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Re:Simone Giertz – Back from brain surgery [video] by PuffinBlue on Thursday July 19, 2018 @09:43AM (#17566162)
We live in a world of marvels.

Often we talk of the future and it's wonders waiting to be discovered, but the here and now has become equally astonishing.

The breadth, depth and scale of human ingenuity and endeavour is jaw-dropping and here Simone and her story is another example.

Maybe I'm being trite by looking for the good in the bad but pause for a moment and think of all that has been learned, how we have built a society and developed infrastructure such that at this particular confluence of time and space we as a species are capable of performing this life saving surgery.

And half a world away I follow the story through yet more confluences of knowledge and development.

It is astonishing. i know it's tempting to take it for granted but take a step back and think about it for a moment. It's astonishing.

I'm 32. I can only imagine how much more marvels I'll witness in my life, either remotely or in person.

Re:Simone Giertz – Back from brain surgery [video] by goodells on Thursday July 19, 2018 @10:23AM (#17566543)
The whole system is awe-inspiring. Have a medical emergency? We'll send a several-ton box on wheels speeding your way within minutes. If you're in a city, the traffic lights will turn red as the emergency vehicle approaches to make passing safer. Paramedics trained in evidence-based pre-hospital medicine will perform the interventions most likely to save you based on their field impression.

And when you arrive at the hospital it gets really cool - at a level 1 trauma center, they should be prepared to give you a CT scan and treat you in 10 minutes or less. That might involve snaking a tiny wire through your arteries all the way from your leg to your head, or administering one of thousands of drugs that has exactly the desired effect.

It's easy to take it all for granted but the technology and systems in place to take care of us are amazing.

Re:Simone Giertz – Back from brain surgery [video] by slg on Thursday July 19, 2018 @11:45AM (#17567377)
And if you live in the US and don't have good medical insurance the entire thing might leave you bankrupt and homeless. The ingenuity of humanity is amazing, but we still seem to get in our own ways a lot.
Re:Simone Giertz – Back from brain surgery [video] by gregpilling on Thursday July 19, 2018 @06:32PM (#17570926)
My son had brain surgery when he was 6. He is now 14. The helicopter ride of 100 miles to the brain center was $25,000 and the brain surgery was $46,000. The helicopter ride took 1 hour and used 2 people. The brain surgery was 6 hours and involved at least 3 surgeons, plus unknown number of support staff. Insurance was willing to cover the surgery, but we had to fight for 6 months for the helicopter ride.

To quote the lead surgeon during the 6 month follow up - "I stopped looking at what we billed, and what I got paid years ago. It never made any sense to me, so I focused on the patient outcome, which did make sense to me". Great human, saved my kids life, was totally supportive afterwards and stayed in touch for a few years.

Medical practices in the USA makes no sense to me. I am Canadian.

Relevant to Simone, I have a friend who had the same problem and actually went to the same surgeon for the problem, but 5 years earlier. My son was recovered in a few days, she spent 6 months in the hospital to recover. The change was a new technique. They fixed my son through his leg, my friend had her skull removed and replaced.

Humanity can do awesome things sometimes. Sometimes great, sometimes horrid.

Re:Simone Giertz – Back from brain surgery [video] by outworlder on Thursday July 19, 2018 @04:21PM (#17569895)
You are still alive though, if it's any consolation.

Now, many countries have this problem solved – for now. As the population ages, the solutions may have to change everywhere.

What I find interesting is that the discussion is almost never framed to address the actual issue: the medical industry in the US simply overcharges with impunity. I was shocked to discover that labor (as in, doctors) isn't even the biggest line item in many (most?) medical bills. Hospitals and clinics will simply crank the bill sky high and then have you or the insurance try to haggle it back down, sometimes at a 3 or 4 digits percentage difference. It's insane. There's also zero transparency on pricing, so it is difficult to shop around even if you have the time.

Re:Simone Giertz – Back from brain surgery [video] by monetus on Thursday July 19, 2018 @05:12PM (#17570327)
Your points summarize the thrust of the first in a series of propublica articles.

https://www.propublica.org/article/why-your-health-insurer-d...

Re:Simone Giertz – Back from brain surgery [video] by um_ya on Thursday July 19, 2018 @03:10PM (#17569398)
The biggest expense to doctors is the cost of getting sued all the time and the insurance doctors need to cover that.
Re:Simone Giertz – Back from brain surgery [video] by spamizbad on Thursday July 19, 2018 @03:31PM (#17569540)
Costs associated with medical malpractice account for just 2.4% of healthcare spending in the United States.

Source: https://hsph.harvard.edu/news/press-releases/medical-liabili...

Re:Simone Giertz – Back from brain surgery [video] by slg on Thursday July 19, 2018 @03:52PM (#17569686)
That isn't addressing um_ya's point because doctors are just a part of the overall healthcare industry but bear the brunt of the malpractice costs. This is just one small piece of a broken healthcare system, but how we handle malpractice in this country is certainly broken. Fixing it wouldn't resolve all our problems, but it would definitely help.
Re:Simone Giertz – Back from brain surgery [video] by spamizbad on Thursday July 19, 2018 @04:31PM (#17569985)
I don't think it's broken at all. Tort law, in general, is what we use as an alternative to more aggressive regulation. You remove tort options, the side-effect will just be more regulatory measures.
Re:Simone Giertz – Back from brain surgery [video] by slg on Thursday July 19, 2018 @05:25PM (#17570429)
Imagine a world in which a software developer was held personally liable for any work they did.

First off, this would kill of a huge part of the open source community (the free as in beer software would all disappear). Employee contracts might be structured in such a way that the employee is responsible for any potential liability. Any customer who felt wronged could sue the individual developer who wrote that code.

These lawsuits would then be decided by a jury of people who know nothing about software development. One of the biggest deciding factors in that case would be who could hire the best lawyers and which lawyers could bring in the best "software experts" to explain why the developer did or did not make a mistake. Even if it was ruled that the developer did not make a mistake, they would be unlikely to ever be able to recoup their legal costs. Meanwhile the payouts from the cases in the customer's favor are so large, people are now incentivized to sue over a much wider range of possible mistakes.

These developers just need to accept that these lawsuits and the wasted time and stress that results from them is simply a part of their profession. Regardless of a developers skill, a majority of developers now won't be able to make it through a career without being sued at least once. Eventually the software developers turn to insurance which costs tens of thousands of dollars per year to protect them against these risks.

Would you think this is a fair system? Could you see that system having a negative effect on the software industry? Do you think this would push people out of the industry who might otherwise be great developers? Would this system, that is ostensibly designed to protect customers, actually result in a better level of service?

Re:Simone Giertz – Back from brain surgery [video] by spamizbad on Thursday July 19, 2018 @06:09PM (#17570774)
> Imagine a world in which a software developer was held personally liable for any work they did.

We already live in this world, it’s just that most software had zero impact on the wellbeing of individuals and/or its mostly licensed as-is.

Software with actual guarantees behind it tends to be very expensive. Their users have tort recourse.

Also major software companies get sued and settle on a fairy regular basis.

Re:Simone Giertz – Back from brain surgery [video] by slg on Thursday July 19, 2018 @06:29PM (#17570905)
>most software had zero impact on the wellbeing of individuals

I agree with the "most" designation, but there is still plenty of software that does have a direct impact.

>or its mostly licensed as-is.

Which is exactly my point. Most software comes with an agreement that limits the liability for the company or person who created or sold the software. Developers are able to hand waive away that legal liability in ways that other professions, specifically in the industry, are not able to.

>Software with actual guarantees behind it tends to be very expensive. Their users have tort recourse.

But that is dictated by the contract which sets standard that is above the legal bare minimum. The legal minimum is much higher for doctors.

>Also major software companies get sued and settle on a fairy regular basis.

I will admit my analogy isn't perfect because of the relatively high number of private practice doctors compared with the relatively lower number of smaller ISV developers. Doctors as a whole have a much higher exposure than software developers as a whole. That is why I noted that contracts might change if software malpractice cases really became a thing.

Re:Simone Giertz – Back from brain surgery [video] by gameswithgo on Thursday July 19, 2018 @05:42PM (#17570562)
We do live in a world where you can be sued for negligence in software or anything else.
Re:Simone Giertz – Back from brain surgery [video] by jackhack on Thursday July 19, 2018 @01:39PM (#17568676)
Awe inspiring is correct!

My grandmother was born in 1888. In her lifetime, she saw the first automobile, the first airplane (propeller-driven, followed by jet aircraft!), radio, "talkies" (movies with soundtracks), television (black & white, then colour!), stereo records, indoor plumbing and electrical service, electronic computers, rockets, artificial satellites, the moon landing, refrigeration(!), vaccinations and antibiotics(!), the internet, and on and on.

She lived through two world wars, and the aftermath, losing brothers and friends as a result. There were joys and horrors to be sure. She remembered seeing the first car (which she called "a noisy piece of junk"), and the first time she spotted an airplane, and her first electric appliances (refrigerator and clothes washer).

For a thousand years prior, life had changed but only incrementally -- someone from the year 900 could still recognize life in 1400. However, in this short 100 year span during her lifetime, from 1890 to 1990, the transformation of civilization was so thorough and amazing that it is difficult to appreciate civilization's quantum jump.

What a profound change! Just stop and imagine this for a moment: a world without automobiles, where all travel is by horse/carriage, or train, or boat, or foot. No antibiotics. The milkman delivered (unpasteurized milk to the front porch) and the ice man delivered a block of ice every few days. There was no telephone -- a telegraph was the "text message" of the day and the radio was as close to instant information as one could get. There was no telephone. Photographic news could take weeks/months to travel across a country or an ocean, and the only way to cross the oceans was a boat with cloth sales or a steam boiler and a commitment of months.

So to think of the transition from a time where a little scratch could lead to an infection that kills you, or an injury to a limb means chopping it off and hoping one lives, a scientific (lack of) understanding illuminated only briefly by Phineas Gage's tamper-rod-through-the-frontal-lobe injury to a time where surgeons can cut abnormal things out of your brain and you go home in a couple days functioning normally is just astounding.

We live in a time of miracles. There is no other way to say it.

Re:Simone Giertz – Back from brain surgery [video] by tomjakubowski on Thursday July 19, 2018 @03:35PM (#17569561)
> someone from the year 900 could still recognize life in 1400.

Where?

Re:Simone Giertz – Back from brain surgery [video] by PhasmaFelis on Thursday July 19, 2018 @05:18PM (#17570371)
Pretty much anywhere, I would think.

Before the last century, the majority of humans supported themselves by farming, and farming didn't change that much until the advent of engines.

Re:Simone Giertz – Back from brain surgery [video] by TomK32 on Thursday July 19, 2018 @04:28PM (#17569956)
Possibly parts of Switzerland where they still speak Romansch.
Re:Simone Giertz – Back from brain surgery [video] by XorNot on Thursday July 19, 2018 @11:01AM (#17566913)
I have weirdly conflicted feelings when I see ambulances go by these days. Because part of me feels this sense of overwhelming pride watching that system work to save someone, people getting out of the way etc.

But then I remember it's only happening because someone's in severe trouble in the first place so it's like "humanity is awesome...oh something not good is happening"

Re:Simone Giertz – Back from brain surgery [video] by TeMPOraL on Thursday July 19, 2018 @11:34AM (#17567259)
I have this habit I copied off the book "Heart" by Edmondo De Amicis[0] - whenever I hear an ambulance approaching, sirens on, I'll take my hat and earphones off, pausing for a moment as a sign of respect. Respect for the person in trouble, for the people trying to save them, and for the system that allows this to happen.

Thank you 'PuffinBlue and 'goodells for bringing this observation up. The civilization our predecessors built and to which we have privilege of contributing is, for all its failings, truly miraculous.

--

[0] - https://en.wikipedia.org/wiki/Heart_(novel)

Re:Simone Giertz – Back from brain surgery [video] by TomK32 on Thursday July 19, 2018 @04:31PM (#17569982)
and then there are people who complain about ambulances blocking parking spaces or even roads... https://www.independent.co.uk/news/uk/home-news/man-paramedi...
Re:Simone Giertz – Back from brain surgery [video] by toomuchtodo on Thursday July 19, 2018 @01:08PM (#17568385)
Northwestern Medicine in the Chicago suburbs has a mobile stroke unit; if there’s evidence you’re having a stroke, they’ll send the stroke unit along with the ambulance and will perform a CT scan in the ambulance to determine what type of stroke you’re having and administer interventions while you’re en route to the ER.

http://westmobilestrokeunit.nm.org/

Re:Simone Giertz – Back from brain surgery [video] by mikec3010 on Thursday July 19, 2018 @03:43PM (#17569628)
I wonder why ambulances don't have mobile x-ray systems? I realize the radiation would have to be managed, but it seems like a great application of technology to perform the imaging and send it digitally while eh route.
Re:Simone Giertz – Back from brain surgery [video] by sxg on Thursday July 19, 2018 @05:04PM (#17570249)
There aren't many cases where having an X-ray done a little faster would be massively helpful. Emergency department physicians and trauma surgeons can read an X-ray for acute trauma in a matter of seconds, and doing the X-ray itself doesn't take more than a few seconds either. It's hard to think of a pathology that would show up on X-ray but not through the patient's presentation or physical exam. Going off memory, I can't think of a situation where an X-ray would be the crossroads that determines what I do next for the patient. Also, an X-ray done in a moving ambulance is probably going to be of fairly low quality. In most cases, they'd just have to redo it in the hospital.

The mobile CT scanner is also not super helpful for much other than determining whether a potential stroke patient has a grossly hemorrhagic stroke. In that one case, it is beneficial, but I don't think mobile CT scanners are used for much else.

Re:Simone Giertz – Back from brain surgery [video] by goodells on Thursday July 19, 2018 @09:24PM (#17571771)
To elaborate why a CT scanner is really really important in this case - there are two general kinds of strokes. Ischemic strokes are caused by a blood clot occluding an artery, preventing blood from reaching part of the brain. On the other hand, hemorrhagic strokes are caused by bleeding within the brain. We can use thrombolytic drugs (e.g. TPA) to break up a clot in an ischemic stroke. However, impairing clotting in a hemorrhagic stroke just makes it bleed faster.
Re:Simone Giertz – Back from brain surgery [video] by sxg on Thursday July 19, 2018 @01:17PM (#17568455)
Re:Simone Giertz – Back from brain surgery [video] by toomuchtodo on Thursday July 19, 2018 @01:29PM (#17568584)
Fantastic to hear. My mother passed due to a subarachnoid hemorrhage (the more difficult type of stroke to treat), so I follow advances in stroke detection and treatment closely.
Re:Simone Giertz – Back from brain surgery [video] by Waterluvian on Thursday July 19, 2018 @04:28PM (#17569961)
Emergency services are so underrated. In minutes I can have medical experts, fire rescuers, or even a small army at my door.

And there's parts of the world where this is simply not a thing. We take it for granted.

Re:Simone Giertz – Back from brain surgery [video] by amorphid on Thursday July 19, 2018 @10:03PM (#17571902)
The thing that blows me away is the idea that nobody knows how to make a pencil. Essentially no one on Earth knows how to make a regular ol' number 2 pencil in it's entirety, from scratch with no materials to a finished product. I saw it in a TED Talk over 9 years, but I don't remember which one. I googled a bit and found a Wikipedia page on a book I'd never heard about called I, Pencil. [1] That's probably source material for the video I watched, which may be the TED talk referenced in the the external link section.

[1] https://en.m.wikipedia.org/wiki/I,_Pencil

Re:Simone Giertz – Back from brain surgery [video] by tomiplaz on Thursday July 19, 2018 @01:00PM (#17568272)
That is true. I would like to add, however, that first and foremost we don't know what anything of this actually is, which I find most awe-inspiring.
Re:Simone Giertz – Back from brain surgery [video] by tomjen3 on Thursday July 19, 2018 @01:02PM (#17568293)
I once walked into a supermarket and really started to look at what was available, every item, how I could buy fresh oranges in the middle of january, trying to imagine the insane number of persons who had to a involved in all the globe spanning supply lines.

It doesn't compare to brain surgery, but the experience was so profound it came close to breaking my mind (if such a thing is possible), I had to give up and leave, because I just couldn't take it.

Re:Simone Giertz – Back from brain surgery [video] by TaupeRanger on Thursday July 19, 2018 @10:56PM (#17572112)
Marvels and horrors. As amazing as our current medical science is, if you get a tiny ball of cancer cells in your pancreas, there's a good chance you'll go years without anyone having any idea, and then slowly die while the foremost experts in the world can do absolutely nothing except feed you poison with the hope of hurting the cancer more than the rest of you.
Re:Simone Giertz – Back from brain surgery [video] by redmaverick on Thursday July 19, 2018 @10:53AM (#17566839)
I recently switched from iPhone to Andriod.. I am utterly blown away by the voice to text feature. With 0 mistakes it is able to recognize and transcribe audio. I can write 500 words in a matter of a few minutes. I can just say switch on the flashlight and it comes on. Turn off the bluetooth and it gets turned off.

I can even just say "call (insert name of restaurant)" and it directly calls them up. I am beyond blown away. The future is now.

Re:Simone Giertz – Back from brain surgery [video] by mynewtb on Thursday July 19, 2018 @12:23PM (#17567812)
Dies that work offline or would I inadvertently feed someone's creepy database?