Comments on: Flying high with just one engine http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/ All that flavorful brownness in one savory packet Sat, 30 Nov 2013 11:11:28 +0000 hourly 1 http://wordpress.org/?v=3.2.1 By: Eli http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-196891 Eli Fri, 14 Mar 2008 19:39:25 +0000 http://sepiamutiny.com?p=5032#comment-196891 <p>I know the Dr. Dicksheet and I just wanted to tell you that Dr. Dicksheet performs the Millard method for correcting Cleft lips.</p> <p>Also the original spelling of his last name was Dixit, he changed it to Dicksheet when he moved to America so that people could pronounce it better. The correct pronunciation is dick-shit.</p> <p>WesternGhaat, I agree with your feelings, we should criticize the poor's access to the health care.</p> I know the Dr. Dicksheet and I just wanted to tell you that Dr. Dicksheet performs the Millard method for correcting Cleft lips.

Also the original spelling of his last name was Dixit, he changed it to Dicksheet when he moved to America so that people could pronounce it better. The correct pronunciation is dick-shit.

WesternGhaat, I agree with your feelings, we should criticize the poor’s access to the health care.

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By: deekshith http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-194282 deekshith Wed, 20 Feb 2008 00:29:11 +0000 http://sepiamutiny.com?p=5032#comment-194282 <p>the correct pronunciation of the surname, afaik, should be deekshith i.e. one who has obtained dikshaa (the sandhi diksha+ith modifies diksha - the small "e" to "ee")</p> the correct pronunciation of the surname, afaik, should be deekshith i.e. one who has obtained dikshaa (the sandhi diksha+ith modifies diksha – the small “e” to “ee”)

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By: Pankaj Tiwari http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-194233 Pankaj Tiwari Tue, 19 Feb 2008 18:53:12 +0000 http://sepiamutiny.com?p=5032#comment-194233 <p>I do not think that anecdotal complication rates should sway an argument on whether Dr. Dicksheet is doing the right operation for the right patient.</p> <p>There are different techniques to repair a cleft lip. Dr. Dicksheet likely trained when the Tennison repair was commonly done and appears to use this technique (based on the two on-table results in the video). It is done less so now that most cleft surgeons favor the Millard repair, but well respected cleft lip and palate centers in the US still perform the Tennison repair.</p> <p>The question of surgical camps is a difficult one. I think if a surgeon commits himself/herself to a particular area and returns to that area on a regular basis to follow up on patients and repair complications, then a high standard of care can be delivered.</p> <p>At the end of the day, indigent care in any country boils down to limited access and resources. I agree that India can do better just as the US can do better. Until then, people like Dr. Dicksheet will continue to work on the front lines. We should all support and applaud those efforts.</p> I do not think that anecdotal complication rates should sway an argument on whether Dr. Dicksheet is doing the right operation for the right patient.

There are different techniques to repair a cleft lip. Dr. Dicksheet likely trained when the Tennison repair was commonly done and appears to use this technique (based on the two on-table results in the video). It is done less so now that most cleft surgeons favor the Millard repair, but well respected cleft lip and palate centers in the US still perform the Tennison repair.

The question of surgical camps is a difficult one. I think if a surgeon commits himself/herself to a particular area and returns to that area on a regular basis to follow up on patients and repair complications, then a high standard of care can be delivered.

At the end of the day, indigent care in any country boils down to limited access and resources. I agree that India can do better just as the US can do better. Until then, people like Dr. Dicksheet will continue to work on the front lines. We should all support and applaud those efforts.

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By: tarta http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-193986 tarta Sat, 16 Feb 2008 21:45:03 +0000 http://sepiamutiny.com?p=5032#comment-193986 <p>i want to clarify my previous comments; becuase when I re-read how I have phrased my comments; it may sound like all I want to do is criticize Dr Dicksheet ---far from it --i am humbled by how dedicated he is to his work, how noble his intentions and efforts are and how despite being disabled , he is a man of principle who remains devoted to doing all that he can for the poorest of the poor ----it is awe-inspiring and humbling. What I am criticizing however, is the state of affairs of health care delivery to the poor--a question for society and government. We wont be doing this man a service if all we do is praise his efforts and go on with our lives as before, without stopping to think about why his efforts are needed in the first place; where in order to be able to help others, he has to create this "assembly line" approach to deliver care.</p> <p>my point is that the fact that society needs to have a debate on access to health care and how we can do better.</p> i want to clarify my previous comments; becuase when I re-read how I have phrased my comments; it may sound like all I want to do is criticize Dr Dicksheet —far from it –i am humbled by how dedicated he is to his work, how noble his intentions and efforts are and how despite being disabled , he is a man of principle who remains devoted to doing all that he can for the poorest of the poor —-it is awe-inspiring and humbling. What I am criticizing however, is the state of affairs of health care delivery to the poor–a question for society and government. We wont be doing this man a service if all we do is praise his efforts and go on with our lives as before, without stopping to think about why his efforts are needed in the first place; where in order to be able to help others, he has to create this “assembly line” approach to deliver care.

my point is that the fact that society needs to have a debate on access to health care and how we can do better.

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By: tarta http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-193985 tarta Sat, 16 Feb 2008 21:27:33 +0000 http://sepiamutiny.com?p=5032#comment-193985 <p>that is a question that society needs to answer --- Is it okay for society to say that such substandard care is acceptable for poor people?? can we truly justifying it by saying that they would have no care at all if it werent for assembly line care--is this a slippery slope?? to say that we as a society will say substandard care is perfectly fine for poor people( a level of care that those of us with money would never dream of accepting) is a major ethical question, in my mind.</p> <p>no care at all isn't the alternative ---excellent health care exists in India --its just that poor people don't have access to it. so,it might seem like semantics on my part,but it is a key distinction, but this is an issue more of access to good health care, not whether good health care exists. (the question of access to health care is indeed a universal question)</p> <p>i don't say all this to criticize this specific doctor --but more as part of a larger debate about access to health care.</p> <p>And, when you have assembly line camps where a doctor flies in, does 70 surgeries in one day, there is no apparent postoperative follow-up visit and we have no idea whether these people have successful outcomes ( a quick google search didn't show me any data on long term outcomes or infection rates at these camps)--- it is food for thought.</p> that is a question that society needs to answer — Is it okay for society to say that such substandard care is acceptable for poor people?? can we truly justifying it by saying that they would have no care at all if it werent for assembly line care–is this a slippery slope?? to say that we as a society will say substandard care is perfectly fine for poor people( a level of care that those of us with money would never dream of accepting) is a major ethical question, in my mind.

no care at all isn’t the alternative —excellent health care exists in India –its just that poor people don’t have access to it. so,it might seem like semantics on my part,but it is a key distinction, but this is an issue more of access to good health care, not whether good health care exists. (the question of access to health care is indeed a universal question)

i don’t say all this to criticize this specific doctor –but more as part of a larger debate about access to health care.

And, when you have assembly line camps where a doctor flies in, does 70 surgeries in one day, there is no apparent postoperative follow-up visit and we have no idea whether these people have successful outcomes ( a quick google search didn’t show me any data on long term outcomes or infection rates at these camps)— it is food for thought.

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By: chitowndesi http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-193984 chitowndesi Sat, 16 Feb 2008 20:49:26 +0000 http://sepiamutiny.com?p=5032#comment-193984 <p><i>so, is it okay for poor people to receive a different level of care than rich people?</i></p> <p>Do they have a choice? Their choice is not between substandard care and higher level of care. If it isn't for these clinics, they might not get <b>any</b> care. Its lack of affordable care that makes what people like Dr Dicksheet does... not just essential, but noble.</p> so, is it okay for poor people to receive a different level of care than rich people?

Do they have a choice? Their choice is not between substandard care and higher level of care. If it isn’t for these clinics, they might not get any care. Its lack of affordable care that makes what people like Dr Dicksheet does… not just essential, but noble.

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By: tarta http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-193979 tarta Sat, 16 Feb 2008 19:28:50 +0000 http://sepiamutiny.com?p=5032#comment-193979 <p>westernghaat's comments, although anecdotal, suggest what i had feared but hesitated to come right out and say --that hapless poor people in india often receive substandard care with "assembly line" surgery via these camps.</p> <p>i think that cataract surgery camps have a high eye infection rate ---before i say this with certainty, i of course should have evidence to back me up--but, i don't know, does this evidence exist? is there a long term follow up? do we know how these patients are doing at one and two years out from surgery? importantly, what is the infection rate? 70 surgeries a day--how are they ensuring the most stringent sterile precautions? are they reusing instruments? or are they sterilizing the instruments in between?</p> <p>a middle income person or a rich person would never consent to a surgery in a camp so, is it okay for poor people to receive a different level of care than rich people?</p> westernghaat’s comments, although anecdotal, suggest what i had feared but hesitated to come right out and say –that hapless poor people in india often receive substandard care with “assembly line” surgery via these camps.

i think that cataract surgery camps have a high eye infection rate —before i say this with certainty, i of course should have evidence to back me up–but, i don’t know, does this evidence exist? is there a long term follow up? do we know how these patients are doing at one and two years out from surgery? importantly, what is the infection rate? 70 surgeries a day–how are they ensuring the most stringent sterile precautions? are they reusing instruments? or are they sterilizing the instruments in between?

a middle income person or a rich person would never consent to a surgery in a camp so, is it okay for poor people to receive a different level of care than rich people?

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By: WesternGhaat http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-193973 WesternGhaat Sat, 16 Feb 2008 18:04:27 +0000 http://sepiamutiny.com?p=5032#comment-193973 <p>Tarta, My account is anecdotal, I have no documents or links to back me up. I was a medical student when Dr Dicksheet came to our town to conduct surgeries at a camp. A lot of my classmates volunteered at this camp and we were in complete awe and thrall of what we were seeing. At that time, he was almost god incarnate! Few years down the line, when I was doing my surgery residency and rotating through the plastic surgery division, I would occasionally see patients coming in for revision of palate or lip which had broken apart after initial surgery, 2-3 mths later as the child grew up. They had all been operated at the camps by Dr Dicksheet. It was really disappointing to learn of that....its really hard when you find out why these cases were failing. According to the professor at our unit, the surgical techniques which were used by the great man were older (from the 60s and 70s) and proved to have the complications I had seen as the child would grow up. He had not changed to adapt to the newer ways! There was a school of thought in the medical profession (in my town) at that time that if you do your work with good intention, a few slip ups and bad results are ok. As I progressed through my training and became more experienced ( and cynical?) I became opposed to the whole practice of conducting surgeries at a camp. For whatever reasons, organising and conducting surgery camps is a big thing in India ( Eye surgery camps are the commonest, followed by polio surgery, and of course tubectomy/vasectomy camps.) While it is gratifying to announce that xx number of patients were examined and treated, there is usually no proper documentation or followups for these patients. Most patients are too poor to afford medical care and costs of surgery and accept whatever care they get. If the results are bad , they accept it as Fate and God's wish.</p> <p>But does providing substandard care to poor illiterate patients become Noble and just , as long as you are doing it with compassion and in good faith? I am still searching for the correct answer.....</p> Tarta, My account is anecdotal, I have no documents or links to back me up. I was a medical student when Dr Dicksheet came to our town to conduct surgeries at a camp. A lot of my classmates volunteered at this camp and we were in complete awe and thrall of what we were seeing. At that time, he was almost god incarnate! Few years down the line, when I was doing my surgery residency and rotating through the plastic surgery division, I would occasionally see patients coming in for revision of palate or lip which had broken apart after initial surgery, 2-3 mths later as the child grew up. They had all been operated at the camps by Dr Dicksheet. It was really disappointing to learn of that….its really hard when you find out why these cases were failing. According to the professor at our unit, the surgical techniques which were used by the great man were older (from the 60s and 70s) and proved to have the complications I had seen as the child would grow up. He had not changed to adapt to the newer ways! There was a school of thought in the medical profession (in my town) at that time that if you do your work with good intention, a few slip ups and bad results are ok. As I progressed through my training and became more experienced ( and cynical?) I became opposed to the whole practice of conducting surgeries at a camp. For whatever reasons, organising and conducting surgery camps is a big thing in India ( Eye surgery camps are the commonest, followed by polio surgery, and of course tubectomy/vasectomy camps.) While it is gratifying to announce that xx number of patients were examined and treated, there is usually no proper documentation or followups for these patients. Most patients are too poor to afford medical care and costs of surgery and accept whatever care they get. If the results are bad , they accept it as Fate and God’s wish.

But does providing substandard care to poor illiterate patients become Noble and just , as long as you are doing it with compassion and in good faith? I am still searching for the correct answer…..

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By: Violet_in_Twilight http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-193954 Violet_in_Twilight Sat, 16 Feb 2008 06:35:43 +0000 http://sepiamutiny.com?p=5032#comment-193954 <p><i>14 · <B><A href="http://sbkt.blogspot.com" rel=nofollow>sakshi</A></B> <a href="http://www.sepiamutiny.com/sepia/archives/005032.html#comment193949">said</a></i></p> <blockquote>Wow! This guy is the gold standard people should be judged by. How many dicksheets are you? 0.002? 0.004?</blockquote> <p>A fantastic notion.</p> 14 · sakshi said

Wow! This guy is the gold standard people should be judged by. How many dicksheets are you? 0.002? 0.004?

A fantastic notion.

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By: tarta http://sepiamutiny.com/blog/2008/02/15/flying_high_wit/comment-page-1/#comment-193950 tarta Sat, 16 Feb 2008 05:38:57 +0000 http://sepiamutiny.com?p=5032#comment-193950 <p>Bound to the wheelchair, his right side paralysed, his heart capacity at a mere 17 per cent, and suffering from terminal cancer of the larynx, Doctor Sharadkumar Dicksheet performs 50 to 70 operations a day for the disfigured poor of India.</p> <p>is there any info on the outcomes, complication rate and success rate of these operations? thats a lot of operations in one day , especially for a surgeon who doesn't have full use of one hand--which means each patient cant be getting much time spent on him/her.</p> Bound to the wheelchair, his right side paralysed, his heart capacity at a mere 17 per cent, and suffering from terminal cancer of the larynx, Doctor Sharadkumar Dicksheet performs 50 to 70 operations a day for the disfigured poor of India.

is there any info on the outcomes, complication rate and success rate of these operations? thats a lot of operations in one day , especially for a surgeon who doesn’t have full use of one hand–which means each patient cant be getting much time spent on him/her.

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