A Jules update, and some wishes

Once again, I find myself moved by Mr. and Ms. Bianchi’s openness. It’s wonderful that they understand how important Jules is for us, and how we just don’t forget. Remarkable people.

I’m pretty sure I speak for a lot of us if I say that Jules is never very far from any of our thoughts. And prayers.

Rehabilitation after severe head injury means a few things. Most importantly, it’s the rehab people who make sure that Jules’ limbs stay flexible, and that his muscles stay as toned as possible. Remember, a good part of our flexibility, and an even bigger part of our muscular health, are due to impulses from the brain that help maintain their growth and metabolic status. When those impulses aren’t incoming, a program of externally applied movement is important. Avoiding pressure sores is also close to a full-time job in anyone with restricted movement.

Respiratory rehab, especially since Jules is breathing on his own (brilliant news, as it’s one less machine to fail dangerously!), can be necessary, to help him cough and clear secretions.

As for brain-specific rehab, I’m at a total loss here. While the other aspects of rehab would presumably feed back body information (“proprioception”) to the brain (gotta help with maintaing plasticity), I don’t know if there are any effective and evidence-based techniques that improve outcome in this phase of severe head injury. It’d be fascinating if any specialists out there commented with info about this.

Lastly, and most importantly, I want to wish you all, EVERY ONE OF YOU, health and joy and warmth. Comfort for those who comfort. Calm after turmoil. You have all been part of this becoming something I had no idea would become as important to me as it has (ok, that sentence sucked. Forgive me, Ms. Dahlberg). Happy New Year to all of you, and let’s really make 2015 amazing!

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What’s next

It’s been a fairly crazy weekend. Not the sort of craziness I was expecting, as you can well imagine.

After careful consideration, I’ve decided to go quiet for a bit.

I’m going to be busy this week working through options and what my next steps could/should be. You will be informed of everything, have no fear. In due time. And I’ll let people smarter than I decide when and how that will be.

Meanwhile, I want to tell you that the upwelling of support and good wishes is extraordinarily gratifying. 

To all of you, whether or not we’ve crossed inky swords, have a safe and healthy, happy and loving holiday season.

An open letter to Gérard Saillant (oh yeah Jean Todt too)

Dear Gérard,

Imagine my surprise at learning that you were in my hospital last week. You actually got on the train from Paris to come here to Liège! It’s a pity you didn’t call me ahead of the visit – we could have had a cup of coffee. Or you could have beeped me to say hi once you got here. But I guess that actually being face to face with someone is not your style. Come to think of it, it never really has been, has it? You did fire me via email!

Imagine my surprise to learn that despite having heard nothing from you or your boss since being fired, YOU ACTUALLY CAME TO MY HOSPITAL BECAUSE OF ME. You made an appointment with the Dean of my medical faculty, to speak about me. Then travelled 2 1/2 hours . . . for me. I’d be flattered if I wasn’t so . . . shocked. But let’s not dwell on the fun we could have had together in Liège, and look instead at what exactly you came here for. I think it’s important that people understand just how you and your boss work.

You came here to try to get me fired.

Not from the job you already fired me from. That one was basically a hobby. A very serious, very time-intensive hobby. No, now you’re aiming higher. You and your boss want me fired from the job that pays my rent. The one I’ve held for 25 years. Wow. Were you wearing a black trench coat and fedora? Maybe I’m glad I wasn’t there. Perhaps you also had instructions to break my knees!

You came here with a dossier consisting of printed copies of my blog posts. And a copy of a personal email TO ME (!!!) from Corinna Schumacher. OMG. An email I actually never received. Probably because it was addressed to “garry.hartstein@…”. Seriously? I get scores of emails EVERY DAY from people all over the world who spent all of 30 seconds finding my email address. But the wife of one of the world’s most famous and wealthy sportsmen isn’t capable of carrying out that difficult task? You’ve got to be kidding me. Hell, dude, even YOU (trusted advisor to “the family”) had my email (again, that’s how you fired me!).

You came here to raise the issue of whether THIS blog violated my contract at work and could therefore be a reason to fire me, or at least to muzzle me.

Now you worry me. Maybe you should sit down. That’s better. Let’s talk.

Let’s just look at the facts, ok?

1) This blog makes no claim to represent the opinions of anyone other than myself. And while my bio may mention that I studied and work at the University Hospital of Liège, no other mention is made of this fact. All blog-related activity, then, is part of my personal life. Period.

2) Doctor-patient confidentiality is never violated, for two pretty good reasons. First of all, Michael is not and (other than the stuff that came up over 15 years of F1) never has been my patient. Second, I make perfectly clear that NONE of what I wrote in the days, weeks, and months following Michael’s accident was based on anything other than conjecture and experience.

3) When opinions are expressed, they are clearly identified as such, and are never presented with an intent to harm. This intent is abundantly clear, and is even explained on numerous occasions.

So you see, Gérard, if you’d have put your thinking cap on before flitting off to “le Paris du nord”, you’d have realised the absurdity of your project. My blog has nothing to do with my job. In fact, things like “privacy”, and “free expression” come to mind – not as sterile principles, but as LAWS THAT YOU ARE ON THE CUSP OF VIOLATING. You and your boss.

You have acted like a hoodlum. What you have done was not unexpected, but was thuggish and disgusting. You might wear expensive suits and a Patek Philippe, but your tactics are from the gutter.

Be aware that I’ve referred the “dossier” you handed over to the Dean to my attorney. You are on very very thin legal ice.

Word to the wise?

Shut up, back off, and watch out.

The Bianchi accident investigation panel

We’ve been given a summary of the Bianchi investigation, and the 300-some-odd page report has been condensed to what looks approximately like 1.5 A4 pages.

Over 300 pages to less than 2. Holy crap. Either there are a hell of a lot of wasted words in the full text, or someone has really mastered the art of the resumé.

I can’t say much about the reasons behind not releasing the full text of the report, but it is clear that the credibility of the conclusions, such as they are, is not helped by the absence of corroborating background.

In addition, when we look at the composition of the panel, we realise that fully HALF the members have a clear and unambiguous conflict of interest in any investigation. The current positions, and indeed future careers in motorsport, of those panel members who are not dear personal friends of the FIA president depend intimately on remaining in his good graces. Mind you, I am not impugning the integrity of anyone. That’s what’s so insidious with conflicts of interest. They only have to appear to exist to have their negative effects.

This of course rang alarm bells when the panel was formed, but courtesy, decorum and respect no doubt calmed the chuckling at the idea of a body investigating itself. I fear that chuckling was perfectly appropriate.

Let’s get a bit more specific.

The primary conclusion, that Jules was driving too fast, is, as I’ve said before, true by definition. I’m surprised at the reactions of those who feel that this is somehow unfair, unjust, or unkind. It is none of these. Young men make mistakes of judgement all the time, and some pay a grievous price for it. That is the case here. The technical details of BBW and FailSafe are just that – details.

I smiled when I read:

It is considered fundamentally wrong to try and make an impact between a racing car and a large and heavy vehicle survivable. It is imperative to prevent a car ever hitting the crane and/or the marshals working near it.

Suppose they’d said that 60 years ago about Armco? We’d not have developed the know-how that led to 6-row tire barriers with conveyor belting, and we’d certainly not have Techpro. I wonder what would’ve happened to my friend Perez in Monaco a few years ago? Actually, I KNOW what would have happened to him. Ironic, isn’t it? Somehow both goals stated in that quote seem worthy of pursuit; neither do they appear mutually exclusive.

Now it gets a bit complicated. You see, the entire summary (and therefore presumably the report itself, but we have no way of knowing that) is focused on the events leading up to the accident. There would appear to be no attempt to look at those elements of the response that are there to mitigate the consequences AFTER the event has occurred. And now I start to get rather uncomfortable.

We are told:

All rescue and medical procedures were followed, and their expediency are considered to have contributed significantly to the saving of Bianchi’s life.

The first part of this statement is patently untrue. Egregiously. The self congratulatory second part, while certainly true, is inappropriate.

Bear with me, and struggle through this excerpt from the Appendix H of the FIA’s own International Sporting Code (that concerned with “Supervision of the Road and Rescue Services”).

An evacuation under intensive care by medically equipped ambulance (equipment and presence of a doctor proficient in resuscitation on board) with an escort may, however, be carried out, provided that the receiving hospital has been approved beforehand for the treatment presumed necessary according to the casualty’s condition and that it can be reached in approximately 20 minutes (except for serious burns), regardless of the weather and road traffic conditions (except in a case of force majeure). If these conditions are not satisfied, the timed session must be interrupted.

d) Unforseen circumstances, especially the weather, may prevent the arrival, departure or return of the helicopter. In such a case, and after consultation between:

– the Chief Medical Officer;
– the Race Director; and
– the FIA Medical Delegate;
an ongoing or interrupted timed session may perhaps continue or be resumed depending on the conditions of evacuation of a casualty under intensive care to one of the hospitals mentioned in the medical questionnaire for the event and approved by the FIA Medical Delegate.

We were told at the Sochi press conference that the evacuation took 40 minutes. Twice the 20 minute upper boundary that THE FORMULA ONE MEDICAL DELEGATE HIMSELF HAD WRITTEN INTO THE REGS.

We were also told at Sochi that Jules’ condition at the end of that waterlogged siren-punctuated ambulance ride to the hospital was exactly the same as when he left the circuit. Are you kidding me?

Don’t get me wrong. I have no doubt that my Japanese colleagues were indeed able to make sure that Jules’ blood pressure, heart rate, oxygen saturation, expired carbon dioxide, etc (the EXTERNAL parameters, the ones we measure easily) were unchanged over 40 minutes.

But find the nearest neurosurgeon and ask him if the brain of a patient who’s had a head injury with immediate coma is the same after 40 minutes of transport as after 20 minutes, and he’ll look at you like you were nuts. Because you are.

Why did Dr. Saillant not address the question of EXACTLY when the Medical Delegate (his personal appointee) knew that the helicopter could not land at the receiving hospital? Under difficult circumstances this often requires near real time communication with the helicopter crew. The delegate is up in race control with nothing else to do during the race. That’s why he’s there. Why was racing not stopped? This is far from a trivial issue, and is all the more dramatic that the FIA’s own regulations would appear to have been ignored by their author, the Medical Delegate.

This is a potentially grievous error, and it is all the more shocking that the question is not even addressed. And unfortunately this is precisely the kind of result one would expect with a panel studded with insiders.