Detective Comics #848: A Medical Review
Detective Comics #848 “Heart of Hush”
Paul Dini, writer
Dustin Nguyen, penciller
There are lots of spoilers here, so don’t read past the warning sign unless you’ve already read Detective Comics #848, don’t plan on reading it, or promise not to whine about the plot being spoiled.
The key portion of the plot, in Haiku:
deprived of her heart by Hush
left at hospital
First of all, let me state what is hopefully obvious. This is no way resembles realistic medicine. It is what can be best described as “classic comic book medicine” — the same kind of medical science that attaches a man’s head to a gorilla’s body or turns someone into a man/bat hybrid. That’s not to say it’s bad, per se, just horribly inaccurate.
Without knowing where Dini is going with this, it’s hard to speculate precisely what’s happened to Catwoman (Selina Kyle), so I’ll make some educated guesses (and probably some less educated guesses as well).
There’s so much to address in this issue, I’ll just hit the highlights. If there’s anything I gloss over or miss, just mention it in the comments and I’ll address it.
Let’s start by looking at the final scene, with Selina attached to every (steampunk looking) machine in the hospital, including — presumably — the machine that goes ping, after her heart has been removed by the villain Hush.
Selina’s heart is missing, so she’s hooked up to either some sort of artificial heart or heart-lung bypass machine. Given the art, it’s hard to tell which. Selina has tubes bringing blood to and from the heart, and we can see blood in the various pumps, so that suggests a heart-lung machine. But on the other hand, why all the wires — especially that huge 220V cable — leading into the chest cavity unless there’s something in there requiring electrical power (and even so, that’s a hell of a lot of wires). I suspect the artist thinks that a heart-lung machine actually involves an artificial heart placed in the chest and doesn’t realize that all the pumping is performed externally.
- Keeping the chest cavity open is an infection waiting to happen. Selina may be missing her heart, but her lungs and other important structures are still there. She needs to have the chest cavity closed tight with some sort of sterile bandage and needs to be on high dose antibiotics.
- The blood/fluid should be flowing in and out through various arterial and venous cannulas, not the chest cavity itself.
- There are multiple units of blood hanging, but she has no IVs to deliver them. If she’s on a heart-ling machine, the blood should be going into the machine, not her. In fact, at least one of the blood units isn’t connected to anything.
- As noted above, she has no IVs, so how is she being kept sedated?
- Why is there so much air mixed in with the blood? It should be a closed system – all fluid; no air. As it’s depicted, they’re just asking for a huge air embolism.
- A little sterility and universal precautions would be a good idea Batman. You just got done fighting and rolling around on a cave floor — you’re covered with guano and who knows what else. Just watch Selina survive the heart-napping just to die of a bat-related infection.
How did Selina get hooked up to this monstrosity of a machine? According to Oracle, she was dropped off anonymously at Gotham General in an abandoned ambulance. Was she hooked up to any machines then, or just propped up — her heart missing? All that equipment couldn’t possibly fit in the back of an ambulance, so much — if not all of it — had to have been attached once she arrived at the hospital. Is this really the best equipment the hospital has? And why are a keg, a muffler, and R2-D2 (the same one from Werewolf by Night, apparently) as part of the machine?
Finally, a few thoughts on the de-heartification surgery scene earlier in the issue:
- Removing a heart — presuming one wants to put it, or another one, back — is an operation that takes more than one surgeon, even if they are the Best Neurosurgeon in the World* (and this is cardiothoracic surgery, not brain surgery).
- It’s nice of Hush to wear surgical gloves and a mask over his bandages (though he’s still missing eye protection and has too much exposed skin for him to be considered in surgical garb).
- Speaking of skin exposure, if Selina is “prepped and ready” for heart surgery, why is her gown still on?
*The phrase “The Best Neurosurgeon in the World” is ™ and © Polite Dissent.
September 10th, 2008 at 7:02 am
Funny, as I get older I find I can suspend my comic book disbelief only so far. That kind of sucks.
Man, for the days when I didn’t question a guy who tried to re-grow his amputated arm and ended up doing it, but also turning into a lizard-man.
September 10th, 2008 at 7:21 am
Considering how big Selina’s breasts have become over the years, it looks like those, too, were stolen. Oh, the huge mammaries!
September 10th, 2008 at 7:36 am
This has nothing to do with the medicine and is more of a general art nit pick, but for anthletic cat burglar, Selina Kyle sure is skinny. Sigh. Remember when Big Barda looked like she could bench press a car but was still really HOT? I miss those days.
September 10th, 2008 at 8:55 am
Off Topic, but how are you enjoying Throne of Jade? I’ve gone through the 1st three books now, and once I’m done moving, plan on moving to #4…
September 10th, 2008 at 9:46 am
Her breasts? It looks like her body from the neck down has faded away. She looks like the girl from the Terminator TV show print ads, just a torso and some wires.
September 10th, 2008 at 10:26 am
Please don’t think that I’m nitpicking typos, but I had to say that the ‘heart-ling machine’ made me giggle. “What’s that panda doing in the OR?!”
September 10th, 2008 at 11:12 am
Selena looks like she’s bleeding spaghetti.
But anyway, it’s Gotham. Maybe in Metropolis they’ll have those fancy artificial hearts, here, they just stick a vacuum cleaner in there and hope for the best
September 10th, 2008 at 11:17 am
One more thing– open-heart surgery usually means a sternotomy, so the hole in Selina’s chest should look nothing like that nice round cavity.
September 10th, 2008 at 6:23 pm
Thank you so much! I was waiting for this post since the issue came out. LOL. When I read the issue, at first I was upset (at what’s been done to poor catwoman) then amused (at the ridiculousness of the premise). Hee!
I was also wondering about some of the things you posted, namely:
1. how she was transported to the hospital. i was assuming she was already attached to the keg, muffler and r2d2 but they didn’t look that portable to me.
2. batman just barging into the ICU without first disinfecting. maybe his costume has germ-repellent?
September 10th, 2008 at 11:41 pm
Official Comment
Nick F.,
I’ve just started the second book. I thought the first book had good characters, a great setting (I’m a sucker for alternate history Napoleonic era), and an enjoyable storyline. My only complaint was that the writing felat a little wooden at times, but I attribute that to it being her first book and suspect it will improve with each subsequent book.
September 12th, 2008 at 2:56 am
Man, this plot sounds like “Spock’s Brain.” Or that old Dick Tracy comic strip storyline where some villain was killing people, removing their hearts and placing them in little mechanical boxes that kept them alive (complete with glass sides so you could see them and a carrying handle on top).
–Mike
September 13th, 2008 at 8:37 pm
[...] While Scott of Polite Dissent reviews Detective Comics from a Medical Perspective: Selina’s heart is missing, so she’s hooked up to either some sort of artificial heart or heart-lung bypass machine. Given the art, it’s hard to tell which. Selina has tubes bringing blood to and from the heart, and we can see blood in the various pumps, so that suggests a heart-lung machine. But on the other hand, why all the wires — especially that huge 220V cable — leading into the chest cavity unless there’s something in there requiring electrical power (and even so, that’s a hell of a lot of wires). I suspect the artist thinks that a heart-lung machine actually involves an artificial heart placed in the chest and doesn’t realize that all the pumping is performed externally. [...]
September 14th, 2008 at 5:14 pm
I don’t think this kind of deconstruction/very deserved criticism is necessarily a matter of getting older, as arkonbey indicates.
The key to why this is pretty stupid, while other comic book science like the guy with the gorilla body and the Lizard’s transformation (or the Hulk’s) isn’t quite as insulting to the intelligence despite being just as or more far-fetched, is that in the latter readers weren’t urged to think too carefully about it. And it was mostly based in obviously fictional premises like ‘cosmic rays” and super-mutations and so on.
But this is meant to be GRIM! and GRITTY! and REALISTIC! ZOMG! they took her heart!!11!! And so it’s presented as if it matters, so the brain automatically starts picking at the idea: “Hey… who put her on those machines, anyway? What are those wires? How’d she survive the ride? What about infection?” as Scott does.
September 15th, 2008 at 5:33 pm
[...] Yes, Catwoman, a.k.a. Selina Kyle, had involuntary heart surgery in the most recent issue of Detective Comics, thanks to Hush, who is now apparently an evil doctor. Polite Dissent has a wonderful list of all the stupid doctoring/medicine that goes on in this issue here, including the totally impractical dozens-of-tubes-inserted-into-open-wounds machine you see above, as well as the sheer impossibility of taking out Catwoman’s heart, driving her to a hospital, and then doctors hooking her up to the doohickey and her still being alive. [...]
October 9th, 2008 at 2:13 pm
I always enjoy the medical reviews you do because I find out something new/interesting. But I’m replying to the Temeraire off-topic post; I stuck with it though I found the first couple of books, to me, were lacking something, especially for a series that received so much acclaim and attention. Then the end of Book 4 left me so cliff-hangered that I immediately bought the hardcover of Victory of Eagles as soon as I saw it and am eagerly awaiting the next book. Btw, Scott, is there any other way for us to post on off-topic stuff? PS, I enjoy your blog/site and always look forward to your medical reviews; your perspective on medical accuracy is hilarious in this context.
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