MURICA

Honestly, I thought this was common knowledge, no?

Hmmmm, probably just an age thing then. I'm sure we learned about it in school.

Diluted Dante wrote:

No. No one in my office has ever heard of this term either.

Diggers propped your lot up in WW1 even after the Gallipoli debacle.

https://www.engadget.com/2018/01/13/hawaii-missile-eas/

?!
0_o

I think my arse would fall out if that happened here.

Those local alerts are odd things. When I was in California last year I kept getting an ‘AMBER’ alert every day, usually about breakfast time, on my phone. They come with a description of a car. I had no idea what they were and so googled it - turns out every time you get one it’s when a kid had been snatched from the street or had gone missing.

Grim.

Do they shut down accounts or anything after they report? I cba to read the article and the thought never really crossed my mind until just now.

Forgive me, I'm going to rant a little bit about the incredibly tragic Jack Adcock case.

It's a story that's had a bit of news coverage, but is very much considered a Big Deal in medical circles right now.  (As such this rant may be a little self indulgent)  It also represents the only time I have ever knowingly agreed with Jeremy Hunt.  (shudder)  It's a story that, if told badly, makes the medical profession sound even more heartless and self interested than we're already described as being.  So bear with me.

Here's the version of events that usually gets told, in one way or another.

Jack Adcock was a 6 year old boy who was admitted to Leicester Royal Infirmary in 2011 with apparent gastroenteritis.  A series of serious mistakes were made as part of his care, which ultimately led to his tragic death.  A number of those mistakes were made by the paediatric registrar on call that day - a Dr Bawa-Garba.  These included failing to immediately recognise early onset sepsis, failing to correctly interpret a blood gas result, and erroneously halting CPR for 1 minute after mistaking the child for another child who had a DNACPR order.

As a result Dr Bawa-Garba was found guilty of manslaughter on the grounds of gross negligence in 2015.  She was given a 12 month suspension by the Medical Practitioners Tribunal Service, but this was overturned by the GMC who took the case to High Court Appeal in order to strike her off the medical register entirely.

And presented like that - it's fair enough.  The Adcock family remain utterly and understandably devastated, but have said they're pleased that they've got justice for their son and that she should have been struck off from the outset.  It has, at least, offered some sort of closure for them.

Dr Bawa-Garba's mistakes are clearly very significant, and are a matter of record.  There's no debate about them.  Indeed, the doctor herself identified them in her own reflection on the event, which she recorded in writing to facilitate a discussion with her educational supervisor in an attempt to ensure that she, and other doctors, learnt from her mistakes.

It's that reflection however that has partly contributed to the panic in medical circles.  It's standard practice if you screw up to immediately own up to your mistakes, and then to offer a detailed review of what went wrong and why, so that people can learn from it.  As I said, it's an important part of making sure those mistakes never happen again.  Following Jack's death, and thanks to that review process the Hospital Trust identified no less than 23 recommendations and 79 specific actions that needed to be taken to stop this sort of thing happening again.

However that personal reflection was used in court against Dr Bawa-Garba, and has resulted in many doctors suddenly announcing that they will no longer be prepared to write such honest accounts in future.  This, in itself, is a Bad Thing.  (Meanwhile the 79 actions needed to prevent it happening again were deemed inadmissible.) 

Also troubling is the context for Dr B-G's mistake.  She had turned up at work that day to discover that the registrar that was supposed to be covering the Childrens Admission Unit hadn't turned up to work.  So she had to cover the CAU in addition to her usual ward work.  (Jack was admitted to the CAU that day.)  Her consultant was also not in the building, but instead working over in Warwick.  The doctors junior to her had only started their paediatric rotation that month.  The hospital IT system was down, so all results had to be phoned for, and they were no longer flagged as abnormal.  The x-ray she ordered was not reported on for 2 1/2 hours (she immediately initiated the correct treatment when she saw it).  The child was given some medication by his mother just before his collapse (which had not been prescribed and may have precipitated the event).  He was moved from the ward he was assessed on to a cubicle on a completely different ward, leading her to mistake him briefly for a child with a DNACPR order who had been on that ward.

So she was doing the work of 3 doctors (4 later in the day), with very little information or support, and without her seniors.  She still fucked up very badly.  But having worked in that sort of scenario myself, I can see all too easily how it happened.  (Most doctors I know seem to regard it as a "there but for the grace of God go I" deal.)

There's now a huge debate amongst doctors as to whether they should refuse to cover other, absent, doctors.  It's caused a huge debate (which is worse - refusing care because you don't think it's safe to do it, or giving care which might not be safe, on the grounds that it's better than not offering anything at all?)  It's a particular problem because doctors working in situations analogous to Dr B-G's are, well, pretty much all of them.

Even Jeremy Hunt has said he's "deeply concerned about the possibly unintended implications" of the decision.  And they're huge.  From people refusing to work, to choosing to be less open about their mistakes.

There is, one last element that I can't quite shake though I have no real evidence for it.  Dr B-G is dark skinned, female and muslim (she wears a head scarf), and I can't help the nagging suspicion that had she been a white man of indeterminate religion we wouldn't be having this debate at all...

That's fucking insane.

That was a great and informative read, Tin, thanks.

Stretching the word "current" as far as it can go....

https://goo.gl/39nx6q

Predictable and kinda old news, but so glaring.

That'd be for my. Other link.

The social media accusations could be misused, but I suspect that the response to any woman who made such an accusation would be so strong that I doubt that many people will be making such accusations for shits and giggles.

I don’t know if it is that easy, TBH. Women who speak out publicly against sexual abuse are taking a huge risk personally and professionally. Personally they’re opening themselves up to all kinds of abuse and the possibility of their personal lives being publicly dragged over, professionally they risk their careers being stunted or ended by being branded a trouble maker or making powerful enemies.

I don’t think that there is anything easy about this.