Posts by Scott Allen10

I wasn't aiming that at you (in case you thought I was!)—I was talking about the news outlet that ran the story...🙂
Plus, honestly, I don't think it works as a good pitch for organ donation at all... I mean, I don't know, it just felt a bit tasteless to me... especially considering his family and those people waiting for transplants (kind of like that story you told me about the killer's organs).

Honestly, making such a massive public spectacle out of organ donations just feels incredibly tacky and crosses a line for me.
I mean, even back home, you usually have no idea where your organs actually came from, though I guess it wouldn't be that hard to find out if you really wanted to.
Besides, keeping a donor stable isn't even the hardest part—you just manage a few meds and some IV drips and you're good—it's the whole headache of proving brain death and dealing with all those intense diagnostic protocols afterward that really gets complicated.

Rachel Brooks63 said:I actually spent some time out on my bike today, just enjoying the ride. 12 milesSo, she went out for a quick run and then just settled for a tiny little bowl of miso soup and three radishes for dinner.

...😲 Man, I’m wiped just reading that, Rachel Brooks63... honestly, what are you, some kind of pro triathlete or something?😁

Honestly, I think the biggest issue is just how low the awareness is here regarding the need for organ donation and the sheer nobility behind it. It’s not like most families even sit around and consider this kind of thing, you know? A tiny fraction of people ever give it a thought. And then, when it actually happens—which is usually sudden and totally overwhelming—people just freeze up. Even if brain death has been officially confirmed by the doctors, there’s this tiny, irrational sliver of hope that someone can pull through, which makes it impossible to give consent when it’s truly over. Plus, you've got that constant, nagging suspicion floating around that "corrupt hospital staff" might try to profit off or sell organs, so even if you were totally pro-donation, a family member might block it out of fear. And damn it, if you're in a coma, your voice just isn't heard anymore.
That being said, like I mentioned before, if someone made their stance on being a donor clear while they were still healthy and active, their family will usually respect those wishes and go along with it.

Hmm... yeah... I guess it’s not entirely logical from a legal standpoint. On one hand, everyone is technically a donor, but then on the other, you have to show respect to the family and honor their wishes, even if they're leaning towards a no... it's tricky.

But look, I really have to stress this: regardless of any legal gray areas, there hasn't been a single organ retrieval performed without written consent from the family. That’s a huge point to make because, like I mentioned before, our society is just so full of these wild conspiracy theories about "killing people for organs" or "taking things without permission," which honestly aren't even a thing in how we handle the process here in the States.

Austin Perez98 said:Basically, you sign if you don't want to, but if you stay quiet, they just assume you're down and take it anyway.
I'm totally on board with that thought, honestly.

Not happening without my family's blessing, though.

Sophia Martinez65 said:Even though anesthesiologists usually ask the family for permission, according to our laws, they aren't actually required to.

Brain death is confirmed through cerebral angiography. Though, I'm not really sure what happens if a hospital doesn't have a cerebral angiography machine on site... I guess the donor would just be moved to another facility.

Personally, I think that law is actually pretty great. 👍 I want to be an organ donor because I'm not looking out for myself, and honestly, if the day ever comes where I'm the one needing a transplant, I'll be glad this system exists.

Here in the States, much like most other Western countries, we follow the principle of presumed consent when it comes to organ harvesting. Basically, that means everyone is considered a potential donor unless they've explicitly stated otherwise during their lifetime—usually by leaving a formal document with their primary care physician.
That’s how the lawmakers intended it to work, but in the real world, the family always gets the final word. If they say "no," then that's the end of the road. From what I know, not a single extraction has happened here if the family stood their ground. There are basically three big reasons for that.
First off, the database used to quickly check if someone opted out isn't even fully functional yet...
Second, certain parts of the law, the regulations, and the ethical codes governing this whole thing talk about "respecting the family," and since honoring their wishes is part of that, things get incredibly murky...
And third—which I'd say is the biggest factor—is that public awareness regarding the nobility of organ donation is still pretty low, and no doctor wants to deal with the headache of fighting with families, dealing with the media, or facing a scandal if they proceed without the family's blessing.
Though, if the donor was clearly pro-donation during their life, the family almost always gives the green light.
So, those donor cards (which don't really hold any legal weight anyway) or specific legal loopholes don't actually matter much in practice. It all comes down to what the family decides.

Regarding proving brain death, there are three main methods used most often: brain perfusion scintigraphy, cerebral angiography, and transcranial Doppler (TCD). I believe EEG and evoked potentials are also acceptable methods, but I'm not sure if anyone actually uses them specifically to prove brain death here in the US.

I think what Jamie Clark74 was showing us is basically just a standard Do Not Resuscitate order. I honestly can't even begin to wrap my head around how much this whole situation changes things for everyone involved, especially when you consider how much we all rely on that hit of Dopamine just to get through a Tuesday, but I guess that's just life, isn't it?o NI can't believe I'm even typing this out, but honestly, life just has a funny way of throwing everything at you all at once, doesn't it? I was sitting here thinking about how much things have changed lately, almost like that one time I stayed up way too late in Chicago just watching the rain hit the window, feeling like the world was moving a million miles an hour while I was stuck in place. It’s wild how we try to make sense of it all, but sometimes you just have to roll with the punches and see where the wind takes you. RYou can always file a Do Not Resuscitate order to opt out of CPR and other medical interventions, but honestly, Jamie Clark74, like someone else pointed out earlier, I don't think that would actually save you from the jaws of the American healthcare system if you were brought in unconscious.🙂 Things just don't work that way here in the States; you can't just decide to call it quits whenever you feel like it.🙂 So, we just finished helping my 80-year-old grandma transition, and man, she had been through the wringer—we're talking triple bypasses, a pacemaker, diabetes, and a massive ischemic stroke that really took its toll on her brain. 😵It was pretty much inevitable that she’d pass after about ten days, but man... you have to wonder how a top-tier neurologist and a sharp anesthesiologist could manage to run up a bill of at least $8,000 or so with the hospital in such a short window. It might sound a bit harsh to say, but there were just so many unnecessary costs piled on there.
Honestly, I feel like when it all comes down to it, whether or not someone actually tries to resuscitate you is pretty much left up to whoever happens to be standing there with you, regardless of what those official DNR papers say.

😬 😬 😬 .....

One of the wildest rumors I heard was that the whole thing just ends up being turned into pâté for some shady way of disposing of stuff... hehehehe...

As for me... I usually go with a quick autopsy first, and then I just burn the evidence...

When things get heavy like this, people honestly lose all sense of logic. In those acute moments when a crisis hits, everyone just wants to cling to life at any cost—it’s that classic mindset of, "Just let them live, somehow it'll work out, maybe they'll pull through..." It's totally human, really; we just pin all our hopes on some miracle recovery without even stopping to consider what the actual outcome will look like. I feel like nobody ever stops to think about the reality of the end result.
I was talking to someone recently whose loved one has been stuck in a persistent vegetative state for years now, following some unexplained brain damage after they spent a month hovering between life and death in the ICU. They told me, almost offhandedly, "Man, if they had just passed away right then and there, I would've gone through the grieving process by now and actually be living my life normally."... hm...it's definitely not always a rational way to look at things.

What you're asking about is euthanasia, and honestly, we don't allow anything like that here in the States; it’ll be a long time before we see any real movement or legislation passed on such an incredibly sensitive issue... Allowing for a dignified death? Who gets to pull that trigger? Under what specific circumstances? Those are just some of the massive questions we're going to have to tackle way down the road.
We really need to be clear that when people talk about "unplugging" here, they usually mean disconnecting a patient from a ventilator or some kind of mechanical breathing machine.
Now, the one exception where this actually happens in our country is in cases of confirmed brain death. In real-world terms, that usually happens during the diagnostic process for organ donation, but if the family decides they aren't interested in donating, the body is simply taken off life support. There isn't really any debate there.
The "gray area"—and I assume this is what you mean by talking about machines—is that murky territory in intensive care where a doctor might decide to stop using Dopamine, Norepinephrine, or other vasopressors to keep blood pressure up. People in the medical field know exactly what I'm talking about, even if there isn't a perfect name for it yet.
If you want another example to throw into the mix, look at that tragic case in the US from a few years back where a court actually denied a woman tube feeding for a few weeks, basically leaving her to starve to death.

I am so sorry to hear about your loved one, but if they do end up pulling through, the family—or whoever is stepping up to provide full-time care—is often looking at some incredibly grueling days and a really difficult daily grind ahead.

This sigma-bladder fistula thing just isn't sitting right with me, especially since my gut was already reconstructed back when I lived in New York City, so I've got no clue how they could even close it without surgery. It feels like I'm just signing up for a lifetime of endless UTIs...
But hey, like I mentioned in our private chat, a New Yorker will probably have more insight on this than I do.

If they’re actually Chinese, you can probably just track them down at any local Chinatown market...😍 ....☕

Alexander Collins4 said:Wait, so how do you feel about smokers then? Aren't they basically committing suicide by proxy? And what about addicts, or people speeding through neighborhoods and putting everyone else at risk? Honestly, I don't think you can just pick and choose who gets care based on their lifestyle. If we start deciding who's "worthy" of a checkup or medical help based on why they ended up in the ER, where does it stop? We’ll be judging people by their eye color next just to decide if they deserve attention. We all know how that ends—it’s a slippery slope from one kind of discrimination to another, even when we tell ourselves we aren't part of either group. Discrimination in a doctor's office is the absolute worst; I won't even get into the morality of it because that's just getting ridiculous.
PS Scott Allen10 mentioned you aren't a doctor, so what's that all about?

I didn't quite catch that last part, specifically the end of the sentence. Could you clarify?
I totally agree that discrimination is unacceptable. You can't deny someone the care they need just because they fall into a certain "category" or group you listed. But... providing necessary care doesn't mean you have to feel sympathy for them or treat them with this deep intimacy like "everyone is the same." At least, that's my take. An overdose victim and someone hit by a car aren't the same thing in my book. Sure, everyone gets treated, but I honestly don't feel any pity for the first group. Plus, since most of them carry things like Hepatitis B or C, you actually have to be extra careful just to avoid catching something yourself.
Every profession has its share of people they just can't stand, even if they still do the job. Why should healthcare be any different?
A recent example...
Some "silver spoon" kid with a massive engine was flying through town at 110 mph and plowed into two people. One died right there in the trauma unit, and the other was critically injured, fighting for her life for about 30 days before surviving, but she's left with permanent disabilities and a hell of a long road to recovery. The idiot himself was pretty banged up too, walking away with broken ribs, a lung contusion, and a broken femur...
About a year later, an emergency comes in for a traffic victim... severe brain injury, dilated pupils that don't react to light... then a second emergency arrives, and it's the guy who caused the accident... the cop says he picked the victim up while speeding...
He walks in, and we realize it's the same "golden boy" from before... the whole crew lost it. The surgeon was visibly disgusted, cursing him under his breath while examining him, and the anesthesiologist gave him a dead serious warning that he wouldn't hear a peep out of him unless he raised his hand first... meanwhile, the actual victim was on the other stretcher getting worked on...
The idiot didn't even have anything major (that's usually how it goes), just a concussion and some scrapes and bruises... went through a CT scan, got some pain meds, a prophylactic antibiotic, and was sent straight to ortho... the victim, on the other hand, had organs harvested after two or three days once the family gave the okay...
So, tell me... is it actually "normal" to treat both patients exactly the same? Yeah, it's normal, but only if you're someone standing on the sidelines who claims to be some kind of saintly altruist.
No, you can't look at patients in black and white, or well, to be precise, in certain parts of healthcare. Everyone has a group of people, illnesses, or conditions they just can't stand... Providing what's required? Absolutely! It's mandatory!... With equal amounts of empathy? ...Man, heck no!

Mango said:Scott Allen10, I honestly never once doubted how much you know or how hard you work at this job... It was just that specific mindset of yours that threw me off a bit. You're totally entitled to your opinion, and honestly, it's all good as long as it doesn't cloud your judgment on the facts. I definitely went a little too hard on you there—you know why—so my bad! 🙂

🙂 ...

Still waiting on any kind of word back from the American Medical Association or the NBA, unfortunately.

Jamie Clark74 said:We really need to focus on suicide prevention... it’s actually possible more often than people think. I mean, where is all that family showing up to cry after someone is gone, when they could have actually stepped up and helped while they were still here?
Maybe the person was dropping hints that they needed help, and everyone just tuned them out?

You nailed it, Jamie Clark74. That's honestly where we can make the biggest impact—prevention is always better than trying to fix things after the fact. But let's be real, society here feels pretty heavy lately; there's so much unemployment and so many people feeling stuck without any real future in sight... it makes it almost impossible to tell if someone is just going through a rough patch or if they're actually planning their exit.
And even if someone does survive an attempt, they often end up back in that same dark place, just like Susan Martin24 mentioned.

I’m pretty sure things are just going to go back to the way they always do in this country—where the big guys get away with everything and nobody even blinks. Honestly, looking at how the media has laid out the facts, this whole situation is such an obvious scam that it deserves its own headline in The New York Times, almost like some over-the-top Yanni concert from a few months back.

Man... I really thought we were going to handle this thing one step at a time, you know? But honestly, it’s hard to just sit back and relax when you've got the daily grind at the office, and then you get home only to have the kids running circles around you while my wife is stressing out because the fridge just died and needs a repairman from GE to come fix it... grrrrrr...