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If your name is Bill Clinton or Strom Thurmond or if you’re a senior
naval brass hat, you can check into Maryland’s Bethesda Naval Hospital
and be assured that you’ll get VIP treatment that includes real doctors
to put you to sleep while the surgeon wields his knife.
But if you’re a nobody — a lowly serving or retired sailor who’s
been promised top quality medical treatment for life if you just stand
down range and let enemy sharpshooters have at you for at least 20 years
— don’t expect the same treatment as what’s given to the new American
royalty at the U.S. Navy’s flagship hospital.
Adm. Bonnie Potter, who runs Bethesda, has recently set up a
double-standard medical treatment system — one for the powers-that-be,
another for the common folk — which has outraged medics at the hospital
and doctors across the nation.
VIPs such as Adm. Fat Bottom get real doctors to administer sleeping
stuff while the troops get only specially trained nurses.
Last month Potter sacked Navy Capt. Alvin Manalaysay, the headman of
Bethesda’s Department of Anesthesiology, because the good doctor refused
to go along with her scheme to allow nurse anesthetists to care for
surgical patients without the supervision of trained M.D.
Before undergoing major surgery recently, I spent as much time
selecting the anesthesiologist as I did the surgeon who slit me open. I
first met with a good pal, Dr. Herman Turndorf, chief of anesthesiology
at NYU, and then with his hand-picked protégée, Dr. Marisol
Garcia-Main. I wanted to make sure I had the best team going. I’m the
healthy living proof that I made the right choice. My doctor
brother-in-law is now almost blind because he didn’t take similar
Dr. Ronald A. MacKenzie, the president of the American Society of
Anesthesiologists says, “In other hospitals, it’s a physician who
determines if a patient is fit to undergo surgery. Who’s going to make
that medical assessment at Bethesda…?”
Anesthesiologists are medical doctors. They’ve years of medical and
specialized training and according to MacKenzie, anesthesiologists
directly supervise 90 percent of all the anesthetics provided to
patients during surgery in the USA.
Dr. MacKenzie says “A generation ago, one surgical patient would die
for every 10,000 anesthetics, but now (because of hands-on
anesthesiologists) the rate of patient deaths has plummeted to one in
250,000 anesthetics or less.”
“It is unconscionable” says MacKenzie, that Potter would expect
someone with only nursing training to be solely responsible for the
administering of anesthesia.
Another Navy Doc makes it more personal. “Anesthesia is not just the
practice of medicine, it is the practice of critical care medicine. You
have to ask yourself, if my child came through the ER door and had to go
to the operating room, who would I want, a CRNA (Certified registered
nurse anesthetist) or an MD? For the Navy and Adm. Potter to institute
this reduced level of care except for the VIPs is not acceptable. Can
she really look at herself in the mirror and think she’s a responsible
person, a leader and advocate for her troops?”
“Anesthesiologists must be involved in the planning, induction,
maintenance and emergence of anesthesia as well as the post anesthetic
care. I’ve worked extensively with the CRNAs and I know they just don’t
have the comprehensive knowledge base that is not infrequently
required,” says another Navy doc.
My father-in-law, Dr. Jerry Haidak, a Dean at the University of
Massachusetts Medical School and a combat surgeon who made the invasions
of Salerno, Anzio and Normandy during The Big War, says he’s worked
alongside “some damn good anesthesia nurses over the years, but they
don’t have the training to deal with all the circumstances that can come
Dr. Haidak is adamant that they “should only work under the direct
supervision of a board certified anesthesiologist.”
The bottom line is if there’s validity to Potter’s policy to have
nurses practice independently as anesthetists, why aren’t they good
enough for everyone without exception across the board? Either they’re
as qualified as board-certified anesthesiologists or they’re not.
Perhaps the Navy should put Potter under the knife and see who she
picks to spec the drugs to keep her alive if things don’t go according