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Doctor Performs Amputation By Text Message 242

Peace Corps Online writes "Vascular surgeon David Nott performed a life-saving amputation on a boy in DR Congo following instructions sent by text message from a colleague in London. The boy's left arm had been ripped off and was badly infected and gangrenous; there were just 6in (15cm) of the boy's arm remaining, much of the surrounding muscle had died and there was little skin to fold over the wound. 'He had about two or three days to live when I saw him,' Nott said. Nott, volunteering with the medical charity Medecins Sans Frontieres, knew he needed to perform a forequarter amputation requiring removal of the collar bone and shoulder blade and contacted Professor Meirion Thomas at London's Royal Marsden Hospital, who had performed the operation before. 'I texted him and he texted back step by step instructions on how to do it,' Nott said."
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Doctor Performs Amputation By Text Message

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  • by yagu ( 721525 ) * <> on Wednesday December 03, 2008 @08:51PM (#25983275) Journal

    I long ago discovered my text-messaging device allows me to talk directly to another person through his or her text-messaging device. Amazing!

    And, not only is this more efficient and accurate, it costs far less. Imagine the lives that could be saved if doctors were given instructions for talking through these text-messaging devices. I, for one welcome the emergence of these devices and their new-found features.

    • by RollingThunder ( 88952 ) on Wednesday December 03, 2008 @09:00PM (#25983359)

      Spoken like somebody who's never needed to pay the astronomical roaming charges or put up with the hideous interference and quality loss on a voice call.

      Sometimes text is faster and cheaper, because you're not spending 90% of the call going "What? Please repeat!"

    • by bjorniac ( 836863 ) on Wednesday December 03, 2008 @09:00PM (#25983361)

      Text message will ensure that all the details get there, not some garbled, half-heard phone call. You also get all the information already available if you need to look back at it quickly and it's in neat understandable writing (anyone who's ever read a doctor's scrawl will know what I mean). For this purpose (transmitting a technical procedure step by step) it's the better of the two media.

      • by Hatta ( 162192 ) on Wednesday December 03, 2008 @09:02PM (#25983405) Journal

        Text message will ensure that all the details get there

        But none of the vowels.

      • Re: (Score:2, Interesting)

        by bane2571 ( 1024309 )
        But really, what makes this news?

        Basically what happened was the guy got bob on the phone and said, "yeah bob, can you fax me over page 113 of surgery for dummies?"

        Sending what amounts to textbook instructions to trained personnel in the field is hardly a noteworthy achievement.
      • by glavenoid ( 636808 ) on Wednesday December 03, 2008 @09:38PM (#25983731) Journal

        This is one of my favorite things about SMS. *When* the data arrive, they arrive intact.

        I got my first cell phone about one year ago. I know, I know, but I really don't need one for normal communications. I just need it to place emergency calls. However (and since my prepaid arrangement allows free incoming texts), I was curious about this whole "texting" thing (which I would probably never use with another person), so decided to figure out just what is really happening. I discovered that most USA cell carriers have a text to email gateway.

        Since the text messages are essentially email, I first decided to hack up a Python script that would alert me via text of any inclement weather. A simple NOAA weather data gatherer, parser, and sender to my SMS to email gateway has saved my ass numerous times. Really. And for a $10 TracPhone, that's not too bad. Of course this is not on par with doing surgery, but I thought it was pretty cool. I didn't stop there, though.

        Since my carrier *does* in fact have a text to sms gateway, the communication can go two ways. Is it possible to create an *unsecure* remote shell so that I can give my home computer commands while away? Why not..? And so friends, in brief, text messages *do* in fact have use other than LOLing ur BFF, and doing remote surgery... You can monitor your torrents, and fetch new ones, kick your pesky friend off your wireless connection, write a new cron job, the possibilities are arbitrary... Just don't let anyone use your phone...

      • Re: (Score:3, Insightful)

        by TubeSteak ( 669689 )

        Text message will ensure that all the details get there, not some garbled, half-heard phone call.

        If you're somewhere that calls are garbled, what assurance do you have that text messages will get through?

        Text is given a very low priority on the wireless network and there is no guarantee that it will ever arrive.

        • by repvik ( 96666 )

          If you can connect a call, you can be pretty sure that a text can come through. Even though the call can be so garbled as to be unintelligible, the text only needs a tiny bit of data to come through. Setting up a call is more "expensive" data-wise.
          Also, a text doesn't need a working connection for more than an "instant", while a call requires a long, continuous connection.
          Oh, and if the network nears its limit with traffic, sms is given higher priority while voice calls are dropped.

      • by jhol13 ( 1087781 )

        Besides, the messages can be sent by a nurse who can then read the replies - no need for the doctor to hold the phone, he might have something else to do with his hands ...

      • anyone who's ever read a doctor's scrawl will know what I mean

        Well, I admit that not all doctors write well, but much of this comes from people being unable to decipher the language of prescriptions. A doctor doesn't write:

        Take two tablets under the tongue twice a day before meals until finished

        They write:

        2T SL BID AC UF

      • by wikinerd ( 809585 ) on Wednesday December 03, 2008 @11:19PM (#25984457) Journal

        Text message will ensure that all the details get there, not some garbled, half-heard phone call.

        There is a serious problem, though: text messages may never get to the destination or may get there late, in case the text server is busy or unavailable, and the most serious problem is that you won't know that someone had tried to text you. With phone calls, at least, you know when the line gets cut off by network problems, but with text messages you can never know unless you were expecting a particular message. There is also no guarantee that you will receive the text messages in the order they were sent, if the server has problems.

        Essentially texting has very similar problems to email when the email servers and intermediaries don't work correctly.

        So, imagine getting the instructions for reattaching the arm before the instructions for removing it, while the instructions for cutting the bone were never delivered at all...

    • Yeah, haha. Now think for a couple seconds about actually performing phone-directed surgery, and maybe you'll see an advantage or two to using text instead of voice.

    • Re: (Score:3, Funny)

      by Hurricane78 ( 562437 )

      I don't know where you're from, but I (in Germany) get a text message at the price of a minute of voice, and the first 50 in every month are included in the plan price.

      In other countries it's much cheaper.

      Yeah. Other counties! Haven't you heard of them? ;)
      Are you French or American? ;)

      • Re: (Score:2, Funny)

        by Anonymous Coward

        In other countries it's much cheaper.

        Yeah. Other counties! Haven't you heard of them? ;)
        Are you French or American? ;)

        I don't know about France, but here in America we celebrate a diverse selection of counties.

        • by Fred_A ( 10934 )

          Yeah. Other counties! Haven't you heard of them? ;)
          Are you French or American? ;)

          I don't know about France, but here in America we celebrate a diverse selection of counties.

          Here in France we have no counties whatsoever. I think the Swiss have some though.

      • my karma. ;)

        If only they knew, that I posted it as a joke, because unlike some other folks, I actually know that it's a funny stereotype.

      • by Z34107 ( 925136 )

        In other countries it's much cheaper.

        Yes, but coverage is cheap if you have two countries splitting the cost of your cell phone tower. :P

    • by ShakaUVM ( 157947 ) on Wednesday December 03, 2008 @09:36PM (#25983713) Homepage Journal

      >>I long ago discovered my text-messaging device allows me to talk directly to another person through his or her text-messaging device. Amazing!

      You mean those wireless devices which replaced the devices which ran over wires which were originally built to text messages to each other in morse?

    • Re: (Score:3, Informative)

      by mikesd81 ( 518581 )
      Not only that, but there are times it takes a half hour or longer for me to get a text message from my friend on another carrier. And we're both in the same bar room.
      • Unless this is the Local Mime Club's Pint Night, I'd have to rate this one "+5, Sad".

        for me to get a text message from my friend on another carrier. And we're both in the same bar room.

    • by Valdrax ( 32670 ) on Wednesday December 03, 2008 @10:10PM (#25983973)

      Did you somehow miss the part where he was calling from Africa to the UK? Have you never priced an international call?

      Assume that you're an Orange customer. (It's the first UK cell phone provider I could think of off the top of my head.) Roaming in Africa and calling England costs £1.20/minute (or over $1.75/minute) if you have the Orange Travel plan.

      Texting is much, much cheaper. In fact, in Africa, it's the dominant form of cell phone communication because voice rates are so ridiculously high in comparison even among local carriers, according to a family member who spent several months there on a mission trip.

      • Exactly - I'm glad to see someone pointed this out already. In Africa, texting is far cheaper than talking on the phone. While the absolute cheapest I could get calls to DEVELOPED parts of Africa was 25 cents per minute, an international text message costs the same. Congo's rates would be far worse (plus the cost of airtime) so that it makes sense that this was conducted by text message - the surgery probably took hours as it was - voice calling in Africa is simply too spotty for that.
      • £1.20/minute (or over $1.75/minute

        Offtopic, but holy crap.... what happened to the pound!? Back when I paid attention to these things, a year ago, that £1.20/minute would have equated to over $2.52/minute USD.

        • by Valdrax ( 32670 )

          Shocking, isn't it? [] I have no idea what's been going on. The US dollar has apparently rallied against most major world currencies except the Japanese yen. Here's an article speculating about why. [] Apparently, risk adverse investors are dumping less "reliable" currencies in favor of "safe" ones like the US dollar and the yen. No, I don't get it either.

      • by Aladrin ( 926209 )

        Right, because when someone's life is on the line, the unknowledgeable doctor's first concern should be his cellphone bill, rather than having instant feedback from the doctor that knows what is going on.

        • Re: (Score:3, Interesting)

          by Valdrax ( 32670 )

          Apparently you and the AC below you have still managed to miss the fact that he's IN! AFRICA!

          This is a doctor doing aid work [] in a third world WAR ZONE [], at a hospital less than 20 miles from the border with Rwanda. [] This is volunteerism; he doesn't even have sufficient *blood* to do the surgery safely, much less someone to reimburse him for what might end up as a several hundred dollar phone bill. You work with the tools you have, and the fact that he was able to pull this off given the resource and budget

    • by Builder ( 103701 )

      I've done a lot of work in that neighbourhood, and believe me, there's no such thing as stable reception out there. You're luck on the odd occasion that you can get a call through.

      Then you get screwed by your home operator cutting you off when you hit some predefined limit that you weren't aware was on there, and you can't call home to tell your wife that you weren't in the hotel that was shelled. Good times....

    • The voice calls to another country are extremely expensive, and in the case of DR Congo I would imagine that call would cost more than the value of the town they were in.

      So why sms messages? Because when you send a message to another country you get charged the same as you were texting anyone else in the country you are in (which is not expensive). This is the reason why they've used sms messages.

  • Costly (Score:4, Funny)

    by mmxsaro ( 187943 ) on Wednesday December 03, 2008 @08:54PM (#25983309) Homepage

    Must have been an expensive operation considering the price of text messaging today.

    • Re: (Score:3, Funny)

      Yes, and his words most have been really cutting.

    • Re: (Score:3, Funny)

      by Anonymous Coward

      Yes if you remember the cost of retrieving data from the Hubble Space Telescope vs. the cost of sending a text message you'll see that it costs an arm.

  • by Anonymous Coward on Wednesday December 03, 2008 @08:56PM (#25983325)

    He intended to do a prostate exam, so it's not quite as good as it sounds.

  • by GrpA ( 691294 ) on Wednesday December 03, 2008 @08:58PM (#25983341)

    Taken from the text logs:


    Things got a little dangerous when another text message came in from his wife mid operation.


    Heh, but still some great work. It's tragic though that there's still a dearth of medical facilities in some countries and life-saving make-do operations like this are common. Kudos to Medicines Sans Frontiers for doing what our own governments should be doing.


    • Re: (Score:3, Insightful)

      by Zibblsnrt ( 125875 )

      A lot of medical jargon is (A) incredibly standardized and (B) designed to abbreviate.

      Ever hear a doctor reciting a prescription over the phone to a pharmacist? They can compress a substantial amount of information about dosages, timing, when to take/avoid something, etc., into maybe a dozen characters. It'd be a bit moreso when you're talking about *removing someone's shoulder blade* (gah!), but if people on both sides know the jargon for anatomy and techniques, you'd probably be surprised at how much info

      • On a recipe I got just a month ago: $(DRUG) 1mg 1/0/1
        The doc forgot to explain it to me that this means: 1 pill in the morning, 1 in the evening.

  • Stories like this make me wonder if cell phones will be the devices that actually deliver on the promise of OLPC.

  • Soo... (Score:5, Funny)

    by Chairboy ( 88841 ) on Wednesday December 03, 2008 @09:01PM (#25983387) Homepage

    What exactly _is_ the emoticon for 'cut off limb X'?

  • by Anonymous Coward

    See? That's why I don't want a cell phone.

    • Yes, that's why I traded mine for a bone saw long ago, because, well, you never know.

    • Re: (Score:3, Funny)

      by rhyder128k ( 1051042 )
      Now we need this innovation to come full circle so that we can surgically remove cell phones with txting capability from British teenagers.
  • by Laser_iCE ( 1125271 ) on Wednesday December 03, 2008 @09:03PM (#25983411)
    DN: hai r u awake?? im wrkn, ths guys missn heaps of his arm, wwyd?
    MT: lol sup? tru tru... kk well ur guna need 2 do a 4 1/4 amp. req rm of the cola bone n shlda blde.
    DN: yea nm nm...... ok so txt me how
    MT: ok is he there now?
    DN: no im at home
    MT: txt me wen u get there k?
  • whole story (Score:5, Funny)

    by The Clockwork Troll ( 655321 ) on Wednesday December 03, 2008 @09:07PM (#25983435) Journal
    I heard the doctor actually texted full instructions on how to reattach the arm but after 151 characters it got cut off.
  • Old News (Score:5, Funny)

    by nEoN nOoDlE ( 27594 ) on Wednesday December 03, 2008 @09:14PM (#25983499) Homepage

    Verizon takes an arm and leg for text messages every month, so amputation by text message isn't anything new.

  • ...MySpace? I especially like the embedded video clips.

    Seriously, teaching someone how to do an operation through text messages will do the opposite of instilling trust in patients. I wonder if he came out of the operating room and said to the worried family, "Mrs Robinson, The operation went great, just like was written in the text message! I am going to stay at my Holiday in Express now."

  • by MsGeek ( 162936 ) on Wednesday December 03, 2008 @09:26PM (#25983619) Homepage Journal

    ...where this guy's doctor was talking him through doing an appendectomy. "It's very straightforward."

  • seriously... (Score:4, Insightful)

    by Cyrus20 ( 1345311 ) on Wednesday December 03, 2008 @09:29PM (#25983649)
    we joke about this.. but it really is amazing that this was possible. can you imagine taking directions for something like that through a text and doing it. to me it would be like someone texting me directions on how to build an engine and me truly making it run
    • ...if you're a mechanic.

      People on both sides of the lines have a thorough understanding of the anatomy involved.

      This is more akin to someone texting the wiring pattern for a foreign network cable. You might have done cable wiring before... you just need to know which order this particular operation is done in.

  • Man... (Score:4, Funny)

    by gparent ( 1242548 ) on Wednesday December 03, 2008 @09:36PM (#25983717)
    I'm kinda glad we have to pay for incoming text messages now. At least that guy who wants to ampute me will have to think twice before pressing send!
    • Re: (Score:3, Insightful)

      by Builder ( 103701 )

      Only the US pay for incoming texts AFAIK... So never go anywhere with a civilised communications infrastructure - there, they'd be able to amputate bits of you for free!

  • by Skater ( 41976 ) on Wednesday December 03, 2008 @10:19PM (#25984031) Homepage Journal

    They'll be all over this method of reducing healthcare costs!

  • Just text "amputation instructions" to 466453. I've used it twice, it works pretty well.

  • Don't.. (Score:4, Interesting)

    by BigGerman ( 541312 ) on Wednesday December 03, 2008 @11:54PM (#25984705)
    .. give HMOs any ideas!
  • by dangitman ( 862676 ) on Thursday December 04, 2008 @12:37AM (#25984933)
    I don't get what the big deal is. One would expect a surgeon to be able to follow instructions from another surgeon. Are people amazed that a medical professional is literate, or something?

Nondeterminism means never having to say you are wrong.