Amer's Cheering Thread!

cobalt60 said:

My understanding is that ETS is only used as a last resort and that most of the drawbacks/risks occur at the time of the surgery. I have yet to read about any long term risks and it DOES NOT destroy "a lot of the autonomic nervous system". It is microsurgery and typically only involves destroying one to two levels of the thoracic sympathetic chain.
It has been used for over a decade with excellent results and minimal acute complications. No where in my reading did I read about any longterm complications that would hurt a sportsman.
I am sure Amer was counseled properly.

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From reading Amer's blog/website he was well aware of possible negative side-effects so it was a conscious decision to have the surgery.

There have been very few thorough medical studies on the subject. The surgery is notable for commercial private doctors in the US that have been actively solliciting patients. There has been a backlash against this surgery by people who suffered long-term side-effects that have started a large number of "warning/support" websites against ETS with full description of the long-term negative side-effects.

The Swedish doctor who pioneered the surgery stopped doing it and has now dedicated his career to tying to help people who suffer long-term side effects, and it has been banned in Sweden.

When thinking of possible drawbacks to a sportsman, I am considering for example the fact that the surgery destroys the sympathetic autonomic nervous system connection to the heart, which could interfere with the regulation of heart rate for excersize (sprints etc).

cobalt60 said:

You obviously do not live in the US nor are you part of the medical system.
Doctors get sued and lose all the time even when the case is poorly substantiated.

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I guess this means as a doctor in the US you have to pay an extremely high insurance premium to protect yourself?

I am not a medical professional but the situation is quite a bit different in the Netherlands as far I can discern:

- Legal cases in the regular courts are very rare. It is very difficult to prove a claim (note that there is no jury in our legal system).
- Doctors generally still enjoy a high level of immunity in the legal system and are highly esteemed, which is due to the legacy of being part of the historical elite.
- There is a court of medical arbitration but it only concerns itself with disciplinary action against negligent or incompetent doctors and does not award compensation to victims. In the vast majority of cases the doctor is not found to be in error.
- Doctors generally do not report errors and medical errors are often covered up, not mentioned in medical records and hospital staff do not report on colleagues.
- Doctors are highly organized in trade organizations and protected by the legal entity of the hospital.
- Until recently the concept of errors being made (especially in a hospital setting) was virtually unheard of.
- General Practitioners are open to discussion with patients and more vulnerable to criticism but in general medical specialists (including surgeons) have their practice in hospitals and are held in high esteem, often authoritarian to patients and other hospital staff, highly legally protected, make a lot of money (much more than all other hospital staff), and considered virtually infallible.

I think the more emancipated position of doctors like in the US is better in many ways (they are considered professionals, not an untouchable part of the elite), but being inundated in legal suits is the other extreme. I think a big drawback of the Dutch system is that incompetent doctors (especially specialists) will often not be identified in their protected position and continue to practice. There is very little public information about the relative merits, success rate or experience of doctors.

I should make a commment on my previous message, I had a discussion with Stupid Dream afterwards who knows a lot about the subject, and she confirmed what I outlined in the message. She also illustrated the key point, however, which is that the Dutch (medical) legal system deviates a lot from even some neighbouring European countries. What is comes down to is that the Dutch legal system retains a lot of archaic heritage that is still providing a lot of legal protection/immunity to the historical "elite". In this context the "elite" includes professions like doctors, the legal profession itself, and notaries (which are still legally required for many types of transactions and charge indiscriminate fees).

Observe that the Netherlands is virtually the only country where there is no jury-based law whatsoever. Law is adminstered by the "elite" itself, which may explain why over time the legal system has resisted changes that would reduce the legal immunity of the elite.