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Re: OB didelphyic/bicornuate and breech --> type of incision?From: Raymond Stephen (Stephen.Raymond@dhhs.tas.gov.au)Mon Jul 28 18:18:27 2008
As it happens I did not ever consider myself "more capable or smarter" than my "attendings". I realised after the time I spent then that there is no reason why burst abdomens had to occur at all, even though they seemed then to be part of what was to be accepted. I think I learned from that experience that there was a better way. The better way was to think about the statistical evidence that showed improved outcomes from different incisions and from different repair techniques and suture materials. That particular consultant was not a wonderful teacher or a wonderful specialist, but I learned something nevertheless. And since then I have found that it doesn't pay to use a midline incision unless you have a good reason. What might seem a good reason to you may not to me, but I have been operating for more than 35 years and it may be that I can manage some things that others can't? As for my "consultant gynae oncologist", she has not been exposed to as much surgery as I and is in no way to be regarded as my mentor or my expert. She knows how to deal with cancer in depth, but her surgical experience is considerably less than mine. My reason for being so persistent about this question of using midlines as little as possible is that my training led me to believe that there is no place for remaining stuck in the old ways when a new way was better. Have you read Joel-Cohen? Pedant? Guilty. I happen to believe that if you do it right you get it right; sloppiness in speech, expression, surgery, consultation, leads to sloppy outcomes, and quite apart from not helping the patient whom you are there to help, will land you in court eventually. Steve Raymond Ph (03)62227898 Cell 0438372395 -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of verner nellsch Sent: Tuesday, 29 July 2008 8:27 AM To: Multiple recipients of list OB-GYN-L Subject: Re: OB didelphyic/bicornuate and breech --> type of incision? eberhard, steve comes across as a humorless, tedious pedant. he uses statistics like a drunk uses lamp posts, for support, not illumination. he insinuates that he was smarter and more capable than his attendings as a "senior registrar", and more discerning than his consultant gyn oncologist. i have not once seen him allow for any other way than his preferred way as being acceptable. i have never once seen him offer comfort for someone on the list when they present with problems, only criticism, and barbed at that. he is dull, and makes others dull for fear of getting one of his responses. so, to use your phrase, i could give a toss as to the person with whom i am dealing. it does not matter who the bag of hot air is, they need deflating. but, perhaps i have misjudged the individual. please enlighten me as to why i should hold him in greater esteem, greater than he seems to hold anyone else. vnellsch
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