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Guest Columnist Author: Peter Pitts Last Updated: Sep 7, 2017 - 10:10:41 PM

Emergency Appendectomy - In and Out

By Peter Pitts
Dec 31, 2009 - 5:44:59 PM

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( - In the debate over healthcare reform, I’ve often considered the old saw that “the plural of anecdote isn’t data.” Sure, but what is it? Having just had an up-close-and-personal interface with the American healthcare system – I have a suggestion: the plural of anecdote is … reality.

This end-of-year revelation comes after my wife’s emergency appendectomy. Here’s the briefest chronology:

2AM: Horrible stomach pain and other relevant symptoms.

5:45AM: 911 call

5:50AM: EMTs arrive

6:00AM: Arrive at emergency room

6:07AM: Wife in emergency room bed

6:15AM: Nurse takes blood

6:20AM: Initial physician consultation

6:25AM: Wife on saline and anti-nausea drip

7:00AM: Wife gets some morphine

7:00AM – 11:00: Wife rests comfortably waiting for CT scan

11:00AM: CT scan (One machine out of service, hence the long wait.)

11:10AM: Resident confirms diagnosis of appendicitis

11:15: Initial consultation with surgery resident

1:00PM: Surgery prep

2:00PM: Surgery

3:30PM: Recovery Room

5:00PM: Admitted to empty room

9:30AM (the following day): Released

To use a pain intensity scale analogy – the entire experience was “moderately painful.”

Which brings me back to the plural of anecdote being reality. As a good resident of the 21st century, I used Facebook to let my friends and family know about my wife’s condition. The Americans were all appropriately sympathetic. The Europeans were mostly amazed. Amazed that we didn’t wait hours for an emergency room bed. Amazed that we saw a doctor in fewer than 5-8 hours. Amazed that we weren’t told to go home and come back at a later date (since her white blood cell count was only slightly elevated and the appendix wasn’t in danger of bursting) and not amazed but astounded that the surgery was done immediately. That there was actually a room available and that it was vacant – at a large urban hospital – they couldn’t even fathom.

Here is one verbatim comment from one continental comrade:

“I waited three days in London to see a GP and 20 hours at ER for an "exploratory op." It burst and I nearly died (to say nothing of the two life-threatening incidents whilst I was being "cared" for). But hey! The public option is better than letting people choose, right?”

So, while the plural of anecdote isn’t data – it is reality. And, in the immortal words of George Santayana, “Those who do not learn from history are doomed to repeat it.”

Speaking of General Santayana, here’s one of his less famous observations – keenly apropos of the current debate on American healthcare reform, “Fanaticism consists in redoubling your efforts when you have forgotten your aim.”

And the occasional anecdote goes a long way to reminding us of that, um, reality.

Peter Pitts

Partner and Director, Global Health
New York

As a Porter Novelli partner and director of global health care, Peter manages the overall Porter Novelli health care team from the New York office. Peter also serves as president of the Center for Medicine in the Public Interest, a think tank on public health care policy issues. From 2002 to 2004, he was the FDAs associate commissioner for external relations. His comments and commentaries on health care policy issues regularly appear in The New York Times, the Los Angeles Times, The Washington Post, The Wall Street Journal, the Financial Times, Health Affairs, The Boston Globe, The Washington Times, the Chicago Tribune, the Chicago Sun Times, The San Francisco Examiner, Investor’s Business Daily, The Baltimore Sun, The Economist, Nature Biotechnology and The Journal of Life Sciences, as well as on BBC, Fox News and The NewsHour with Jim Lehrer, among others.

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