients_he\

ar_long_awaited_apology/

[Guest guest]

I am sure that you are not alone in taking your professional duties

seriously. It all depends on the person.

I remember a news story from a decade ago about a Greek cruise ship in

Greek waters in which it was believed that the ship was lost. The

captain and crew abandoned ship in the only motor launch. The cruise

director was left to captain the ship, the clown operated the radio,

and other duties were taken over by the passengers. And the ship did

not sink. It made it into port safely. And the courts dealt with the

cowardly captain and his crew, who all lost their sea licenses. But

in many other cases, this sort of behavior does not happen and there

are many other cases of heroism at sea.

>

> I'm a nurse and I believe it would be against every nursing

principle I hold to turn my back on the sick and the dying just to

save my own skin. I could not die in peace knowing I had walked away

from people who needed help and care. If that means I might die as a

result, well that's the way the dice roll.

[Guest guest]

I'm sure we'd all like to escape a dangerous situation, but when you see people in worse shape then you are you just can't abandon them. It's just not right.

Do one thing every day that scares you.

Eleanor Roosevelt

From: Lee <jackalope_lepus@...>Subject: [Flu] Re: GPs might take flight in bird flu crisisFlu Date: Thursday, August 14, 2008, 7:13 PM

I am sure that you are not alone in taking your professional dutiesseriously. It all depends on the person.I remember a news story from a decade ago about a Greek cruise ship inGreek waters in which it was believed that the ship was lost. Thecaptain and crew abandoned ship in the only motor launch. The cruisedirector was left to captain the ship, the clown operated the radio,and other duties were taken over by the passengers. And the ship didnot sink. It made it into port safely. And the courts dealt with thecowardly captain and his crew, who all lost their sea licenses. Butin many other cases, this sort of behavior does not happen and thereare many other cases of heroism at sea.>> I'm a nurse and I believe it would be against every

nursingprinciple I hold to turn my back on the sick and the dying just tosave my own skin. I could not die in peace knowing I had walked awayfrom people who needed help and care. If that means I might die as aresult, well that's the way the dice roll.