Angry Doctor

Wednesday, September 14, 2005

Man charged with giving unsound medical advice

If only...

Bonus Bogus Story

Singapore -

A man was charged in court today for wrongfully causing the blindness and loss of limb of another man.

Mr Ngo Yeet Aw, 56, is charged with causing grevious bodily harm to Mr Watt Eh Foo, also 56.

Mr Ngo allegedly advised Mr Watt, a diabetes patient, to ignore a recommendation by his doctor to start on insulin therapy. Mr Watt became blind last month as a complication of his poorly-controlled diabetes. As a result of his visual impairment, he injured his left leg, which subsequently became gangrenous and had to be amputated.

Police arrested Mr Ngo after a complaint was filed by Mr Watt’s doctor, who cannot be named because he is a potential defendant in the case. He was charged in court today.

“I told him he should be started on insulin before his eyes and legs become affected, but he said his good friend told him that people who start insulin will end up with multiple complications. Idiots don’t realise that the poorly-controlled diabetes is the reason why they have all these complications and why they need to be on insulin in the first place, not the other way round!” said the angry doctor.

Mr Ngo’s lawyer, Mr Susa, told Straight Times that he plans to use the insanity plea again, but this time with a twist.

“Anyone who takes the word of a layman over a doctor in the matters of medical treatment can arguably be called insane, so my client’s words cannot be directly responsible for the plaintiff’s insane actions. If anything, the doctor should be censured for not picking up and treating his insanity!” said Mr Susa.

Mr Watt is currently warded at the Institute of Mental Health for psychiatric assessment. Straight Times’ sources inform us that the preliminary assessment by the psychiatrist as “Insane? Maybe. Stupid? Definitely.”



  • "Insane? Maybe. Stupid? Definitely."

    I love that... wahahhahaha

    By Blogger Jassie, At September 14, 2005 6:04 pm  

  • Brilliant!

    By Blogger aliendoc, At September 14, 2005 8:13 pm  

  • Hmmm there is some controversy going on regarding insulin. There have been some studies that show that insulin actually promotes the formation of series 2 prostaglandins (eicosanoids) which promote inflammatory and thrombogenic pathways. Thus some researchers have postulated that insulin may be a double edged sword in some respect.

    The thing about these controversies is that lay people tend to use the information in the wrong context because they do not fully understand and appreciate the information.

    A patient who is an insulin-DEPENDANT diabetic needs insulin to control his blood glucose levels. He NEEDS the insulin or else he will die. If he does not keep his blood sugar level well controlled, then he will have other complications involving the eyes, cardiovascular system, neurological system, increased infections of the limbs risking gangrene and amputation and kidney failure among others.

    Such IDDM patients are better off injecting insulin than not.

    However there are some who postulate that high fasting insulin levels in normal people may indicate an excess amount of insulin producing a pro-inflammatory state in vivo. This then causes other problems. This is still controversial, but the plan of management for patients with high levels of fasting insulin would be to go on a reduced carbohydrate, low glycemic index carbohydrate diet. That helps to reduce the stress on the pancreas to produce high levels of insulin in order to control blood sugar levels, since insulin is secreted in response to changes (rise) in blood glucose levels. In some way it has been suggested to help slow the progression to full blown diabetes. Diabetes is merely an imbalance in the relationship between insulin and glucose.

    Some researchers also postulate that excess insulin gives rise to inflammation and in turn causes insulin resistance at the insulin receptors.

    Please note that all this is still under research and have not been confirmed.

    However it does no harm to reduce the intake of carbohydrates, and take predominantly low GI carbohydrates day to day.

    A valid comment is that there are essential amino acids, essential fatty acids, but no such thing as essential carbohydrates. We do need some fibre (carbohydrates) in our diets to maintain healthy digestive systems and many essential vitamins and minerals are obtained from fruits and vegetables (carbohydrates). The term essential refers to the fact that the human body cannot obtain such substances from other sources and have to consume them.

    However if one is diabetic they should find a doctor and discuss their plan of management carefully as there are considerations to be made regarding balancing diet control and medication in the management of diabetes.

    Most people hear something and then make their own conclusions. And that is plain dangerous!

    On the other hand I do acknowledge some of the ideas, concerns and expectations that patients may have gathered from reading books and surfing the internet.

    And in my own way I search for the relevant indicators, clinical guidelines and ethical issues in my own research and then reconcile the two ICEs.

    By Anonymous Anonymous, At September 14, 2005 8:20 pm  

  • Inflammation is the new pink.

    Unfortunately it takes years for postulations to become trials to become evidence to become clinical guidelines.

    I cannot imagine that the evidence will one day show that insulin for uncontrolled diabetes cause more harm than good.

    But then, Vioxx.

    By Blogger angry doc, At September 14, 2005 8:36 pm  

  • man i learn more from these blogs and the comments than i did from all my lectures throughout all 5 years combined


    it's either that you guys are extremely informative and knowledgeable, or it could be because i always fall asleep even when i'm sitting right in front of the class

    By Anonymous Anonymous, At September 14, 2005 10:05 pm  

  • If medical school do anything it was to put me off learning.

    Once you start practising self-learning becomes necessary and enjoyable, because you are not ust mugging for an exam, but learning things to apply in your craft.

    By Blogger angry doc, At September 14, 2005 10:19 pm  

  • Yeah, I totally agree with you angry doc.

    Medical school was all about passing exams. Not so much about becoming good doctors.

    I think learning from specialists is one of the worst ways to learn primary care and especially preventive medicine.

    Most specialists see very sick people in the hospital. I mean that's what they are good for. They hardly ever see normal people. So it would be fair to say that specialists have absolutely zero experience in teaching patients how to prevent diseases. They are good at treating them after they have come on, but they are the worst to learn how to prevent diseases and stay healthy.

    I went for a CME on stroke prevention. The specialists idea was to take hypertensive medication, diabetic medication, lipid lowering drugs and even more medicine!

    When I asked about diet and all. One specialist commented that if he had a stroke, he'd want to take his lipitor and enjoy laksa rather than go on diet.

    The topic was PREVENTION of stroke. He totally missed it.

    As such I have little respect when my patients tell me their specialist told them not to worry about diet because they were on medication already.

    I usually ask them a simple question. To become a healthier person, do you take better nutrition and more fruits and vegetables or more and more drugs?

    Most people don't realise it, but many specialists dish out drugs to their patients but would not do the same for themselves when they have the same disease. They take vitamins and supplements. But they won't do that for their patients because they fear their patients would laugh at them.

    By Anonymous Anonymous, At September 15, 2005 10:29 am  

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