werner@aecom.UUCP (10/23/86)
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[Note: CABG, as in Coronary Artery Bypass Graft is pronounced 'Cabbage']
How a Farmhand paid for His Cabbage:
The Peter/Paul Principle
JAMA May 9, 1986 (255:2446)
To the Editor. -- A 53yr-old man underwent coronary artery bypass surgery
after his second myocardial infarction. The surgery was elective,
recommended because of high-risk lesions on cardiac catheterization, and
was funded by the state vocational rehabilitation program. His
subsequent course was uneventful.
Two months after surgery, he returned to his primary physicians,
reported no cardiac symptoms, and asked if he could return to work. For
the previous two years he had done farm work, and it was assumed that his
intention was to return to this, so he was advised that he could return
to work with the usual precautions. Exuberant, he left the office
volunteering, "Don't worry, doc! Now you will get your money." Two days
later we noted on the front page of the local newspaper that our patient
had resumed an earlier occupation -- bank robbery!
Critics of coronary artery bypass surgery or vocational
rehabilitation programs should take note of the success of both programs
in this particular case, which highlights, by its absence, the value of
a carefully taken history.
Karl Brandspiegel, MD
Mark M. Walsh, MD
Elizabeth City, NC
--
Craig Werner (MD/PhD '91)
!philabs!aecom!werner
(1935-14E Eastchester Rd., Bronx NY 10461, 212-931-2517)
"Man posesses limited intelligence, but alas, unlimited stupidity."