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December 1997
Volume 61 |
Number 12
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LETTERS TO THE EDITOR
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| Let's Recognize
Other OB Anesthesia Pioneers |
The article
by John S. McDonald, M.D. on the contributions John J. Bonica,
M.D., made to obstetrical anesthesia is excellent. It graces one
of the outstanding contributors to anesthesiology of all time
(Dr. Bonica).
One point of clarification needs to be made, however. Dr. Bonica's
24-hour obstetrical anesthesia service was not unprecedented in
the northwest United States in the 1950s. His friends and co-regional
anesthesia enthusiasts and trailblazers Daniel C. Moore, M.D.
and L. Donald Bridenbaugh, M.D., offered a 24-hour, in-house,
physician-delivered obstetrical anesthesia service from October
1952 onward.1-5 R.N. Rutherford,
M.D., an obstetrician at Virginia Mason, Seattle, Washington,
worked with Drs. Moore and Bridenbaugh to be the first with father
participation in the obstetrical suite. This practice drew such
widespread attention that an article landed in Life Magazine
on June 13, 1955, describing this exciting new trend (below).
My purpose for writing this letter is not to detract from the
wonderful contributions of Dr. Bonica, but to allow recognition
of the pioneering work of Drs. Moore, Bridenbaugh and Rutherford
as well.
Stephen M. Rupp, M.D.
Seattle, Washington
References:
- Moore DC, Bridenbaugh LD. Is it
practical for medical anesthetists to supply a 24-hour obstetrical
service? West J Surg Obstet Gynecol. 1955; 63:382-385.
- Lindstrom C, Moore DC. Trends in
obstetrical anesthesia following the acceptance of a 24-hour
physician anesthesia service. West J Surg Obstet Gynecol.
1957; 65:63-68.
- Rutherford RN, Moore DC, Dare J,
Rose PA. Coordinated obstetric care. Obstet Gynecol.
1956; 8:581-590.
- Moore DC, Bridenbaugh LD. Physician
anesthesia, regional block and father participation: The ultimate
in care of vaginal delivery. West J Surg Obstet Gynecol.
1964; 72:37-44.
- Hayden GE, Moore DC, Bridenbaugh
LD. Maternity care should be family centered. Mod Hosp.
1964; 102:104-105.
Opening Pandora's Box
The article
by Douglas G. Merrill, M.D., was a true breath of fresh air in
the expanding pain management spectrum. We have preached for years
that our knowledge and skill in the performance of nerve blocks
is rarely an indication to perform them.
The farmer who chooses the right seed and finds the right soil,
sun and rain will harvest a bountiful crop. Patient selection,
examination and outcome studies should tell us what is best for
the patient.
Unfortunately, the financial incentive for procedures is very
attractive to a large number of people.
In my travels throughout the country, I am still amazed at the
extraordinary numbers of lumbar epidural steroid injections that
are performed. There is some unknown magic in scheduling three
of them at once. The only three of anything that really helps
are on the slot machines in Las Vegas.
We are a new specialty, and we must learn to walk and observe
before we can run. The fraudulent nature of the cases described
can only inhibit our growth.
Thank you for opening Pandora's Box.
Sheldon L. Burchman, M.D.
Milwaukee, Wisconsin
Segment of Pain Patients Seek Help
I have been practicing clinical anesthesia for 22 years and have
been an amputee for 35 years. Recently, I have become active on
several Internet network lists where amputees can contact each
other with various questions and advice. I have been dismayed
to see the number of people who are still suffering with phantom
pain and have been horrified to see some of the advice which is
circulating over the Internet (DMSO, alcohol, marijuana, masturbation
and the indiscriminate use of ketamine). Not once in several months
has anyone made mention of seeking treatment by a Board-certified
specialist in pain management. Clearly, ASA has failed to reach
this population with the message that help is available.
I am not a pain management specialist, but having a foot
in both worlds, so to speak, I feel a moral obligation to do something
constructive which, hopefully, will be of mutual benefit. As an
individual, I am trying to deliver correct medical explanations
to this population and would very much appreciate the help of
my colleagues, who are certainly more knowledgeable than me.
I would like to educate and inform this population about the
current scientific explanations of phantom pain, its pathophysiology
and treatment and to publicize the role of pain management specialists
as a valuable resource. My intent is to share this with the amputee
net site, national amputee associations and support groups and
the prosthetic organizations.
Many of you have existing Web sites about your pain management
services. Would you be willing to share this information? I would
like to post these addresses on the amputee list server.
My eventual goal would be to set up a Web site covering the entire
scope of phantom pain and pain management for the amputee. Hopefully,
this would encompass education, information, consultation for
the practitioners and referrals for the patients. Perhaps such
a Web site already exists, but I have not found it.
Be assured that I have no interest of any financial gain in this
endeavor.
Christina Skoski, M.D.
Huntington Beach, California
hkcs@gte.net
The views and opinions expressed in the "Letters
to the Editor" are those of the authors and do not necessarily
reflect the views of ASA or the NEWSLETTER Editorial Board.
The Editor has the authority to accept or reject any letter submitted
for publication. Letters must be signed (although name may be
withheld on request) and are subject to editing and abridgment.
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