Polite Dissent

JSA #60 “Redemption Lost, Part 1″
Geoff Johns, writer
Tom Mandrake & Don Kramer, pencilers

The JSA is the only group that not only has a doctor, but actually has him practice medicine. This issue shows Dr. Mid-Nite (Pieter Cross) and one of his assistants operating on a bullet wound victim in the back of his clinic. Pieter is also recalling the first life he was unable to save: his mother’s.

The medicine is this issue is mostly well done, with a handful of nit-picks. Johns also earns extra-points for bringing up a rare tropical disease.

First, the operating room staff is definitely minimalist: just Pieter doing surgery and his assistant administering anesthesia and watching the monitors. While I doubt this would meet quality of care guidelines, it is an emergency situation. By OSHA rules, his assistant needs a mask and eye protection. The sterile technique also leaves a little to be desired, with Pieter wiping his brow with his bloody hand (a definite no-no; do that while scrubbed in and the surgeon will smack you. Plus, Pieter’s in his costume — so what good is wiping his brow going to do anyway?).

His assistant warns Pieter that some flutter is occurring. Ventricular flutter rapidly degenerates into venticular fibrillation, a dangerous and fatal rhythm. Pieter says the heart was injured, which can certainly lead to ventricular flutter and fibrillation. My nitpick is that the rhythm shown on the monitor, and the rhythm just before he flatlines, is not a flutter (nor a fibrillation rhythm), but looks instead like a normal heart rhythm.

Pieter reveals that his mother contracted Chagas disease while on a seminar with him in Brazil. Chagas disease is a parasitic infection transmitted by the bite of the Reduviid bug, also known as the assasin bug. If caught early, it is treatable, but in most cases a chronic infection develops that causes serious heart and gastrointestinal problems many years later. At this point, the infection is not curable, and the symptoms alone must be treated. It’s certainly possible that his mother caught Chagas on a trip to Brazil, it is common there, but that would have had to have been at least 10-20 years ago…so how long has Pieter been a doctor?

One last thought: In the Doctor Mid-Nite mini-series, we learn that Pieter has had his medical license revoked. When did he get it back? Or is he practicing medicine without a license?