From: James Keating <james.k.keating**At_Symbol_Here**GMAIL.COM>
Subject: Re: [DCHAS-L] CHAS services for 2022 survey
Date: Fri, 31 Dec 2021 15:55:31 -0500
Reply-To: ACS Division of Chemical Health and Safety <DCHAS-L**At_Symbol_Here**Princeton.EDU>
Message-ID: 002501d7fe88$c037f8e0$40a7eaa0$**At_Symbol_Here**



Thanks so much for the advice. An attorney friend of mine (malpractice) warned me to always have an assertive advocate with you when you go to the hospital or as soon after admission as possible. He has shared some horror stories to me.


HAD is hospital acquired death that kills an estimated 200,000 or more people per year as a result of mistakes and misdiagnosis along with secondary infections acquired during the hospital stay. In this time of Covid and seasonal flu the danger is of HAD is a very real problem. One out of three patients placed on a ventilator end up dead from bacterial pneumonia. Moreover, there is currently a reluctance on the part of many Doctors and even more hospitals to prescribe and administer the drugs that are readily available to treat Covid 19. Therefore, a knowledgeable and assertive advocate is essential to assure prompt treatment with the proven regimen of drugs - a ventilator should probably be the last resort if all else fails.


Jim Keating

From: ACS Division of Chemical Health and Safety <DCHAS-L**At_Symbol_Here**Princeton.EDU> On Behalf Of eSupport
Sent: Thursday, December 30, 2021 11:54 AM
To: DCHAS-L**At_Symbol_Here**Princeton.EDU
Subject: Re: [DCHAS-L] CHAS services for 2022 survey


I was helping out the local University by teaching a section of Organic chemistry a couple years back (but for pay; I have my own college tuitions to pay!) when my Mom was diagnosed with pancreatic cancer. Having that online faculty access to medical journals was an incredible asset at that time.


And how that meshes with the established mindset aspect of this discussion, boy, whew.  I also learned the you have to take charge of your own medical care, even when going to a "brand name" cancer center, particularly one that is franchised (for example, one that rhymes with, oh, I dunno, "MD Anderson"). I discovered that they have a set playbook they won't deviate from (they have to call the mothership and argue with you over wanting say, Cyberknife instead of conventional radiation).  I perceived a mindset of going through the motions for an older patient with a poor prognosis. In the course of treatment we had to, on our own, make a diagnosis of hepatic encephalopathy AND come up with the one drug that treated it, an antibiotic which works by altering the gut bacteria to produce less ammonia (ammonia buildup causes the encephalopathy), and had to convince the insurance company to cover it ( ). Another time, they discharged her around dinnertime after a 3 day stay so dehydrated that we brought her back to the ER early the next morning on the verge of death; they had to put FOUR liters of fluid into her.  And so much more. So just some lessons learned - "experts" don't always know what they are doing, for sure. And access to knowledge is key.


Rob Toreki


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On Dec 30, 2021, at 11:16 AM, Alan Hall <oldeddoc**At_Symbol_Here**GMAIL.COM> wrote:


One thing members might consider to increase scientific/medical data is to become a volunteer Adjunct faculty member at a local college or university.


I  was for many years affiliated in such a role and while I did not have remote access to all the on-line journals my institutions had, I could go to the library there and access and download whatever journals they subscribed to.  Giving a workshop or a lecture once in a while was also a good professional experience.


Alan H. Hall, M.D.

Medical Toxicologist


On Thu, Dec 30, 2021 at 10:07 AM Ralph Stuart <ralph**At_Symbol_Here**> wrote:

> >Most public libraries participate in Interlibrary Loan, but I don't know how far that participation dips into technical journal articles.
That is an advantage of an academic library in the electronic era - I usually receive an ILL requested article within 24 hours, if it's available. I remember the days when articles on fax paper the same week was state of the art ;).

That does raise another issue in the hazmat headlines collection - linkrot. The half life of hypertext links on the commercial Internet is about 2 years and a random sampling of the collection I have on pinboard seems to confirm that - about 50% of 2012 links still find something. So the snippets I collected in 2012 are often as much information as is available about those events.

The results are much better in peer reviewed journals, but not fool proof. Monona's story about the 1937 article shows the value of the technical archives; maintaining these requires librarians rather than newspeople...

- Ralph

Ralph Stuart, CIH, CCHO


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