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Advice please re. RT for Dupuytrens, & the rest
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09/10/21 12:01
scumble

not registered

09/10/21 12:01
scumble

not registered

Re: Advice please re. RT for Dupuytrens, & the rest

My letter today to Prof. S:

You wonder why a Korean oncologist can study your papers in English but cannot conduct a video interview in the same language.

... It is one thing to study a paper written in English by a colleague in the same field of professional knowledge. It is quite another to be able to converse in English, even on the same subject. Effective skill in English conversation ... is rare in Korea. In medicine, it is not generally prioritized.

(The oncologist)... is prepared to admit the limits of his knowledge. He wishes to understand more about the application of a third series of fractions when the edge of the proposed field intersects a previous field of therapy. This does not mean that he wishes to exercise a judgment contrary to yours. He and I depend completely on your guidance. Nevertheless, I cannot in decency expect him to follow instructions while he remains unfamiliar with the theroetical basis from which they proceed.

(Further)... I do not really feel entitled to ask this man, who is a hospital consultant, to spare time for a video consultation when he is constantly dealing with patients, including children, who suffer from life-threatening disease.

Seegenschmiedt's reply:

'I understand that no VIDEO CONSULTATION is required as it appears that Consultation makes no sense …
Thus, I herewith stop further suggestions.'

To be clear: I would have been only too glad for a video consultation, but I don't think the oncologist can take part. I've asked Prof. S. the same question 3 times. It is the refusal to answer, and this appalling response, that makes NO SENSE. I know how to unsubscribe from the site, but will somebody please tell me how I can remove my entire thread and all posts as quickly as possible?

    09/10/21 14:21
    wach 

    Administrator

    09/10/21 14:21
    wach 

    Administrator

    Re: Advice please re. RT for Dupuytrens, & the rest

    Hi scumble,

    you ought to be able to delete any of your posts individually. I am not aware of a command by which you can delete all your posts with a single click.

    Regarding Prof. S' response it might actually sound more harsh than it was meant, due to cultural differences. What sometimes sounds offensive in English may be a completely normal statement in German. That doesn't mean that Germans are rude per se, rather they have a different way to express themselves and, within their culture, they are as polity as anyone. I myself used to work for an American company and recall that an American colleague once asked why such a pleasant person like his German counterpart is writing such offensive mails. It turned out that no offence at all was intended, the German guy actually was embarrassed when I asked him. He just had translated into English what he would have written in German ...

    Anyway, this is a long thread and posts might be interesting to other patients. Thereore I would prefer keeping it.

    Wolfgang

      09/11/21 03:52
      scumble

      not registered

      09/11/21 03:52
      scumble

      not registered

      Re: Advice please re. RT for Dupuytrens, & the rest

      Dear Dr. Wach,

      I have several German friends. They are close friends and I have known them for decades. I think we have all caused unintended offence to Americans at some time, haven't we?

      The point is, I have caused unintended offence to Professor Seegenschmiedt, which is why he does not answer my question. I attach to this post a document with our recent email exchange.

      When I ask my German friends a question, they do not refuse to answer. Now, my case is complicated because I live in Korea. So it is not only the German position that must be considered, but the Korean one also. Without explaining this, I cannot make my situation clear.

      The Professor complains about my 'long' letter. His posts are also long. But in his case, it is not because he has a lot to explain. It is because he cannot write intelligible English. This is not promising for a video conference with a Korean doctor whose English skills are worse than his.

      The Professor does not want to understand my position. He is not obliged to help me, of course. But he knows the question I am asking. Because of the unusual difficulties of my situation, I need an answer very soon. He chooses not to answer. I have offended his self-importance, because I had to correct his assumptions.

      So: (1) Prof. S. offers to answer my question by video consultation. (2) He decrees that my oncologist should also be present. (3) I have to explain that it is difficult to include the oncologist, and I give two reasons. (4) Prof. S. immediately withdraws his offer of help.

      This is not German ingenuousness. It is more like arrogance.

      My Korean wife believes he will not answer my question because he does not know the answer! Anyway, I will find it out for myself.

      Thank you.

        09/14/21 12:31
        scumble

        not registered

        09/14/21 12:31
        scumble

        not registered

        Re: Advice please re. RT for Dupuytrens, & the rest

        Regarding my question about new growth on the edge of a previous radiation field, the oncologist Richard Shaffer at Genesis Care UK has directed me to his blog, where this is discussed:

        https://www.thedupuytrenspractice.com/20...erhose-disease/

        I am still amazed at the response I received from Prof. Seegenschmiedt. Why could he not simply do the same?

          09/14/21 12:59
          spanishbuddha 

          Administrator

          09/14/21 12:59
          spanishbuddha 

          Administrator

          Re: Advice please re. RT for Dupuytrens, & the rest

          I think there has been an unfortunate misunderstanding, possibly exacerbated by written text and language miscommunication, perhaps you have seen that Profs has previously posted on the forum on the topics you are asking about:
          https://www.dupuytren-online.info/Forum_...59783926.html#4
          https://www.dupuytren-online.info/Forum_...48247359.html#6

            09/14/21 13:17
            scumble

            not registered

            09/14/21 13:17
            scumble

            not registered

            Re: Advice please re. RT for Dupuytrens, & the rest

            Unfortunate yes, misunderstanding no, with great respect. And yes, I read those posts before asking my question of the Professor. He understood the question perfectly. He wouldn't give me an answer, I suppose, because I don't have a PhD in medicine. But it is an important question.

            6 September, from Prof. Seegenschmiedt:

            Your situation should be solved properly together with your brace radiation oncologist from South Korea.I have had now long-term experience in performing VIDEO CONSULTATIONS for physicians alone, patients alone and a threesome of the patient, the doctor and me together .... might be possible in your case. Unfortunately, the radiographic image from the extension of the RT portal does not allow to draw any appropriate conclusions ... this issue could be resolved with a common consultation - In such a session I could also explain the rationale of the 3rd RT-series. Please let me have your thoughts about this option.

            6 September, from me:

            I will consider your suggestion carefully. One obstacle in this case is the oncologist's poor English, and the potential for communication failures.

            9 September, from me:

            Your offer of a 3-way consultation is very generous, but I fear it will not work. The oncologist (a hospital consultant) is constantly attending to patients with malignant disease, and I do not think I can ask him to spare the time for a video discussion on my treatment.  Further... even if a competent translator were involved, misunderstandings are likely to impede communication and delay progress. My next appointment with him is on the 23rd. If you are able to answer my questions about the RT dose on overlapping fields, that would be extremely helpful. If you believe that a video consultation is the best way to do this, I will of course comply. But I am afraid it will be too difficult to involve the Korean oncologist in such an exercise.

            9 September, from Prof. Seegenschmiedt:

            If his English is POOR how could he read and understand my publications before ???

            10 September, from me:

            You wonder why a Korean oncologist can study your papers in English but cannot conduct a video interview in the same language.

            ... It is one thing to study a paper written in English by a colleague in the same field of professional knowledge. It is quite another to be able to converse in English, even on the same subject. Effective skill in English conversation ... is rare in Korea. In medicine, it is not generally prioritized.

            (The oncologist)... is prepared to admit the limits of his knowledge. He wishes to understand more about the application of a third series of fractions when the edge of the proposed field intersects a previous field of therapy. This does not mean that he wishes to exercise a judgment contrary to yours. He and I depend completely on your guidance. Nevertheless, I cannot (reasonably) expect him to follow instructions while he remains unfamiliar with the theroetical basis from which they proceed.

            (Further)... I do not really feel entitled to ask this man, who is a hospital consultant, to spare time for a video consultation when he is constantly dealing with patients, including children, who suffer from life-threatening disease.

            10 September, from Prof. Seegenschmiedt:

            'I understand that no VIDEO CONSULTATION is required as it appears that Consultation makes no sense …
            Thus, I herewith stop further suggestions.'

            Edited 09/14/21 15:58

              09/14/21 17:17
              spanishbuddha 

              Administrator

              09/14/21 17:17
              spanishbuddha 

              Administrator

              Re: Advice please re. RT for Dupuytrens, & the rest

              scumble:

              (Further)... I do not really feel entitled to ask this man, who is a hospital consultant, to spare time for a video consultation when he is constantly dealing with patients, including children, who suffer from life-threatening disease.

              10 September, from Prof. Seegenschmiedt:

              'I understand that no VIDEO CONSULTATION is required as it appears that Consultation makes no sense …
              Thus, I herewith stop further suggestions.'
              I fear the misunderstanding is here. The answer is entirely 'logical' based on the preceeding answer, although some continuity context perhaps is omitted.

                09/15/21 05:06
                scumble

                not registered

                09/15/21 05:06
                scumble

                not registered

                Re: Advice please re. RT for Dupuytrens, & the rest

                spanishbuddha:
                scumble:

                (Further)... I do not really feel entitled to ask this man, who is a hospital consultant, to spare time for a video consultation when he is constantly dealing with patients, including children, who suffer from life-threatening disease.

                10 September, from Prof. Seegenschmiedt:

                'I understand that no VIDEO CONSULTATION is required as it appears that Consultation makes no sense …
                Thus, I herewith stop further suggestions.'
                I fear the misunderstanding is here. The answer is entirely 'logical' based on the preceeding answer, although some continuity context perhaps is omitted.

                I am sorry, but there is no logic.

                There is only logic if the Professor, and moderators, fail to understand my entire post. I will try again.

                There is a question about RT that is not answered in the Professor's posts. Very basically, why must a third dose be limited to 15 Gy, when it is on the edge of a previous field? The question is asked by my Korean oncologist.

                I put this question to Professor Seegenschmiedt.

                The Professor offers a consultation, including the option of a three-way consultation with the oncologist. He says he will then answer the question. He asks for my thoughts on this suggestion.

                I give him my thoughts. I explain that I need his help, but a three-way consultation is difficult to arrange. Also that it is unlikely to work well. I give the reasons, which are clear.

                Prof. Seegenschmiedt protests, in Trump-style CAPITALS, that the oncologist should be able to speak English, if he was previously capable of reading the Professor's papers.

                This is nonsense, and I explain why. Very few Korean doctors can converse effectively in English.

                By the way, the Professor also assumes his own English is comprehensible. Judging from his posts, I should say not very. But this would not prevent a successful video consultation between the two of us. I am still waiting for an answer to that question.

                The Professor then complains that my letter is long, declares that 'consultation makes no sense' and that he has nothing further to say to me.


                How can any of you claim this is logical or reasonable?

                If it has anything to do with cultural/linguistic barriers, it means the Professor's English comprehension is very poor. Certainly by the standards of Germans I know. That's OK, but why expect a Korean doctor to do better?

                No, the truth is that he lost patience. I did my best to explain a difficult set of circumstances, none of which I am responsible for. He did not want to understand; he lost patience. Evidently, also, he does not want to discuss the question with me because I am not an oncologist.

                Why is it necessary to point this out? It's there, in the above.

                By the way, the disease is advancing and causing debility. That is why I needed an answer to the question. That is the point of this forum.

                Dr. Shaffer understood my question immediately. In his own opinion there is insufficient research to ensure that a higher dose than 15Gy is safe in all cases when applying a third dose. That is an answer, and it is enough.

                Edited 09/15/21 05:47

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