Adonis Diaries

Archive for July 30th, 2012

I am still in a blank: What happened in the bus at airport of Burgas (Bulgaria)?

On July 18, a”terrorist” blew himself in a busload of Israelis and US citizen “tourists” from the seashore airport of Burgas (on the Black Sea) to where?

Information seeping through were scarce and it stopped completely on its track: The story had to be covered up, and we have the right to be suspicious of the real story…

Meanwhile, and for a couple of days, Israel blamed Iran and Hezbollah and rogue States for the suicide attack and moved its army to the borders with Gaza, Lebanon and Syria…

Israel military officially welcomed the dead 5 Israeli “tourists” at Tel Aviv airport. Are they tourists or a covert team on a mission planned and organized in cooperation with the US? Has this team finished its mission and was planning of enjoying quality time in Varna? Has the covert mission been “uncovered” and the team was to be disposed of…? Particularly that it “coincided” with the assassination of 5 of the highest Syrian ranking officers…

Apparently, the 36 year-old blond “terrorist” man spent 4 days in Bulgaria, and resided for 48 hours in the resort of Varna in company with a girl. He entered Bulgaria from Roumania? And from where did the Israeli and US tourists come? I bet from Roumania too…

A second parter activated the 3 kg of Trolite that the man carried in his backpack…

How this tourist entered Bulgaria? Why insisting on a faked driving license from Michigan State? Had he entered without a passport? Was whisked in…?

I am still in a blank: after a week of the incident, intelligence pieces are scarce and not that informative.

Was the covert plot “uncovered” and the team was to be sacrificed by the undercover blond guy?

Turkey should be on high alert as Syria is disintegrating: Israel secret agents are flooding Bulgaria, Roumania and every other State around the Black Sea. Turkey has to keep a low profile on Syria and tend for more serious dangers coming its way, and not from the Syrian regime…

I am still in a blank. Do you have any clear pieces of intelligence?

Is it the less information the better in critical split-second decision cases?

ER of Cook County Hospital (Chicago)

ER of Cook County Hospital (Chicago) on West Harriston Street, close to downtown, was built at the turn of last century. I was home of the world’s first blood bank, cobalt-beam therapy, surgeons attaching severed fingers, famous trauma center for gangs’ gunshot wounds and injuries…and most famous for the TV series ER, and George Cluny

In the mid 90’s. the ER welcomed 250,000 patients a year, mostly homeless and health non-insured patients… Smart patients would come the first thing in the morning to the ER and pack a lunch and a dinner.  Long lines crowded the walls of the cavernous corridors…

There were no air-conditioners: During the summer heat waves, the heat index inside the hospital reached 120 degrees. An administrator didn’t last 8 seconds in the middle of one of the wards.

There were no private rooms and patients were separated by plywood dividers.

There were no cafeteria or private phones: The single public phone was at the end of the hall.

One bathroom served all that crowd of patients.

There was a single light switch: You wanted to light a room and the entire hospital had to light up…

The big air fans, the radios and TV that patients brought with them (to keep company), the nurses’ bell buzzing non-stop and no free nurses around… rendered the ER a crazy place to treat emergency cases

Asthma cases were numerous: Chicago was the world worst in patients suffering from asthma…

Protocols had to be created to efficiently treat asthma cases, chest pain cases, homeless patients…

About 30 patients a day converged to the ER complaining of chest pains (potential heart attack worries) and there were only 20 beds in two wards for these cases.

It cost $2,000 a night per bed for serious intensive care, and about $1,000 for the lesser care (nurses instead of cardiologists tending to the chest pain patient…)

A third ward was created as observation unit for half a day patients.  Was there any rational protocol to decide in which ward the chest-pain patient should be allocated to? It was the attending physician call, and most of the decisions were wrong, except for the most obvious heart attack cases…

In the 70’s, cardiologist Lee Goldman borrowed the statistical rules of a group of mathematicians for telling apart subatomic particles. Goldman fed a computer data of hundreds of files of heart attack cases and crunched the numbers into a “predictive equation” or model.

Four key risk factors emerged as the most critical telltale of a real heart attack case:

1. ECG (the ancient electrocardiogram graph) showing acute ischemia

2. unstable angina pain

3, fluid in the lungs

4. systolic blood pressure under 100…

A decision tree was fine-tuned to decide on serious cases. For example:

1. ECG is normal but at least two key risk factors are positive

2. ECG is abnormal with at leat one risk factor positive…These kinds of decision trees…

The trouble was that physicians insisted on letting discriminating factors muddle their decisions. For example, statistics had shown that “normally” females do not suffer heart attack until old age, and thus a young female might be sent home (and die the same night) more often than middle-aged black or older white males patients…

Brendan Reilly, chairman of the hospital department of Medicine, decided to try Goldman decision tree.  Physicians were to try the tree and their own instincts for a period.  The results were overwhelmingly in favor of the Goldman algorithm…

It turned out that, if the physician was not bombarded with dozens of pieces of intelligence and just followed the decision tree, he was better off in the allocation to ward process…

For example, a nurse should record all the necessary information of the patients (smoker, age, gender, overweight, job stress, physical activities, high blood pressure, blood sugar content, family history for heart attacks, sweating tendencies, prior heart surgeries,…), but the attending physician must receive quickly the results of the 4 key risk factors to decide on…

Basically, the physician could allocate the patient to the proper ward without even seeing the individual and be influenced by extraneous pieces of intelligence that are not serious today, but could be potential hazards later on or even tomorrow…

Mind you that in order to save on medical malpractice suits, physicians and nurses treating a patient must Not send the patient any signals that can be captured as “contempt”, feeling invisible and insignificant  https://adonis49.wordpress.com/2012/07/26/what-type-of-hated-surgeons-gets-harassed-with-legal-malpractice-suits/

Many factors are potential predictors for heart attack cases, but they are minor today, for quick decisions…

No need to overwhelm with irrelevant information at critical time.  Analytic reasoning and snap judgment are neither good or bad: Either method is bad at the inappropriate circumstances.

In the “battle field” the less the information coming in, the less the communication streams and the better the rapid cognition decisions of field commanders…

All you need to know is the “forecast” and not the numbers of temperature, wind speed, barometric pressure…

Note: post inspired from a chapter in “Blink” by Malcolm Gladwell


adonis49

adonis49

adonis49

Blog Stats

  • 1,377,066 hits

Enter your email address to subscribe to this blog and receive notifications of new posts by email.adonisbouh@gmail.com

Join 721 other followers

%d bloggers like this: