To the Editor:

Re “Sufferers Misplaced Limbs as Docs and Well being Care Giants Prospered” (“Working Earnings” collection, entrance web page, July 16):

A small group of physicians has made tens of millions performing pointless or incompetent stents and atherectomy procedures on sufferers with peripheral vascular illness — the narrowing or blockage of arteries carrying blood to the legs — when medical remedy could also be higher.

When these invasive procedures fail, the physicians and hospitals nonetheless acquire hefty reimbursement, and the affected person might lose a leg by amputation.

As a vascular surgeon for over 4 a long time, I’ve witnessed this overuse of procedures and have identified that producers pay tens of millions of “consulting” charges to some physicians who overuse stents and atherectomy units.

How can we shield the wants of the affected person? Sufferers ought to search second opinions about elective vascular procedures. Second, a class-action swimsuit in opposition to a number of producers which have facilitated this overuse is overdue. Let’s save extra legs and lives!

John Hallett
Charleston, S.C.
The author is a professor emeritus of surgical procedure at Mayo Clinic and the Medical College of South Carolina.

To the Editor:

Your story relating to the usage of atherectomy to deal with peripheral artery illness was a wonderful alternative to tell your readers concerning the epidemic of amputations our nation is now dealing with brought on by important limb ischemia (C.L.I.) — essentially the most extreme finish stage of peripheral artery illness.

As a substitute, you didn’t embrace knowledge and medical research that do present the efficacy of atherectomy and different minimally invasive therapies in treating C.L.I. sufferers. Suppliers like us want choices past amputation for C.L.I. sufferers too sick to qualify for vascular bypass surgical procedure.

The statistics are sobering: Many C.L.I. sufferers is not going to endure a proper vascular analysis or process to enhance blood movement, growing the chance for main amputation and in-hospital dying. Even minor amputations with out an accompanying try to enhance blood movement may end up in threat of main amputation and dying. As much as 50 p.c of sufferers who obtain an amputation will die inside the first 12 months; 70 p.c will die inside 4 years. Individuals of coloration obtain amputations at 1.5 to 4 instances the speed of white Individuals.

Well being organizations are paying consideration. The American Diabetes Affiliation has declared warfare on preventable amputation by forming the Amputation Prevention Alliance. It has been joined by nationwide organizations together with the American Coronary heart Affiliation, that are calling for a 20 p.c discount in non-traumatic amputations by the tip of this decade.

As a rustic, we’ve got to do higher. We now have to offer a number of choices to greatest serve sufferers. Sadly whereas it’s generally unavoidable, we have to cease seeing amputation as a suitable main resolution when different options can be found.

Bret N. Wiechmann
Gainesville, Fla.
This letter was signed by 55 different physicians working in interventional radiology, vascular surgical procedure, interventional cardiology, angiology and podiatry.

To the Editor:

My 76-year-old husband has peripheral artery illness and different medical circumstances and was prone to dropping his leg. A Michigan cardiovascular clinic really helpful amputation. One other clinic referred us to Dr. Jihad Mustapha, who was featured prominently in your article. He moved with urgency and saved my husband’s leg with peripheral arterial endovascular interventions together with atherectomy and deep venous arterialization.

There will not be any assured medical procedures or excellent medical practitioners. Dr. Mustapha is sensible by way of his medical reward and bedside method.

I have no idea how lengthy my husband may have full performance of his leg. However I’m grateful that he has his leg at the moment. Will amputation be in his future? Probably. However I’m appreciative for the extra time that he was given because of Dr. Mustapha.

Marlene Smith
Ypsilanti, Mich.

The Pursuit of Gender-Impartial Wording

To the Editor:

Re “Yo, an Solely New Gender-Impartial Pronoun” (Opinion, July 22):

Prof. John McWhorter writes that one resolution to the dearth of gender-neutral pronouns comes from audio system of Black English in Baltimore: the usage of “yo” as a third-person pronoun, changing “he” and “she.” One of many sentences he cites for instance that is “Yo was tuckin’ in his shirt!”

Nonetheless, the sentence exhibits an apparent flaw on this tried resolution. With the possessive pronoun “his,” it’s clear that the individual referred to is male.

What is required to unravel the issue is gender-neutral substitutes for all pronouns, along with the topic pronouns “he” and “she”: the possessive pronouns “his” and “her,” the item pronouns “him” and “her,” and the reflexive pronouns “himself” and “herself.”

Kudos to the youngsters in Baltimore, however there’s extra work to be achieved.

Sue Dicker
New York
The author is a linguist and a retired professor of English at Hostos Neighborhood School, CUNY.

To the Editor:

John McWhorter has centered his gender-neutral pronoun alternative a lot on the pronoun alone that he has left behind an necessary element to readability: the verb.

When Professor McWhorter factors out that German has two “sie” pronouns — one for “she” and one for “they” — he leaves out that every pronoun is paired with a verb that clarifies which “sie” is getting used: sie spricht (she says) and sie sprechen (they communicate).

Utilizing “they” as a singular pronoun could be advantageous, too, if we used the third-person singular verb. That means, the plural “they” may proceed to check with multiple individual with out confusion.

They is. They’re. They’re each advantageous with me.

Louise Egan
Queens
The author is a non-public English language instructor for worldwide professionals.

To the Editor:

Re “What’s Subsequent After Over-the-Counter Delivery Management Capsules?,” by Daniel Grossman (Opinion visitor essay, July 21):

The approval of over-the-counter oral contraception is certainly a significant advance, as Dr. Grossman convincingly demonstrates.

On a extra political observe, one also can argue that this single motion, favored by main medical teams and the Biden administration, will probably forestall extra undesirable pregnancies and abortions than the sum of all so-called anti-abortion activism, together with that of the Supreme Courtroom.

If solely all of the “proper to life” activists may very well be satisfied to hitch in doing what truly decreases abortions with out harming girls, everyone would profit. Not that I’m holding my breath, however one can dream.

Steve Heilig
San Francisco
The author is a co-editor of The Cambridge Quarterly of Healthcare Ethics.

Is A.I. a Self-Starter?

To the Editor:

Given all the latest concern about synthetic intelligence, we must always take into account the next: Can A.I. by itself pose an authentic query or determine an issue and comply with up with an answer?

The power to take action appears to be a uniquely human functionality. Until and till A.I. can accomplish that, it would probably stay a device manipulated by its customers.

Christopher A. Biltoft
Salt Lake Metropolis