A cikin rubutun Brownstone Journal na baya, I bayar duba lafiyar lafiyar Amurka daga matakin ƙafa 30,000, da kuma kwarewa Na dawo a cikin 1978, yayin da mazaunin likitancin ciki wanda ke da tasiri mai zurfi akan aikin ƙwararru na na gaba. A yau, Ina so in mai da hankali musamman kan abubuwan da na samu game da cututtukan cututtuka (ID) a lokacin makarantar likitanci, wurin zama na likitancin gida (IM), da kuma farkon aikin kulawa na farko na karkara, kamar yadda na yi imani yana ba da abin da muka taɓa ambata a matsayin "lu'u-lu'u na asibiti" a cikin bayyanar da martanin Covid.
Na halarci Makarantar Kiwon Lafiya ta SUNY Downstate daga 1973 zuwa 1977. Babban ci gaban ID a cikin wannan lokacin shine ganowa da halayen ƙwayoyin T, da kuma samar da su a cikin glandar thymus. Kafin wannan lokacin, kawai aikin da aka sani na glandan thymus shine dangantakarsa da myasthenia gravis. A gaskiya ma, kafin shekarun 1970s, nau'i na Merck Manual (wani lissafin bincike da magani da aka buga tun 1899) an gane radiation zuwa kai da wuyansa a matsayin magani mai dacewa don matsananciyar kuraje. Abin baƙin ciki shine, idan glandan thymus ya shafa sosai, marasa lafiya za su ci gaba da abin da ke da kuma har yanzu ana san su da mummunar cututtuka na rigakafi (SCID), wanda mutuwa daga sepsis zai kasance akai-akai.
Wani fasalin da ke da alaƙa da ID na horo na makarantar likitanci shine Asibitin Kings County (KCH), wanda ke kan titi daga Downstate, yana da wani gini na musamman don kula da masu fama da tarin fuka (TB). A wancan zamanin, ana iya tilasta wa marasa lafiya su zauna a asibiti na tsawon watanni don tabbatar da bin magunguna. Na tuna, duk da haka, ana ƙalubalantar dokokin da suka ba da izinin irin wannan ɗaurin kurkuku, kuma an soke su jim kaɗan bayan na fara horon zama na.
A cikin faɗuwar shekara ta 1976, a matsayina na ɗalibin likita na shekara huɗu, na yi zaɓe a hidimar huhu. A wancan lokacin, an yi wa dubun-dubatar Amurkawa, galibinsu tsofaffi, allurar rigakafin cutar murar alade da ake tsammanin ba ta taba faruwa ba. A zahiri, monologue na Johnny Carson akan Nunin Yau Dare a wasu lokatai ya haɗa da quip cewa mun ƙirƙiri maganin rigakafi don neman cuta. A gaskiya ma, yayin da akwai ƙasa da kima na mutuwar daga cutar murar aladu, an sami mutuwar ɗari da yawa daga maganin alurar riga kafi, galibi a matsayin rikitarwa na cutar Guillain-Barre (GBS) da ke haifar da alurar riga kafi. Ba da daɗewa ba bayan fara wannan zaɓen, wata mata mai shekaru 70 da haihuwa wadda ta karɓi maganin mura na aladu makonni da yawa da suka gabata an shigar da ita sashin kula da huhu tare da rashin iya hadiyewa, da kuma matsanancin damuwa na numfashi.
An ƙaddara cewa tana da GBS, mai yiwuwa daga maganin alurar riga kafi, wanda ya gurɓata tsokoki na esophage da diaphragmatic ta hanyar lalacewa ta hanyar rigakafi ga jijiyoyi na waɗannan tsokoki. Ta bukaci shigar da iska tare da injina, kuma aikina na farko shi ne sanya bututun hanci sau biyu a kullum don samar da abinci mai gina jiki. Ta kasance a kan na'urar numfashi na tsawon makonni biyu, kuma ciyarwar nasogastric ya kasance tsawon makonni hudu. Bayan sati shida ta warke sosai ta koma gida. Iyakar abin da ya rage mata GBS shine faduwa a gefe guda na fuskarta (wanda aka sani da palsy Bell).
Bayan watanni da yawa, na ganta yayin da nake tafiya a filin KCH (hakika, ta fara ganina), kuma ta kusan zuwa gare ni don ta rungume ni. Har yanzu ina tuna wannan lamarin kamar jiya ne! Ba zan yi mamakin gano cewa Anthony Fauci yana da hannu a ƙoƙarin rigakafin ba. Aƙalla, tsarin aikin sa ne.
A cikin bazara na 1977, kusa da ƙarshen shekara ta huɗu na ɗalibin likitanci, na yi zaɓin Rheumatology. A lokacin muna ganin adadin cututtukan cututtukan ƙwayar cuta na Lyme, yawanci a cikin haɗin gwiwa. Sai bayan shekaru biyu ne muka yanke shawarar cewa waɗancan majiyyatan sun kasance a ƙarshen lokacin rashin lafiyarsu, bayan sun kamu da kwayar cutar da ta haifar da amosanin gabbai shekaru 3-5 a baya. Bayan wasu shekaru ne aka taso da zato kuma gaba daya an yarda cewa wannan kwayar halitta ta samo asali kuma an sake shi daga dakin gwaje-gwaje na bioweapon na gwamnati a Matsuguni ko Tsibirin Plum. Har yanzu, wasu abubuwa ba sa canzawa.
Na kasance a Downstate don horar da zama na IM, wanda ya fara a watan Yuli 1977. Mafi yawan kwarewata shine a KCH, ɗaya daga cikin asibitoci mafi yawan aiki a duniya, wanda shine kuma har yanzu yana cikin tsarin Kiwon Lafiya na Birnin New York +. Na kuma dauki lokaci mai yawa a Asibitin Gudanar da Tsohon Sojoji (VA), wanda yanzu wani bangare ne na Kula da Kiwon Lafiya na VA New York Harbor, tare da gajerun lokuta a Asibitin Jami'ar da ke Downstate.
Juyawana na farko shine a sashen kula da gaggawa na manya na KCH. Ganin sunansa a matsayin wurin da za ku iya ganin komai da komai, na damu matuka game da fara horo na IM a can. Shi ne lokacin da na fahimci cewa, idan aka fuskanci yanayi mai tayar da hankali, duniya za ta iya kasu kashi biyu: (1) waɗanda haƙoransu ke rufewa har ba za ku iya ci ba; da (2) waɗanda za su ci hanyarsu ta ƙofar firij domin su sami abinci da sauri. Yawancin mutane suna cikin rukuni #2. Ina cikin rukuni na #1, don haka na yi asarar 10lbs a cikin makon farko na wannan jujjuyawar, tun da na fara makon a 135 lbs da 5'10".
Ban sake samun nauyi ba sai karshen shekarar farko ta zama. Sai na sami wani sitika na ajiye motoci, wanda ya ba ni damar yin tuƙi zuwa wurin aiki, maimakon tafiya. Nan da nan na sami ƙarin fam 20 kuma na girma paunch, wanda har yanzu ina da fiye da shekaru 45 bayan haka! A wancan watan ne lokacin da NYC baƙar fata ta faru. Ina aiki da karfe 4 na yamma zuwa tsakar dare, wanda na kashe na dinke masu sace-sacen jama'a, amma hakan na iya zama batun wani sakon jarida na Brownstone.
Juyi na na wata na uku (Satumba 1977) na kasance a cikin babban ɗakin mazaje. Kusan nan da nan (a karshen mako na Ranar Ma'aikata), na shigar da wani matashi dan shekara 21 da ke daure da zazzabi mai zafi, rudani mai laushi, da kananan vesicles da suka rufe dukkan jikinsa. Likitan jijiyoyin jijiyoyi da sun yi huda lumbar, sai dai vesicles sun yi yawa har suna tsoron gabatar da wani abu daga gare su a cikin ruwan kashin baya. A wancan zamanin, mun yi abin da aka sani da gwajin Tzanck, inda aka goge gindin vesicle, kayan da aka samu an sanya su a kan zamewa, kuma an lalata su.
Nan da nan ya bayyana alamun yiwuwar kamuwa da cutar ta herpes. A wancan zamanin, maganin rigakafi kawai da ake samu shine acyclovir na ciki, wanda har yanzu magani ne na bincike, wanda ake samu daga Jami'ar Michigan, Ann Arbor. Har yanzu ina tunawa da ’yan’uwanmu ID da aka kai maganin zuwa filin jirgin saman LaGuardia, inda suka dauko shi suka kawo shi asibiti inda na yi amfani da shi ta drip ta cikin jini. Mara lafiyar ya murmure gaba daya cikin kimanin kwanaki 5 kuma an sallame shi. Sai bayan shekaru 7 na sami farkon abin da nake magana a matsayin "tsarki sh * t" lokacin da na gane cewa wannan majiyyaci yana da AIDS. Da alama wannan matashi ya mutu a cikin shekara guda da wannan asibiti.
Wani ban sha'awa mai ban sha'awa a cikin wannan yanayin ya faru ne lokacin da wani likitan dabbobi mai suna Julian Rosenthal ya nemi izini ya zana samfurin jini don yin binciken fararen jini. Bayan kamar wata biyar, na yi karo da Dr Rosenthal a tsakiyar dare, a lokacin da nake kira, na tambaye shi ko ya sami wani abu. Ya ce yayin da adadin farin jinin majiyyaci ya kasance na al'ada, ba shi da masu taimakawa-T-cell.
Ga wadanda ba ku da masaniya da kalmar, mataimaki-T-cells, yanzu an san su da ƙwayoyin CD4. Ya bayyana cewa wannan likitan ilimin likitancin ya ƙusa mahimmin alamar kula da cutar kanjamau tun farkon 1978! A wancan lokacin, ba shakka, ba mu san abin da za mu yi da wannan binciken ba; shekaru uku ne kacal da waɗannan kwayoyin halitta ma aka siffanta su. Don haka, bayanan da muhimmancinsa sun ɓace har tsawon shekaru da yawa.
A watan na gaba (Oktoba 1977), na kasance a Asibitin Downstate inda na shigar da wani ɗan sanda mai ritaya a Brooklyn, wanda ya kai shekaru 70 kuma ya kasance ɗan Italiyanci. Yana da ciwon huhu da ba a taɓa gani ba. Yana da cutar sankarar jini ta lymphocytic (CLL) na tsawon shekaru da yawa, kuma ya kai matsayin da, a cikin shekaru 2-3 da suka gabata, yana buƙatar ƙarin jini kowane watanni 3-4. A lokaci guda, na gaji direban trolley da ya yi ritaya a Brooklyn, wanda shi ma ya kai shekara 70 kuma ya zama ɗan ƙasar Irish, wanda ya ƙara yin baƙin ciki saboda yawan kwanaki a asibiti. Bana tuno meye ciwon nasa.
Sa’ad da na girma a Queens, na ɗauki lokaci mai yawa a Brooklyn, tun da kusan dukan ’yan’uwana sun zauna a wurin tun lokacin da na tashi daga jirgin a tsibirin Ellis a lokacin WWI. Hakika, sa’ad da na kai ɗan shekara 10, na yi tunanin cewa sa’ad da mutanen da ke zaune a Queens suka kai wasu shekaru, ana tura su zuwa Brooklyn! Don haka, na yi amfani da duk lokacin da na samu tare da waɗannan majiyyatan biyu na tambayar su game da rayuwa a Brooklyn kafin lokacina (an haife ni a shekara ta 1951).
Na kuma gane cewa saboda duka majiyyatan suna ƙara yin baƙin ciki, yana iya zama kyakkyawan ra'ayi don samun mazan biyu a ɗaki ɗaya na masu zaman kansu. Na ambata wannan ga babban mazaunin wanda ya yarda kuma ya sa hakan ya faru. Majinyatan biyu sun yi hulɗa sosai, kuma ɗakin su ya zama wurin zama na gida ga duk wanda ke aiki a wannan sashin. Ba sai an fada ba, iyalan wadannan majinyata biyu sun dauke ni kamar ni tauraron dutse ne, kuma saboda ingantacciyar yanayin tunani, yanayin jikinsu ya inganta cikin sauri.
Komawa ga majiyyaci tare da CLL da ciwon huhu na huhu, likitan huhu ya yi bronchoscopy ta amfani da madaidaicin ma'auni (masu sassaucin ra'ayi ya kasance kwanan nan an haɓaka su, kuma ba su da yawa). Rahoton ya dawo a matsayin ciwon huhu na pneumocystis (PCP), wakili mai kamuwa da cuta wanda da kyar aka ambata a lokacin horon makarantar likitanci na. Yanzu mun san cewa PCP pneumonia alama ce ta AIDS mai cike da busa, amma ba a san hakan ba sai bayan shekaru 4 ko 5. Ban tuna waɗanne magunguna aka yi amfani da su don magance PCP a waɗannan kwanaki ba, amma na san cewa ba trimethoprim-sulfamethoxazole ba ne, wanda yake samuwa, amma ana amfani da shi kawai don maganin cututtukan urinary.
A cikin shekarar farko na zama na IM ne, baya ga sassauta dokar keɓancewa game da masu cutar tarin fuka, adadin masu cutar tarin fuka ya ragu sosai, ta yadda aka canza ginin TB zuwa wasu amfani, da sauran ƴan marasa lafiya na tarin fuka an ɗauke su zuwa wuraren kiwon lafiya na yau da kullun. Canjin kawai da aka yi don ɗaukar waɗannan marasa lafiya, da zarar sun daina buƙatar keɓewa, shine ƙari na hasken UV a bayan inuwar taga.
Tunawa na ne a farkon wannan cutar ta Covid na fara matsawa don amfani da UV a cikin tsarin HVAC a duk wuraren taron jama'a na cikin gida, maimakon amfani da kayan kariya marasa amfani. A haƙiƙa, ba a buƙatar abin rufe fuska a wuraren da ake jinyar masu cutar tarin fuka, kuma ban tuna ana buƙatar abin rufe fuska a cikin ginin tarin fuka da zarar an ɗauke marasa lafiya daga sashin keɓewa zuwa wani buɗaɗɗen ward. Zan lura cewa a cikin shekaru bakwai na makarantar likitanci da kuma zama na IM, ƙasa da ɗimbin ɗalibai, ma'aikatan jinya ko ma'aikatan gida sun gwada ingancin tarin fuka.
A gaskiya ma, babban haɗari ga ma'aikatan gida shine sandunan allura da kwangilar HIV (wanda ba a bayyana shi ba har sai 1984) ko kuma, mafi mahimmanci, hepatitis C (wanda aka sani a lokacin da ba A / non-B hepatitis, tun da cutar ba ta riga an kwatanta shi ba). Sandunan allura sun faru da mu duka, a matsakaici, kusan sau 2-3 a kowace shekara. A wancan zamani, babu wanda ya sa safar hannu lokacin zana jini ko kuma yayin da yake yin wasu ayyukan kula da majiyyaci inda aka sami fallasa ruwan jiki, idan aka yi la'akari da cewa ba a ƙirƙiri daidaitattun matakan kiyayewa da aiwatar da su ba har sai bayan shekaru da yawa. Bugu da ƙari, ikonmu na kare samar da jini daga HIV da hepatitis C bai faru ba sai 1994!
Rage cututtukan tarin fuka ya zama ɗan gajeren lokaci. Farkon kamuwa da cutar kanjamau a cikin shekarun 1980, wanda ya haifar da yanayin rigakafi, ya haifar da hauhawar tarin tarin fuka, tare da yawancin lokuta masu jure wa magunguna da yawa. Ya ɗauki fiye da shekaru goma, da haɓakar maganin rigakafin cutar kanjamau (HAART) don samun yaduwar tarin fuka zuwa abin da ya kasance a ƙarshen 1970s. Abin lura, an sami babban jinkiri a ci gaban HAART saboda neman samar da maganin rigakafi, ƙoƙarin da wani Anthony Fauci ya jagoranta. Wasu abubuwa ba sa canzawa!
Mu ci gaba da sauri zuwa Yuni 1978. Wata ne na ƙarshe na shekara ta farko na zama, kuma na kasance a sashin mata a KCH. An kira ni da misalin karfe 11 na dare cewa ana shigar da wani yaro dan shekara 12 a gare ni. Yawancin lokaci, ana shigar da wanda ya kai shekarun zuwa asibitin yara; duk da haka, saboda matsalolin likita, an yanke shawarar shigar da ita aikin likita. Wannan yarinya ta yi fama da rashin lafiya mai kama da mura kwanaki da yawa wanda har ta kai ga ta kasa tashi daga kan gado. Ba a iya samun hawan jininta, kuma ta yi fari sosai. Ina dubanta, ba zato ba tsammani ta ɗaga kai cikin inci ɗaya na fuskata, ta ce, “Don Allah a taimake ni,” nan take ta faɗi ta mutu.
Mun yi CPR har zuwa wayewar gari, tsawon aƙalla sa'o'i shida, kuma ba mu sami bugun zuciya ɗaya ba. An samu izinin yin gwajin gawarwaki, kuma bayan watanni uku, ya bayyana dalilin mutuwar a matsayin kwayar cutar myocarditis. A tsawon lokacin rikice-rikice na Covid, duk lokacin da aka ambaci myocarditis, musamman a cikin yara, cikin sharuddan sallamawa, jinina zai tafasa. Har yanzu yana yi.
Bari mu ci gaba zuwa lokacin da yake kusa da ranar ma'aikata 1978, lokacin da nake dan shekara ta biyu kuma babban mazaunin sashin huhu a KCH. Mun shigar da wasu ’yan’uwa biyu da ke fama da ciwon huhu, waɗanda suka zama alamun fashewar Legionnaires a Cibiyar Tufafi da ke wajen kantin Macy. An bi da su tare da erythromycin kuma sun yi kyau. CDC, NYC Dept of Health (kafin a haɗa su da NYC Dept of Mental Hygiene), da NYS Dept of Health sun haɗa kai don tabbatar da ganewar asali kuma sun ba da shawarar maganin da aka ba mu ta hanyar ID ta abokan aiki. Duk sun tafi lafiya. Ganin abin da muka gani yayin amsawar Covid, shin hakan na iya faruwa!?
A yau, muna da spirometers na hannu waɗanda ke ba da bayanan aikin huhu cikin sauri da sauƙi waɗanda ke taimakawa wajen tantance lokacin da marasa lafiya ke shirye don fitarwa. A lokacin, da mun yi amfani da dakin gwaje-gwaje na huhu (ta hanyar alƙawari kawai), inda aka yi amfani da ƙwanƙarar ƙarfe mai tsayi ƙafa biyar a cikin wanka na ruwa don samun irin wannan bayanin. Ban tuna da ganin majiyyaci a cikin wannan lab ba. Ya faru ne da ni da mazauna shekara ta farko muna yin zagaye na tsakar dare sa’ad da muka tarar da majinyatan biyu a cikin matattakala suna shan taba tare da budurwarsu. Na juya ga mazaunan shekara ta farko, na bayyana cewa marasa lafiya biyu ba su yi mani guntun numfashi ba… me kuke tunani? Da suka amince, sai muka yanke shawarar tura su gida washegari da safe. Yaya abin yake ga likitancin asibiti a cikin mafi kyawun sa?
A matsayina na babban mazaunin unguwar, na samu gabatar da shari’o’in a Grand Round, wanda ke da manyan wakilai daga hukumomin da aka ambata da kuma masu halartar ID da yawa daga ko’ina cikin NYC. An buga duka Grand Ronds. A cikin 'yan shekarun nan, an sami sake bullowar shari'o'in Legionnaires, duk da cewa mun samar da ƙayyadaddun ka'idoji don rigakafin wannan kamuwa da cuta wanda yake da inganci a yau kamar yadda yake a lokacin.
Da zarar kwayar cutar da ke haifar da Legionnaires ta keɓe, CDC ta gwada samfuran jini daga barkewar cutar zuwa 1920s, lokacin da ba a tantance dalilin ba. An gano cewa mai yiyuwa ne wannan kwayar halitta ta rikide a karshen shekarun 1920 lokacin da aka fara amfani da na'urorin sanyaya iska mai sanyaya ruwa. Ku da kuka kasance a kusa kafin wannan fashewar Legionnaires za ku iya tunawa cewa lokacin da kuke tafiya a titunan Manhattan a lokacin bazara, akwai hazo da za a iya ji. Ruwan da ke fitowa daga na'urorin sanyaya iska mai sanyaya ruwa ne ke ta shawagi daga rufin saman benen. Wannan hazo na dauke da kwayoyin halittar Legionnaires. Ta hanyar ɗaukar ƙazamin, an kawar da haɗarin kamuwa da cuta. An sami barkewar annobar Legionnaires na baya-bayan nan, a mafi yawan lokuta, ta hanyar yin watsi da wannan sanannen matakin kiwon lafiyar jama'a.
Ɗaya daga cikin samfuran CDC da aka gwada, kuma an tabbatar da shi daga Legionnaires' kwayoyin Ya kasance daga barkewar cutar a cikin 1968 a cikin ginin ofishin gwamnati a Pontiac, MI wanda aka fi sani da zazzabin Pontiac. Akwai wani labari na Afokirifa game da barkewar cutar ta Pontiac, ta yadda hakan ya faru ne a daidai lokacin da ma’aikatan za su shiga cikin rashin lafiya, inda gwamnati ta yi barazanar korar duk wanda bai zo aiki ba. Ganin cewa ba a ƙayyade yanayin rashin lafiyar ba har sai CDC ta duba samfuran jini shekaru goma bayan haka, an kori ma'aikata.
Na fara jin wannan labarin a farkon shekarun 1980. Koyaya, a cikin 2012, na sami damar tuntuɓar likitocin kiwon lafiyar jama'a waɗanda ke aiki yayin duka 1978 Legionnaires' da 1969 Pontiac Fever fashewa, kuma ba su da tunawa da wannan taron. Dangane da nau'ikan bayanan sirri da muka gani daga hukumomin kiwon lafiyar jama'a yayin amsawar Covid, Ina dagewa da tunawa da abubuwan da suka faru har sai an tabbatar da in ba haka ba!
A kusa da karshen mako na Ranar Ma'aikata na 1979, ni mazaunin shekara uku ne da ke rufe sashin kula da lafiya na KCH. Wasu daga cikin mazauna shekara ta farko da aka yi wa waya a daren jiya sun gabatar da karar wata budurwa mai zazzabi da gudawa. Tana da tarihin hyperthyroidism, don haka tunanin nan da nan shine cewa wannan guguwa ce ta thyroid, wanda zai iya zama barazanar rai. Na yi shakku, tunda matar tana da kiba sosai, wanda ba sifa ce ta hyperthyroidism ba, kuma wasu alamun hyperthyroidism ba su halarta ba.
Na tambayi ko sun yi al'adar stool. Lokacin da amsa ta kasance, a'a, na yi shi nan da nan. Ya dawo kwana ɗaya daga baya tabbatacce ga Salmonella. Sai ya zama ma'aikaciyar abinci ce a cafeteria KCH. A cikin sa'o'i 24-48 na gaba, ma'aikatan gida sama da 400 sun zo tare da Salmonella. Wasu ayyukan sun lalace gaba daya. Abin da ya fi muni shi ne ilimin tabin hankali. Da yawa ga masu tabin hankali ana kallon su a matsayin matsi! Labari mai dadi shine kowa ya murmure. Na kasance ɗaya daga cikin ƴan ƙalilan da ba su yi rashin lafiya ba, musamman saboda ba za a kama ni na mutu ina cin abinci a wurin cin abinci na KCH (ko wani wurin cin abinci a asibitin da na yi horo ba). Kullum zan sami wurin pizza kusa (Na kasance a cikin mutanen Brooklyn. Enuff ya ce!).
Na kammala zama na IM a ƙarshen Yuni 1980 kuma nan da nan na ƙaura zuwa gundumar karkara a cikin jihar NY don fara aikin likita na. Har wa yau, a wajen karshen mako na Ranar Ma’aikata, na shigar da wani dattijo mai tsananin gudawa, wanda ya girma Shigella kan al’adar stool. Shigellosis cuta ce mai saurin kamuwa da cuta ta yadda kawai yana ɗaukar ƙananan ƙwayoyin cuta 100 don haifar da cikakkiyar rashin lafiya. Yawancin cututtukan ƙwayoyin cuta masu haifar da gudawa suna buƙatar dubban kwayoyin halitta a kowace millilita don haifar da rashin lafiya. Ma’aikatan jinya da dama da na’urorin fasahar lab sun yi rashin lafiya, duk da cewa sun san taka tsantsan da ya kamata. Ban yi rashin lafiya ba kuma ban aika wa wani ba, yana nuna cewa aikin wanke hannuna tabbas ya yi kyau sosai.
Majinyacin na asali ya mutu ne daga rashin lafiyarsa, amma kafin a kai shi ga sauran majiyyaci a cikin dakinsa na sirri. Wannan majinyacin kuma ya tsufa sosai amma ya tsira. Babban abin tunawa da wannan majiyyaci shine kafin wannan rashin lafiya ya sha fama da rashin lafiya na tsawon lokaci wanda ya koma gwamnatin Roosevelt (Teddy, ba Franklin) ba! Bari in tabbatar muku cewa Shigellosis bai taba zama maganin ciwon ciki ba.
Abubuwan da na samu a cikin ID sun bayyana suna nuna cewa yayin da wasu manufofi / ayyuka da haɗin gwiwa tsakanin ƙwararrun kiwon lafiya na iya kasancewa mafi kyau a wancan lokacin fiye da yadda suke a yau, wasu daga cikin tsaba na martanin Covid da ba daidai ba suma suna cikin shaida. Wani abu daya tabbata shine ganin cewa yawancin al'amuran da na gabatar sun faru ne a kusa da ranar ma'aikata, na gaskanta cewa ba shi da kyau a kasance da ni a ranar ma'aikata, amma yana iya zama ba kyakkyawan ra'ayi ba ne a kusa da ni a ranar ma'aikata.
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Steven Kritz, MD likita ne mai ritaya, wanda ya kasance a fagen kiwon lafiya tsawon shekaru 50. Ya sauke karatu daga SUNY Downstate Medical School kuma ya kammala zama na IM a Asibitin Kings County. Wannan ya biyo bayan kusan shekaru 40 na ƙwarewar kiwon lafiya, ciki har da shekaru 19 na kulawa da haƙuri kai tsaye a cikin ƙauyen ƙauye a matsayin Kwamitin Certified Internist; Shekaru 17 na bincike na asibiti a wata hukumar kiwon lafiya mai zaman kanta-ba don riba ba; kuma sama da shekaru 35 na shiga cikin lafiyar jama'a, da tsarin kiwon lafiya da ayyukan gudanarwa. Ya yi ritaya shekaru 5 da suka gabata, kuma ya zama memba a Hukumar Binciken Institutional Review (IRB) a hukumar da ya yi bincike a asibiti, inda ya kasance shugaban IRB tsawon shekaru 3 da suka gabata.
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