From: gwr@hedonist-1.lanl.gov (Graham W. Redgrave)
Subject: Re: spina bifida information needed, please!
Organization: Los Alamos National Laboratory
Date: Fri, 21 Aug 1992 23:08:35 GMT

In article <16148@pitt.UUCP>, km@speedy.cs.pitt.edu (Ken Mitchum) writes:
|> In article <1992Aug20.043005.22931@news.eng.convex.com> cash@convex.com (Peter Cash) writes:
|> 
|> >Do you perhaps have spina bifida confused with anencephaly?
|> 
|> If he does, you can probably get his medical license revoked.
|> 
|> >
|> >Dr. Banks' gross ignorance is yet more proof that the average medical
|> >professional in this country receives very little training in the
|> >evaluation of mental and physical disabilities and defects. If you want to
|> >know something about spina bifida, Down's syndrome, or cerebral palsy,
|> >you'd best not ask a doctor.
|> 
|> Well, Dr. Banks is not quite the average medical progessional. He
|> happens to be board certified in neurology and an assitant professor
|> at a medical school. I guess that should make him super-ignorant.
|> 
|> The fact is, many of the things you posted were the same things that
|> Dr. Banks posted, including the likelihood of paraplegia and mental
|> retardation. You chose to look at it from the cheery side of things,
|> which perhaps you have been forced to based on personal experience.
|> Dr. Banks is paid to look at things from a slightly more detached
|> viewpoint, tempered by his years of experience. The fact that his
|> experience has led him to a less hopeful view of this condition
|> does not make him ignorant, or you wise. You owe him an apology.
|> 
|>  -Ken Mitchum MD
|>  km@cs.pitt.edu

While over the past couple of months I have developed a real respect
for the "doctors on the net," particularly those from Pitt, and while
Peter Cash's remarks seem needlessly caustic, I feel the need here to 
interject my own layman's perspective.  

It seemed clear to me that Tony Lin was asking for as "cheery" a perspective 
as possible, since he clearly included himself as part of the "we" who were 
requesting information (which I take to signify his stake in the girl's
condition).  Furthermore, because of Dr. Banks' usual levelheadedness
on the net, I really did think that spina bifida was a sentence of death or
worse.  I had such thoughts because the thing that stuck most in my mind
about Dr. Banks' message was this line:

    >                                 Most of these infants would die
    >as neonates (and still do in most countries) but in this country
    >we do them the dubious service of "saving" them so they can spend
    >their entire lives in institutions.

Whether or not he meant to, Dr. Banks delivered a blow to anyone who takes
what he says at all seriously and who is concerned about the fate of the person 
with spina bifida.  In my ignorance of spina bifida, I could not see from 
Dr. Banks' statement how the girl Mr. Lin is concerned about had any chance for 
a meaningful life.  What came across to me as a layman was that Dr. Banks 
_felt_that_treatment_was_only_a_'"dubious"'_service_, and that those who 
survive this service spend the rest of their lives in institutions.  Mr. Cash's
account said otherwise.  Apparently it is possible for those with spina 
bifida to live full lives.  They would probably not see the service done to them
as "dubious."

So, Drs. Bank and Mitchum, people _do_ listen to you and take what you say
seriously, more seriously than what others say, precisely because you do have
training.  I may not have heard what I was meant to in Dr. Banks' words, but
that seems to be part of the burden of being a doctor (if I may project a little ;-).

Sorry for the length of the post.

Sincerely,

Graham Redgrave
gwr@temin.lanl.gov

--Could anyone confuse what I am saying with what the government would say?--