A Quote by John Roberts
Pretty much everybody knows there are not enough organs for all of those patients who need to get transplants, and what happens is, is that organs are actually directed in liver transplantation to those patients who are the sickest. So the patients who have the greatest chance of dying in the next three months or so are the ones who get the priority for the liver transplant.
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We don't have enough solid organs for transplantation; not enough kidneys, livers, hearts, lungs. When you get a liver and you have three people who need it, who should get it? We tried to come up with an ethically defensible answer. Because we have to choose.
When we think about living donor transplant, what we're banking on is the ability of the liver to regenerate itself. Now, it's not the same sort of regeneration we think about with the starfish where we cut off the arm and it grows a new arm. With the liver, what happens is the remaining liver gets bigger, and your body knows the size of the liver that it needs, and when it recognizes that there is not enough liver, it sends nutrients and signals to the liver and says "get bigger."
When a liver becomes cirrhotic, those are the common complications. We see that the patients have bleeding from their stomach and intestines. They have abdomens that become full of fluid. Their ankles swell with the same type of fluid, and they also can become confused and not themselves. Those are kind of the main things that we see when people get end-stage liver disease and have cirrhosis.
At a time when Democratic leaders are pushing rationed care in a world of limited resources, Americans might wonder where the call for shared sacrifice is from illegal immigrant patients like those in Los Angeles getting free liver and kidney transplants at UCLA Medical Center. 'I'm just mad,' illegal alien Jose Lopez told the Los Angeles Times last year after receiving two taxpayer-subsidized liver transplants while impatiently awaiting approval for state health insurance.
For the liver, what's so interesting is that there's no stem cell in the liver. So the normal liver actually can regenerate. It's one of the only organs in the human body that can do this, and we've known this since the time of Greek mythology.
If we had enough cadaver organs to go around we wouldn't do living donor liver transplants because one is we don't want to put a donor at risk, but the second is that it's a more difficult surgery for the recipient because you're getting a piece of a liver rather than a whole liver. It takes you longer to recover, and it has more complications related to where we sew together the blood vessels and the bile ducts.
An interesting opportunity is actually not just thinking about building organs for patients, but actually building little tiny organs that you could do drug screening on.
Lets take away the incentives to do 'to' patients and instead create incentives to do 'for' patients, to be 'with' patients. We don't need to do comparative effectiveness trials to see if that works; we can just ask patients.
I wasn't afraid of treating Ebola patients in the isolation unit. That was the safest job. But seeing patients in the clinic, seeing patients in the emergency room, being in the community - those things gave me pause.
Patients are patients because they are out of rapport with their own unconscious... Patients are people who have had too much programming - so much outside programming that they have lost touch with their inner selves.
I am a spiritual person. I'm a Catholic. I treat my patients, the dead patients, as live patients. I believe there is life after death. And I talk to my patients. I talk to them, not loudly but quietly in my heart when I look at them. Before I do an autopsy, I must have a visual contact with the face.
Whenever you see shrinks on television, they're so clearly written by patients. They're either idealized or they're demonized or they love their patients. All they ever think about is their patients.
Some hospitals screen all ICU patients and isolate those with MRSA, a process that can be challenging for both caregivers and patients.
A study of over 10,000 patients shows clearly that chemo's supposedly strong track record with Hodgkin's disease (lymphoma) is actually a lie. Patients who underwent chemo were 14 times more likely to develop leukemia and 6 times more likely to develop cancers of the bones, joints, and soft tissues than those patients who did not undergo chemotherapy .
Ventilators can be reused but hospitals need a sufficient supply to treat critically ill patients while still allowing enough time for each ventilator to be refurbished between patients.
We need a comprehensive renewal of the nursing care system in Germany, and quickly. The two-tier medical system must be abolished. Patients with public health insurance are waiting months to be seen by a specialist doctor, while doctors increasingly give priority to privately insured patients. That's unacceptable. We also need an educational revolution. Medicine, nursing care, education: Germany is not a modern country when it comes to these three areas. We have to adapt our policies to the social reality. These are projects that can awaken Germany out of its torpor.
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