The Ella Tannous Case: When Every Lebanese Suddenly Becomes A Doctor

Ella Tannous

I just wasted 7 years of my life in medical school.

Naturally, when you live in the country with the likes of professor Marcel Ghanem, Dr. Joe Maalouf, Tony Khalifeh and their friends, is there a point for you to remotely try to get an education? They will tell you what you need to know, give you medicine crash courses and guide public opinion on the matter.

Clearly, they’re the ones who know everything and those doctors are just backward-minded folks who only care about money.

Ella Tannous is a young 9 months old whose pediatrician is now in jail. Why is he in jail? Because we live in a corrupt country where security forces get carried away by the sensational reporting of Kalam Ennas and other similar shows to ruin the life of a man simply because of the science of Marcel Ghanem’s report and that dramatic Lord of the Rings music in the background and the tears of the child’s mother as she whispers: why can’t my little girl play with barbies?

Again, what would I know. I’m sure that policeman in between his Malek el Tawou2 sandwiches was busy reading medical textbooks. Give me the differential of a crying baby, kind sir. Oh, you have cramps from all the garlic consumption? Excuse me.

According to her parents, Ella had a high grade fever for which they contacted her pediatrician, Dr. Issam Maalouf, who ran some tests that revealed Ella most likely had a viral illness and prescribed medications to lower her fever.

However, Ella’s fever did not subside and upon contacting the doctor again, he told them not to worry and to use cold towels to try and drop her temperature.

When the parents saw that their child’s situation did not improve they took her to the hospital. It was a Sunday. The pediatrician did not see Ella that day and instead saw her the following day when she had already deteriorated.

He got her transferred to AUBMC where further treatment was done. Ella, however, was in shock and in a state called DIC (Disseminated Intravascular Coagulation) and had gangrene in her limbs, which had to be amputated to save her life.

This is what happened with Ella Tannous according to her parents:

*cue in dramatic music.*

What happened to their child is surely devastating to them and Ella’s parents have every right to be sad and heartbroken over what happened to their daughter.

But just because someone’s daughter had complications does not make that person a doctor who can go on air and pretend they know what makes sense scientifically and what doesn’t. It also does not give Marcel Ghanem or any Lebanese media, who were quick to jump on this very delicious scoop, the right to become full blown medical professionals who spent their times doing night duties in pediatrics.

So let’s go with what we know one by one:

1) Ella’s blood tests revealed a viral illness. Viruses are not treated with antibiotics as Ella’s father was alluding should have happened. In fact, the side effects of those antibiotics and possible increasing resistance to them make their use in viral illness not recommended. How do you treat a viral illness, scientifically? You provide symptomatic relief. A patient has fever? You give anti fever medication. A patient has a sore throat? You provide pain relief, etc.

2) Ella’s fever persisted. Viral illnesses can have fevers that persist. You still give anti-fever medications and monitor. This is what you do, unless LBC or Annahar have new guidelines that we need to be aware of, in which case enlight us please.

3) Ella deteriorated and they contacted her physician as they took her to the hospital. He didn’t recognize them at first. Well, bring the guillotines. A pediatrician could not recognize over the phone a patient out of the hundreds that he has. He must be incompetent. Issam Maalouf’s mistake? He did not go see Ella that day at the hospital. However, that hospital is a university hospital and they should have been reporting back to him every single that happened with Ella as she would’ve been admitted under his care.

4) Ella’s fever continues and she starts experiencing decreasing urine output and becomes lethargic. These are signs of dehydration and deterioration. Dehydration can lead to kidney damage because blood flow to the kidney is decreased which causes something that is called acute kidney injury. This is not what probably happened to Ella, however.

5) Because of her decreasing immunity fighting the virus, Ella contracted another bacteria called Group A Strep (GAS). This bacteria is virulent and has been known to cause a wide array of complications when not recognized and treated early. To recognize and treat it early, you need to maintain a very high level of suspicion which in the setting of a clear viral illness, such as Ella’s case, was not the case.

Due to her low immunity, Ella had a dissemination of GAS. This led her to go into septic shock and full blown DIC. Septic shock is an extremely lethal condition whereby the body cannot adequately find the overwhelming infection. DIC is a complication of septic shock that leads to the depletion of the body’s ability to coagulate the blood through the formation of little clots that block blood vessels across many organs and vessels. The condition is extremely lethal.

In fact, the combination of septic shock and DIC is usually unescapable. Ella is lucky to be alive. Do you know why she’s lucky to be alive? Because her pediatrician saw the signs early enough to transfer her to a hospital that can manage her well.

 

Bring The Pitchforks, Why Don’t You:

After all that they’ve done, I can’t believe the Lebanese populace still trusts Lebanese media blindly when it comes to medical issues just because they’re sensationalized enough for their liking.

This is the same media that wanted to convince you we had a Guillain-Barré virus.

This is the same media that, a few years ago, ruined an OBGYN’s life by pretending they know medicine and accused him of killing one of his patients who was giving birth. That patient had an amniotic fluid embolism that is a lethal and extremely rare complication of giving birth. That doctor’s future was ruined anyway. He was also thrown in jail for something out of his hands before the courts realized that he was thrown in jail simply because of Tony Khalifeh’s report at the time.

Issam Maalouf joins the growing list of doctors whose entire career rests upon the whims of a reporter who understands nothing and who goes by what the parents or family of a patient are saying as if they know what’s happening, as if they know the medicine behind diseases. A devastated parent is not a doctor.

This is the same media that now has you convinced a competent doctor is now where he belongs, behind bars, and has you changing your display pictures to “Justice for Ella” snapshots.

When faced with a report from the Lebanese Order of Physicians about what actually happened, that same media downplays the report as inaccurate. Because clearly, the Order of Physicians does not know the medicine behind what’s going on. Those physicians did not go to med school for years and then did residency and fellowship programs for more years only to be ridiculed on air for being imbeciles.

Complications in medical scenarios happen. Not every single complication, despite how deliciously journalistic it looks, is a headline story.

With all due respect to a patient’s family, the esteemed reporters across the Lebanese republic and the people holding the pitchforks in Ella’s defense: You really have no freaking clue what you’re saying. Stop suggesting treatment modalities. Stop suggesting scientific explanations. Stop ruining people’s lives just because it makes for fancy headlines.

And then you get the Ministry of Health pretending they suddenly understand medicine to bring their pitchforks too. You know, that same ministry who turned Lebanon’s food safety issue into a Star Academy-like nominee-every-week report fashion.

There is a reason we go to medical school for endless years. There is a reason we do residency for another batch of endless years. Only doctors can know when medical errors occur. Only doctors can judge another doctor who does a medical error. Only doctors know how to treat patients and diagnose them. Only doctors know how to manage complications.

This is not elitism. This is common sense. This extends to other professions as well. I can’t judge the work of an architect, but an architect can. I can’t judge the work of an electrical engineer, but another electrical engineer can, etc.

The bottom line is: I just wasted 7 years of my life in medical school, that much is clear. Because clearly, Marcel Ghanem and his friends know better than me and all my colleagues.

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Let’s Talk About How Nabil Habib & Kalam Ennas Blew A Cancer “Cure”

I am furious.

There’s nothing I’d love more than to have my field discussed openly among people. There’s nothing more I’d love than to make people more aware about cancer, about the different treatment modalities. I’d even teach people all the pharmacology I know about cancer drugs if I were able to.

I approached the latest – currently airing – Kalam Ennas episode with caution. I had a faint clue who Nabil Habib was. They were discussing one of the most funded, most controversial, most challenging aspects of medicine lately. I figured I’d tune in.

Yes, I’m furious.

I’m not a chemist nor do I aim to be. But when it comes to protocol – when it comes to every single facet of what makes medicine works, what makes this branch of our lives that has cured so many people all around the world functional, he has blown to bits. And he’s condescending about it.

I have no idea who figured it was a scientifically sound idea to get a chemist who has a proposal for a cancer drug on air to discuss his work, have almost no opposite scientific opinion to what he was saying save for the few questions the show’s host got spoon-fed moments before going on air. But do you want to know what’s the great idea? It’s quoting the bible left and right for some scientific credibility.

First, an accomplished scientist wouldn’t need to go on media to discuss his work in order to convince people about it. Regular viewers are not those who need to be convinced about any scientist’s work – other scientists need to be. Getting a one-sided opinion on a talk-show is not having a scientific discussion. Getting people who have been “cured” by your methods is not science. You know what’s science? It’s having data that supports what you’re presenting without any shred of doubt. And then people will follow.

Second, the thing about scientific data is that there are ways for it to be amassed. And those rules exist for a reason: because science takes time, because such “cures” have to be so thorough as not to give people false hope, because arguments such as “this disease is ripping our societies” are not valid scientifically. Each step of the development of the drug from the lab to the clinic has to be monitored and submitted to the FDA. Nabil Habib has not done that. These are the steps to be followed for a drug development (link – you need to create an account to read it). Nabil Habib has blown these steps to pieces. But fear not, he has patented it – never mind that he used it on people as a “secret recipe” prior to the patent process.

Drug development

Third, the drug development procedure is a process that costs at least half a billion dollars. I’m sure Dr. Habib doesn’t have such means under his disposal. If his drug had been as wondrous as he’s making it out to be, then he would have definitely sold it to a major pharmacological company by now. He would have been a billionaire already and the drug would have been much further along development. And he’d have had the chance to cure much people than the 600 he claims he’s currently treating, an odd claim since I didn’t know chemists usually have patients who are people that suffer from a disease where any glimpse of hope is enough to get them going.

Such a TV show is not the platform to host a scientific discussion. I have no idea if the molecule in question is as beautiful as it has been portrayed to be simply because there has been no opposite opinion to its merits. I have no idea if the claim that this molecule has no side effects is valid: a molecule that can affect so many different types of cancers, affect different types of tissues cannot not have absolutely no side effects worth mentioning. I have no idea if what this man is claiming, even when it pertains to all the different kinds of cancers, is correct or not. But fear not, I have no right to know whether what he’s saying is a fact or not.

Such a TV show, aiming to capitalize on the interest of people, doesn’t get to screw over physicians who either refused or are not allowed to be hosted on it just because it’s what gets viewers. Dr. Georges Chahine will face hell tomorrow because the segment he gave prior to the Lebanese syndicate of physicians issued its decision on the episode was not amended to reflect that decision. The excuse? “It’s not our property anymore.” Excuse me? Whose property is it?

Such a TV show doesn’t serve to educate people. It doesn’t serve to expose a facet of Lebanese society that’s troubling us all. It doesn’t even better things for any of us. What it does is serve as a marketing ploy, nothing more and nothing less, to this chemist and his molecule while ridiculing every single physician who has taken more than a decade of his life to know how to do his job and get guests to tell everyone that those physicians are nothing but ignorants trying to ride people’s backs.

Lebanese TV doesn’t discuss science. Lebanese TV only deals with trash. There are Lebanese scientists who are working tirelessly on ways to deal with cancer (link). But we get this instead. My mother, a current cancer patient, felt this show ridiculed her struggles with her disease. But let’s just keep on making shortcuts, bypassing regulations and proclaiming persecution in order to emerge as messiahs. We’re Lebanese and we just roll like that. There are absolutely no standards whatsoever that can faze us.

 

Saad Hariri To Be On Kalam Ennas on January 31st

Saad Hariri

Lebanon’s most famous invisible/disappeared man is preparing a comeback. And it starts in 10 days.

Marcel Ghanem’s TV show on LBC will be the first political talk show in months (maybe even a year) to host the former prime minister of the country and the head of one of its largest parties who left the country soon after the January 2011 coup not to be heard of or seen again.

Don’t worry though – Saad Hariri wasn’t in grave danger in his self-exile in Paris, unless you count that broken leg skiing on the French (or was it Swiss?) Alps. Throughout the past two years, Hariri has gradually but surely decreased his presence all around even on Twitter following not one (click here) but two (click here) gaffs on social media.

Either way, the episode should be quite interesting. I, for one, hope it wasn’t part of an exclusive deal aiming to get viewers without tackling any serious questions. With the tricky situation the country is going through, Marcel Ghanem better be ready to grill Saad Hariri about what he has been up to these past two years and what he intends to do in the coming months.

I’m sure everyone wants to know.

Will you be watching? The whole country will.