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Published 03:52 от Zushakar

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I decided to continue in surgery. Huth And the location? Had you already thought about where you were going? Lewis Yes, back to New York City. The Hospital for the Ruptured and Crippled Huth Had you picked a hospital, or did you have to be chosen by a hospital? I thought I would like to get into residency at Bellevue Hospital where I had my medical education, but he wasn't very encouraging about that.

I even went down in my uniform to try and impress him, because it had a lot of stripes on the sleeve. That didn't impress him, and he wasn't interested. So I hunted around elsewhere, and it was suggested that I go to the Hospital for the Ruptured and Crippled. I went there, was interviewed, and taken on for a year of residency.

It was late in January and all residencies had been filled. Huth Was that the name of the hospital? About ten years later it affiliated with Cornell medical school and New York Hospital. It was renamed Hospital for Special Surgery. Huth What can you tell me about your residency experiences in that hospital? Lewis Well, I really think I learned the basics of surgery there.

Most of the surgery was hernia, but hernia really made clear the principles of operating on tissues, dissection of structures from each other, and wound healing. I became interested in the history of the institution. There were large volumes, about the same size as this [holds up a large book], containing all different types of hernia operations that had been done there, going back to the s. The information there also reported post-operative stays in the hospital, many of which were two, three, and four weeks in bed, and certain peculiar things that were done, like putting on a body cast to retain the hernia repair.

Huth Did you find any innovative things that were still being used when you were in practice--that had started much earlier? Lewis No. Most of the technical procedures were the same as in the s. It was only in the fifties and sixties that several modifications were adopted. The hernia patients, when I was there, were admitted on Sunday, operated on on Monday, and discharged on Friday. There weren't any weekday admissions except for irreducible and strangulated hernias.

My workload was light and thus afforded me time to study surgical textbooks and journals. Huth So you had much practice? Lewis Yes. It was a moderately busy practice. Huth Was this a public hospital? Lewis No, this was a private, non-profit hospital operated by the Society for the Ruptured and Crippled. Huth Did they tend to get patients requiring surgery from all over the city, or was it mainly set up to serve just one area?

Lewis Primarily, cases came in because they were private patients of the doctors who were on the staff. Lewis No, I was the only one, but there were several orthopedic residents. Huth Did you benefit considerably from being the only one? Lewis Yes, I certainly did. Huth Do you know how they happened to allow you to be a resident there? Was it that they always liked to have at least one resident, or did they open it up to you especially? Lewis No, they always had a resident.

Huth And you just happened to apply at the right time? Lewis Just at the right time. That's about it, I guess. A urologist who was on the attending staff sponsored me there. I don't remember his name. Huth Is there anything else you want to tell me about that particular hospital?

Was that for more residency? Lewis Yes, that was continuation of residency. The work at the Ruptured and Crippled was helpful in easing me back into the practice of surgery after five years in the army. Huth To put this in perspective, you had been away from surgery because of your army duties.

You worked in the medical supply area, so was this a way to get back into practice? Lewis Yes, right. It was called the Kingsbridge Veterans Administration Hospital. I spent two years there. Lewis It was very productive. There was one surgeon, the VA attending surgeon, whose name I can't recall. His method of operating--was very much to my liking, so I tried to fashion my own technique after his.

He operated speedily, knew the anatomy, and didn't chit-chat. Operate, go in, and get out! Once he was so fast that with one stroke of his scalpel he sliced through the abdominal wall and into the liver. Huth And did you follow that from then on? Lewis From that time on that was the way I always liked to work. It taught me that the liver was close to the skin. Huth Were there other residents at this hospital?

Lewis Oh yes, yes. There were a whole slew of residents there. Huth Were there others in surgery? Lewis In general surgery, yes. There were four-year residency requirements for the American Board of Surgery. I only spent two years there. I received one year credit to the board for my army service, and another year for my year at Ruptured and Crippled. So I came into the third year residency, and I had to spend only two years at Kingsbridge. I got my accreditation for the American College of Surgeons by having my army service added as a year of training.

Huth You mentioned the American College of Surgeons. Is that a requirement to become a surgeon--to be accredited? Lewis No, it's not a requirement, but it's one of those things that labels one a qualified surgeon. I had to report fifty major surgery cases in great detail. Huth That means certification. Is that like board certification?

The boards are another certification. For that, I had to take examinations, oral and written examinations. Huth And that came after the residency? Huth As to your patients in the Veterans Administration hospital--were they mainly returning veterans from World War II, or--who were your patients?

Huth So you had a very broad exposure to surgery there. How about friends there--did you make any friends that were your friends later on? I guess we all went our separate ways afterwards. Huth Was your family there--were you living at home? In the residency, do physicians tend to be living in the hospital itself?

I want to get a picture of what it was like. Lewis One of the attending surgeons of the VA hospital was Dr. Fred Bancroft, one of the Bancroft family. Furthermore, if deception should be illegal, why not self-deception? The last time I checked, the typical Randian accepted the law of defamation. False claims abound on the Internet. If believed, many would be very damaging. But most Internet users have the common sense to ignore unsubstantiated accusations, so in practice they do little harm.

Why is it so important? In other words, the law of accessories is not a footnote to libertarian theory; it is the entire basis on which government leaders are considered mass murderers — as opposed to bystanders exercising their freedom of speech.

But the libertarian, who believes in freedom of the will, must insist that while it might be immoral or unfortunate for A to advocate a riot, that this is strictly in the realm of advocacy and should not be subject to legal penalty.

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