The French are admitting that they lied about Arafat's test results, botched his care, failed to diagnose his disease, then watched the Arab leader die of complications that could have been averted.
French authorities have responded to this blog's relentless questioning regarding Yasser Arafat's test results.
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CSI MEDBLOGS STAT SUMMARY OF THIS POST
(if you don't want to read it all):
AFTER THE SUMMARY, skip to the end and read TAKE HOME LESSON
_______________________________________________________________________
ONE: The French now admit Arafat's Cat Scan of the abdomen was not normal
TWO: The scan showed liver "nodules"
THREE: They were afraid to biopsy the nodules because of Arafat's low platelets
WHAT THIS MEANS:
1. They lied about Arafat's test results (as this blog has been saying all along)
2. They saw lesions on the liver which they knew were either cancer or cirrhosis -- so they lied about Arafat absolutely not having "cancer"
3. If they nodules represented cirrhosis then there was no need to do a biopsy, so they either are incompetent and don't know how to read a CT scan
OR
4. They thought the nodules represented cancer, not cirrhosis. Then, they were afraid to do a diagnostic biopsy because of low platelets, but these types of biopsies are done all the time -- you just have to administer platelets right before doing the procedure -- so they failed to diagnose in a situation where diagnosis was possible
5. Because their incompetence and diagnostic timidity delayed diagnosis and treatment, Arafat developed a complication which lead to his death before any effective therapies could be initiated (they now admit Arafat developed a bleeding complication called DIC which probably lead to his brain bleed)
6. The entire charade thereafter -- the whole comatose cowboy routine -- was a stall and a cover-up while they tried to figure out what the hell to tell everyone
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NOW FOR THE LONG VERSION:
AS STATED HERE THAT CT COULD NOT HAVE BEEN NORMAL
For weeks, CodeBlueBlog has been questioning the initial French report of a "normal" CT of the abdomen. As stated here many times, Arafat could NOT have end-stage liver disease and a normal CT.
Now, for the first time, the French are admitting they lied. Worse, the new revelations give a glimpse into just how bad their diagnostic and therapeutic skills are. I'm sure when the full records are reviewed the extent of the total incompetence and deceit will be staggering.
WHAT THE THUNDER SAID: Datta. Dayadhvam. Damyata.
1. LIES
a. French medics saw significant findings on the CT yet they said the CT was normal
b. They also said Arafat did not have cancer, yet they admit they could not biopsy the liver nodules to rule cancer out
The CT was NOT normal. Now, according to Le Monde the French docs say that when they looked at the CT:
"they saw nodules on the liver"
Oh, they did? Did they forget to mention those "nodules?" A minor point? NOT!
"Nodules" on the liver may refer to the nodular contour of the peripheral liver edge noted on CT scan (see this post) which indicates the end-stage liver disease we've been talking about for so long.
But let me say this: the French medics are not saying "nodular liver," they are saying "nodules." Nodules could be tumors. In the setting of cirrhosis, nodules could represent deadly liver cancer (same thing that Mickey Mantle had with his cirrhosis); but, if there were NO cirrhosis, then the nodules could be cancer spread from somewhere else (called metastases).
But the French said Arafat didn't have cancer, right? And they said there was NO CANCER on his CT scan.
2. INCOMPETENCE
But if there were nodules on the liver then the French can not know that Arafat didn't have cancer. And they PROVE that they saw the "nodules" and didn't know whether or not this represented cancer (thus completing a circular lie) when they told Le Monde again
"although they saw nodules on the liver, doctors did not reach a definitive diagnosis of cirrhosis because the platelet problem meant it was too dangerous to do a liver biopsy."
In essence the Saturday Night Live crew of physicians taking care of Arafat are saying that they saw the potential cancer but didn't want to do the test that would diagnose the cancer because the platelets were too low to do a biopsy.
Here's what this proves:
3. FAILURE TO DIAGNOSE
There is NO NEED to do a biopsy to diagnose cirrhosis -- I diagnose cirrhosis every day just by looking at the typical liver on CT -- I NEVER do a biopsy.
If they say they had to do a biopsy then they are either INCOMPETENT or they suspected liver cancer or cancer spread from somewhere else (metastases).
Le Monde says that the French Docs did not want to do the biopsy they felt was necessary because they felt it was "too dangerous" to do a liver biopsy with Arafat's low platelets (this could cause bleeding)
I can tell you that I have done MANY invasive procedures, including liver biopsies, on patients with low platelets. When the biopsy is necessary, we just give the patient an infusion of platelets, then do the biopsy. A liver biopsy can also be done "internally" through a transjugular approach. Sacre Bleu! But this would be MODERN medicine, not the medieval stuff practiced in France.
4. DIAGNOSTIC DELAY--->COMPLICATION--->A TRIP TO COMA WORLD
So the French medics see an abnormality then they either don't recognize it for what it is OR they are wrongly afraid to do the diagnostic test needed. The proper diagnosis is delayed and Arafat develops a dreaded complication called DIC (disseminated intravascular coagulation), as again stated by Le Monde:
Le Monde cited “very good sources” as saying Arafat died of a blood disorder called disseminated intravascular coagulation, or DIC — where platelets are depleted by the formation of a multitude of microscopic blood clots all over the body and blood oozes easily from anywhere that’s vulnerable
The DIC leads to Arafat's brain bleed (intracerebral hemorrhage) and then we have the famous slow descent into ever deeper States of Coma revealing the one thing the French doctors were good at: describing the slow demise of their patients. At least they are good at something.
My suggestion? Turn that hospital into a hospice, then the docs can do what they do as a service instead of providing calamity.
CodeBlueBlog's TAKE HOME LESSON:
Acute, high tech, sophisticated care is expensive -- REAL expensive. Countries with nationalized heal care don't feel that it is cost-effective to beef up high-tech, high-end care, especially on the community level. But in the United States, we put out the money and provide sophisticated, high-end care in almost every community. Icu-type care is the best, right here, in the United States.
Countries with nationalized health care do a real good job with the cheap stuff: handing out eyeglass prescriptions and taking care of your cold; but, when you or your loved ones wind up with a bad or sudden, severe problem that needs immediate, sophisticated, high-end care you better be in the U.S. because THAT'S when our health care system versus theirs makes a BIG difference.
The reason Canada and England and France have high patient satisfaction survey numbers is because 95% of people never need ICU- type care. Nationalized systems KNOW this. So they skimp on the tough stuff and give everyone pablum and everyone is happy. Until you REALLY need help.
Stay tuned.



Would you consider the situation the the French did it on pupose?
"Arafat developed a complication which lead to his death before any effective therapies could be initiated (they now admit Arafat developed a bleeding complication called DIC which probably lead to his brain bleed)
6. The entire charade thereafter -- the whole comatose cowboy routine -- was a stall and a cover-up "
to change the political situation?????
Posted by: Cynic | November 21, 2004 at 10:47 AM
Your blog is fascinating. We needed a good Medical CSI blog around here.
Posted by: geena | November 28, 2004 at 10:46 PM
Thank you!
I want to welcome contributions from everyone in the medical field who comes across any CSI-worthy items and I'm thinking about a forum where it becomes a group effort/post that I can mediate and post on with feedback and input/contributions from a wide variety of health care people.
Thanks again.
Posted by: CodeBlueBlogMD | November 29, 2004 at 04:02 AM
Outstanding doctor, outstanding intellect, outstanding writer and thinker.
Keep the infomation flowing. Our country needs dedicated doctors.
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