http://www.nytimes.com/2014/10/03/us/dallas-ebola-case-thomas-duncan-contacts.html“

You write “so the Liberia question may not have been asked” (for medical reasons, that is), and suggest that his Liberian connectoin might have emerged merely in response to a request for a SS number.

And yet, in the excerpt I provided from Lester’s press conference, he seems to explicitly be saying that it was explicitly asked: “He volunteered that he had traveled from Africa in response to the nurse operating the checklist and asking that question.”

“The checklist” I believe would be a series of questions that follow guidelines relating to infectious diseases, and “asking that question” indicates she asked the question about travel to/from Africa, not a question about a Social Security number (a question that had probably already been asked, probably by the clerk early in the intake).

In addition, you ask, “why did he not say ‘I’m from Liberia and I might have Ebola’ as they gave him the antibiotic and sent him home?” We certainly all wish he had; it would have been an excellent idea, and I’ve wondered it myself, but I have several answers: he may have thought he’d already communicated that fact when he told the nurse he was from Liberia, and then demonstrated/described his symptoms. Did he need to provide a possible diagnosis, too? Also, although it’s hard to tell from the stories that have been given out, I’d say there’s a good possibility that he did not know the woman in Liberia he’d helped drive to the hospital died of Ebola rather than some pregnancy-gone-wrong, or even that she’d died in the first place. I’ve read several articles on that, and it’s not been made clear.

I don’t think it was up to the patient to provide a possible diagnosis for his own illness, especially as terrifying a one as that, which I would imagine sparked a lot of denial and wishful thinking in the patient. The medical people had more than enough information to put two and two together, and should have done so—at least, in terms of suspicion and cautionary measures. They completely and utterly failed.

And those details still don’t seem to be forthcoming. For obvious reasons, I think: protecting against the lawsuit they fear.

In this case, Lester said it was a “complex care team” doing the intake. Now, that might just be a BS Orwellian term that doesn’t actually mean much of anything complex, or caring, or demonstrating teamwork. But it implies some sort of coordination. And supposedly the Liberian origin of the guy was written in the chart. Should have been red-flagged, highlighted, etc., but apparently was not.

That’s all we can say about the details of the intake at the moment. Don’t sit on a hot stove awaiting further word on it from the hospital, either.

Anyone interested in a little comic relief – in the sardonic sense I earlier mentioned – might enjoy reading this article from a leftist site.

Even their “power to the people” paint job cannot cover over the cracks they reveal in their own argument while presenting a few simple facts.

It also seems that they cannot quite believe the ignorance and the incompetence of their own left-Democrat ideological constituency currently [as of 2012] inhabiting positions of civic authority.

“Detroit Department of Health and Wellness Promotion Director Loretta V. Davis told VOD to email her so she could send documents allegedly proving the state established Detroit’s health department in 1978, as she contended at the City Council hearing May 16.. She said they were part of the Michigan Public Health Code, but could not cite a section. To date she has not responded to VOD’s email, sent the same day as the hearing.

In fact, Detroit’s Health Department has had a long and prominent history as an independent city-operated entity since 1825. ….

By 1953, the article’s authors [of a cited work] say, the [Detroit Health] Department operated [Detroit] Receiving Hospital, Herman Keifer Hospital, Maybury Sanitorium (for tuberculosis patients), a Redford Emergency Branch [small hospital], the City Physician’s Service which provided 36,007 home visits that year, five district health centers which provided well-child care among other services, school dental clinics, and the Central Office X-Ray Clinic. – See more at: http://voiceofdetroit.net/2012/05/21/detroit-founded-health-dept-in-1825-it-previously-ran-3-hospitals-including-detroit-general-5-clinics-physician-home-visit-services“

Read it and weep, or laugh, as your personal constitution disposes.

Protocols may have changed a good deal since the time when I worked, though from fairly recent experience as a patient it seems like the basics are the same.

The patient often tells the clerk one story, a second version to the nurse, then something completely different when the doctor comes in. And communication between those on the staff is variable, depending on their own rapport, how busy it is just then, and whether the patient’s case seems interesting or out of the ordinary vs routine. How well did this patient speak English? ER physicians are often under the gun to control the patient interview and glean the essential problem as quickly as they can. I remember hearing from a doctor who worked at Kaiser for a while that they were pressured to spend no more than seven minutes with each patient before making a working diagnosis and moving on.

So-called “flu-like symptoms” represent a large percentage of those who visit the ER unnecessarily and lead to it being swamped, At the boat people we would hear “baby sick”, end of story, again and again.

And some doctors are jerks. So I don’t know. Too many variables to have any clear idea what this patient’s ER visit was really like.

Neo has more or less answered that question, I see.

As for public hospitals …

Some cities which once had them – Detroit for example had two major and one smaller ones – no longer do: due to the moral and managerial incompetency of the population in control of and drawing upon, them.

Which is probably a good part of why the private is being appropriated under whatever pretext is handy, by the incompetent public.

I suppose we could even make laws that anyone with certain kinds of knowledge could be commanded by the state to perform certain kinds of acts, or face penalties.

I’m not sure why I would be interested in preserving the health and life of persons like that, though.

” You drive on public roads, therefore you owe me a lift”

“neo-neocon Says:
October 2nd, 2014 at 6:35 pm

DNW:

I don’t see your analogy as correct.

I am not predicating any of my arguments about the public health responsibilities of physicians on the fact that the state licenses them, nor am I making an analogy to the licensing of other people. …”

My roughly analogous statements were presented for the purpose of provoking more accurate thought on the actual predicate for licensing in the first place.

Are, on the one hand, licenses to ensure that certain levels of competency are met by those offering personal or highly technical service for hire (medical doctors or civil engineers), or for engaging in a consequence freighted public privilege (driving a motor vehicle as opposed to walking on a roadway)?

Or, on the other hand, is licensing for the purpose of bringing socially valued activities, and their practitioners under close government control and direction?

It’s obvious that many on the left have forgotten or reject the original purpose of licensing, and imagine it as the latter position by default.

In your case, you have now explicitly denied that the duty you mention is related to the license, and have apparently only mentioned licensing in the first place as part of an ensemble of fait accompli government encroachments, statutory and otherwise.

I have read he was asked for his SSN, which is normally asked at the front end, as basic ID, to which he allegedly replied, “I don’t have one. I’m from Liberia.” So the Liberia question may not have been asked, having been pre-emptively answered. There are 10,000 Liberians in North Texas, and they probably use ERs all the time.

And if he was not profoundly ill on ER visit #1, why did he not say “I’m from Liberia and I might have Ebola” as they gave him the antibiotic and sent him home?

This coming week will tell a most profound story about our future, as more illness occurs.