Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

The Prehospital 12-Lead ECG blog receives its first hate mail

There is a post titled, The Prehospital 12-Lead ECG blog receives its first hate mail. I could provide some explanation, but the title pretty much says it all. However, Tom B. does an excellent job of using the heckler to provide personal entertainment for his readers. I provide some commentary of my own, but go read what Tom B. wrote.

Third, it is academically dishonest and even perhaps illegal to directly quote from an article without a proper citation.

Academically dishonest? I guess I will have to call Tom, Professor Tom.

Please provide a citation for the improper citation being illegal.

There is a link to the article that appears to have inspired this tirade. The link seems to be to an article by the same Mr. Matthew Paulus, BME, EMT-P, MS-S NP-S/Cardiopulmonary CNS-S, who seems to have ignored the link. I guess that he only acknowledges a certain style of citation. A link is a citation, even if it is not in the form that Letter Man might prefer. My link to Prehospital 12-Lead ECG could result in my arrest for not being a proper citation? Oh, my!

It is equally dishonest and professionally unethical to make criticisms of published materials using nothing more than mere opinion.

Mere opinion?

I am insulted!

My opinion is scattered throughout my posts, but describing it as mere opinion is a mistake. And probably illegal!

OK. It isn’t illegal.

So, I should expect a visit from Letter Man?

The entire concept of publishing a paper is to put it out there for your peers to criticize. It’s one of the hallmarks of science.


Furthermore, I found your opinions unfounded, misguided, inaccurate, unkind, irresponsible, and lacking an academic foundation.

What? No proof of some communist conspiracy? Alien abduction? That’s all you’ve got?

I advise you to use caution, sound judgement, graciousness, sound ethics and humility when publicly critiquing published materials.

Good gracious!

If you’re attacking me on style points, then point taken. I can be a bit brash sometimes.

Let’s hope that this guy doesn’t decide to actually work in EMS, rather than just write about EMS. Brash doesn’t even begin to describe the vocabulary of some of the patients. Then, assuming he cavalierly dispenses calcium channel blockers to wide complex tachycardia patients, he may be find the plaintiff’s attorney to be more than a bit unpleasant.

Though I do not know the person’s background, it forces one to wonder whether this blogger is educated beyond what his own intelligence permits.

It doesn’t force me to consider that, at all. However, Letter Man is consistent in his misinformation.

I will avoid this site and advise others to do so until it can be based on a solid foundation of knowledge.

He will avoid this until things change?

If he avoids the site, how would he know if things change?

Personal opinion does not cut it.

Please provide some evidence to support this personal opinion.

Thank you,
Matthew Paulus, BME, EMT-P, MS-S NP-S/Cardiopulmonary CNS-S

I love the Thank you, after all of the failed attempts at insults. They would need to have some substance to not fail.

BME? Bloviating Medic Emeritus?

I wonder about all of the MS-S NP-S/Cardiopulmonary CNS-S. Does the -S mean student?


Maybe I should list the books that I am reading with -R after the title. Maybe a movie that I am watching with -W. Of course, maybe -S does not mean student. Clearly, he knows it all.

I am surprised that there was no accusation of libel. Libel is the adult version of, You can’t say that! With all of the accusations of libel directed at me, no lawyer has yet contacted me. Thank you for the giggles, Mr. Paulus.


Whistle-Blowing Nurse Is Acquitted in Texas

Much has been written about the fanatics criminals trying to get Anne Mitchell, RN locked up. I will only give a brief summary.

A quack – Rolando G. Arafiles Jr., who for some odd reason has not yet been stripped of his medical license, had the sheriff investigate anonymous reports to the Texas Medical Board about his abuse of patients. The sheriff arrested Nurse Mitchell and charged her with a felony that could put her in jail for 10 years and could include a $10,000 fine. The fraudulent investigation probably did contribute to her being wrongfully fired. The county prosecutor, who works for the charlatan, decided to prosecute.

All of these frauds belong in jail.

The case was investigated by Sheriff Robert L. Roberts Jr., a friend and admiring patient of Dr. Arafiles, and tried by the county attorney, Scott M. Tidwell, a political ally of the sheriff and, according to testimony, Dr. Arafiles’s personal lawyer.[1]

In case you are thinking that this is a misrepresentation of their criminal abuse of power, the jury did not have to deliberate for long.

The jury foreman said the panel of six men and six women voted unanimously on the first ballot, and questioned why Mrs. Mitchell had ever been arrested.[1]

Where would a good story about fraud be without a bunch of cognitive dissonance?

Sheriff Roberts said he was disappointed in the verdict but did not regret the prosecution.[1]

The next jury should arrange for these frauds to be bunkmates in a prison where they do not have any friends.

We want nurses and others to feel comfortable reporting potential problem doctors to state medical boards. The medical board should be the ones determining if the complaint is valid.

After the verdict, the nurses’ lawyers pivoted quickly to the lawsuit[2] they have filed in federal court against the county, the hospital and various officials, charging that the firings and indictments amounted to a violation of due process and their First Amendment rights.[1]

Texas, it turns out, has laws that protect whistle-blowers — but only from civil suits. Criminal prosecution is another matter entirely. After the medical board received the nurses’ anonymous complaint, its investigators gave a copy to Dr. Arafiles. That complaint alleged that he’d given patients inappropriate care, including sewing a rubber tip not intended to be attached to humans onto a patient’s crushed finger (a case that the Texas Department of State Health Services had red-flagged). Too, the complaint noted, Arafiles urged patients to buy Zrii, a questionable nutrition supplement sold via a pyramid-marketing structure.[3]

Last month Andrew Wakefield was publicly humiliated for his fraud. Let’s hope they follow that up with criminal charges.

This month another scam artist, Rolando G. Arafiles Jr., is publicly humiliated for endangering patients, as well. Likewise, let’s hope that after the civil trial, there are criminal charges filed against this witch doctor and his minions.

White Coat has written about this –

Nurse Acquitted

Respectful Insolence has written a lot about this –

Report a bad doctor to the authorities, go to jail? It might really happen for Anne Mitchell, RN in Winkler County, Texas

Dr. Rolando Arafiles: Antivaccine rhetoric topped off with colloidal silver for the flu and Morgellons disease

Report a bad doctor to the authorities, go to jail? The trial, day two

Report a bad doctor to the authorities, go to jail? The cranks weigh in

Winkler County Nurse Anne Mitchell is not guilty, not guilty, not guilty, not guilty!


^ 1 Whistle-Blowing Nurse Is Acquitted in Texas
By Kevin Sack
Published: February 11, 2010
New York Times

^ 2 Anne Mitchell and Vickilyn Galle, plaintiffs, vs. Winkler County Memorial Hospital; Stan Wiley, individually and in his official capacity as administrator of the Winkler County Memorial Hospital; Robert L. Roberts, Jr., individually and as Sheriff of Winkler County, Texas; Rolando G. Arafiles, Jr., individually; Scott M. Tidwell, individually and in his official capacity as County Attorney; and Mike Fostell, individually and in his official capacity as District Attorney, defendants.
US District Court for the Western District of Texas, Pecos Division.
Free Full Text PDF

^ 3 Medical emergency – In reporting a doctor’s mistakes, a West Texas nurse risked going to prison
Houston Chronicle Editorial
Feb. 11, 2010, 7:53PM


First Amendment and Holocaust Denial

At Respectful Insolence is a post, Holocaust denier and neo-Nazi sympathizer David Irving slithers his way through the western U.S., that riled up one of the commenters. Hardly a first on that blog. This commenter is not disagreeing with Orac on the evils of the Holocaust. No peter has his own solution way to deal with the nasty problem of the Jews Holocaust deniers.

It appears that someone has made the statement, What’s good for the goose is good for the gander, just a few times too many within earshot of this ZioNAZI. He is not happy with the idea that Holocaust deniers should be allowed to speak. His conclusion is that once you forbid discussion of bad ideas, the ideas cease to exist. The way he writes, I get the feeling that he would go much farther than that.

Holocaust deniers are people who claim that the NAZIs did not do all of the bad things that they really did do. David Irving has come up with the bizarre tactic of claiming that the NAZIs only killed 1.74 million Jews, not the commonly accepted number of 6 million Jews. This makes little sense.

Your honor,

I am innocent! I did not murder Millions of Jews. I only murdered millions of Jews.

Many people have wondered what might cause some people to follow these orders to round up, torture, and kill millions of people. Well, if you want an example of someone demonstrating rabid hatred that might be manipulated into this kind of behavior, read what peter has written here, here, here, here, here, here, here, here, here, here, here, here, and here. The links are to peter’s individual comments on the same post. Or you can just read through the comments from the top.

A more rational approach to the problem of what can get a seemingly ordinary person to behave as a sadistic murderer was put forward by Stanley Milgram.

The results as seen and felt in the laboratory are disturbing. They raise the possibility that human nature, or more specifically the kind of character produced in American democratic society, cannot be counted on to insulate its citizens from brutality and inhumane treatment at the direction of a malevolent authority. A substantial proportion of people do what they are told to do, irrespective of the content of the act and without limitations of conscience, so long as they perceive that the command comes from a legitimate authority. If, in this experiment, an anonymous experimenter can successfully command adults to subdue a fifty-year-old man and force on him painful electric shocks against his protests, one can only wonder what government with its vastly greater authority and prestige, can command of its subjects.
(S. Milgram. Quoted in ‘Encyclopedia of Genocide’. Ed. Israel W. Charney. Pub. ABC-CLIO. Volume 1, page 333.)

Is it impossible to repeat these experiments, now?

Apparently not.

Part I:

Part II:

Part III:

One thing peter mentions that is true is the need for responsibility for one’s actions. He does not seem to feel that there is any responsibility for his actions, because he believes that, the misbehavior of others automatically relieves him of responsibility for his actions.

The evil of others does not excuse evil on our part.

p. 98 Man’s Search for Meaning by Dr. Viktor Frankl.

Only slowly could these men be guided back to the commonplace truth that no one has a right to do wrong not even if wrong has been done to them. I can still see the prisoner who rolled up his shirtsleeves, thrust his right hand under my nose and shouted, “May this hand be cut off if I do not stain it with blood on the day when I get home!” I want to emphasize that the man who said these words was not a bad fellow. He has been the best of comrades in the camp and afterwards.

Viktor Frankl wrote this after he learned that his wife, mother, father, other relatives, and many of his friends had been killed murdered in concentration camps.

Dr. Frankl did not see being a victim as an excuse to victimize others.

p. 93

It is apparent that the near knowledge that a man was either a camp guard or prisoner tells us almost nothing. Human kindness can be found in all groups, even those which as a whole it would be easy to condemn.

p. 94

From all this one may learn that there are two races of men in the world, but only these two—the “race” of the decent man and the “race” of the indecent man. Both are found everywhere. They penetrate into all groups of society. No group consists entirely of decent or indecent people.

Some people rejoice in knowing that they are not evil, while others seem to be of the opinion that, if used by good people, evil is not evil. For them, the concept of a lesser of two evils is important. The definition of evil is important. Distinctions among degrees of evil are only important at sentencing hearings.

Another way, perhaps the best way to deal with the people susceptible to these behaviors is with ridicule. Mitchell and Webb do a great job of providing ridicule.

“Being tolerant does not mean that I share another one’s belief. But it does mean that I acknowledge another one’s right to believe, and obey, his own conscience.” Viktor Frankl

Tyranny cannot defeat the power of ideas.

Helen Keller As quoted in the Fighting the Fires of Hate: America and the Nazi Book Burnings exhibit at the United States Holocaust Memorial Museum (13 April 2003)