Newman. And now this...

[Hamhock]

https://www.nytimes.com/2017/04/13/...cutting.html&eventName=Watching-article-click

It frightens me that I suspect this is much more likely to be true than I suspected the accusations against David Newman were true when I first heard them.

HH

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[deleted109597]

There's a lot of terrible doctors out there. Some give opioid Rx for sex. Some perform procedures they shouldn't.
People are terrible, and doctors are a subset of people. The rates are likely similar.

 

[Emapp20177]

Hope she gets life. How horrifying. I'm glad the new justice department is (apparently) proactive.

Also, Henry Ford already took down her profile from their website, they're really on it lol.

 

[Hamhock]

There's a lot of terrible doctors out there. Some give opioid Rx for sex. Some perform procedures they shouldn't.
People are terrible, and doctors are a subset of people. The rates are likely similar.

That's the thing: Newman didn't "give opioid Rx for sex" and Nagarwala didn't "perform procedures" she "shouldn't". If so, then it would make sense to try to create an analogy of proportion.

I know Ninja didn't say the highlighted crimes are analogous, but Ninja's post lends one to think in those terms.

Regardless of this, what is more concerning to me is that this forum and the online EM world in general went nuts over Newman's crimes, but this barely registers. Clearly Newman is a huge name and -- AFAIK -- contributed far more to medicine than Nagarwala even dreamed of...but where is the outrage?

I maintain Nagarwala's crimes FAR exceed those of Newman in terms of harm to the innocent and to the wisp of trust left between the community and physicians...or at least they should.

And although opioid abuse, sexual abuse, and crime in general may be performed by physicians in a similar proportion to the general public, the crimes of Newman and Nagarwala are not similar and may not even be possible crimes for the "untrained" person. These are different crimes that should be treated differently. And it's particularly concerning both offenders were "faculty" members.

Working my mind around this,
HH

 

[The White Coat Investor]

Oh she's an emergency doc? I didn't realize that. How embarrassing.

 

[doggydog]

Oh she's an emergency doc? I didn't realize that. How embarrassing.

She is/was an APD at Henry Ford.

 

[RustedFox]

Livonia, Michigan.

Ever been there? I have. Its an enclave of Islamic extremism.

No desire to go back.

 

[Doctor_Strange]

Livonia, Michigan.

Ever been there? I have. Its an enclave of Islamic extremism.

No desire to go back.

Just curious, how so?

 

[RustedFox]

Just curious, how so?

How so what ?

 

[GeneralVeers]

Just curious, how so?

"I think he's saying that islamist extremism is bad" - Captain Obvious

 

[Doctor_Strange]

How so what ?

Sorry, I meant can you expand on what Islamic terrorism there was or is? Was someone arrested or something...?

Sent from my SAMSUNG-SM-N900A using SDN mobile

 

[SpaceLeftBlank]

Livonia, Michigan.

Ever been there? I have. Its an enclave of Islamic extremism.

No desire to go back.

Detroit-area (including the city next door to Livonia) native here, and this made me chuckle. Livonia is actually a fairly "non-diverse" place (until relatively recently there was literally a Wonder Bread outlet store there, to give you an idea). Compared to other areas of Metro Detroit, Livonia's Middle-Eastern/Islamic population barely registers. Most of the Middle-Eastern-native people in Livonia are actually Christian. The Islamic population tends to be in Dearborn, Detroit, or Hamtramck, and is decidedly not extremist.

There are reasons not to want to rush back to Livonia (most of them related to how dull it is) but "hotbed of Islamic extremists" is pretty laughably far down the list.


Sent from my iPhone using SDN mobile

 

[throckmortonDO]

There's a lot of terrible doctors out there. Some give opioid Rx for sex. Some perform procedures they shouldn't.
People are terrible, and doctors are a subset of people. The rates are likely similar.

This.

examine history. humans are capable of terrible things. an MD/DO degree does not necessarily preclude one from such behaviors

 

[RustedFox]

Detroit-area (including the city next door to Livonia) native here, and this made me chuckle. Livonia is actually a fairly "non-diverse" place (until relatively recently there was literally a Wonder Bread outlet store there, to give you an idea). Compared to other areas of Metro Detroit, Livonia's Middle-Eastern/Islamic population barely registers. Most of the Middle-Eastern-native people in Livonia are actually Christian. The Islamic population tends to be in Dearborn, Detroit, or Hamtramck, and is decidedly not extremist.

There are reasons not to want to rush back to Livonia (most of them related to how dull it is) but "hotbed of Islamic extremists" is pretty laughably far down the list.

You're right; I am probably confusing the two. Pretty easy to do, though - because they're 12 miles apart and the whole thing felt like an Indiana Jones movie where I was walking through an Arabic market with plenty of people doing shady things and "closing up shop" when a whiteboy was within eyesight or earshot. Quick, Ahmed... hide the several tons of fertilizer and blasting caps before the infidel sees...

Am I painting with broad brushstrokes? Yep. Do I really care? Nope. Am I surprised that this atrocity happened where it happened, because of who and what was involved? Nope.

 

[GeneralVeers]

You're right; I am probably confusing the two. Pretty easy to do, though - because they're 12 miles apart and the whole thing felt like an Indiana Jones movie where I was walking through an Arabic market with plenty of people doing shady things and "closing up shop" when a whiteboy was within eyesight or earshot. Quick, Ahmed... hide the several tons of fertilizer and blasting caps before the infidel sees...

Am I painting with broad brushstrokes? Yep. Do I really care? Nope. Am I surprised that this atrocity happened where it happened, because of who and what was involved? Nope.

That is racist. Your cis-gendered oppression is creating micro-aggressions!

 

[deleted109597]

C'mon guys. We can have this discussion without it devolving into this.

 

[FistLength]

That is racist. Your cis-gendered oppression is creating micro-aggressions!

more like his extreme exaggeration was laughable and he got called out for it. Follow up with "tough guy don't care" persona lol.

 

[WilcoWorld]

This is a professional forum, let's make it look like one.

 

[Doctor_Strange]

You're right; I am probably confusing the two. Pretty easy to do, though - because they're 12 miles apart and the whole thing felt like an Indiana Jones movie where I was walking through an Arabic market with plenty of people doing shady things and "closing up shop" when a whiteboy was within eyesight or earshot. Quick, Ahmed... hide the several tons of fertilizer and blasting caps before the infidel sees...

Am I painting with broad brushstrokes? Yep. Do I really care? Nope. Am I surprised that this atrocity happened where it happened, because of who and what was involved? Nope.

Are you secretly Alex Jones?

 

[RustedFox]

more like his extreme exaggeration was laughable and he got called out for it. Follow up with "tough guy don't care" persona lol.

K.

I'm actually being sincere. Take a look at the map. It was over five years ago, so I probably confused or conflated the two. Nevermind that. Call me all the names you want; the news story speaks for itself.

 

[Amazingmuzmo]

You're right; I am probably confusing the two. Pretty easy to do, though - because they're 12 miles apart and the whole thing felt like an Indiana Jones movie where I was walking through an Arabic market with plenty of people doing shady things and "closing up shop" when a whiteboy was within eyesight or earshot. Quick, Ahmed... hide the several tons of fertilizer and blasting caps before the infidel sees...

Am I painting with broad brushstrokes? Yep. Do I really care? Nope. Am I surprised that this atrocity happened where it happened, because of who and what was involved? Nope.

The news story states that an individual has been prosecuted for crimes which they committed of their own volition. To assume that they did this because of their beliefs, whether religious or otherwise, is making an assumption which is both presumptuous and perhaps showing of your own inner prejudices. To say that she did this because she's a religious extremist would be akin to saying Newman committed his crime due to Christian extremism.....that is to say you are literally pulling it out of your ass.

 

[RustedFox]

The news story states that an individual has been prosecuted for crimes which they committed of their own volition. To assume that they did this because of their beliefs, whether religious or otherwise, is making an assumption which is both presumptuous and perhaps showing of your own inner prejudices. To say that she did this because she's a religious extremist would be akin to saying Newman committed his crime due to Christian extremism.....that is to say you are literally pulling it out of your ass.

K.

You know why good jokes are funny? Because there's a small but pertinent element of truth to each one.

Google the phrase "Judgmental maps". You'll find a joke site with maps of various US cities, with each section/neighborhood renamed to illustrate something otherwise particular about each section. My home city is on there, too. To be honest, the jokes are generally spot-on about the relevant neighborhoods.

Take a look at the map of Detroit, and you'll see the sections near Livonia/Dearborn labeled "ISIS", "Sadr City", and "Hezbollah".

Oh, and to address your statement of "to assume that they did this because of their beliefs... etc", I simply want to say: "Uh, dude: The (often ritual) act of female genital mutilation is linked pretty closely with one particular religion and the convictions of its extreme adherents." Its a well-documented phenomenon. What Newman did is in no way recognized to be linked to any religion or its belief system/practices.

 

[Lexdiamondz]

K.

You know why good jokes are funny? Because there's a small but pertinent element of truth to each one.

Google the phrase "Judgmental maps". You'll find a joke site with maps of various US cities, with each section/neighborhood renamed to illustrate something otherwise particular about each section. My home city is on there, too. To be honest, the jokes are generally spot-on about the relevant neighborhoods.

Take a look at the map of Detroit, and you'll see the sections near Livonia/Dearborn labeled "ISIS", "Sadr City", and "Hezbollah".

Oh, and to address your statement of "to assume that they did this because of their beliefs... etc", I simply want to say: "Uh, dude: The (often ritual) act of female genital mutilation is linked pretty closely with one particular religion and the convictions of its extreme adherents." Its a well-documented phenomenon. What Newman did is in no way recognized to be linked to any religion or its belief system/practices.

No, it's not.

FGM is a cultural & geographic phenomenon, not a religious one - as evidenced by the fact that 1) most Muslims don't practice it and 2) it's relatively widely practiced by Christians in certain countries as well.

 

[RustedFox]

No, it's not.

FGM is a cultural & geographic phenomenon, not a religious one - as evidenced by the fact that 1) most Muslims don't practice it and 2) it's relatively widely practiced by Christians in certain countries as well.

Funny; you don't hear scores of new stories involving Jesuits, Hugenots, Episcopal, Jehovah's Witnesses (etc) and this practice.

You can split hairs all you want; the practice is most common among a particular creed. To pretend otherwise is disingenuous. We can fight about who's Google-Fu is better, and who's sources are reliable and unreliable - but whatever.

 

[WilcoWorld]

Female genital mutilation is an abhorrent practice - one that deserves to be loudly denounced. That being said, I do not see the relevance of this discussion to Emergency Medicine. Whereas Newman committed his crime while working in an ED as an ER Doc (making his crime a relevant topic for discussion on this thread) Nagarwala was not representing our specialty when she did these terrible things.

As such, I think @Dr.McNinja said all that needed to be said on this forum in the thread's 2nd post:
"People are terrible, and doctors are a subset of people. The rates are likely similar."

 

[Lexdiamondz]

Funny; you don't hear scores of new stories involving Jesuits, Hugenots, Episcopal, Jehovah's Witnesses (etc) and this practice.

You can split hairs all you want; the practice is most common among a particular creed. To pretend otherwise is disingenuous. We can fight about who's Google-Fu is better, and who's sources are reliable and unreliable - but whatever.

I'm not pretending otherwise. If it was so associated with "a particular creed" then you'd see people of that creed from all over the world doing it, and yet for the most part it's limited to people from a specific geographic region (central and north africa) regardless of religion.

If you're gonna paint billions of people with a broad brush, at least be accurate man.

 

[RustedFox]

I'm not pretending otherwise. If it was so associated with "a particular creed" then you'd see people of that creed from all over the world doing it, and yet for the most part it's limited to people from a specific geographic region (central and north africa) regardless of religion.

If you're gonna paint billions of people with a broad brush, at least be accurate man.

(Sigh)

I'm done after this before the PC police come after me.

You do see people of a certain creed doing it "all over the world", hence the stories like this very one about it existing in certain enclaves in the US and other nations around the world. You see people of all creeds doing it. More some than others. Less others than some. More in some places than other, less in others than some.

Bye.

 

[Apollyon]

.....that is to say you are literally pulling it out of your ass.

In an episode of irony, I am going to tell you that you are literally incorrect. Did you actually see him "pull" something out of his "ass"?

If I said, "my hands are literally ice cold", I would likely be screaming in horrible pain, and have them amputated. I would never say, "this food tastes like literal ****", because I've never eaten ****.

The word you needed was "figuratively".

 

[jw3600]

Isn't the majority of FGM done in African countries that are predominantly Christian?

 

[Angry Birds]

Can this be moved to the lounge? It doesn't belong in the EM sub-forum. I'm really trying hard not to talk religion and politics here and this topic really has the potential to split the EM staff (of SDN Hospital) in half. Better if the mods move this to the appropriate place.

 

[deleted109597]

Moving it will kill it. I may as well just kill it here. I'm happy to do so, since it was nearly dead and then resurrected.

 

[deleted109597]

I am reopening this as we have new information today. However, it will be watched closely.

 

[Hamhock]

I feel the following two links are valuable for the typical citizen and the emergency medicine physician specifically.
Please note that the moderators (eg Ninja) are taking a risk here. They have re-opened this thread upon request. Tread carefully, thoughtfully, and with a spirit of discovery and enlightenment.

https://www.annemergmed.com/article/S0196-0644(17)31449-X/fulltext
Federal Ban on Female Genital Mutilation Ruled Unconstitutional by Judge

Anyone from Henry Ford want to comment?

HH

 

[deleted109597]

We've discussed this a bit in the other forms of social media. It's not that the judge felt that it was "right" or even "ok". He is just saying it's a state issue, since it doesn't cross federal lines.
Murder is the same way from what I've gathered. Very few murders are federal.

 

[nimbus]

From the nytimes....

“Lawyers for the defendants have argued that the Dawoodi Bohra practice is a protected religious procedure and is not mutilation but rather a “ritual nick” that doesn’t remove the clitoris or labia as do some forms of cutting.”

If it is indeed a ritual “nicking” as described by the defense lawyers, I fail to see the difference between this and religious male circumcision.

 

[Tenk]

From the nytimes....

“Lawyers for the defendants have argued that the Dawoodi Bohra practice is a protected religious procedure and is not mutilation but rather a “ritual nick” that doesn’t remove the clitoris or labia as do some forms of cutting.”

If it is indeed a ritual “nicking” as described by the defense lawyers, I fail to see the difference between this and religious male circumcision.

Male circumcision reduces the risks of penile cancer and other penile infections and complications. Also this isn’t a “nick,” it’s removal of the clitoral hood. It’s a surgical procedure done to curb female sexual drive. This crap shouldn’t exist today in the United States.

 

[RustedFox]

Male circumcision reduces the risks of penile cancer and other penile infections and complications. Also this isn’t a “nick,” it’s removal of the clitoral hood. It’s a surgical procedure done to curb female sexual drive. This crap shouldn’t exist today.

Fixed that for you.

 

[Tenk]

Fixed that for you.

While I agree, with regards to federal vs state law that kind of ends at our borders.

 

[nimbus]

Male circumcision reduces the risks of penile cancer and other penile infections and complications. Also this isn’t a “nick,” it’s removal of the clitoral hood. It’s a surgical procedure done to curb female sexual drive. This crap shouldn’t exist today in the United States.

I’m against all surgical procedures of dubious benefit, especially in children. But isn’t the clitoral hood analogous to the foreskin?

 

[Hamhock]

Male circumcision reduces the risks of penile cancer and other penile infections and complications.

...but in the VAST majority of the cases, that is not why infants are circumcised.

HH

 

[miacomet]

FWIW, Michigan passed a law banning FMG, but it's not retroactive, so it doesn't apply here. They are still pursuing federal charges having to do with transporting a minor across state lines with criminal intent.

 

[Tenk]

I’m against all surgical procedures of dubious benefit, especially in children. But isn’t the clitoral hood analogous to the foreskin?

Women don’t get clitoral cancer, phymosis, paraphymosis, or balanitis. Being analogous does not make them equal. Not even close. One is done for clear cut medical reasons, the other is done to disempower women.

 

[Tenk]

...but in the VAST majority of the cases, that is not why infants are circumcised.

HH

How do you know? Did you ask every parent? I have been around many circumcisions and discussions of such and these reasons are very commonly brought up.

 

[miacomet]

There are many organs that could be prophylactically removed to prevent cancer- breast, ovary, appendix etc, but we don't. Sure, male circumcision has some possible health benefits, but it's a surgical procedure with risk of bleeding, poor cosmetic outcome, infection, sexual dysfunction etc. I don't think there's any great data on the risks of male circumcision, thus we need more data to say whether it's a net health benefit.

Most European countries frown on male circumcision. This is an issue of culture, not medicine. More data could change that.

 

[Tenk]

There are many organs that could be prophylactically removed to prevent cancer- breast, ovary, appendix etc, but we don't. Sure, male circumcision has some possible health benefits, but it's a surgical procedure with risk of bleeding, poor cosmetic outcome, infection, sexual dysfunction etc. I don't think there's any great data on the risks of male circumcision, thus we need more data to say whether it's a net health benefit.

Most European countries frown on male circumcision. This is an issue of culture, not medicine. More data could change that.

Are you a doctor? Because you are saying some really ignorant stuff.

Literally, ALMOST EVERY SINGLE penile cancer, paraphymosis, phymosis and balanitis are found in uncircumcised males. They hardly ever occur in circumcised males and actually can’t in phymosis and paraphymosis because the disease is actually caused by the foreskin. We don’t need more data because the data is already out there: the diseases are found almost entirely in uncircumcised males.

 

[Hamhock]

How do you know? Did you ask every parent? I have been around many circumcisions and discussions of such and these reasons are very commonly brought up.

Oh, come on.
This is disingenuous.
Perhaps recently the putative protective benefits of circumcision have become part of the discussion; but to claim this is why for the past 50 years circumcisions have been widely performed in the US is just complete obscurantism.
HH

 

[miacomet]

Are you a doctor? Because you are saying some really ignorant stuff.

Literally, ALMOST EVERY SINGLE penile cancer, paraphymosis, phymosis and balanitis are found in uncircumcised males. They hardly ever occur in circumcised males and actually can’t in phymosis and paraphymosis because the disease is actually caused by the foreskin. We don’t need more data because the data is already out there: the diseases are found almost entirely in uncircumcised males.

Defensive much? Yes, it's true these are found in uncirced males, just as breast cancer is found in women with breasts that haven't been removed, but have we compared this to the complication rates from circumcisions? Have we looked at populations where circumcision is much less common and determined whether subjecting every infant male to genital surgery is a reasonable cost-benefit analysis?

You haven't addressed the complication rate from circumcision, which isn't tracked. You haven't addressed the issue of other prophylactic surgeries and whether we should encourage them. You haven't addressed the fact that many medical bodies don't find the evidence compelling. You haven't addressed the decreasing number of state Medicaid programs that will pay for circs because they find the evidence less than compelling. You haven't addressed that many (perhaps most) parents do this for cultural reasons.

 

[Tenk]

Oh, come on.
This is disingenuous.
Perhaps recently the putative protective benefits of circumcision have become part of the discussion; but to claim this is why for the past 50 years circumcisions have been widely performed in the US is just complete obscurantism.
HH

Who cares about why they did something 50 years ago or a thousand years ago. I care about the present because I live in the present. If there were no medical benefits to circumcision, I wouldn’t defend it, in fact, I’d probably be arguing against it. But guess what? There are!

 

[miacomet]

Who cares about why they did something 50 years ago or a thousand years ago. I care about the present because I live in the present. If there were no medical benefits to circumcision, I wouldn’t defend it, in fact, I’d probably be arguing against it. But guess what? There are!

There are also complications. There are also mistakes. The data on the effect on sexual pleasure is not clear. They don't do this in Europe. In fact, they aggressively discourage it in many countries. I can't think of another organization aside from the AAP that recommends it, and they don't recommend it that strongly.

 

[Tenk]

Defensive much? Yes, it's true these are found in uncirced males, just as breast cancer is found in women with breasts that haven't been removed, but have we compared this to the complication rates from circumcisions? Have we looked at populations where circumcision is much less common and determined whether subjecting every infant male to genital surgery is a reasonable cost-benefit analysis?

You haven't addressed the complication rate from circumcision, which isn't tracked. You haven't addressed the issue of other prophylactic surgeries and whether we should encourage them. You haven't addressed the fact that many medical bodies don't find the evidence compelling. You haven't addressed the decreasing number of state Medicaid programs that will pay for circs because they find the evidence less than compelling. You haven't addressed that many (perhaps most) parents do this for cultural reasons.

Ok since you are so knowledgeable please show me all this magical data.

Also, you didn’t answer my question.