A medical puzzle for 7Aug06

[Guest guest]

How would PCP affect the kidneys?

G

>

> Pneumocystis carinii secondary to HIV infection?

>

> -aro

>

> --- In texasems-l@yahoogrotexasem, wegandy1938@, wegandy1

> >

> > HR = 74, RR = 18, BP = 128/70. Blood glucose is 106. Denies

> night sweats,

> > but has lost about 12 pounds in the last 3 months. No ability to

> do a UA at

> > this time. 12-lead shows sinus rhythm with normal axis.

> >

> > GG

> > In a message dated 8/7/06 11:25:30 PM, txladymedic@ In a messa

> >

> >

> > >

> > > A set of vital signs, a 12 lead ECG if you have access to it. Come

> > > to think of it a blood sugar check and UA if you have access to it

> > > would be a good idea too. night sweats? weight loss/gain? I'm

> > > personally thinking it almost sounds like the beginning signs of

> > > Congestive heart failure but can't rule out TB or damage to lungs

> > > from inhaling stuff he shouldn't have.

> > >

> > >

> > >

> > > --- In texasems-l@yahoogro --- In texasems-l@ya --- In te

> > > >

> > > > You come home from a busy shift, when a neighbor, Mrs. Dincker,

> > > approaches

> > > > you and asks if you have a minute to talk. Though you're bone

> > > tired, she's a

> > > > nice lady and keeps an eye on your house while you and your spouse

> > > are at work,

> > > > so you say sure.

> > > >

> > > > She relates that her 18 year old son, Duane, has a cough that

> > > won't seem to

> > > > go away. It started maybe 4 months ago and has been a dry cough

> > > up until a

> > > > week ago when he started coughing up blood-streaked sputum. He

> > > seems to be

> > > > coughing up more and more blood. She says that he's a heavy

> > > cigarette and

> > > > marijuana smoker, and he also has been caught sniffing gasoline

> > > fumes several times

> > > > lately. Even though he's a slacker and doesn't work, she's

> > > worried that he

> > > > may have TB. He seems to be short of breath a lot, and just sits

> > > around.

> > > >

> > > > She also mentions that he has complained of a burning sensation

> > > when he

> > > > urinates, and she has noticed that his feet look swollen some of

> > > the time. She's

> > > > very worried, but she can't get him to go to the doctor.

> > > >

> > > > She asks if you will talk to him. What do you think might be his

> > > problem,

> > > > and what other things would you ask and do if he will allow you to

> > > interview

> > > > him and do a history and physical on him?

> > > >

> > > > Gene Gandy

> > > >

> > > >

> > > >

> > > >

[Guest guest]

,

Actually, Wikipedia is edited in a way. Anyone can edit an article, and

many items have been edited again and again. The theory behind Wiki is that

the

world will step up to the plate and through unlimited participation, the

truth will emerge. There are people who are Wiki fanatics, and they exist in

every discipline, and they serve as volunteer editors. Post something that's

not correct, and chances are that somebody will edit it.

There's a comprehensive article in the July 31 issue of The New Yorker, by

Schiff, in which the origins of Wikipedia are traced and its current

organization analyzed.

There are a little less than 1,000 formal administrators, all volunteer, They

can regulate who does what and, to some extent, influence the content. They

monitor the " editing " and can sustain an edit or reverse it. Most of these

administrators are what most of us would call " eggheads, " college professor

types, and so forth but they have expertise in the areas they work in.

Yet, it's bureaucracy " doesn't necessarily favor truth. " However,

according to the article, last year Nature published a survey comparing 42

entries on

scientific topics on Wikipedia with their counterparts in Encyclopedia

Britannica, and Wiki had four errors for Britannica's three. Not exactly a

ringing

endorsement of either one.

All publications contain errors. The New England Journal of Medicine, and

the Journal of the American Medical Association have each had embarrassing

errors within memory.

So how can one avoid being snookered in by a flawed article? My technique

is to read multiple sources on the topic I'm researching.

Before I wrote the Goodpasture's puzzler, I read probably a dozen articles on

it, including the Merck Manual, on's Principles of Internal Medicine,

articles from eMedicine Online, and a bunch of stuff from the Kidney Foundation

and others turned up in a Google search.

Nobody ought to take anything he reads at face value. Skepticism is the

foundation of science. All sources, including Wikipedia, are just that:

sources of information, but the information must be verified and vetted.

Toward better learning.

Gene G.

>

> Beware of Wikipedia. It is not edited. For an interesting view of the

> site: http://www.theonionhttp://www.thhttp://www

>

> _____

>

> From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On

> Behalf Of wegandy1938@wegandy

> Sent: Tuesday, August 08, 2006 11:26 PM

> To: texasems-l@yahoogrotexasem; Paramedicine@ParamedicinePar

> Subject: Re: Re: A medical puzzle for 7Aug06

>

> For those who want to know more about autoimmune diseases, of which there

> are

> many, Goodpasture' many, Goodpasture'<wbr>s being just one, Wikipedi

>

> Go to: http://en.wikipedia

> <http://en.wikipediahttp://en.http://en.wikipehttp://en.w>

> .org/wiki/List_ .org/wiki/Lis .org/wi

>

> It has a nice, short description of each of the standard autoimmune

> diseases.

>

> Research is a tool that many EMS personnel don't do well; yet, it can open

> the door to much knowledge. I saw my nephrologist today, and he pulled out

> his

> Blackberry three or four times during my visit to look up things about

> drugs,

> lab values, and so forth, and he's a board certified nephrologist. Nobody

> can remember all there is to remember.

>

> The same information is available to us, and all we have to do is know how

> to

> access it and have the incentive to do it.

>

> Much has been said on these lists about medic education recently. Blame has

> been placed at the feet of the EMS educators, and to a great extent, that's

> where it belongs. But students also have a responsibility to guide their own

>

> learning processes.

>

> The line between being a tradesman and a professional is not crossed until

> one learns and accepts that one's education is one's own responsibility, not

>

> that of someone else. Teachers cannot teach very much. They can assist a

> student to learn, but to state an adage, " you can lead a horse to water, but

> you

> can't make it drink. "

>

> Some students simply do not have the intellectual tools to progress further

> than a certain level, but many more have the tools but have never learned to

>

> learn on their own.

>

> If you're a student, let me say this to you: It is NOT my duty to teach

> you. It is my duty to help you learn in every way that I can think of, but

> learning takes place between your ears, not mine.

>

> If you don't think you're getting a good education, then educate yourself.

> The easiest way to do that these days is to use the Internet. Do a Google

> search for any term or topic and you'll find a wealth of materials.

>

> eMedicine Online is a great source, it's free to students and teachers, and

> all you have to do is register. Yes, it's a site aimed at doctors. So what?

> Doctors are just like us, except that they have taken more courses and,

> yes, learned how to teach themselves. That's the big difference.

>

> How many of you read JEMS and EMS Magazine regularly? If you don't you're

> missing a wealth of information. And those are only trade publications.

> You'll find REAL research articles through the Internet, and if you try, you

> can

> read and understand them.

>

> It's time we became professionals, not techs. But a profession consists of

> the individual professionals who inhabit the discipline. If we are not

> individually professional, then we'll never have an EMS profession.

>

> Gene G.

>

>

[Guest guest]

Awesome Job Wes.....the world needs you to be a paramedic...soon!!!

Jules

Re: Re: A medical puzzle for 7Aug06

> >

> > If it were an autoimmune disease, what are some of the

possibilities?

> >

> > GG

> >

> >

[Guest guest]

Well said Gene G.!

Hi all. I'm new to this site. I've been here about a month. I have enjoyed

reading everyones posts. I love the medical puzzles. Keep them coming.

Jo NREMT-P

wegandy1938@... wrote:

For those who want to know more about autoimmune diseases, of which

there are

many, Goodpasture's being just one, Wikipedia has an excellent list.

Go to: http://en.wikipedia.org/wiki/List_of_autoimmune_diseases

It has a nice, short description of each of the standard autoimmune diseases.

Research is a tool that many EMS personnel don't do well; yet, it can open

the door to much knowledge. I saw my nephrologist today, and he pulled out his

Blackberry three or four times during my visit to look up things about drugs,

lab values, and so forth, and he's a board certified nephrologist. Nobody

can remember all there is to remember.

The same information is available to us, and all we have to do is know how to

access it and have the incentive to do it.

Much has been said on these lists about medic education recently. Blame has

been placed at the feet of the EMS educators, and to a great extent, that's

where it belongs. But students also have a responsibility to guide their own

learning processes.

The line between being a tradesman and a professional is not crossed until

one learns and accepts that one's education is one's own responsibility, not

that of someone else. Teachers cannot teach very much. They can assist a

student to learn, but to state an adage, " you can lead a horse to water, but you

can't make it drink. "

Some students simply do not have the intellectual tools to progress further

than a certain level, but many more have the tools but have never learned to

learn on their own.

If you're a student, let me say this to you: It is NOT my duty to teach

you. It is my duty to help you learn in every way that I can think of, but

learning takes place between your ears, not mine.

If you don't think you're getting a good education, then educate yourself.

The easiest way to do that these days is to use the Internet. Do a Google

search for any term or topic and you'll find a wealth of materials.

eMedicine Online is a great source, it's free to students and teachers, and

all you have to do is register. Yes, it's a site aimed at doctors. So what?

Doctors are just like us, except that they have taken more courses and,

yes, learned how to teach themselves. That's the big difference.

How many of you read JEMS and EMS Magazine regularly? If you don't you're

missing a wealth of information. And those are only trade publications.

You'll find REAL research articles through the Internet, and if you try, you can

read and understand them.

It's time we became professionals, not techs. But a profession consists of

the individual professionals who inhabit the discipline. If we are not

individually professional, then we'll never have an EMS profession.

Gene G.

[Guest guest]

Beware of Wikipedia. It is not edited. For an interesting view of the

site: http://www.theonion.com/content/node/50902

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of wegandy1938@...

Sent: Tuesday, August 08, 2006 11:26 PM

To: texasems-l ; Paramedicine

Subject: Re: Re: A medical puzzle for 7Aug06

For those who want to know more about autoimmune diseases, of which there

are

many, Goodpasture's being just one, Wikipedia has an excellent list.

Go to: http://en.wikipedia

<http://en.wikipedia.org/wiki/List_of_autoimmune_diseases>

..org/wiki/List_of_autoimmune_diseases

It has a nice, short description of each of the standard autoimmune

diseases.

Research is a tool that many EMS personnel don't do well; yet, it can open

the door to much knowledge. I saw my nephrologist today, and he pulled out

his

Blackberry three or four times during my visit to look up things about

drugs,

lab values, and so forth, and he's a board certified nephrologist. Nobody

can remember all there is to remember.

The same information is available to us, and all we have to do is know how

to

access it and have the incentive to do it.

Much has been said on these lists about medic education recently. Blame has

been placed at the feet of the EMS educators, and to a great extent, that's

where it belongs. But students also have a responsibility to guide their own

learning processes.

The line between being a tradesman and a professional is not crossed until

one learns and accepts that one's education is one's own responsibility, not

that of someone else. Teachers cannot teach very much. They can assist a

student to learn, but to state an adage, " you can lead a horse to water, but

you

can't make it drink. "

Some students simply do not have the intellectual tools to progress further

than a certain level, but many more have the tools but have never learned to

learn on their own.

If you're a student, let me say this to you: It is NOT my duty to teach

you. It is my duty to help you learn in every way that I can think of, but

learning takes place between your ears, not mine.

If you don't think you're getting a good education, then educate yourself.

The easiest way to do that these days is to use the Internet. Do a Google

search for any term or topic and you'll find a wealth of materials.

eMedicine Online is a great source, it's free to students and teachers, and

all you have to do is register. Yes, it's a site aimed at doctors. So what?

Doctors are just like us, except that they have taken more courses and,

yes, learned how to teach themselves. That's the big difference.

How many of you read JEMS and EMS Magazine regularly? If you don't you're

missing a wealth of information. And those are only trade publications.

You'll find REAL research articles through the Internet, and if you try, you

can

read and understand them.

It's time we became professionals, not techs. But a profession consists of

the individual professionals who inhabit the discipline. If we are not

individually professional, then we'll never have an EMS profession.

Gene G.

[Guest guest]

OK so now IN THE FIELD what questions or assesments etc could have led us to

this answer. I mean I understand the lab value options that we all know are not

going to be first line options in most ER settings and are probably more a

specialty lab.

I am not saying that we cannot but can we?

Terrell

wegandy1938@... wrote:

,

Actually, Wikipedia is edited in a way. Anyone can edit an article, and

many items have been edited again and again. The theory behind Wiki is that the

world will step up to the plate and through unlimited participation, the

truth will emerge. There are people who are Wiki fanatics, and they exist in

every discipline, and they serve as volunteer editors. Post something that's

not correct, and chances are that somebody will edit it.

There's a comprehensive article in the July 31 issue of The New Yorker, by

Schiff, in which the origins of Wikipedia are traced and its current

organization analyzed.

There are a little less than 1,000 formal administrators, all volunteer, They

can regulate who does what and, to some extent, influence the content. They

monitor the " editing " and can sustain an edit or reverse it. Most of these

administrators are what most of us would call " eggheads, " college professor

types, and so forth but they have expertise in the areas they work in.

Yet, it's bureaucracy " doesn't necessarily favor truth. " However,

according to the article, last year Nature published a survey comparing 42

entries on

scientific topics on Wikipedia with their counterparts in Encyclopedia

Britannica, and Wiki had four errors for Britannica's three. Not exactly a

ringing

endorsement of either one.

All publications contain errors. The New England Journal of Medicine, and

the Journal of the American Medical Association have each had embarrassing

errors within memory.

So how can one avoid being snookered in by a flawed article? My technique

is to read multiple sources on the topic I'm researching.

Before I wrote the Goodpasture's puzzler, I read probably a dozen articles on

it, including the Merck Manual, on's Principles of Internal Medicine,

articles from eMedicine Online, and a bunch of stuff from the Kidney Foundation

and others turned up in a Google search.

Nobody ought to take anything he reads at face value. Skepticism is the

foundation of science. All sources, including Wikipedia, are just that:

sources of information, but the information must be verified and vetted.

Toward better learning.

Gene G.

>

> Beware of Wikipedia. It is not edited. For an interesting view of the

> site: http://www.theonionhttp://www.thhttp://www

>

> _____

>

> From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On

> Behalf Of wegandy1938@wegandy

> Sent: Tuesday, August 08, 2006 11:26 PM

> To: texasems-l@yahoogrotexasem; Paramedicine@ParamedicinePar

> Subject: Re: Re: A medical puzzle for 7Aug06

>

> For those who want to know more about autoimmune diseases, of which there

> are

> many, Goodpasture' many, Goodpasture'<wbr>s being just one, Wikipedi

>

> Go to: http://en.wikipedia

> <http://en.wikipediahttp://en.http://en.wikipehttp://en.w>

> .org/wiki/List_ .org/wiki/Lis .org/wi

>

> It has a nice, short description of each of the standard autoimmune

> diseases.

>

> Research is a tool that many EMS personnel don't do well; yet, it can open

> the door to much knowledge. I saw my nephrologist today, and he pulled out

> his

> Blackberry three or four times during my visit to look up things about

> drugs,

> lab values, and so forth, and he's a board certified nephrologist. Nobody

> can remember all there is to remember.

>

> The same information is available to us, and all we have to do is know how

> to

> access it and have the incentive to do it.

>

> Much has been said on these lists about medic education recently. Blame has

> been placed at the feet of the EMS educators, and to a great extent, that's

> where it belongs. But students also have a responsibility to guide their own

>

> learning processes.

>

> The line between being a tradesman and a professional is not crossed until

> one learns and accepts that one's education is one's own responsibility, not

>

> that of someone else. Teachers cannot teach very much. They can assist a

> student to learn, but to state an adage, " you can lead a horse to water, but

> you

> can't make it drink. "

>

> Some students simply do not have the intellectual tools to progress further

> than a certain level, but many more have the tools but have never learned to

>

> learn on their own.

>

> If you're a student, let me say this to you: It is NOT my duty to teach

> you. It is my duty to help you learn in every way that I can think of, but

> learning takes place between your ears, not mine.

>

> If you don't think you're getting a good education, then educate yourself.

> The easiest way to do that these days is to use the Internet. Do a Google

> search for any term or topic and you'll find a wealth of materials.

>

> eMedicine Online is a great source, it's free to students and teachers, and

> all you have to do is register. Yes, it's a site aimed at doctors. So what?

> Doctors are just like us, except that they have taken more courses and,

> yes, learned how to teach themselves. That's the big difference.

>

> How many of you read JEMS and EMS Magazine regularly? If you don't you're

> missing a wealth of information. And those are only trade publications.

> You'll find REAL research articles through the Internet, and if you try, you

> can

> read and understand them.

>

> It's time we became professionals, not techs. But a profession consists of

> the individual professionals who inhabit the discipline. If we are not

> individually professional, then we'll never have an EMS profession.

>

> Gene G.

>

>

[Guest guest]

Gene, these are excellent comments. I am reminded of the difference

between training and learning. Training teaches you " how " - learning

teaches you not only " how " but " why " . When you know why you are doing

something or why it works that way, you can adapt and extend your

knowledge. Let's not just be trained to recognize a specific set of

conditions.

These medical puzzles are great learning tools. There are never enough

scenarios to work through.

Regards,

Dick

At 11:25 PM 8/8/2006, you wrote:

>For those who want to know more about autoimmune diseases, of which there are

>many, Goodpasture's being just one, Wikipedia has an excellent list.

>

>Go to: http://en.wikipedia.org/wiki/List_of_autoimmune_diseases

>

>It has a nice, short description of each of the standard autoimmune diseases.

>

>

>Research is a tool that many EMS personnel don't do well; yet, it can open

>the door to much knowledge. I saw my nephrologist today, and he

>pulled out his

>Blackberry three or four times during my visit to look up things about drugs,

>lab values, and so forth, and he's a board certified nephrologist. Nobody

>can remember all there is to remember.

>

>The same information is available to us, and all we have to do is know how to

>access it and have the incentive to do it.

>

>Much has been said on these lists about medic education recently. Blame has

>been placed at the feet of the EMS educators, and to a great extent, that's

>where it belongs. But students also have a responsibility to guide their own

>learning processes.

>

>The line between being a tradesman and a professional is not crossed until

>one learns and accepts that one's education is one's own responsibility, not

>that of someone else. Teachers cannot teach very much. They can assist a

>student to learn, but to state an adage, " you can lead a horse to

>water, but you

>can't make it drink. "

>

>Some students simply do not have the intellectual tools to progress further

>than a certain level, but many more have the tools but have never learned to

>learn on their own.

>

>If you're a student, let me say this to you: It is NOT my duty to teach

>you. It is my duty to help you learn in every way that I can think of, but

>learning takes place between your ears, not mine.

>

>If you don't think you're getting a good education, then educate yourself.

>The easiest way to do that these days is to use the Internet. Do a Google

>search for any term or topic and you'll find a wealth of materials.

>

>eMedicine Online is a great source, it's free to students and teachers, and

>all you have to do is register. Yes, it's a site aimed at doctors. So what?

>Doctors are just like us, except that they have taken more courses and,

>yes, learned how to teach themselves. That's the big difference.

>

>How many of you read JEMS and EMS Magazine regularly? If you don't you're

>missing a wealth of information. And those are only trade publications.

>You'll find REAL research articles through the Internet, and if you

>try, you can

>read and understand them.

>

>It's time we became professionals, not techs. But a profession consists of

>the individual professionals who inhabit the discipline. If we are not

>individually professional, then we'll never have an EMS profession.

>

>Gene G.

[Guest guest]

Jo,

In my opinion, you might also want to check two other Yahoo Groups which have a

lot of scenarios as well.

One is Paramedicine http://groups.yahoo.com/group/Paramedicine

The other is called the EKG Club http://groups.yahoo.com/group/EKG_club

-Wes Ogilvie

Re: Re: A medical puzzle for 7Aug06

Well said Gene G.!

Hi all. I'm new to this site. I've been here about a month. I have enjoyed

reading everyones posts. I love the medical puzzles. Keep them coming.

Jo NREMT-P

wegandy1938@... wrote:

For those who want to know more about autoimmune diseases, of which there are

many, Goodpasture's being just one, Wikipedia has an excellent list.

Go to: http://en.wikipedia.org/wiki/List_of_autoimmune_diseases

It has a nice, short description of each of the standard autoimmune diseases.

Research is a tool that many EMS personnel don't do well; yet, it can open

the door to much knowledge. I saw my nephrologist today, and he pulled out his

Blackberry three or four times during my visit to look up things about drugs,

lab values, and so forth, and he's a board certified nephrologist. Nobody

can remember all there is to remember.

The same information is available to us, and all we have to do is know how to

access it and have the incentive to do it.

Much has been said on these lists about medic education recently. Blame has

been placed at the feet of the EMS educators, and to a great extent, that's

where it belongs. But students also have a responsibility to guide their own

learning processes.

The line between being a tradesman and a professional is not crossed until

one learns and accepts that one's education is one's own responsibility, not

that of someone else. Teachers cannot teach very much. They can assist a

student to learn, but to state an adage, " you can lead a horse to water, but you

can't make it drink. "

Some students simply do not have the intellectual tools to progress further

than a certain level, but many more have the tools but have never learned to

learn on their own.

If you're a student, let me say this to you: It is NOT my duty to teach

you. It is my duty to help you learn in every way that I can think of, but

learning takes place between your ears, not mine.

If you don't think you're getting a good education, then educate yourself.

The easiest way to do that these days is to use the Internet. Do a Google

search for any term or topic and you'll find a wealth of materials.

eMedicine Online is a great source, it's free to students and teachers, and

all you have to do is register. Yes, it's a site aimed at doctors. So what?

Doctors are just like us, except that they have taken more courses and,

yes, learned how to teach themselves. That's the big difference.

How many of you read JEMS and EMS Magazine regularly? If you don't you're

missing a wealth of information. And those are only trade publications.

You'll find REAL research articles through the Internet, and if you try, you can

read and understand them.

It's time we became professionals, not techs. But a profession consists of

the individual professionals who inhabit the discipline. If we are not

individually professional, then we'll never have an EMS profession.

Gene G.

[Guest guest]

Terrell,

The most important tool in the field for discovering this situation is your

history and physical. The history of gradually increasing pulmonary problems,

over several months, leading to the present hemoptysis, suggests a

progressive disease. The other clue was the problem urinating, and eventually

the

discovery of possible blood in the urine. The patient's age is also a

contributing clue.

It is not intended that a paramedic or even a physician would be able to

diagnose this problem in the field. The purpose of scenarios like this is to

hone your history and physical taking skills, and to broaden your understanding

of disease processes in general.

Further, I want to encourage people to learn to research problems and find

the answers to puzzles. Medics are notoriously poor at using the vast

information resources that are readily available.

The reason Wes was able to find the answer so quickly is that lawyers become

experts at research.

One can always say, " why do I need to know this to be a paramedic? I can't

diagnose this case and there's not much I could do to treat it in the field

except to do the basics. " That's true, but knowing about medicine in general

makes us better able to anticipate things that might go wrong, to differentiate

inconsequential conditions from serious ones, and to hone our critical

thinking skills. I subscribe to the principle that the more I know, the better

I'll be at everything I do.

I don't know whether or not this answers your question. You may have other

thoughts.

Gene

>

> OK so now IN THE FIELD what questions or assesments etc could have led us to

> this answer. I mean I understand the lab value options that we all know are

> not going to be first line options in most ER settings and are probably more

> a specialty lab.

> I am not saying that we cannot but can we?

>

> Terrell

>

> wegandy1938@wegandy wrote:

> ,

>

> Actually, Wikipedia is edited in a way. Anyone can edit an article, and

> many items have been edited again and again. The theory behind Wiki is that

> the

> world will step up to the plate and through unlimited participation, the

> truth will emerge. There are people who are Wiki fanatics, and they exist in

> every discipline, and they serve as volunteer editors. Post something that's

> not correct, and chances are that somebody will edit it.

>

> There's a comprehensive article in the July 31 issue of The New Yorker, by

> Schiff, in which the origins of Wikipedia are traced and its current

> organization analyzed.

>

> There are a little less than 1,000 formal administrators, all volunteer,

> They

> can regulate who does what and, to some extent, influence the content. They

> monitor the " editing " and can sustain an edit or reverse it. Most of these

> administrators are what most of us would call " eggheads, " college professor

> types, and so forth but they have expertise in the areas they work in.

>

> Yet, it's bureaucracy " doesn't necessarily favor truth. " However,

> according to the article, last year Nature published a survey comparing 42

> entries on

> scientific topics on Wikipedia with their counterparts in Encyclopedia

> Britannica, and Wiki had four errors for Britannica's three. Not exactly a

> ringing

> endorsement of either one.

>

> All publications contain errors. The New England Journal of Medicine, and

> the Journal of the American Medical Association have each had embarrassing

> errors within memory.

>

> So how can one avoid being snookered in by a flawed article? My technique

> is to read multiple sources on the topic I'm researching.

>

> Before I wrote the Goodpasture' Before I wrote the Goodpasture'<wbr>s

> puzzler,

> it, including the Merck Manual, on's Principles of Internal Medicine,

> articles from eMedicine Online, and a bunch of stuff from the Kidney

> Foundation

> and others turned up in a Google search.

>

> Nobody ought to take anything he reads at face value. Skepticism is the

> foundation of science. All sources, including Wikipedia, are just that:

> sources of information, but the information must be verified and vetted.

>

> Toward better learning.

>

> Gene G.

>

>

>

> >

> > Beware of Wikipedia. It is not edited. For an interesting view of the

> > site: http://www.theonionhttp://www.http://wwhtt

> >

> > _____

> >

> > From: texasems-l@yahoogro From: texasems-l@yahoogr From: texasems- From

> > Behalf Of wegandy1938@ Behalf

> > Sent: Tuesday, August 08, 2006 11:26 PM

> > To: texasems-l@yahoogro To: texasems-l@yahoog To: texasems-l

> > Subject: Re: Re: A medical puzzle for 7Aug06

> >

> > For those who want to know more about autoimmune diseases, of which there

> > are

> > many, Goodpasture' many, Goodpasture'<wbr>s being just one, Wikipedi

> >

> > Go to: http://en.wikipedia

> > <http://en.wikipediahttp://en.http://en.http://en.whttp:/>

> > .org/wiki/List_ .org/wiki/Lis .org/wi

> >

> > It has a nice, short description of each of the standard autoimmune

> > diseases.

> >

> > Research is a tool that many EMS personnel don't do well; yet, it can open

> > the door to much knowledge. I saw my nephrologist today, and he pulled out

> > his

> > Blackberry three or four times during my visit to look up things about

> > drugs,

> > lab values, and so forth, and he's a board certified nephrologist. Nobody

> > can remember all there is to remember.

> >

> > The same information is available to us, and all we have to do is know how

> > to

> > access it and have the incentive to do it.

> >

> > Much has been said on these lists about medic education recently. Blame

> has

> > been placed at the feet of the EMS educators, and to a great extent,

> that's

> > where it belongs. But students also have a responsibility to guide their

> own

> >

> > learning processes.

> >

> > The line between being a tradesman and a professional is not crossed until

> > one learns and accepts that one's education is one's own responsibility,

> not

> >

> > that of someone else. Teachers cannot teach very much. They can assist a

> > student to learn, but to state an adage, " you can lead a horse to water,

> but

> > you

> > can't make it drink. "

> >

> > Some students simply do not have the intellectual tools to progress

> further

> > than a certain level, but many more have the tools but have never learned

> to

> >

> > learn on their own.

> >

> > If you're a student, let me say this to you: It is NOT my duty to teach

> > you. It is my duty to help you learn in every way that I can think of, but

> > learning takes place between your ears, not mine.

> >

> > If you don't think you're getting a good education, then educate yourself.

> > The easiest way to do that these days is to use the Internet. Do a Google

> > search for any term or topic and you'll find a wealth of materials.

> >

> > eMedicine Online is a great source, it's free to students and teachers,

> and

> > all you have to do is register. Yes, it's a site aimed at doctors. So

> what?

> > Doctors are just like us, except that they have taken more courses and,

> > yes, learned how to teach themselves. That's the big difference.

> >

> > How many of you read JEMS and EMS Magazine regularly? If you don't you're

> > missing a wealth of information. And those are only trade publications.

> > You'll find REAL research articles through the Internet, and if you try,

> you

> > can

> > read and understand them.

> >

> > It's time we became professionals, not techs. But a profession consists of

> > the individual professionals who inhabit the discipline. If we are not

> > individually professional, then we'll never have an EMS profession.

> >

> > Gene G.

> >

> >