| 00:00 - 00:03 | Lewis: Today we have two cases on our elective list |
| 00:04 - 00:05 | The first is a lady with backpain |
| 00:05 - 00:07 | For this case we plan to do a posterior interbody fusion |
| 00:08 - 00:12 | For the second case, she has a grade 1 degenerative spondy |
| 00:12 - 00:15 | And therefore also needs fusion, ideally front and back ofcourse |
| 00:17 - 00:19 | Dr Hall: no need to do a fusion on either |
| 00:19 - 00:21 | Non op for the first patient, and decompression alone for second |
| 00:24 - 00:26 | Lewis: But Boss... |
| 00:27 - 00:28 | We thought ... |
| 00:31 - 00:33 | ...we thought the grade 1 spondy needs stabilising (Steven) |
| 00:34 - 00:36 | Steven: She has sagitally orientated facets |
| 00:53 - 00:58 | Dr Hall: everyone leave the room except Steven, Varman, Anum, and Lewis |
| 01:13 - 01:15 | Dr Hall: You fucking idiots always want to do the latest thing! |
| 01:15 - 01:17 | Not everybody needs a fusion! |
| 01:18 - 01:23 | I have done thousands of decompressions and have NEVER seen a patient come back with a problem |
| 01:25 - 01:28 | Why do you want to make a quick case... |
| 01:29 - 01:31 | ...into three hours of fucking around |
| 01:31 - 01:34 | and not to mention unnecessary complications and harm |
| 01:34 - 01:37 | I should report you to the medical council for incompetence |
| 01:37 - 01:40 | Have you learnt nothing during your time at the RAH? |
| 01:40 - 01:42 | Varman: But we thought given her backpain... |
| 01:42 - 01:46 | Mr Hall: Backpain! Christ, we can only make that worse you fool! |
| 01:46 - 01:48 | But Boss, her discs light up on CT SPECT |
| 01:48 - 01:52 | I dont give a flying fuck about her SPECT |
| 01:53 - 01:54 | Waste of resources! |
| 01:56 - 01:57 | We never had that fancy imaging in my day |
| 01:57 - 02:00 | The patient is 85years old |
| 02:00 - 02:03 | Just get them off the table as fast as possible |
| 02:04 - 02:08 | Why waste 3hours of your life, and our precious healthcare dollars |
| 02:08 - 02:13 | And hearing Aaron harp on about screw harmony, I couldnt take it, it'd drive me mad! |
| 02:14 - 02:16 | And even Simon asks this same question every Thursday SDM |
| 02:17 - 02:21 | A decompression takes most of us 45minutes if done properly |
| 02:27 - 02:29 | Except Yuchow who can do it in 30 |
| 02:30 - 02:34 | But then spends an hour ensuring adequate haemostasis |
| 02:34 - 02:36 | and they still get a haematoma.. |
| 02:41 - 02:42 | ...despite the drain |
| 02:43 - 02:47 | And if i hear about one more patient requiring a fusion |
| 02:48 - 02:53 | I will personally write to RACS and have you running pain clinics the rest of your career |
| 02:54 - 02:56 | Which will be short lived |
| 02:56 - 02:59 | You have all been brainwashed by industry and surgeons from the eastern states |
| 03:00 - 03:02 | front, back, 360, fusion...rubbish! |
| 03:04 - 03:07 | Annum: its ok we can put the patient on Matthews list |
| 03:14 - 03:16 | My Hall: My consultant colleagues are no better |
| 03:19 - 03:23 | The other day Aaron said to me "We have to move with the times" |
| 03:25 - 03:26 | Cancel my list |
| 03:31 - 03:33 | My gum has lost its flavour |
| 03:40 - 03:46 | At least Leeanne will be happy with the outcome, as the fellows will be confined to clinic.. |
| 03:46 - 03:49 | where they belong, and wont have an excuse.. |
| 03:53 - 03:56 | ..to not do virtuals |
