1. Thread:Mass hysteria over “mass hysterectomies” in “ICE” detention facilities. Twitter is ablaze and “mass hysterectomies” is of course,trending. Let’s look at the complaint. “Several advocacy groups” filed a whistleblower complaint on behalf of a nurse regarding (cont.)
2. “exorbitant rate[s] of hysterectomies”performed at an “ICE” facility. The article is extremely vague (how many complainants) blames ICE for physician interventions/procedures(whether appropriate or not) and claims the nurse is a “whistleblower”.Of course the article is (cont.)
3. peppered with horrifying statements accusing the doctor of being an “organ collector”and improper anesthesia delivery. In order to determine what “mass hysterectomies”means,we need to know how many patients underwent the procedure, a big unknown and a huge red flag (cont)
4. A hysterectomy is not the type of procedure that can be performed in a detention facility. It requires a medical facility equipped with a surgical suite,surgeons,assistants and an anesthesiologist.The unknown physician must be a board certified OB-GYN with hospital (cont)
5. privileges or operating a well equipped private medical clinic.
Assuming he does nothing but hysterectomies for ICE and his formaldehyde uterine collection he’d have to have every single person working with him on board, as it would raise red flags left and right from (cont.)
6. admin staff (clinic or hospital based) to nurses,assistants,anesthesiologist,etc. “Hey, how come this guy does nothing but hysterectomies on detainees, all day long?”
The claim is bogus.
Can a physician perform unnecessary surgical procedures? Yes. However, (cont.)
7. somebody pays for the procedure and unless there is a millionaire backing up the whole project, somebody will ask billing questions. Exactly. Back to “how come you bill us for all these hysterectomies on detainees...”the procedure alone costs thousands of dollars. (cont.)
8. Yes, a doctor can occasionally perform unnecessary,ill-advised, criminal procedures. When there is a pattern (multiple similar procedures, same type of patient,same billing) the state, the hospital,the board,the party responsible for payment will look into the matter. (cont.)
9. The claim is bogus.Medical responsibility-detention facilities are responsible for delivering appropriate medical care(that does not happen all the time),however,medical decisions are made by physicians independently,the only concerns a facility can raise are regarding (cont.)
10. the safety,security and the good order of the institution related to the treatment in question-can the inmate be safely transported and supervised at X location,when, what restraints can be used and if they interfere with the procedure (removing handcuffs for IV access(cont.)
11. removing restraints after anesthesia induction, etc.). ICE, GEO,any other agency for that matter cannot prevent a physician from delivering treatment (or force a physician to perform a medical procedure) provided there is informed consent from the patient. (cont.)
12. Whistleblowers are generally anonymous, that’s why there are reporting procedures in place. Did the nurse complain to the medical dept. supervisor,management of the facility, ERO field office, state health authorities, ABOG? Unknown. Why would advocacy groups file a (cont.)
13. complaint with OIG “on behalf” of the nurse? The nurse had the option of doing so independently of these groups, the groups could have filed their own complaints, inmates too, since they have medical grievance procedures and access to phones (in most cases for free). (cont.)
14. Medical professionals are expected and obligated to report abuse and negligence be it through malfeasance or nonfeasance. Nobody would bat an eye and retaliation would result in opening a big can of worms and a lot of heads rolling. All big unknowns, again red flags. (cont.)
15. The claim of “mass hysterectomies”, whatever that means, is bogus. It is inflammatory and unnecessary. One can only think of a mountain of bloody female organs and a mad doctor in a bloody lab coat akin to pre-Joseph Lister surgeons. What is the truth? I don’t know, (cont.)
16. I don’t know,I can safely assume nothing nearly as bad as what it is claimed to be.Of course,if you’re a liberal,Trump is Hitler and ICE facilities are concentration camps.Or maybe we should wait for an investigation and a report before making outlandish claims of mass abuse.

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More from @IGalalien

27 Aug
Thread 1. Recently there’s been some controversy regarding Puerto Ricans and whether they are immigrants or not. The debate misses a few important points: being an American, an American National or an American Citizen are 3 different things and very few people understand (cont.)
2. ...the differences (some legal, some societal). The Constitution doesn’t always follow the flag- Citizenship is a contract between the state and the individual, where the individual is subject to full US jurisdiction and entitled to live,work and vote in the US. (cont.)
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Read 12 tweets
2 Jun
1. Most people won’t give a damn because this is gonna be long and boring but here we go:
-So far,we have 2 different medical examiners/pathologists and 2 strikingly different opinions regarding Floyd’s cause of death. Hennepin County-no traumatic asphyxia,cardiovascular disease
2. and possibly a toxicology report pointing at drugs (legal or illegal) as well as physical interaction with the police during arrest.
Dr. Baden’s opinion-traumatic asphyxia, cerebral hypoxia/anoxia (compression of R carotid artery) airway patency and chest excursions/diaphragm
3. Functional limitations due to restraint methods,body position (prone) and officer interventions (knee pressure on neck, pressure on back, head position) and handcuffs.
Pathology is a science. It is not a Tarrot reading session. Question is: who’s right, who’s wrong?
Read 8 tweets

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