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Hello, I'm Jim Oussman
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and I was invited to come and talk to you about my ideas about research and I'd like to tell you five important things that I know that are very helpful in becoming a successful clinician, scientist
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and person
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First thing is observation.
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Let's say a patient comes to see you.
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And the patient comes with the family. You see them in your consulting room. You see them in the hospital.
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Normally you'd ask them some questions. You see what you can learn.
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But there's more than you can learn by just talking to the patient. You have to observe
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You observe the patient. You observe how the patient's dressed. You observe their speech. You observe how they're talking about their problems. You observe where they look. You observe the
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family's reaction.
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You look at the husband. You look at the wife or the spouse. You have to put into your mind's computer every minute. information that you're learning because you have to make a decision about the
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patient, you're making a decision about the family, you have to make a decision on what to do, and you only have a short time to get to know them. So you have to use every minute and second of
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that short time to accumulate as much information as you can about the patient so you understand the patient and the patient's disease. So the key is to keep your brain's computer on all the time You
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watch them if they're walking down the hall, you're seeing another patient. You see if the lymph that you saw in the room is a lymph that they have walking down the hall. You watch them interact
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with people. You learn everything you can and you store it in your brain's computer.
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Now the second thing, let's take an example, research. Patient comes to you and let's say the most common disease in the country today is COVID. In your country, everybody's
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It's one that concerns everybody.
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Everybody's been frightened about the disease.
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A patient comes to you complaining that they've had, they feel nauseated, they feel they don't very feel well, they've got my trouble, muscle aches and pains, they have some trouble breathing,
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and they say, Well, I've lost my sense of smell and taste.
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While you're asking all these questions, that's the complaint the patient has. Through your mind are going, various other possibilities. Is the patient of influenza? Does everybody in the family
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have influenza? Is this something that's in your neighborhood or in your schools? Or is this something unusual? Does the patient have increased your intracranial pressure with nausea and vomiting?
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How can we explain all these things? So you need to ask the patient. the question so you can find out in the same when you go to the laboratory. What is the question I need to answer? So you have
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some ideas and you go look and you examine the patient and you don't find much and you do some laboratory work, you'll find some inflammatory cells, you know that temperature is up.
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And so you think the patient may have an infectious process. You looked in the fund eye, you don't see any, you see good venous pulsations, so it's not in a cranial pressure. It could be many
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other things. But those would be the things that would be most common. Yes, they've had people in their neighborhood. So you go to the literature and you take all this information and you say,
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what do people know in the literature, how do people present? You find they present this way with an influenza, they present this way with COVID, they present this way with other diseases. and
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you read more and more about it, and you find out, well, if they lose their smell and sense of smell and taste, that's a hallmark of people who have COVID. No, not everybody has that symptom,
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but a high percentage do. And so you begin to form a list which is your differential diagnosis or what are the possibilities? Or if you're in the laboratory doing any experiment, you see some
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reactions, you've done your research, and you have to record that You have to be very observant.
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So now let's say you've gone through the literature, you say, well, I think the patient may have COVID and you read the literature further and you say, well, some people in Europe and America
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don't treat the patient right away. That's a little strange to you because if a patient comes with some symptoms, you wanna do something to treat the patient.
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Okay, so we do that. So you look in, you find in Bangladesh, they treat the patient with hypermectin and the patient gets well. They can't afford to have a vaccine. In India, that's, they
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tried the vaccine, it didn't work. And you know that they then tried hypermectin and it worked. You go to have a patient who comes from South Africa. That's where there's endemic malaria. And
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these people are treated with hydroxychloroquine which prevents the COVID disease. Maybe this is a patient who broke through What are you gonna do next? And peru, they do the same thing. You go to
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the United States, they don't treat early. There's no drug for treating patients early, they say. That's what you're told. That's not what your experience is. They say in the United States, we
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wanna wait. Well, okay, we wanna wait, but the patient can get rapidly worse and
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deteriorate. Then they have to go into the hospital, they're put on a ventilator, 70 of those patients die. So you don't have much room for error here.
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So let's say you don't know, you go ahead and you treat the patient.
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You were able to find a vaccine, you vaccinate the patient, but wait a minute. What's the data on the vaccine? Well, they say it's safe, hasn't been tested extensively in animals.
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It's gonna take two vaccine shots to do this as the patient got that kind of time.
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You've read some reports that they treat people with steroids 'cause they think it's a hyperimmune response to this organism.
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And
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so, if your treatment's not working, then you have to go to the next level of treatment. But you have to do what is common sense and what comes from experience.
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So, you go ahead and let's say the treat the patient And let's say the patient did get better with Ivermectin.
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And when the patient got better with however much in you, you feel very happy about that. The family's happy. The patient gets worse, they're gonna be very worse. But you read the literature some
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more and you find out where the results, what happens with these people, what happens with this drug? And you find very confusing information in the literature.
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You find that some people who say it's a very toxic drug, you find other people say it's not, you know that in your country, they've given it to many people, and because of parasitic disease
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without any problems, it's been around for years, decades. So that's strange to you.
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So the literature doesn't relate to your experience.
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And you look at the results in the United States and in Europe, you find there's very high death rates. And that doesn't make sense to you when you look at these other countries, they're very low
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death rates
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So the question is, what's the truth? What are you being told? So you've got a plan, you've tried it, it seems to work in your patient. Patient's getting better, that makes sense.
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I've remectin is basically not only it's against parasites, but it's an antiviral tree. Works in the cellular mechanisms.
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So you're confused, but you're happy, but you're confused because the literature is conflicting The patients are told different information. You're told different information, but you got a good
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result.
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So the question next is, what's the next question? That's why? Why did the patient get better? Why did this treatment work when everybody said it wouldn't work?
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Why if I waited, is the patient getting worse? And what are the choices I have, which are very limited? Does that make sense?
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articles in the literature, pro and con. It shouldn't be in science. We're using people are using the same data. We should get the same answer. So something's wrong. And you find out that the
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literature has become politicized. Major journals that we had confidence in, like Lancet, on Nature, New England Journal of Medicine, Journal of the American Medical Association, publish
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articles and then retract them.
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So you're troubled, but that's the truth. So the most important question is why? And you keep asking why and you're going to find an answer.
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Now, this relates to what you do daily.
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You go to the operating room and you stand and watch your assistant in operation. What do you do with that five hours a time? What I did is I took this information, I got the operative report. I
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made some notes on it, I filed it away.
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Or for the patient that I worked on in the hospital, leaves the hospital to get the discharge summer and still makes some notes, I filed that away. So what you're doing is compiling a living record
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of your personal experience with a whole variety of diseases. In your first year, you may see 500 patients, maybe more. Two years, a thousand, maybe more And you go up to 2, 000, 3, 000, 4,
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000 patients. That's a lot of experience. That's how they write textbooks. And you're writing your own textbook, which you know, you're verified, you have faith and confidence. And you can
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compare that to what other people's experiences. You'll find it similar.
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And so don't discard that experience. Use it. It's very helpful to you. It'll be helpful long term. You may not read it later in life, but it helps you learn quickly.
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Now, what's the most important principle in life and the laboratory?
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We know that there, most of the research done is reasonable, fair, truthful, but there is research done, that's not truthful.
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I just told you about some on this very important disease in major journals around the country. What's the principle? Do unto others as you would have done unto you that wasn't followed? What would
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you want if you were the patient? You want to know the truth. You want to know what's been done elsewhere. You want to know it as a doctor. I had a doctor who came to me did an operation nine
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times because you read it in a textbook written by a major figure in the world
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and he couldn't do the operation didn't work. Well, he found out that certain details of
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the operation were left out of the book.
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So, you have to do unto others as you would have done unto you because you can only operate with the truth, I can only operate with the truth. And as colleagues, we need to have the truth among
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ourselves. So I've left you with a set of principles, observation, data collection, research, ask the question, why? What do you do with all this information, record it and file it, and do
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unto others
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as you would want done unto you? I appreciate your attention, that's my email address, that's the address of SNR. Thank you very much. If
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you enjoyed this presentation, the material provided in this program is for informational purposes and is not intended for use as diagnosis or treatment of a health problem or as a substitute for
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consulting a licensed medical professional.
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Please fill out your evaluation of this video to help us improve our programming and also obtain CME credit.
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The recorded session is available free on SNIdigitalorg.
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If you have questions or comments or you want to send your CME application, send it to osmondSNIdigitalorg
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This program is supported by the James I. and Carolyn R. Osman Educational Foundation owner of SI and SI Digital, and the Waymaster Corporation produces of the leading gen television series,
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Silent Majority Speaks and Role Models, and the Medical News Network
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Thank you
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