Shiffman%SCH-GILA@sri-unix.UUCP (02/13/84)
From: Harris Shiffman <Shiffman at SCH-GILA>
>From the Los Angeles Times Calendar Section, 12 February 1984:
E.T., You Should Have Phoned Home For A Second Opinion
E.T could have sued for malpractice but he went home instead.
Gentle, good and lovable E.T. didn't even contact a lawyer after he
almost died on this planet in 1982, but some medical experts now think
he probably had a good case against the doctors who treated him in
Steven Spielberg's "E.T. The Extra-Terrestrial".
Seriously. Real-life doctors are making a fuss over the type of
medical treatment E.T. received. Some emergency-medicine specialists
think that doctors in the movie not only may have failed to recognize
that E.T. could have been suffering from a drug overdose, but they
apparently neglected a basic procedure that is taught to first-year
medical students.
A cheeky debate on the subject has been carrying on for more than a
year in the letters column of the medical monthly Annals of Emergency
Medicine. In the current issue, Dr. Alexander Lampone of St. John's
Hospital of Santa Monica - the actor/doctor who headed the medical team
that tended to the creature - defended his actions. But he did indicate
some uncertainly, noting, "Well, how do you know what to give an alien
from space?"
If they had been sued by E.T., Lampone and his team certainly would
have had a novel defense - one not seen in the average malpractice
dispute. They say that they did everything that their colleagues claim
they failed to do. But it actually was director Spielberg who endan-
gered their professional reputation by editing out many of the most
important steps in the battle to save E.T.'s life, they claim.
It's an ancient lament in Hollywood that the actor's best perfor-
mance was left somewhere on the cutting-room floor. But a doctor's?
Spielberg wasn't around to shed any light on any of these allega-
tions. His office said that he was out of town and unavailable. "And
frankly," a spokeswoman said, "on something like this, I wouldn't have
the faintest idea who to refer you to."
Why all of this is relevant today is testimony more to the glacial
pace of medical-journal communication than to anything else. But
criticism of E.T.'s medical care has been quietly and slowly - if
facetiously - building. It began in August, 1982, at a medical
symposium on rare poisoning cases, continued in the correspondence
columns of the medicine journal a year later and came to a head in the
current issue.
The debate pits Lampone against a prominent local emergency
physician, Dr. Jonathan Wasserberger of the Charles R. Drew Medical
School, Dr. Richard Weisman, director of the New York City Poison
Control Center and a prominent expert in the field of toxicology, and
Dr. Gary Ordog, a colleage of Wasserberger's at Martin Luther King
General Hospital.
E.T.'s physicians, say Wasserberger, Weisman and Ordog, made so
many mistakes when they tried to resuscitate the poor creature that they
almost killed him in the process.
For one thing, the E.T. medical team failed to ask little Elliot,
his young human friend, just what the stricken creature had been eating
in the days before the attack. If the doctors had asked, Elliot
probably would have told them that E.T. had liberally consumed Coors
beer and corn chips, a diet that almost certainly resulted in a
potentially catastrophic glucose deficiency. Because the doctors didn't
ask, they never began emergency intravenous therapy to correct the
dangerous interruption in his blood-sugar levels - whatever they
normally should have been.
Worse still, E.T.'s doctors completely overlooked the fact that his
pupils were constricted and his skin - if that's what you call it - was
turning bluish in the unmistakable first signs of cyanosis,, a sure
indication he wasn't getting enough oxygen. Together, those symptoms
should have warned E.T.'s physicians the poor creature was a victim of a
narcotic overdose.
That doesn't mean E.T. was a junkie, the dissident doctors quickly
added. E.T.'s bizarre physiognomy probably resulted in his manufac-
turing massive amounts of opiate-like natural chemicals. Humans do
essentially the same thing on a much smaller scale, in the manufacture
of natural pain-relieving chemicals called endorphins.
But E.T. probably produced such large quantities of natural narco-
tics that, when his body tried to compensate for the psychological
trauma of being abandoned on Earth, he essentially overdosed himself.
His doctors missed that, though, and lost an opportunity to pump him
full of a substance called a narcotic antagonist to ward off the
potentially fatal effects of his do-it-yourself drugs, the doctors
charge.
E.T.'s doctor joined the fray in the current issue, writing, "I am
pleased that our efforts did not go unnoticed by those with knowledge to
judge and evaluate the scene."
Then, having dismissed virtually all of the deficiencies in E.T.'s
care by using the "Spielberg-cut-it-in-editing" scenario, Lampone seems
to conclude that it doesn't matter since the patient survived anyway.
Specifically, Lampone asserted that he and his colleagues did give
E.T. several doses of Nalaxone, a common narcotic antagonist. And he
said that, contrary to the allegations against him, little Elliot, the
boy's family and friends were all quizzed on E.T.'s eating habits. "You
just have to assume that sometime during that period (the scene when
E.T.'s medical crisis occurs) we would have taken a thorough history,"
Lampone said.
"His heart arrested, and we were going to give him electrical
shocks, but if you shock someone with a crystalline skin, how do you
know you won't just crack them open?" Besides, Lampone said, "you can
rest assured that E.T. received the very best care. God was on our
side, and E.T. lives. He'll be back.
"Spielberg wouldn't settle for second best for his alien.
Spielberg is that kinda guy."
It was at the 1982 International Symposium on Toxicology in Aspen,
Colorado, that Weisman and Dr. Lewis Goldfrank, one of Weisman's
colleagues at Bellevue Hospital, concluded that E.T.'s bizarre "skin"
color and tight restriction of his pupils fingered him as a likely
overdose victim.
E.T. needed a narcotic antagonist, Weisman and Goldfrank contended.
In fact, Weisman said, in recent research, the two New York doctors have
even come up with a dosage level - two milligrams - in case any emergen-
cy room in the country finds itself with an extraterrestrial as a
patient.
Months later, Wasserberger, a board-certified poison specialist and
assistant professor at Drew Medical School, expanded on the original
accusation.
"Considering the way the case appeared to have been handled, I
would say E.T. is lucky to be alive," Wasserberger told Calendar. "We
have to realize that, in many ways, E.T. was like a child. His only
nourishment appeared to have been Coors and corn chips, and alcohol in a
child is known to cause profound hypoglycemia (a shortage of sugar in
the blood).
"The doctors should have at least found out what he'd been eating
for the last couple of days. He looked like any wino they wheel into
the emergency room on Saturday night."
Then, Wasserberger said, there is the matter of the overdose. "You
could tell his brain was producing inordinate amounts of narcotics," he
said. "He was overly happy about his situation. He was a little blue,
and his pupils were small."
Wasserberger said that "if we had to take it at face value from
what they showed us on the screen, there was obvious malpractice."
Unlike some internecine disputes in medicine, however, this one
appears unlikely to spill over into the courts, the public meetings of
some medical society or the back-room backbiting of the bars and other
places where doctors gather after work. The diplomatic Wasserberger
read Lampone's explanation in the latest issue of the journal and
pronounced himself mollified - if not entirely satisfied - with the
cutting-room-floor claim.
"He's a prominent physician at a major hospital here in town,"
Wasserberger said of Lampone, "and I will take him at his word."kcarroll@utzoo.UUCP (Kieran A. Carroll) (02/20/84)
* I read a story a few years ago (by Frederic Brown, I think), in which an alien's ship crashes in the sea, off the coast of an East European fishing community. The local doctor is called in to try to help the injured pilot. The doctor is the only one i the village who doesn't think of the creature as a demon, and has some inkling of life coming from other planets. However, he has little idea of what medical procedures to use. He decides the safest course is to simply dress the creature's wounds, and avoid giving it any injections or drugs. He uses sterilized dressings impregnated with (I think) some sort of sulphur compound (as an antibiotic). Te sulphur reacts with the creature's "blood"; the thing screams, goes into convulsions and dies. The point of the story has a lot to do with the facetious "ST mal- practice suit". Terrestrial medicine uses a set of chemicals that are compatible with our bodily makeup, and which are designed to provoke certain responses in our bodies. An alien, the product of an entirely different evolutionary system, would almost certainly react differently to our medicines than we'd expect. In this story, he reacted chemically instead of medically, an entirely likely result. That's what mainly spoiled the ending of Speilberg's film for me. -Kieran A. Carroll ...decvax!utzoo!kcarroll