THE SIX QUESTIONS:
A GUIDE TO JUDGING FAVORABLY

As Jews approach the High Holy days it is useful to remember that the Torah teaches that, whenever we experience or hear about the negative behavior of another person, we must "judge favorably." In simple terms, that means giving the benefit of the doubt. But how can one follow that advice when it seems that the facts clearly point to someone's guilt?

Sometimes we jump to the wrong conclusion because the facts are different from what we perceive them to be. Even if our facts are accurate, we often misinterpret the intent behind them. When we drop the assumption that there was a negative intention behind someone's actions towards us, we automatically deflate much of the anger and hurt that we feel.

Here are six possible ways to analyze a situation and jump to a good conclusion:
1. Are you sure it happened at all? Sometimes our perceptions of what we see and hear are mistaken.

2. Are you sure the details are correct? One small detail can completely alter the scenario. Something may have been exaggerated or omitted that would make a big difference.

3. Do you know if the other person intended harm? Often the consequences are unforeseen.

4. Do you know the assumptions the other person was operating under? Maybe the other person was operating under a misconception that would explain their behavior.

5. Could the other person's act have been the result of an innocent, human error? Everyone has limitations. Perhaps this person lacked experience, was forgetful, distracted or simply didn't think carefully enough before acting.

6. Do you know what events preceded the negative action? The other person may be enduring a great deal of pain, frustration or stress. This might be a response to a specific situation, like an illness or financial loss. Or it could be a deeper, more pervasive problem that effects the person's entire life.

Although the Torah requires us to judge others with favor and compassion, we are not required to accept abusive behavior from others. Physical, verbal or emotional abuse must be addressed and corrected.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

*Tune in later for THE SEVEN REASONS WHY MEDICAL ERRORS OCCUR.

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For more health info and links visit the author's web site www.hookman.com

Post-cholecystectomy cystic duct stump leak: a preventable morbidity

Irshad Ahammed et al writes that “While major bile duct injury is the most serious complication following laparoscopic cholecystectomy, bile leak from the cystic duct stump remains the commonest morbidity.” This is a retrospective assessment of all patients who had a cholecystectomy over a 5-year period from April 2003 to March 2008.

Data related to bile leakage were obtained from the Unisoft endoscopic retrograde cholangio-pancreatography (ERCP) database.

Overall 2011 cholecystectomies were performed, of which 488 were done as emergency procedures. Thirteen patients had significant bile leakage, three of which were from accessory ducts, in one the source could not be identified and nine had a cystic duct stump leak (CDSL), which formed the basis of this study. Emergency cholecystectomies seem to have a higher incidence of CDSL Eight of the nine CDSL patients had successful ERCP and stenting. One had a percutaneous trans-hepatic cholangiography and stenting. CDSL following emergency laparoscopic cholecystectomy was up to threefold higher than after elective procedures.

CONCLUSION: The CDSL of 0.44% was comparable to the reported incidence in the literature. Endoscopic management remains the treatment of choice.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

*Tune in later for STROKES.

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For more health info and links visit the author's web site www.hookman.com

ABLATION FOR ATRIAL FIBRILLATION: NOT RISK FREE

The risk for death after AF ablation is 1 in 1000 patients or 1 in 1385 procedures.

Catheter ablation is an accepted procedure for patients with atrial fibrillation in whom medical treatment is ineffective. Currently, the only indication for AF ablation is impaired quality of life (QOL); ablation is not recommended for patients without symptoms who merely wish to stop taking warfarin. Individuals with AF have an increased mortality risk, and no AF treatment, including ablation, has been shown to reduce that risk. The AF ablation procedure itself carries a variety of risks. However, the incidence of death from complications of AF ablation has not been determined, because the data are from single-center or small multicenter trials.

In this international survey of 162 centers, published in Journal Watch Cardiology May 27, 2009-32,569 patients underwent 45,115 AF ablation procedures. In all, 32 deaths occurred (0.98 per 1000 patients; 0.71 per 1000 procedures), including 7 from tamponade, 5 from atrioesophageal fistula, and 3 from stroke.

Comment by a cardiologist: These data provide useful guidance to physicians and patients regarding the risks of AF ablation. Whether a 1-in-1385 procedural mortality risk is justified by potentially improved QOL is an individual patient decision. However, to put this risk in perspective, it is roughly the equivalent of the risk of knee replacement
— another invasive QOL-improving procedure — and it is much lower than the risk of elective coronary percutaneous interventions, arguably also performed largely to improve QOL.

CITATION:
Cappato R et al. Prevalence and causes of fatal outcome in catheter ablation of atrial fibrillation. J Am Coll Cardiol 2009 May 12; 53:1798.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

* Tune in tomorrow for A NEW NON INVASIVE TEST FOR ALZHEIMERS.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com