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Comment by brnt | Hacker News Reader

There's hacking and there is _hacking_.

My sister is training to be a doctor and she has come to dislike the heavily regulated environment we have here in which doctors are not allowed to do anything of this sort. Now, they also don't usually need to, which is a good think, but after she returned from a year in South America, she misses the on-your-feet thinking, creativity and flexibility she could and had to employ to give her patients the care they needed.

I can imagine pulling this off is a great source of satisfaction and validation.

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Yeah, but as a South American, one thing is being able to be creative, another is _needing_ to be creative, which means doctors are not being given the resources they need (which is common here).

Letting doctors have fun under pressure, or ensuring good outcomes for patients? Mmmh, I wonder what we should choose as a society... /s

Of course, it's preferable to not require such creativity from doctors. But some people do well in adverse circumstances, and it takes an adverse circumstance to find out, I guess. For patients sake, I'm glad some people can focus on the outcome and not on executing protocols they learned in school.

Yeah, but the problem is that some doctors are not capable of doing things of this sort safely, and thus doctor regulations happen. There are definitely unnecessary regulations out there, but I imagine that most of them are simply yet another symptom of "any large enough system eventually gets ruined by abuse".

Improvised answers aren't safe. It's just sometimes they're the best of a bad set of options.

I'm naturally cool as hell when something goes wrong. Dunno why, just am (I'm definitely not especially cold-blooded in general). Weird thing happens in traffic? I act, get out the other side, and only in retrospect go "oh, wait... that was really bad" (now, oddly, if something happens ahead in traffic but doesn't affect me, after a beat I often get a pretty strong adrenaline kick that's fairly unpleasant, but for whatever reason it either doesn't happen or I never feel it at all if I actually need to react)

Work emergency? Awesome, I'm fine—great, even. Serious family problem that could be of the life-or-death sort? I will get. Shit. Done. As long as shit needs to be done, and will keep it together the whole time without a moment's lapse or even really having to try not to fall apart.

I sometimes think I'd probably have been an awesome mammoth hunter.

Alas, normal life these days rarely offers opportunities to operate at actual-peak perfect-flow state like that, and I like life enough that I've not tried to fill that void with extreme sports or anything of that sort.

I think the "I actually kind of prefer serious emergencies to normal, safe life, maybe?" thing isn't super rare. Dunno if it's normal, exactly, but I think it's common enough.

Famous case in Brazil: in 1998 a surgeon used cyanoacrylate glue on the heart of a patient: https://www1.folha.uol.com.br/fol/geral/gx055168.htm

Using cyanoacrylate glue is is very common in medicine for skin closure. Doesn’t seem ridiculous to use in other settings.

The point is that most surgeons today would not pull that off, as if it goes wrong their career might end abruptly.

The patient, on the other hand, dies after “attempting all the standard procedures” and nobody is at fault.

I think it was not known at that time. The surgeon asked the nurse to go out of the hospital to buy the glue.

It was well known for quite some time before that.

US Combat Medics used it in the field in Vietnam in the '70s.

In the US a medical formulation was not approved until 1998, but as the sibling notes it was used in the Vietnam War by US medics. Medical studies in the 1980s showed it to be superior to stitches [1]

Cyanoacrylate is just (a very - the most? - common form of) superglue, but the medical formulations were tweaked to be less harmful to skin among other benefits.

There is also VetBond, which is similarly n-Butyl cyanoacrylate as are some medical-grade superglues, but it is only approved for animal use and thus available without a prescription (despite being chemically identical to somemedically approved glues).

[1] https://en.wikipedia.org/wiki/Cyanoacrylate#Medical_and_vete...

First I heard of it was when my kid was rushed to hospital from kindergarten for a cut above hos eyebrow (where his best friend had thrown a toy car at him, probably in a tiff about who'd get to play with it) in ~2006-7. It was a funny colour, a bright light purple; I presume for better visibility (in contrast to most normal human skin colours) both at application and afterwards. Faded away after a few days IIRC; can't recall any return visit to check on it.

Cyanoacrylate also bonds with proteins. It's a commonly used topical hemostatic and adhesive. It's usually for relatively dry and clean skin incisions but I certainly understand their attempt to use it in open surgery if things got desperate enough.

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