{"id":810,"date":"2019-05-07T07:02:43","date_gmt":"2019-05-07T04:02:43","guid":{"rendered":"http:\/\/acilbulten.net\/?p=810"},"modified":"2021-11-10T22:38:16","modified_gmt":"2021-11-10T19:38:16","slug":"mitolojiden-bilime-muzik","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/aciltipbulteni\/2019\/05\/07\/mitolojiden-bilime-muzik\/","title":{"rendered":"Mitolojiden Bilime M\u00fczik"},"content":{"rendered":"\n
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Yazar: Altu\u011f Kanbakan,<\/em> <\/strong>Akdeniz T\u0131p mezunu, Cerrahpa\u015fa\u2019 da acil t\u0131p e\u011fitimine devam etmekte. Delikasap Rock\u2019n\u2019Roll K\u00fclt\u00fcr\u00fc Mecmuas\u0131\u2019 nda yakla\u015f\u0131k on y\u0131ld\u0131r yaz\u0131p \u00e7izmekte. Acilde \u00e7al\u0131\u015f\u0131rken ayyuka \u00e7\u0131kan stresini Instagram\u2019 daki EM Fun Facts hesab\u0131nda kitleler ile payla\u015farak \u00fczerinden atmaktad\u0131r.<\/em><\/p>\n\n\n\n

Tarihin tam olarak hangi noktas\u0131nda mesle\u011fimiz olan hekimlik ba\u015flad\u0131 bilinmez ama ilk primitif hekimin de bir acilci gibi hayat kurtarmak i\u00e7in u\u011fra\u015ft\u0131\u011f\u0131 varsay\u0131m\u0131n\u0131 \u00e7ok seviyorum. Salt \u2018acil t\u0131p\u2019 g\u00fczellemesi yapmak ya da yapt\u0131\u011f\u0131m\u0131z i\u015fin daha \u2018y\u00fcce\u2019 bir anlam ifade etmesi i\u00e7in bir milat arad\u0131\u011f\u0131mdan de\u011fil; aksine en do\u011fal hekimlik i\u015flevi olan hayat kurtarma \u00e7abas\u0131n\u0131n bir par\u00e7as\u0131 olmaktan duydu\u011fum mutluluk nedeniyle bu varsay\u0131m\u0131 be\u011feniyorum.
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Elbette bu yaz\u0131n\u0131n amac\u0131, siz de\u011ferli okuyucular\u0131 benim neleri sevip sevmedi\u011fim konusunda s\u0131kmak de\u011fil ancak bu hayat kurtarma \u00e7abas\u0131n\u0131 farkl\u0131 bir pencereden sizlere aktarmaya \u00e7al\u0131\u015fmak; kabiliyetim dahilinde ise ba\u015fka bir perspektif kazand\u0131rmak olacak.
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1891 y\u0131l\u0131nda, Alman cerrah Dr. Friedrich Maass\u2019\u0131n operasyona almay\u0131 planlad\u0131\u011f\u0131 dokuz ya\u015f\u0131ndaki bir hastas\u0131n\u0131n kloroform inhalasyonu sonras\u0131nda meydana gelen pupiller dilatasyon ve siyanoz sonras\u0131, ani bir refleks ile ba\u015flad\u0131\u011f\u0131 \u2018ksifoid alandan\u2019 ya da kendi deyi\u015fi ile kalp b\u00f6lgesinden yapt\u0131\u011f\u0131; kompresyon ile siyanozun ortadan kalk\u0131p pupiller dilatasyonun d\u00fczelmesi bir milad\u0131n ba\u015flang\u0131c\u0131 olacakt\u0131. Dr. Maass kompresyona, solunum h\u0131z\u0131nda ba\u015flamay\u0131 d\u00fc\u015f\u00fcnm\u00fc\u015ft\u00fc ancak yetersiz oldu\u011funu g\u00f6r\u00fcnce h\u0131zlanm\u0131\u015ft\u0131
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O g\u00fcn hastas\u0131 ile ilgili olarak Maass \u015funlar\u0131 yazm\u0131\u015ft\u0131: \u201co anda hastan\u0131n \u00f6ld\u00fc\u011f\u00fcn\u00fc d\u00fc\u015f\u00fcnmeliydim. Buna ra\u011fmen, heyecan\u0131m\u0131n doruk noktas\u0131nda, kalp b\u00f6lgesine do\u011frudan kompresyona ba\u015flad\u0131m. H\u0131zl\u0131 ve g\u00fc\u00e7l\u00fc bir \u015fekilde \u00e7al\u0131\u015ft\u0131m. Pupiller h\u0131zla konstrikte oldu ve b\u00fcy\u00fck bir h\u0131zla devam etti\u011fimde hemen k\u00fc\u00e7\u00fcld\u00fcler ve duraklamalar s\u0131ras\u0131nda, yava\u015flad\u0131m, gasping tarz\u0131nda solunma tekrar ba\u015flad\u0131\u201d(1).
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Bu insanl\u0131k i\u00e7in k\u00fc\u00e7\u00fck ad\u0131m, 1960\u2019lara gelindi\u011finde American Heart Association (AHA) taraf\u0131ndan sistematik olarak ele al\u0131nd\u0131 ve bug\u00fcn kullanmakta oldu\u011fumuz algoritmalar\u0131n atas\u0131n\u0131 olu\u015fturan a\u011f\u0131zdan-a\u011f\u0131za solutma ve g\u00f6\u011f\u00fcs kompresyonunu te\u015fvik eden yay\u0131nlara d\u00f6n\u00fc\u015ft\u00fc. 1963 y\u0131l\u0131na geldi\u011fimizde ise AHA,  ilk KPR k\u0131lavuzunu, daha do\u011frusu ilkelerini yay\u0131nlad\u0131. Hekimlik prati\u011fimizin ba\u015f k\u00f6\u015fesinde duran ABC yakla\u015f\u0131m\u0131 da bununla ba\u015flam\u0131\u015f oldu diyebiliriz.
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Belki de Anglo-Amerikan t\u0131bbi yakla\u015f\u0131m\u0131n\u0131n da alameti farikas\u0131 haline gelen bu k\u0131lavuzdan sonra elbette y\u0131llar i\u00e7inde b\u00fcy\u00fck de\u011fi\u015fiklikler ya\u015fand\u0131. Kan\u0131ta dayal\u0131 t\u0131p yakla\u015f\u0131m\u0131n\u0131n objektif g\u00fcc\u00fc ile \u015fekillenen k\u0131lavuzlar arac\u0131l\u0131\u011f\u0131 ile kompresyonun ne denli \u00f6nemli oldu\u011fu bilgisi edinilmi\u015fti. \u0130\u015fte tam burada bizim hikayemiz ba\u015fl\u0131yor.
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Hekimlik hayat\u0131m\u0131zdaki \u2018hayata d\u00f6nd\u00fcrme\u2019 \u00e7abas\u0131n\u0131n daha pop\u00fcler bir konu haline gelmesi ile ilk m\u00fcdahalenin yayg\u0131nla\u015fmas\u0131n\u0131n \u00f6nemi artt\u0131. 1960\u2019l\u0131 y\u0131llar\u0131n ba\u015f\u0131ndan itibaren kardiyopulmoner res\u00fcsitasyonun yap\u0131lmas\u0131 te\u015fvik edilirken bir yandan da bilimsel geli\u015fmeler \u0131\u015f\u0131\u011f\u0131nda tekrar g\u00fcncellenmesi g\u00fcndemdeydi. 1972\u2019de ise Amerika\u2019n\u0131n Seattle \u015fehrinde ilk kez yap\u0131lan toplu KPR e\u011fitimi sonras\u0131nda bu hayati m\u00fcdahalenin toplum taraf\u0131ndan daha da bilinir hale gelmesi hedefler aras\u0131nda yer ald\u0131.
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Bu yaz\u0131n\u0131n konusunu olu\u015fturan as\u0131l olay ise, 2005 y\u0131l\u0131nda Hawaii \u00dcniversitesi\u2019nde pediatrik aciller konusunda uzmanla\u015fm\u0131\u015f Dr. Alson Inaba\u2019n\u0131n bir \u00f6nerisi oldu. AHA\u2019n\u0131n tan\u0131kl\u0131 kardiyak arrest olgular\u0131nda erkenden m\u00fcdahale i\u00e7in insanlar\u0131 bu konuda e\u011fitme hedefi zaman i\u00e7erisinde olu\u015fmu\u015ftu. Dr. Inaba, t\u0131p fak\u00fcltesindeki bir KPR e\u011fitimi i\u00e7in s\u0131k\u0131c\u0131 slaytlar yerine bir ske\u00e7 haz\u0131rlarken, akl\u0131na dakikada 103 vuru\u015f say\u0131s\u0131na sahip \u2018o\u2019 \u015fark\u0131 gelmi\u015fti (2). Yapt\u0131\u011f\u0131 etkili ve dikkat \u00e7ekici e\u011fitim sonras\u0131nda bunu AHA\u2019 ya sundu ve \u00f6nerisi kabul edildi. B\u00f6ylelikle 2008 y\u0131l\u0131nda, AHA\u2019n\u0131n \u201cHands-Only CPR\u201d slogan\u0131 ile Bee Gees\u2019in pop\u00fcler disko ritmi \u2018Staying Alive\u2019 hayatta kalman\u0131n simgesi haline geldi.
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G\u00fcn\u00fcm\u00fcz t\u0131p e\u011fitiminde de kendine b\u00fcy\u00fck bir yer edinen res\u00fcsitasyon e\u011fitiminin bir m\u00fczik par\u00e7as\u0131 ile daha da g\u00f6z \u00f6n\u00fcnde olmas\u0131 b\u00fcy\u00fck bir geli\u015fme kan\u0131mca. Zira insanl\u0131\u011f\u0131n ilkel d\u00f6nmelerinde sa\u011fl\u0131k kavram\u0131n\u0131n bir par\u00e7as\u0131 olan m\u00fczik, ritualistik uygulamalarda kendine yer edinmi\u015fti. Antik Yunan mitolojisinde sa\u011fl\u0131k tanr\u0131s\u0131 olan Asklepios\u2019 a atfedilen \u00f6zelliklerden biri de m\u00fczik (ya da do\u011fa sesleri \u2013 eldeki verilerin yetersiz olmas\u0131 nedeniyle kesin bir yorumda bulunam\u0131yoruz) arac\u0131l\u0131\u011f\u0131 ile hastal\u0131klar\u0131 iyile\u015ftirdi\u011fi y\u00f6n\u00fcnde idi.
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M\u00fczi\u011fin toplumsal hayattaki yeri, \u015f\u00fcphesiz salt mitler ya da g\u00fcn\u00fcm\u00fcz e\u011flence sekt\u00f6r\u00fcnden ibaret de\u011fil. M\u00fczik ayn\u0131 zamanda toplumsal de\u011fi\u015fimlerin bir par\u00e7as\u0131 olarak kar\u015f\u0131m\u0131za \u00e7\u0131kmakta. Bu konuda en iddial\u0131 savlardan biri Frans\u0131z akademisyen ve ekonomist Jacques Attali\u2019ye ait. Attali, 1977 y\u0131l\u0131nda yay\u0131nlad\u0131\u011f\u0131 kitap (3) ile; Para, \u0130ktidar ve M\u00fczik kavramlar\u0131 \u00fczerinden insanl\u0131k tarihini yorumlam\u0131\u015ft\u0131.
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Bu yorumlamada insanl\u0131k tarihindeki \u00fcretim-iktidar ili\u015fkilerinin m\u00fczik de\u011fi\u015fimi ile ili\u015fkili oldu\u011funu; hatta m\u00fczik \u00fcretim bi\u00e7imlerinin de\u011fi\u015fiminin iktidar-\u00fcretim ili\u015fkilerini \u00f6ng\u00f6rd\u00fc\u011f\u00fcn\u00fc savunmu\u015ftu. Detaylar\u0131 belki ba\u015fka bir yaz\u0131ya kalabilir ancak kitab\u0131n ilk b\u00f6l\u00fcm\u00fcn\u00fc olu\u015fturan \u201ckurban edimi\u201d k\u0131sm\u0131n\u0131 bu yaz\u0131 i\u00e7in dikkate de\u011fer buluyorum.
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Kurban edimi, bir kefareti; \u00f6denmesi gereken borcu ve sonras\u0131nda kavu\u015fulan iyile\u015fmeyi ya da katarsisi (ar\u0131nmay\u0131) ifade eder. \u0130nsanl\u0131k tarihinin her basama\u011f\u0131nda bu kurban edimine rastlan\u0131r. Tanr\u0131lar\u0131n hiddetinden ka\u00e7\u0131nmak i\u00e7in verilen kurban edilen bireyler; g\u00fcn\u00fcm\u00fczde ise bir a\u00e7\u0131dan pek \u00e7ok sanat dal\u0131 ve kimi zaman spor, toplumsal ve i\u00e7 \u015fiddetin bask\u0131lanmas\u0131 i\u00e7in yap\u0131lan birer e\u011fretilemedir. Attali\u2019 nin g\u00f6z\u00fcnden de m\u00fczik bir e\u011fretileme arac\u0131 olarak g\u00f6sterilir. M\u00fczi\u011fi, g\u00fcr\u00fclt\u00fcn\u00fcn kar\u015f\u0131s\u0131na koyar ve bireysel-toplumsal ayaklanman\u0131n, kurals\u0131zl\u0131\u011f\u0131n ehlile\u015ftirilmesi, bast\u0131r\u0131lmas\u0131 olarak kodlar. Ayn\u0131, rahip-doktorlar taraf\u0131ndan  bedensel bozukluklar\u0131n giderilmesi i\u00e7in harmoninin; m\u00fczi\u011fin kurban edilmesi gibi. Ya da Aristoteles\u2019in Poetika<\/em>\u2019 s\u0131ndaki \u201cTragedyalar katarsis sa\u011flar\u201d ve \u201cm\u00fczik, e\u011fitim ve ar\u0131nma i\u00e7in kullan\u0131labilir\u201d d\u00fc\u015f\u00fcncelerinden hareket edelim. Kendi trajedilerinin ba\u015f akt\u00f6rleri olan arrest vakalar\u0131m\u0131z i\u00e7in en b\u00fcy\u00fck ar\u0131nma hayata tekrar ba\u011flanmak; biz hekimler de bunun i\u00e7in e\u011fitilirken t\u00fcm bunlar\u0131n ortas\u0131nda neden m\u00fczik yer almas\u0131n?
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Bu d\u00fc\u015f\u00fcnsel egzersiz bir yana, elbette \u2018tedavi\u2019 maksatl\u0131 m\u00fczi\u011fin yerini ak\u0131l y\u00fcr\u00fctme; analitik d\u00fc\u015f\u00fcnce ve modern t\u0131bb\u0131n ba\u015flang\u0131\u00e7 noktas\u0131 olan bilimsel y\u00f6ntem ald\u0131. Yine de ya\u015fam ile \u00f6l\u00fcm\u00fcn bu denli yak\u0131n oldu\u011fu bir an\u0131n \u2013kardiyak arrestin- y\u00f6netiminde de kendine yer edinmi\u015f m\u00fczi\u011fin \u00f6yk\u00fcs\u00fc ger\u00e7ekten dikkat \u00e7ekicidir. Yoksa sadece tuhaf bir tesad\u00fcf m\u00fc?<\/p>\n\n\n\n

Kaynak\u00e7a:<\/strong><\/em><\/p>\n\n\n\n

  1. Figl M, Pelinka LE, Mauritz W. Resuscitation great Franz Koenig and Friedrich Maass. Resuscitation. 2006;70:6\u20139.<\/li><\/ol>\n\n\n\n
    1. JABSOM News (7 Haziran 2012) FACULTY: UH Pediatrics Professor Alson Inaba Takes Center Stage at \u201cStayin\u2019 Alive\u201d National CPR Awareness Week Event [Web blog] Eri\u015fim Tarihi 14 Kas\u0131m 2018, http:\/\/jabsom.hawaii.edu\/faculty-uh-pediatrics-professor-alson-inaba-takes-center-stage-at-stayin-alive-national-cpr-awareness-week-event\/<\/li><\/ol>\n\n\n\n
      1. Attali, J. (2005). G\u00fcr\u00fclt\u00fcden M\u00fczi\u011fe: M\u00fczi\u011fin Ekonomi-Politi\u011fi \u00dczerine. \u0130stanbul: Ayr\u0131nt\u0131 Yay\u0131nlar\u0131 ISBN:975-539-445-1<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

        Yazar: Altu\u011f Kanbakan, Akdeniz T\u0131p mezunu, Cerrahpa\u015fa\u2019 da acil t\u0131p e\u011fitimine devam etmekte. Delikasap Rock\u2019n\u2019Roll K\u00fclt\u00fcr\u00fc Mecmuas\u0131\u2019 nda yakla\u015f\u0131k on y\u0131ld\u0131r yaz\u0131p…<\/p>\n","protected":false},"author":1599,"featured_media":812,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10015],"tags":[136],"class_list":["post-810","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sosyal-blog-yazisi","tag-muzik"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/810","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/users\/1599"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/comments?post=810"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/810\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media\/812"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media?parent=810"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/categories?post=810"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/tags?post=810"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}