Arizona Shooting/TBI/The Media

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Llenroc

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After the Arizona shooting happened, I had a few discussions with people that I know about TBI. They were amazed at how someone could survive a shot to the head, and I explained that lesions to the brain stem or upper spinal cord cause immediate death. Other lesions cause swelling which usually results in death, but can be saved if the person is brought to a hospital quickly enough. I also talked a little bit about what typical deficits might be with injuries to different parts of the head.

All this given the fact that I have no particular interest in TBI and haven't even rotated on a TBI service yet.

Anyway, folks found this to be extremely fascinating. In fact, I can't recall the last time I talked about any topic at some length which different folks found so interesting.

I'm surprised though that there haven't been more PM&R doctors on TV to talk to the public about head injuries. I've seen a bunch of neurosurgeons on TV. Everything that they've stated though has been extremely vague. Definitely none of the details that I just went into above. More like typical cliches: "It's going to be a long road ahead... From ICU they go to the Step down unit... Moving hand = good..." Or they go into critical care stuff about ventilators and sedating drugs which says little about long term prognosis, and which most folks probably don't care about.

Anyway, I'm not saying that PM&R doctors should be opportunistic about this tragedy, but now seems like a really good opportunity to get on TV, educate the public, and perhaps bring some attention to rehabilitation hospitals and the PM&R field in the process. Even most podunk towns in America have their own local news shows where they have some doctors segments bringing on local physicians to talk about health issues.
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I believe Dr. Steven R Flanagan (NYU Chair) may be speaking on Good Morning America about this.

Llenroc said:
After the Arizona shooting happened, I had a few discussions with people that I know about TBI. They were amazed at how someone could survive a shot to the head, and I explained that lesions to the brain stem or upper spinal cord cause immediate death. Other lesions cause swelling which usually results in death, but can be saved if the person is brought to a hospital quickly enough. I also talked a little bit about what typical deficits might be with injuries to different parts of the head.

All this given the fact that I have no particular interest in TBI and haven't even rotated on a TBI service yet.

Anyway, folks found this to be extremely fascinating. In fact, I can't recall the last time I talked about any topic at some length which different folks found so interesting.

I'm surprised though that there haven't been more PM&R doctors on TV to talk to the public about head injuries. I've seen a bunch of neurosurgeons on TV. Everything that they've stated though has been extremely vague. Definitely none of the details that I just went into above. More like typical cliches: "It's going to be a long road ahead... From ICU they go to the Step down unit... Moving hand = good..." Or they go into critical care stuff about ventilators and sedating drugs which says little about long term prognosis, and which most folks probably don't care about.

Anyway, I'm not saying that PM&R doctors should be opportunistic about this tragedy, but now seems like a really good opportunity to get on TV, educate the public, and perhaps bring some attention to rehabilitation hospitals and the PM&R field in the process. Even most podunk towns in America have their own local news shows where they have some doctors segments bringing on local physicians to talk about health issues.
Click to expand...
 
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Llenroc said:
More like typical cliches: "It's going to be a long road ahead... From ICU they go to the Step down unit... Moving hand = good..."
Click to expand...

Ever been on neurosurgery rounds when they see patients at 5am? "Hey Mr. ___, wiggle your toes! Show me two fingers! Good, see you later."
 
People are enthralled by neurosurgeons. 500 Physiatrists could all tell a patient the same thing, but if one neurosurgeon tells them something different, they'll do whatever he says.

99.9% of people have no clue about CNS injuries, recovery or rehab. They only know phrases like "His doctors all said he'd never walk again. But he proved them wrong." The press likes to feed on this and do a 5-minute piece on the Senator moving her hand. If a senator had not been shot in this rampage, it would have gone off the news radar within 2 days.
 
As much as I agree w/ Llenroc about not seeming opportunistic, events involving a prominent celebrity can be quite helpful in bringing attention to a cause, at least temporarily. If Giffords progresses well in rehab, this should bring increased public notoriety to our field, at least the subspecialty of TBI. Maybe, because a politician is involved, it will also result increased recognition within Congress. Perhaps increased sympathy towards things like health policy change?

Any telegenic TBI docs out there willing to be the face of PM&R?
 
Good morning America had a segment about her trip to rehab at Baylor today..... And with picture if TIRR in the background they interviewed none other than a Baylor trauma surgeon and asked him to discuss the rehab process and her potentiall recovery....
 
PMR 4 MSK said:
People are enthralled by neurosurgeons. 500 Physiatrists could all tell a patient the same thing, but if one neurosurgeon tells them something different, they'll do whatever he says.

99.9% of people have no clue about CNS injuries, recovery or rehab. They only know phrases like "His doctors all said he'd never walk again. But he proved them wrong." The press likes to feed on this and do a 5-minute piece on the Senator moving her hand. If a senator had not been shot in this rampage, it would have gone off the news radar within 2 days.
Click to expand...


i was involved in the care of a different political figure when i was in residency. lets just say that the media reports of how he was doing and how he was actually doing were not exactly congruent.

the politician was still voting in important legistation, but i couldnt get him to remember the date or where he was. nice.

also, giffords was a rep, not a senator. there'd be even a bigger hubbub
 
But was too nervous to bring up the topic...lest I be lambasted as an opportunist.

But seriously...what Taus said is right and continues to happen in the media.

Perhaps, instead of focusing on national level news coverage, local university PM&R departments TBI attendings could give a little insight on the spectrum of TBI(from mild to severe) and the recovery process.

It's been my experience, unless severe, TBIs are often overlooked. The more people that are aware, the more will actually seek help and primary care doctors, specialists, and other extenders can make the appropriate referrals.
 
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"When Giffords arrived in Houston, Dr. Gerard Francisco, who will lead the rehab team, couldn't have been more upbeat.

"She has great rehabilitation potential," Francisco says. "She will keep us busy, and we will keep her busy as well.""

I met Dr. Francisco on my interview trail a while back and I am CERTAIN he had much more to say than these two blurbs. At least someone finally interviewed a physiatrist.
 
Here in Texas Dr. Francisco has been on the news for the past few days. This morning, he gave an update on her motor skills. They also interviewed my friend Oscar Sanchez, who is an attending at Baylor. Am waiting for Dr. Kothari to be interviewed about prognostic indicators. :D I have to say they are all very photogenic and articulate - better than some of the other docs on TV.

I like that they say that a "team of physicians" is helping with the rehabilitation. They have gone as far as saying "rehabilitation physician". She's still in the ICU so the neurosurgeons are talking more right now. They also interviewed TBI patients. I'm just waiting for the word "physiatrist". Who wants to start betting on how it will be reported:

1. psychiatrist
2. podiatrist
3. they'll actually get it right - physiatrist
4. none of the above - they will cut it before it makes it on air
 
5. physical therapist
6. Hydroxycut commercial

:)
 
Anyone else find it funny that most insurances will not let you send a patient home overnight for a "test run", or even for a Sunday afternoon out with family, but the Senator got to leave rehab to travel to FL twice for a few days simply to see her husband strapped in to the world's largest liquid bomb?

Oh, that's right, her health care plan pays for anything and everything, with little/no out-of-pocket expenses, and no oversight. Unlike most of her constituents. Or anyone else outside of government.

If someone put a bullet in my head, would TIRR be falling over itself to get me down there?

(grumble, grumble, grumble...)
 
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