Saturday, December 4, 2010

How much does Duke's Dr Alison Toth know about orthopedics?

I thought I knew orthopedic pain until osteomyelitis (bone infection) and the botched surgery by Duke’s Michael Bolognesi and Dr Jonathan Riboh.  

The longer I lay in bed, in pain and becoming weaker from muscle atrophy, I think about Dr. Alison Toth and the fact that she could have/should have taken the hardware out of my left leg in mid-2008.   But, it is unfair to "blame" people if they are simple (for lack of a better word) ignorant.  

Dr Alison Toth is a medical physician and probably very smart.  I mean, you have to be smart to get through med school.  Right?

And, Alison Toth, MD is the director of Duke Women's Sports Medicine Program, and an Assistant Professor of Surgery (Orthopaedics).  

Wow.  Those credentials are impressive (if Alison is your daughter or your personal friend.)

But the credentials are actually not so impressive when overshadowed by the lack of compassion and the apparent (IMHO) poor clinical skills.  In fact, the clinical skills of Alison Toth, MD can be downright scary if you are:

               An orthopedic patient at Duke Medical, or
               A female student athlete at Duke

Dr Mark Easley (Duke Orthopedics) placed the hardware in December 2004 but apparently was unaffected by my inability to function with the constant pain. I presume he was unaffected. Unless - and this would be weird - Dr Easley just thought it was cool that I was in debilitating pain for over 5 years.  

Dr Mark Easley requested that Dr Alison Toth take over my case because Dr Easley thought that a female orthopedic surgeon would understand the female anatomy better.  What?  Really? Do Dr Easley's female patients know that?

Dr Alison Toth apparently did not understand that HTO hardware in a leg is absolutely unnecessary when the tibia is healed.  Or and this would be weird . . . she thought it was cool that  was in debilitating pain.

If Dr Alison Toth really knew anything about female anatomy then she would have removed the hardware in my leg in 2008. Or, and again, this would be weird . . . she thought it was cool that I was in debilitating pain.  Would a physician at Duke Medical think it was cool (or even okay) for a patient to be in debilitating pain.  I mean, Duke's Dr Raymond Wase thought it was okay or cool.  And Dr Wase was trained as an orthopedic surgeon. SO maybe other DUke physicians trained as orthopedic surgeons think it is cool to let a patient remain and pain.

And if the trained orthopedists is like Dr Raymond Wase than it would even be more cool to accuse the sick and suffering patient (who by the way has dead tibia bone) of being a crazy narcotic seeking kook!  Yeah that's cool.  Cool but weird.

You know what is really not cool at all?  In my decades of experience with Duke  Medical, Duke Medical physicians and surgeons do not understand or appreciate a basic truism of medicine – good physicians should actually want to alleviate pain and suffering.

If Dr Easley or Dr Toth had understood that the hardware was unnecessary, causing pain and potentially creating an infection in my tibia, then they must have been able to follow the logic to conclude that the hardware should be removed. Knowledge is not the same as practicing good medicine.

But if Dr Easley or Dr Toth had the knowledge and practiced good medicine then perhaps:

1.          I could have taken better care of my dad the last 1.5 years of his life;   and
2.          I might not be at risk of dying today.

When is the last time I thanked Dr Easley, Dr Toth, Dr Bolognesi and Dr Riboh for (as my dad Robert Handy sarcastically thanked Dr Veshana Ramiah after she insulted him) “showing me how much they know.”


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