Bad News Tovarich

Cols:

I have a problem. I hoped to have good news for you but this is not the case.

The situation is this. Three medical professionals in Ontario have diagnosed me as having a brain trauma injury resulting from the car accident. One medical professional in Quebec has an alternate opinion.

Three should out vote one. All three doctors in Ontario have experience with brain trauma injury but none of them are neurologists. The doctor in Quebec is a neurologist. This means he is higher in the medical hierarchy and for this reason his opinion outranks the others.

There are a number of problems with his position. First, the tests he prescribed are bog standard tests but they are known to not detect the type of injury I have.

Four months ago I believed the MRI and other big machine, big science, big expense, tests would detect the injury, confirm the diagnosis, and provide some resolution. Prior to the test results being available one of my Ontario doctors advised me that MRI does not resolve DAI injury and DAI is likely what I have.

What is DAI? I have to look it up again in Wikipedia 🙂 During a violent rotational acceleration of the brain mass, the brain tissue (which is not of uniform density) will distort and twist and the connections between the axons will come apart. An MRI only resolves details greater than 1 millimetre. The damage to the axons is at the twenty micron level and is not resolved by MRI imaging.

When I was in the Coast Guard I gained experience with trauma injuries, amputations, you name it. Almost all of these had a mechanical component in which the flesh was torn, or cut, or punctured. DAI is different. The injury is primarily chemical, not mechanical. The initial damage to the brain tissue causes changes in brain chemistry and it is this chemical cascade that damages the brain cells. Mechanical damage and edema are visible on MRI diagnostic imagery. DAI injury will not be seen.

The Quebec doctor ordered a test known to be inappropriate for my type of injury. Not surprisingly, the test results were negative. He then infers from this negative result that I am OK, and have no injury. This is false. The true problem is that he ordered an inappropriate test.

So he either does not understand his job, or understand brain science, or he doesn’t give a damn, or he doesn’t like the “maudit Anglais.” Maybe all four.

I filed a complaint with the Collège des médecins du Québec. That was submitted on June 11th. I had a response from the Collège on Monday. They back the doctor. They tell me he is 100% OK. But their letter of exoneration contains multiple errors and misstatements of fact. To be honest, I don’t think they care very much either.

I have a deadline of October 20th to submit a response. I have done a logical analysis of what they have written and I believe they don’t know how to think. My advantage is that my first true love was epistemology. Epistemology is the study of knowledge, of what can be known, and not known. People diss Arts studies as a waste of time but through the years I have found my background in philosophy to have been of immense value. Most people simply do not know how to think. What we call logic is not natural to our species. From the age of fourteen, I was training myself to think in a disciplined and logical way and this been a huge benefit in a wide variety of settings. Was of no help whatsoever in preserving the marriage.

Given that I write very slowly and I must submit a response by the 20th of October, I expect I am going to be very busy.

Just wanted to let you know what has been going on up here. Really want to hear about your trip to Russia. Maybe we can talk next weekend?

All the best,

Love,

Dad

DAI on Wikipedia