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Dr. Fink' email is very close to the trueth, I think
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Dr. Fink' email is very close to the trueth, I think# WaterWorld - 未名水世界
S*4
1
Sorry I can't type Chinese now. So exciting!
Although Dr. Fink stated in a way that he hear something from a source in
China and the source "alleged" tons of stuff . I think it somewhat very
close to the truth because he was one of the doctors who helped in
diagnosing Ling's symptom. Also, he didn't mention the girl's name in his
email but I think it's Wei given she was the only suspect.
And now it makes perfect sense why Sun Wei needs to change her name and
birthday: to get a VISA from US without tracking down her suspect identity.
And let's assume she is in the US right now, everything would be very simple
. Just provide the evidence that Sun Wei and whatever the name she is using
is the same person. Then the suspect identity will be exposed.
The case study is attached below. source:http://www.rafink.com/tao.php
-------------------
The Tao of the Internet
by Robert A. Fink, M. D., F.A.C.S.
On April 11, 1995, I found in my Internet mailbox a message, in "fractured"
English, from a young graduate student at Beijing University in China. It
was a message of desperation. It concerned the plight of a fellow graduate
student in chemistry, a 21-year-old woman who lay in the Intensive Care Unit
of the University Hospital of Peking Union Medical College (PUMC). PUMC is
a medical school established by the Rockefeller family in the early part of
the twentieth century, and, as the model for Abraham Flexner's seminal
report on medical education, perhaps, "the most American of non-American
medical schools". A reconstruction of the young woman's case history to that
date is as below:
In early December, 1994, the patient complained of abdominal pain, cramping,
and extremity pain. Extensive tests, including autoimmune studies, thyroid
tests, pelvic and abdominal untrasound, skull x-rays, and bone marrow
examination were all normal. It was noted that the patient had some
abnormalities of her nails, but this was not reported further. She was
treated with "traditional Chinese medicine" and was discharged, improved.
She subsequently returned to work (in a chemistry lab); we still do not know
what chemicals she was working with. An "afterthought" was listed in the
report, this a piece of data which was to become critical in the diagnosis
of this woman's condition; and that was the fact that, shortly after the
onset of the abdominal symptoms on December 8, 1994, the patient's scalp
hair fell out, and she "became bald".
After a period of improvement (and some re-growth of hair), the patient
returned to the hospital with signs of peripheral neuropathy in the
extremities, rapidly progressive disturbances in sensorium (and recurrent
alopecia), developed multiple cranial nerve palsies, became comatose, and
required a ventilator. She also showed muscular spasms, described as "
oculogyric crises", and a tracheostomy was performed. Lumbar puncture and
MRI studies of the brain were normal, and studies for viruses, including
Lyme Disease, were negative. The patient was treated with "shotgun"
antibiotics with no improvement.
At that point, the author corresponded with the sender of the "distress
message". I learned that a number of other physicians, including people from
the United States, Canada, Great Britain, Singapore, Thailand, Indonesia,
and other countries, were also communicating with the student-sender and
several other students at the University. The students in China have
Internet connections but, (as we later learned), hospitals and physicians do
not. We were forced to engage in our later communication with the medical
professionals either by facsimile, which is tightly controlled by the
Chinese Government; or by sometimes circuitous person-to-person connections.
Information transmitted over the Internet to the students often did not
reach the medical professionals who were treating the patient. This was due
to the complex hierarchy of the Chinese culture, in which accepting
information from "students" is almost as alien to Chinese professionals as
is dealing with "outsiders". This lack of direct communication has proven to
be the most significant negative factor in this equation.
One of the earliest possible diagnoses which came to the mind of the author
(and several others of the "outsiders") was that of heavy metal poisoning (
the alopecia was the "clue"). We asked if tests had been performed for heavy
metals and were assured that such had been done early on. We later
discovered that these consisted only of a screen for arsenic!
By March 16, 1995, the patient had been in coma for several weeks; and,
despite normal cerebrospinal fluid findings, a diagnosis of Guillain-Barre
syndrome was made by the Chinese physicians. By April 12, 1995, the patient'
s condition had not changed, and a repeat lumbar puncture revealed an
elevated protein (248 mg.%) and 6 leukocytes. The impression of Guillain-
Barre syndrome was reinforced, despite messages from the "outsiders" that
this picture was not consistent with Guillain-Barre.
At about this same time, the author and John W. Aldis, M.D., a physician
working in the U. S. State Department, and formerly the Embassy physician in
Beijing, conceived of the idea of thallium poisoning, this after Dr. Aldis
was sent an article by Rose Miketta, M. D., a physician with Searle
Pharmaceutical Company, explaining the neurotoxic effects of thallium. We
again suggested that the patient be checked for thallium poisoning. This
recommendation was further backed by others, including Dr. David Bullimore
at St. James' Hospital in England, and several other p hysicians in the
United States. Yet, two weeks passed before the Chinese physicians decided
to perform the thallium study. It required an intervention by personnel at
the American Embassy in Beijing, and personal contacts between Dr. Aldis and
several o f the PUMC doctors (whom Dr. Aldis had known from his days in
Beijing), and faxes of articles directly to the hospital, before the test
for thallium was finally run. The results were striking. The patient had
levels of thallium in blood, urine, cerebrosp inal fluid, hair, and nails
which were more than 50 times higher than "normal"! As to the source of the
thallium, this remains unknown; but certain laboratory chemicals contain
thallium; and, in the Orient, there are several industrial compounds (
includi ng several brands of rat poison) which contain thallium (its use is
generally outlawed in the western world).
Once the diagnosis was established, the next problem was encountered.
Several of us, using the Internet and other online databases, searched the
literature for the optimum method of removing thallium from the body. A
number of methods were cited; but to xicologists at the New York and Los
Angeles Poison Control Centers felt that the most effective treatment was
that of administration of the dye Prussian Blue (ferric ferrocyanide) and
renal hemodialysis, with addition of potassium chloride. Then came the
problem of obtaining the Prussian Blue (a common industrial chemical which
was eventually found in China). Underlying this difficulty was the fact that
, once again, advice from "outsiders" was suspect by the Chinese.
Finally, after many phone calls, faxes, and other communications (the
doctors at PUMC would not deal with the students, who had Internet
connections), including the involvement of the patient's family (several of
whom were known political figures locally) , the Prussian Blue-hemodialysis
regimen was started on May 5, 1995, this almost one month from the initial
proposal of the diagnosis of thallium intoxication and some forty days after
the patient had lapsed into coma and had become apneic.
I wish that I could report a "happy ending" here. The patient responded
rapidly to the treatment, and, within 15 days after the institution of
treatment, the patient's thallium levels in blood, urine, and cerebrospinal
fluid had decreased to near-zero (a lthough certain other tissues, such as
nails and hair, will retain the metal for many weeks and will slowly "leach
out"). Sadly, the patient's neurological condition has not improved to a
significant degree. She now has been partially weaned from the ve ntilator,
and seems to recognize her parents; but she does not as yet have full
consciousness, nor does she exhibit much in the way of voluntary or
purposeful activity. The long period of brain intoxication in this case
appears to be the reason for her l ack of further progress to date and the
prognosis for recovery remains guarded.
In recent years, there has been geometric growth in the use of online
communication in medicine. The new field of "Telemedicine" is rapidly being
advanced in the developed countries, with computer review of case histories,
imaging studies (many of which are digital in their native form), and other
medical data becoming almost "routine" in making judgments, for example, as
to the transport of seriously ill or injured patients to tertiary medical
centers. In our own area, patients are transported on a dai ly basis, from
small facilities out in the "hinterland" to major urban medical centers.
Physicians at outlying hospitals have, through a simple computer/modem
connection, access to specialists and centers with advanced technology. The
growing use of ISDN (Integrated Services Digital Network) telephone lines
has made the transfer of complex information, including full-resolution MRI
and CT scans, into a rapid and seamless procedure. The global Internet
renders such "connectivity" a relatively inexpensive reality to be enjoyed
by health care professionals and patients throughout the world.
Despite this availability of technology (and, in the case of this
unfortunate student), however, the finest advances in global communication
cannot surmount centuries of tradition and cultural differences. In this
case, the cultural differences delayed im plementation of the large volume
of collective knowledge which was brought to bear on behalf of a young woman
; and sadly in this instance, was probably "too little and too late". As
with other problems in this world, it still comes down to the "human fac tor
".
As we advance the cause of "Telemedicine" and other interactive technologies
, we must never lose sight of the fact that, behind these wonderful machines
are the minds and hearts, and prejudices, of the human beings who run them.
It is in this "human aren a" where we need to place our educational
emphasis, so that the marvels of the modern digital age can be used for the
advancement of our species and of the world as a whole.
AUTHOR'S NOTE:
This paper is dedicated to Zhu Lin, the 21-year-old student who is the
subject of the case report. Acknowledgement is also gratefully made to John
W. Aldis, M. D. (U. S. State Department); Xin Li (telemedicine fellow at
UCLA Medical Center); Dr. Ashok Ja in (USC Department of Emergency Medicine
and Los Angeles Poison Control Center); Dr. R. Hoffman and his colleagues (
New York City Poison Control Center); Dr. David Bullimore (University of
Leeds, England); and the myriad other people who labored on behalf of a
young woman, critically ill halfway across the world.
avatar
m*r
2
maybe we can contact Xin Li, the telemedicine fellow at UCLA.
这篇文章指出一个很好的方向,研究telemedicine的人可能研究过这个case。当年靠洋
人救了命,今天可能还是要洋人重现当年的经过。

simple
using

【在 S**********4 的大作中提到】
: Sorry I can't type Chinese now. So exciting!
: Although Dr. Fink stated in a way that he hear something from a source in
: China and the source "alleged" tons of stuff . I think it somewhat very
: close to the truth because he was one of the doctors who helped in
: diagnosing Ling's symptom. Also, he didn't mention the girl's name in his
: email but I think it's Wei given she was the only suspect.
: And now it makes perfect sense why Sun Wei needs to change her name and
: birthday: to get a VISA from US without tracking down her suspect identity.
: And let's assume she is in the US right now, everything would be very simple
: . Just provide the evidence that Sun Wei and whatever the name she is using

avatar
n*8
3
很重要的文献。
要点:
最初作者和其他外来的大夫都认为是重金属中毒,建议重金属检查。后来建议只做“砷
”检查。后来才怀疑是铊。
:)
avatar
m*r
4
你英文太差了吧
人家是惊讶于当怀疑是重金属中毒时,医院居然只检查了一项!

【在 n*****8 的大作中提到】
: 很重要的文献。
: 要点:
: 最初作者和其他外来的大夫都认为是重金属中毒,建议重金属检查。后来建议只做“砷
: ”检查。后来才怀疑是铊。
: :)

avatar
n*8
5
挑刺没用,重要信息是外国大夫先怀疑是重金属,而不是铊。你有何感觉?
:)

【在 m**r 的大作中提到】
: 你英文太差了吧
: 人家是惊讶于当怀疑是重金属中毒时,医院居然只检查了一项!

avatar
m*r
6
什么感觉,你去读读同时期的文献再来说话,这是telemedicine历史上很重要的事件。
人家感叹于telemedicine难的不是技术和通信,是文化政治造成的沟通障碍,延误了最
佳治疗时机

【在 n*****8 的大作中提到】
: 挑刺没用,重要信息是外国大夫先怀疑是重金属,而不是铊。你有何感觉?
: :)

avatar
S*4
7
重金属被很快排除,因为很常见。我觉得你看到医生会的信还不够信服的话,要么孙粉
,要不就应该work on you logic thinking.

【在 n*****8 的大作中提到】
: 挑刺没用,重要信息是外国大夫先怀疑是重金属,而不是铊。你有何感觉?
: :)

avatar
S*4
8
不敢苟同,见原文:
“One of the earliest possible diagnoses which came to the mind of the
author (and several others of the "outsiders") was that of heavy metal
poisoning (the alopecia was the "clue"). We asked if tests had been
performed for heavy metals and were assured that such had been done early on
. We later discovered that these consisted only of a screen for arsenic!“
原文说的意思是他们问协和有没有做各种重金属测试,他们觉得重金属应该早就测过了
。后来他们才发现,协和所谓的重金属测试只测了一种:砷!
我猜你要么没读,要么没读懂。

【在 n*****8 的大作中提到】
: 很重要的文献。
: 要点:
: 最初作者和其他外来的大夫都认为是重金属中毒,建议重金属检查。后来建议只做“砷
: ”检查。后来才怀疑是铊。
: :)

avatar
C*r
9
同意你的,有人偷鸡摸狗偷换概念。

on

【在 S**********4 的大作中提到】
: 不敢苟同,见原文:
: “One of the earliest possible diagnoses which came to the mind of the
: author (and several others of the "outsiders") was that of heavy metal
: poisoning (the alopecia was the "clue"). We asked if tests had been
: performed for heavy metals and were assured that such had been done early on
: . We later discovered that these consisted only of a screen for arsenic!“
: 原文说的意思是他们问协和有没有做各种重金属测试,他们觉得重金属应该早就测过了
: 。后来他们才发现,协和所谓的重金属测试只测了一种:砷!
: 我猜你要么没读,要么没读懂。

avatar
D*9
10
楼上的不厚道啊,以洗地工来讲,it已经很尽力地把那些字都翻译出来了,虽然是内容
没读懂,LOL。。。。。
avatar
n*8
11
一个合理的解释是,有人一开始就告诉协和是铊,因此协和就没做重金属了,但还是做
了砷。 老美还以为沟通有问题,其实是中间人传递有问题。
:)

on

【在 S**********4 的大作中提到】
: 不敢苟同,见原文:
: “One of the earliest possible diagnoses which came to the mind of the
: author (and several others of the "outsiders") was that of heavy metal
: poisoning (the alopecia was the "clue"). We asked if tests had been
: performed for heavy metals and were assured that such had been done early on
: . We later discovered that these consisted only of a screen for arsenic!“
: 原文说的意思是他们问协和有没有做各种重金属测试,他们觉得重金属应该早就测过了
: 。后来他们才发现,协和所谓的重金属测试只测了一种:砷!
: 我猜你要么没读,要么没读懂。

avatar
S*4
12
then 为什么协和一直阻挠检测铊呢?!
avatar
n*8
14
因为协和不相信一个大学生,非医学专业能提供什么有用的信息。
更不知道他的确知道。
:)

【在 S**********4 的大作中提到】
: then 为什么协和一直阻挠检测铊呢?!
avatar
C*r
15
协和的医生都像三八这样没逻辑那北京居然还有活人真是奇迹唉。

【在 n*****8 的大作中提到】
: 因为协和不相信一个大学生,非医学专业能提供什么有用的信息。
: 更不知道他的确知道。
: :)

avatar
n*8
16
估计后来协会的确服了,年轻2B就是厉害,不用学就能测出铊。
:)

【在 C**********r 的大作中提到】
: 协和的医生都像三八这样没逻辑那北京居然还有活人真是奇迹唉。
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