Polite Dissent

There are several problems with the presentation of Sgt. Patrick Mancini, as shown in Phantom Jack issue #2, pages 9-11. I find it distressing that the drawings of the sergeant’s uniform were so poorly done. Not only were there multiple mistakes regarding the uniform itself, but there were multiple continuity mistakes.

I can understand missing some of the finer points regarding military uniforms; I get confused at times, and I had to wear one. However, the more blatant errors are hard to ignore. Artists use references for drawing all the time, why not use a reference for drawing the Army uniform? I was able to turn up multiple reference photos/illustrations in only a few minutes of internet searching. Even worse than the uniform mistakes are the multiple continuity mistakes between panels, even panels on the same page.

Uniform mistakes:
1. Military members do not wear hats indoors.
2. The US Army Class A Uniform coat has two sets of pockets, one upper and one lower.
3. There is no name tag.
4. He is missing rank patches/insignia.
5. Other insignia/devices are missing.

Continuity errors:
Page 9, panel 1: Ribbons, no medals, no arm patches.
Page 9, panel 3: Stripes clearly evident on left epaulet
Page 9, panel 4: Ribbons, and now medals too!
Page 10, panel 4: Ribbons, no medals. Left epaulet now sporting pins instead of stripes. Left arm patch now present. Shirt collar out.
Page 11, panel 1: Ribbons, medals may be present (obscured by word balloon), shirt collar in, no arm patch, back to stripe on epaulet.
Page 11, panel 3: And Lo — there shall come a tie tack! Ribbons, no medals, and now no pockets.
Page 11, panel 5: Ribbons, no medals. Pockets are back though.

My first rotation in the third year of medical school was obstetrics/gynecology. I had started with a month of gynecological surgery at St. Johns Mercy Hospital, and now I was doing two weeks of high-risk obstetrics at St. Mary’s Medical Center. St. John’s was busy, but relatively cushy. On the other hand, St. Mary’s was not as busy, but we ended up working at least twice as hard.

A classic tonight! To get ready for Spider-Man 2, I’m going to dip into the back issue bin, and take a look at The Amazing Spider-Man #3, containing the first appearance and origin of Doctor Octopus!

Otto Octavious was a brilliant atomic researcher who experimented on dangerous radioactive materials using special metal arms of his own design. A lab explosion one day exposed him to high doses of radiation, causing brain damage and fusing his arms to him.

Hospital doctor at bedside: The X-Rays show an uncertain amount of brain damage! I’m afraid his mind has been permanently damaged!

An X-Ray is useful for showing structures (such as the bones and lungs), but will not show brain damage. While some brain damage is detectable by fancier tests — like MRIs and CT scans — many kinds of brain damage do not show up at all on radiological studies. A series of nerve and neuropsychological tests would be the best way to detect and diagnose brain damage.

It is way to early for the doctor to predict permanent brain damage “in the hours that follow [the explosion].” Because of the radiation, there would be a great deal of swelling in the brain. But this swelling is only short-term, and the brain would improve as it resolves. Long-term prognosis is better predicted by looking for chronic brain changes, not just short-term ones.

In fairness to Stan Lee and Steve Ditko, the CT scan wan’t used until the mid-1970s, and the MRI until the mid-1980s, long after The Amazing Spider-Man #3 (July 1963). Brain damage in those days would need to be diagnosed by neurological testing, not x-rays.

But the brain of Dr. Octopus — the brain which has been damaged by radiation — reacts in a bitter way…

Radiation can certainly cause brain damage. Shortly after exposure, fluid can collect in the brain, causing headaches, nausea, vomiting, sleepiness and confusion. This usually goes away on its own.

Long term brain damage from radiation can occur months or years after exposure, and consists of memory loss, progressively worsening dementia, and difficulty thinking. It can also include flawed perceptions and personality changes.

These results are all from studies of radiation levels used during treatment of brain tumors. What high-dose radiation exposure (like what Dr. Octopus was exposed to) will do to the brain has not been well studied.

I found this while searching the web for some obscure medical information. From the “There Are Always People With Stranger Obsessions Than Yours” Pile:
List of Films about Possesed Body Parts

Shane at Near Mint Heroes (finally!) brings his own thoughts to my Lost Sense of Wonder post, and brings up an excellent point that I had completely failed to recognize (but not failed to be irritated by).

This should be a good time for Fantastic Four fans as there are three different series about the FF (not counting the Human Torch series). First, there is Mark Waid’s and Mike Wieringo’s run on the Fantastic Four, highly anticipated and highly publicized. There was even a successful letter-writing campaign to bring them back after an apparently premature termination. Next came the Ultimate Fantastic Four by Brian Michael Bendis, Mark Millar, and Adam Kubert. This series brought the FF into the Ultimate universe. Finally, there is the Marvel Knights 4, by Robert Aguirre-Sacasa and Steve McNiven. Compared to the other two series, this one has seen much less praise and press.

Unfortunately, only one of the series really shines. The others are just unimpressive Fantastic Four tales or weak attempts to retell a good story.

As much as I looked forward to Waid’s run on the Fantastic Four, I haven’t found it anything remarkable. The revision of Dr. Doom from a man of science to a man of magic was clever, but the rest of that arc was a rather standard Doom story, just with “magic” substituted for “technology”. Too many of the recent stories have been dealing with the dangers of technology, and Reed is clearly the focus of Waid’s tales. Everyone else, even Doom, just acts as a foil for him. We understand that it’s Reed Richards, flawed and guilt-stricken hero, but enough already. Move on. At least Ben and Johnny get some time in the spotlight, Sue just seems to exist just to be Wife-to-Reed and Mother-to-Franklin-and-Val. I was totally unmoved by the recent trip to the afterlife and meeting with the “creator.” The peril all seemed superficial: Ben can’t get through the door to Heaven because you built it Reed! Wieringo’s art is good, but sometimes the characters look too child-like. This series does have the best covers, as they are action covers, not poster covers.

The Ultimate Fantastic Four is just a weak re-hash of the original, reminding me way too much of the “Heroes Reborn” Fantastic Four. No one has yet improved upon the original Fantastic Four origin. Reed and Sue as teen prodigies trying to open a channel to the Negative Zone just doesn’t have the visceral thrill of the tragic space flight. Reed and Ben come off the best here. Johnny is pretty much a typical tag-along comic-book style teenager. Sue is the least member of this team, too, existing solely to be rescued by the others. The de-condensed story telling works against this title, dragging out a thin story too long until it’s even weaker. And as for changing Doom’s last name? Now I can’t think of him without a picturing a certain Belgian B-movie actor. The covers are way too poster-ific.

On the other hand, I find that the least anticipated series stands head and shoulders above the others. Over at Marvel Knights 4, we have a more plausible scenario of the Fantastic Four losing their millions and having to join the workforce than in Waid’s Fantastic Four. These aren’t action-laden stories by any stretch; instead they’re character studies of each individual as they have to go out into the “real world” and face what normal non-super powered people must deal with every day. Aguirre-Sacasa has a better grasp of the characters than Waid does. The stories have been well written and every character gets a chance to shine equally here. The art by McNiven has been nice as well. The covers, while poster-styled, are better than most of Marvel’s poster covers.

So my recommendations are to pick up Marvel Knights 4, ignore Ultimate Fantastic Four, and substitute any of the Fantastic Four Essentials volumes for the currrent Fantastic Four.

It was a late fall Monday, during my third year of medical school. I had just finished a horrifically boring month of Geriatric Psychiatry at the VA hospital, and now was doing a month of Adult Psychiatry at the local psychiatric hospital. It was a locked ward, and every day we had to be buzzed in to the unit, and be buzzed out at the end of the day.

The frailty of Peter Parker’s Aunt May was legendary back in the Silver Age. But just how sick was she? Is it true she couldn’t enter a hospital without receiving an operation – even if it was just to pay her bill?

To kick off this weekend’s celebration of the medical excitement of the early Amazing Spider-Man issues, let’s look at the illnesses suffered by Aunt May in the first 3 ½ years of the comic (this covers Amazing Spider-Man issues #1-43, and annuals #1-3 – coincidentally, these are the same issues reprinted in The Essential Spider Man, Volumes 1 and 2, for those of you who want to play along at home).

The following list sums it all up nicely (my notes are in red. ASM stands for Amazing Spider-Man):

To sum up, Aunt May was in the hospital 3 times: issues #9-10, issue #17, and issues #31-34. She also received 3 operations, in issue #9, around issue #17, and between issues #33 and #34. That’s 3 operations in 3 hospital visits, quite an average!

In 46 issues, she had 3 operations. That’s 1 operation every 15.3 issues. She was in the hospital for a total of 7 issues, or 15.2% of the time. At this rate, by the time Amazing Spider-Man had reached issue #500, she would have had 33 surgeries, and been in the hospital for a total 75 issues…

In Amazing Spider-Man #10 (March 1964), Aunt May is recuperating in the hospital after undergoing surgery in the previous issue. Peter Parker comes to visit her after the surgery. He meets with the doctor, who tells him:

Your aunt is doing as well as can be expected, son, after her operation…but she does need a blood transfusion! What is your blood type?

Peter hesitates, afraid of causing problems for Aunt May with his radioactive spider-tainted blood, but ultimately relents and provides blood for a transfusion.

Why does the doctor need blood from Peter for a transfusion? Aunt May is a relative by marriage, not blood, so Peter has no better chance of matching her blood type than a random person off the street. Furthermore, blood banks had been established in the United States starting in 1937. By 1962, there were 4,400 hospital blood banks, 123 community blood centers, and 55 American Red Cross blood centers in the United States. Certainly a hospital in New York City would have a blood bank – or at least access to a community blood bank — and they shouldn’t need Peter’s blood at all (except as a plot point).

Before the transfusion, Peter’s blood is tested:

Lucky for me my blood checked out okay! The tests didn’t reveal my super qualities!

The hospital only checked for blood type, so of course the tests wouldn’t show any spider qualities.

The physician then proceeds to transfuse Peter’s blood directly into Aunt May. This is unusual because even directly donated blood is purified and concentrated so that only the needed portions (in this case the red blood cells) are transfused. Otherwise, fluid overload may result — especially in frail elderly ladies.

Finally, the hospital is using glass bottles to hold the blood, which was anachronistic even in 1964. Plastic bags for storage and transfusion of blood had been developed in 1950 and gone into widespread use almost immediately. I would strongly recommend that Aunt May find a better hospital next time.

Returning to Peter, as he was donating blood, he was worried about his powers:

If my strength comes from my blood, which was affected by the spider’s bite, how will this transfusion affect me? I’ll probably be weakened for a while, until the blood cells can replenish themselves!

He is right to be concerned. After a blood donation, no strenuous activity or heavy lifting is recommended for 24 hours. While it takes less than one day for a person to replenish the fluid lost in donation, it takes 4-6 weeks to replenish all the red blood cells donated.

The following day, despite his doctor’s advice to rest, Spider-Man fights the Enforcers:

Getting weak! Doctor told me to take it easy for a while! My body hasn’t yet replenished the spider blood cells which I lost in transfusion!

He has to run away from the battle to recover (but don’t worry, he manages to catch them all the next day).

Peter is mistaken in thinking that his body has spider blood cells. First of all, spider blood is very different from human blood (it’s blue, for starters) and has only a very few cells. They have no red blood cells. Second, non-human blood cells cause serious antibody reactions in humans. Spider-Man may get his power from his blood, but it isn’t due to any spider blood cells. Peter’s a talented scientist and knows better, so I assume he was just speaking metaphorically…

Interesting sources:

1. The Blood Book. An very thorough site concerning blood and blood transfusions.
2. Two sites with good information on the biology of spiders.
3. How sick is Aunt May?

In Amazing Spider-Man #39 (August 1966), Peter Parker has a bad head cold and goes to visit the doctor. Dr. Bromwell examines him and states:

You have a whopper of a cold son – but some anti-histamine pills and a B-12 shot will have you as good as new again!

First, Dr. Bromwell recognizes that Peter just has a cold, so does not give him any antibiotics. They would not do any good, as a cold is a viral infection and not caused by bacteria.

Anti-histamines are effective against certain cold symptoms, such as sneezing and runny noses. They don’t work against every cold or every symptom. Since Peter is complaining of sneezing, anti-histamines are a good choice (they were prescription-only drugs in the 1960s). A decongestant would be another good choice, and better for his nasal congestion, though it wouldn’t do much for the sneezing.

B-12 shots are useful for people who have a Vitamin B-12 deficiency. The shots do not have any significant affect on individuals with normal B-12 levels. While many patients believe that B-12 injections will give them more energy, there is no good evidence to support this. There is some weak evidence showing B-12 injections will help certain medical conditions such as Chronic Fatigue Syndrome, but a B-12 shot will do absolutely nothing for a cold. Giving a B-12 injection to Peter would do nothing other than give him a sore arm and a thinner wallet. However, in defense of Dr. Bromwell, he is following standard medical practices of the 1960s, so judged in that light he is correct in his choice of giving Peter a B12 injection.

Finally got that long bike ride today the weather has denied me the past few weeks. It went well for the most part, but those last ten miles were killer (and the headwind was no help). Came home and crashed, and have been mostly zombie-fied the remainder of the day.

The parents came up from St Louis yesterday. My mother and the Polite-wife went shopping for lawn furniture and arts & crafts supplies, while my father and I went hiking at a couple of obscure central Illinois sites. First we went to Dickson Mounds, a state museum about mound-building Native Americans, and the Mississipian culture in general. Next, we went to the Gleason Sand Prairie nature preserve where there is about 4 square-miles of sand dunes and unusual plants and animals in the center of Illinois. There were hillsides of prickly pears in bloom, and we saw over 15 lizards and skinks in a ten minute period. Also saw a couple of deer ticks (Ixodes scapularis), but managed to get them off before they bit (no Lyme disease here!). We returned home, and all cooked a nice meal together (salad, sesame chicken, and gyoza) before they returned home.

All in all a nice relaxing and sunny weekend. Next weekend: I’m on call again (sigh).

Sunday Blog-o-bits:
1. Matt Rossi presents us with some comic stories he would like to write. The first one, concerning Tony Stark, is particularly good. I’m always up for pulp-style action, plus he references Robert E. Howard as a bonus. His second idea seems very complex and convoluted (but no more than certain Legion of Super-Hero stories and ret-cons), and while I like the idea of tying the origins of several extraterrestial races (including the Martians, Kryptonians, and Daxamites), I’ve never seen in pulled off well. Remember that issue of Star Trek: the Next Generation where it turns out the humans, Klingons, Vulcans, Romulans, etc. all had a common ancestor. It should have been graoundbreaking, but was never referenced or mentioned again (A Mopee, as Mr. Silver Age would say). His third story raises some interesting consideration as well. Well worth reading.

2. One month to the Tour de France!

3. Bible inspired diets [editor's note: link now dead] are on the rise. This is the third article I’ve seen in last two weeks. I don’t care how religious you are, this is not a good idea. Remember, most people before the Industrial Revolution (and that includes Biblical times), were significantly less healthy than we are, and they died early (and were shorter!) due in large part to poor nutrition.

4. Finally, good news this week: cancer rates are down.

After a blood transfusion from Peter Parker in Amazing Spider-Man #10, Aunt May was exposed to “radioactive particles” and became very ill by Amazing Spider-Man #29 and nearly died. Her symptoms of fatigue, fainting and bleeding were consistent with radiation poisoning. Mortality is at least 50% at the amount of radiation she absorbed (and higher still in the elderly).

Damage from radiation depends on several things: the dose, the amount of time exposed, and the distance from the source. Some radiation poisoning symptoms can occur immediately, but most symptoms take longer to develop. Certain symptoms do not occur until years later.

Depending on the dose, immediate symptoms of radiation poisoning include nausea and vomiting, headache, fever, and diarrhea. Higher doses may cause a loss of consciousness, and it is theorized that very high doses (greater than 8000 rads) will kill immediately. Radiation burns generally appear on the skin within hours to weeks.

Delayed symptoms can include fatigue, infection, easy bleeding, hair loss, and skin lesions. The amount of time before these symptoms appear also depends on the dose of radiation; higher doses cause symptoms to appear sooner. In high doses shock, coma, and death can occur within days to weeks.

Individuals exposed to high amounts of radiation who survive the immediate and delayed symptoms have significantly higher cancer rates ten or more years later.

Aunt May received a transfusion from Peter in issue #10. Her first symptoms were noted in issue #29. In the bizarre world of comic-book time, it’s hard to know for certain how many months of radiation exposure she actually had.

Her radiation dose was undoubtedly a very tiny amount. However, because these “radioactive particles” were circulating in her blood (from issue #10 until they are neutralized in issue #33), she had a very long exposure time. She started with an extremely low initial exposure since she did not develop any immediate symptoms. Over time, her exposure increased from the “mild” level to the “moderate” level based on her symptoms. Mild symptoms include fatigue and fainting. There is no mortality at this level. At the moderate level, fatigue and fainting continue. Increased infections occur, and bleeding is very common. Mortality at this level is 50% at 6-8 weeks. Given Aunt May’s general debilitated state and ever increasing radiation exposure, it is no surprise that she went from mild to moderate to potentially lethal very quickly.

Treatment includes IV fluids, antibiotics, blood transfusion, and bone marrow transplantation. However, Aunt May was lucky and received the miraculous serum ISO-36 and recovered completely (or as completely as Aunt May ever recovers).

Yes, I know it’s a bastardization of several superior Japanese anime series, but this was the one of first cartoons that caught my fancy and inspired my imagination (the other being Battle of the Planets). The local TV station in Virginia showed it every day, and my friends and I would run home after school to watch it. Even 20+ years later, I can still sing the theme song (much to my wife’s dismay).
I have the first season on DVD, and cringe at some of the plot points and characterizations that I loved as a kid. The animation is dated and the stories are cliche (but this series originated some of those cliches), and the science laughable (Mars is light years away from Earth?). Still, it’s engrossing to watch, and I’ll sit through the series at least once a year.

As part of our Obstetrics/Gynecology rotation, we had to finish a 10 station practical exam the final week (this was in addition to the 3-hour written exam). You had 10 minutes at each station, and received a score of 1-10. The ten scores were added together to give a final score of 10-100. The tests included ultrasound reading, patient counseling, laboratory interpretation, online medical reference searches, and several stations dedicated to physical exam skills.

I was 40 minutes into the exam and felt confident. I had been able to pinpoint the placenta on the ultrasound. Online research was a snap. Talking to the patient on the phone had been relaxed and natural. Then I came to the Pap smear practical.

This station consisted of a plastic mannequin of a female pelvis and an OB resident sitting next to it. I was supposed to pretend the resident was my patient, and talk to her, but perform the exam on the mannequin. I knew the resident well as we had been on call together several nights. It was a little awkward pretending someone I knew was my patient, but I learned to cope quickly. I explained what I was doing and answered her questions. I finished the basic exam and then moved on to the Pap smear itself.

Unfortunately, plastic mannequins have a property real people don’t: elasticity. As soon as my brush touched the mannequin, it flexed, and the instrument shot out of my hand, over the heads of several incredulous students, and bounced off the far wall. Newton’s Third Law had never been demonstrated better.

The resident was trying so hard not to laugh; tears were rolling down her cheeks. Calmly and matter-of-factly I told her, “On a real patient, that would never have happened.” I then picked up a replacement brush and finished the exam without incident.

She must have believed me, because I scored a 9 on that station, and a 93 overall.

Being a history buff, I enjoyed reading H’s review of Batman Family #1 so much, I just had to track down my own copy. Batgirl (the original — no wait, the second if you count Bette Kane’s Bat-Girl) and Robin (the original) against Benedict Arnold. Benedict Arnold! Perfect — I had to read this. So thanks to e-Bay, I now am the proud possesor of an inexpensive copy of the issue in question.

First impression: I like the Mike Grell artwork. He has always been a favorite of mine – I have the entire run of Warlord, and his Green Arrow was the definitive one. Here his art is good, not as polished as he is on later books, but still good. He does seem to have an issue with drawing bizarrely triangular anatomy on Barbara, though.

The story is a riot and needs to be read to be believed. The Devil has all the denizens of Hell, and the best villain he can come up with is Benedict Arnold? Sure, it was the Bicentennial, but I didn’t think the Devil would have the Spirit of ’76. (Now that’s a bad movie. Anyone else see David Cassidy and Olivia d’Abo in The Spirit of ’76? Ugh.)

As can be expected, the story is a mish-mash of historical accuracy. Barbara’s retelling of the history of Benedict Arnold left out most of the reasons he turned traitor, such as repeated politically-based court martials, serious debt, and a socially ambitious Loyalist wife. I expected better from a librarian turned Congresswoman. Admittedly, she was filming a public service announcement, so she’d be lucky if anyone actually watched it.

The anachronisms were thick. I was struck by Arnold’s understanding of modern (well, modern in 1976) media. He not only knows what cameras and film are, but knows what the “airwaves” are. They get TV down in Hell now? Plus, how did he know who Stonewall Jackson was?

At the battle of Saratoga, Arnold suffered a serious injury in his left leg, leaving him lame. Yet he’s walking and running fine in this comic. I’m sure the Devil fixed him right up, but I would have asked him to do something about that pot belly as well.

Don’t get me wrong: despite all my nit-picking, I thoroughly enjoyed the story. The premise alone is worth the price of admission.

The rest of the stories are a mixed bag. The Alfred story was a lightweight one from back in the days when he was more of a bumbling character. I prefer him the clever, quiet and somewhat condescending character he is now.

I can’t add much to H’s critique of the Commissioner Gordon story except to say that Robin’s dialogue is particularly painful. Remember that scene in Better Off Dead where Lane’s father is trying to talk “hip” to him? It’s like that, but even worse. Adults should not try to write trendy teenage dialogue. Period.

I enjoyed the Man-Bat story. I had never read it before, and always liked the character. Neal Adams and Dick Giordano present us with some beautiful and appropriately moody art. In terms of the story, I did find it interesting that Batman welcomed the new “hero” with open arms, as opposed to his “get the hell out of my Gotham” attitude nowadays.

Inhumans #11 and 12 No Matter the Cost, parts 3 and 4
Sean McKeever, writer
David Ross, penciler

The beginning of Inhumans #11 is well done. Through a series of sepia-toned memories and family pictures, the back story of Terry Halley Jr., the antagonist of the tale, is told.

His brother William dies at age 8 from an aortic aneurysm. It is very unusual for a child to die of an aortic aneurysm unless it was caused by blunt trauma (which this wasn’t). Most aortic aneurysms are due to bad arteriosclerosis (hardening of the arteries) and occur in older individuals. Some childhood aneurysms are caused by Marfan’s Syndrome, a genetic disorder that has a definite look to it — tall and thin (think Abraham Lincoln; there is some speculation that he had Marfan’s). About 2% of other aortic aneurysms are congenital, and this is probably what his brother had. McKeever is right that a ruptured aortic aneurysm will kill instantly.

His father dies at age 52 from “complications due to liver failure.” The main cause of liver failure is alcohol abuse. Sure enough, if you look at the three family pictures of Terry Haller Sr., he is always holding a drink, and looking more and more disheveled in each picture. Clever.

Both his mother and wife die of “accidental overdoses” of medicines. I suspect his mother’s was a suicide (so soon after the death of his father), and his wife’s probably was too. Most overdoses of antidepressants are.

His son is born with an unnamed genetic condition. Terry tries everything to cure his son including gene therapy, holistic medicine, shamans, and psychics but nothing works.

Gene therapy is a fascinating concept. Basically, in a genetic disorder where we know which exact gene is wrong, is there a way we can correct it? Muscular dystrophy, cystic fibrosis and sickle cell anemia are all good candidates for this therapy because we know precisely which gene is incorrect. The problems lie in getting the good gene into the right place in the correct cell without causing more problems. Not an easy task and no good solutions have been found…yet. Watch for gene therapy to advance dramatically in the next decade.

Nitpick time.

1. In issue #11 and #12, Terry Haller’s son is shown in a hospital bed with what looks like a large wire going to his left chest. I assume this is supposed to be the lead to his cardiac monitor, but monitors require 4 small leads, not one large one.
2. His nasal canula (oxygen tubing) in issue #12 is wrong as well. I’ve covered this before (with pictures!) so I won’t go into depth here.
3. Finally, at the end of Inhumans #12, Nahrees is reunited with her “boyfriend” Damon, who she believed had been killed. In issue #10, Damon is shot in the back and falls about 1 foot to land on the grass. Yet in the hospital he is shown with his head swathed in bandages, and his hair shaved as if he had brain surgery. It’s not clear how he went from shot in the back to a head wound. Maybe the bad guy ran him over with the car as he left?

While children are fairly common in comics, pregnancy has only rarely been shown. The following is an informal list of pregnancies that have been shown, or *may have been shown* in comics. The list is entirely from memory, and so ommissions and mistakes are probably quite common. I am striving for a list not of characters who have been pregnant, but whose pregnancy has been shown in comics.
I would appreciate any additions.
This list does deal primarily with super-hero comics because that is what I am most familiar with, but I welcome non-super-hero suggestions as well.

Heroes:
AQUAMAN
Dolphin and Garth (Tempest) recently had their son Cerridan. I missed a bunch of Aquaman, so I don’t know if they ever showed the pregnancy.

FANTASTIC FOUR
Sue Richards lost her first pregnancy, but then had Franklin with her second. A magical/time-stream induced third pregnancy recently gave the Richards a daughter, Valeria.
Lyja Storm, as I recall, was pregnant and gave birth to an egg(?)

INCREDIBLE HULK
Betty Banner was pregnant, but miscarried.

FLASH
Iris was pregnant with twins at the time that the silver age Flash (Barry Allen) died.
Linda West lost twins recently in the current Flash.

INFINITY INC.
Hippolyta Hall was pregnant a *long* time, and ultimately gave birth to Daniel.

ANIMAL MAN
Annie was pregnant and gave birth in the last issues of the series.

JSA
Hawkgirl was pregnant as a teenager, but this was presented after the fact, so probably shouldn’t be on this list.

STARMAN
Jack fathered children with the Mist (see below) and his significant other, Sadie.

LOSH (1)
Garth Ranzz (Lightning Lad) and Irma Ranz (Saturn Girl) had twins. Now, twins are the usual on Winath, Garth’s home planet; however, Irma come from Titan. Plus are the twins fraternal or paternal? Both have been shown on Winath in the series.

LOSH (2)
In the “five years later” Legion, Night Girl was not only married to Cosmic Boy, but also pregnant.
Also Laurel Gand had a child.

LOSH (3)
Apparition (Tinya Wazzo) and Ultra Boy (Jo Nah – you talk about bad puns, his name was ‘Jo Nah’ and he was swallowed by an outer space whale) have married and had a child (Cub).

L.E.G.I.O.N.
Stealth had a child by Vril Dox.

AVENGERS
Wasn’t Ms. Marvel impregnated by some extraterrestrial being at one point?

TEAM TITANS
Donna Troy was pregnant at the beginning of this series.
Wasn’t Mirage pregnant at the end?

X-MEN
Madelynne was pregnant with Scott Summer’s child (and gave birth to him) in the X-Men.

Villains:
Punch & Jewlee
They showed up in Hawk & Dove toting a toddler, but I don’t know if the pregnancy was ever mentioned or shown in Suicide Squad or elsewhere.

Chesire
Gave birth to Lianne, fathered by Speedy/Arsenal (Roy Harper), but I don’t know if the pregnancy was shown.

Mist
Had a child by Jack (Starman). Do not recall if the pregnancy was shown.

Non-Super-Hero:
STRANGERS in PARADISE: Francine recently miscarried.

In my junior year at college, my hardest class was Physics 197. This was the second semester of general physics for science majors. It was harder than the first semester, because it dealt with more abstract concepts such as optics, electromagnetic waves, and quantum mechanics. It was taught by Dr. Bender, a Harvard-trained quantum physicist who liked to inject a little history into his lectures.

Dr. Bender had just finished up a particularly dense discussion of some of the finer points of quantum electrodynamics. He then started brought up some of the scientists who had made the field famous including Albert Einstein, Richard Feynman, and Freeman Dyson.

Looking around the large lecture hall, he asked if anyone had ever heard of Dyson.

Without thinking, I raised my hand. Surely if I had heard of him, lots of other students would know him as well. When the girl next to me nudged me in the ribs, I was mortified to discover I was the only one with my hand in the air.

“How have you heard of Dyson?” Professor Bender asked.

“Dyson spheres*,” I replied, my voice echoing in the still air.

He looked at me closely for a second, then nodded and said, “Very impressive.” Turning back to the chalk board, he resumed the lecture as the rest of the class glared at me.

I didn’t have the heart to tell him I only knew about Dyson spheres from reading about them in a comic book. Who knew all those years ago that New Mutants Annual #1 would make me seem smart to a university physicist? A dollar well spent.

*This was several years before the Dyson Sphere/Scotty returns episode of Star Trek: The Next Generation.

I’ve just finished the third issue of the new She-Hulk, and find myself quite enamored of the series. The story and art combine well to make a compelling read.

The art by Juan Bobillo is good in the way that it is deceptively simple, yet conveys the story well. There have been some complaints that his She-Hulk/Jen looks too much like a kewpie doll, or too young. While I agree that she is somewhat “kewpie” looking, I don’t think she looks too young. The art is emphasizing the waif-ness of Jen, and the simplicity of the She-Hulk (if she can’t smash it she doesn’t know want to deal with it). Each character is distinct, and his backgrounds are well drawn. The man absolutely cannot draw the Thing though.

Dan Slott does a good job with stories that highlight both sides with the Jen Walters/She-Hulk dichotomy. She-Hulk was shown as a wild party girl in the first issue, but that fit with her past portrayals. In the recent Avengers, Geoff Johns has shown her to be all business, but it’s always been well established that she has constantly favored her She-Hulk side and the freedom it represents. She’s always been a bit of a wild card, too. Remember that when she first joined the Avengers, she knocked Hawkeye’s taxi upside down, then picked up her own convertible, hoisted it on her shoulder, and carried it to the mansion.

I appreciate the fact that the stories play up Jen’s native intelligence and abilities. It’s been a long time since plain Jen Walters had a chance to shine. It was Jen who won the court case in issue #3, not the hot-shot lawyer. It’s clear that she’s realizing the importance her long forgotten human self just as she is beginning to understand that She-Hulk is just being used, particularly by the aforementioned lawyer.

The court cases shown in issues #2 and #3 are cleverly conceived. Both deal with situations that could logically arise in a super-hero universe. Both cases are concluded capably. Dr. Strange also makes supporting (consulting, really) appearances in both issues, but I don’t remember him being as omniscient as he is portrayed here though.

There is some enjoyable subtle humor in the issues as well. When Jen’s new neighbor is attacked by the Avenger’s security system of “super-strong carbonadium alloy”, he accuses her of just making up words. A few panels later, Jarvis shows up wielding a baseball bat and wearing a pan on his head; the pan he assures Jen, is made of “forbushion alloy.” Finally, in court, the Infinity Gauntlet is referred to as “Thanos v the Universe”, as if it were a court case.

Last but not least, I appreciate all the single-issue stories. While each issue builds on the previous one, each story is entire in itself. This is a nice change from the decompressed storylines in vogue now.

The Goblin Reservation, by Clifford D. Simak, tells the story of Professor Peter Maxwell. In the not too far future, humanity has rediscovered all the creatures of legend – elves, trolls, goblins, banshees, and so on. All of the supernatural creatures have been accounted for except the dragon. Maxwell, a professor of Supernatural at the University, has made it his life’s work to find a dragon.

As the story begins, Maxwell arrives back on Earth by matter transporter after spending several fruitless weeks searching a distant star system for rumors of a dragon. His transmitter beam was hijacked on his way to Earth, and he found himself a guest on a mysterious crystal planet for several days. While there, he was asked to share the immense knowledge of this mysterious planet with Earth.

He finally returns home to discover that his transmitter beam was not hijacked, but duplicated. Another Peter Maxwell returned two weeks before and died in a mysterious “accident.” Maxwell’s attempts to re-establish his life are complicated. His apartment has been leased to a new tenant – a graduate student with a pet saber-toothed tiger. His teaching job no longer exists. His friends want him to pay back the money they spent on his funeral wreath.

Meanwhile, he is trying to figure out what to do with this knowledge he has been asked to share. He is approached by a group of mysterious aliens, the Wheelers (who look like giant pill bugs on wheels), and who seem to know too much and wish to purchase this knowledge from him. How can he reconcile his own loyalties, return to his previously happy life, and fulfill his appointed duties wisely?

The book showcases the common Simak themes. The first is the search for knowledge. As a former newspaper reporter, Simak injects this into almost all of his characters, many of whom are reporters themselves. In The Goblin Reservation, the character Ghost represents this quest in its most basic sense. He knows that he is someone’s ghost, but he can’t remember whose. Peter Maxwell represents this idea turned on its end. Maxwell has the knowledge – but doesn’t know what to do with it. Who is he supposed to give the knowledge to, and how? The quests of both the Ghost and Maxwell are an integral part of the novel’s ultimate outcome.

Simak’s stories commonly show the struggle between the urban and rural ways of life. This is often shown as conflict between technology and the “simple life”. His characters are generally unassuming individuals thrust into some technological conundrum. In this novel, the Wheelers represent the technological aspect while Maxwell himself represents the uncomplicated rural lifestyle. Both his caveman friend, Alley Oop, and his goblin friends represent the ideal of the pastoral life; another concept common in Simak’s novels.

All of Clifford Simak’s science fiction novels are unreservedly recommended. He was a not a multiple award winner (Nebulas and several Hugos) by accident. His stories, originally written in the 1960s and 70s, still ring true today.

The Goblin Reservation is more light-hearted than most of Simak’s other novels. It is a near-perfect blend of action, humor, and conscience and has my highest recommendation.
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Rashes are fascinating. They are one of my favorite diagnoses to see in the office. It is amazing that the skin, a single organ, can respond in so many entirely different ways to a limited number of causes. Rashes can be red, blue, purple, red, white, brown or almost any other color of the rainbow. There are hundreds of textures, including bumpy, solid, flaky, or even slimy. There can be no pattern, a ring pattern, a swirl pattern, a Christmas tree pattern, or any of hundreds of other patterns.

Rash identification breaks down into three possibilities, all fairly equally spread. This gives us Scott’s Rule of Rashes:

1. One-third of the time I know exactly what it is. (“Why, that’s pityriasis rosea“)
2. One-third of the time I have a general idea of what it is, and a good idea of how to treat it. (“That looks like some kind of irritant dermatitis. We should be able to calm it down with a steroid cream.”
3. One-third of the time I have no idea.

I first formulated my rule of rashes when I started my career as an Air Force physician. As I’ve gotten more experienced and entered private practice, I find that the rule still holds true for the most part, although there’s less category 3 and more category 2 now.

I should have known from the start that it was going to be a bad day. I woke up late, which is unusual for me, so I didn’t have time to shave before I had to leave for my OB rotation at St. John’s Mercy Medical Center. My overnight kit was in the student call room, so I knew I’d be able to shave at the hospital before rounds started.

As I was walking into the OB ward, a couple of the nurses I passed mentioned that I was looking pretty pale. I just smiled and said, “I’m always pale.” Not until I was shaving did I realize that I really did look pale. I had given blood the day before, so that probably explained most of it. I wasn’t worried; our routine was always the same: pre-rounds on the OB patients with the residents, a leisurely breakfast, then full rounds with the attending physician. I would have plenty of time to rehydrate and get a good breakfast.

Unfortunately, things didn’t work out that smoothly that morning. In the middle of our pre-rounds, an emergency C-section came in. The attending grabbed the two residents and me, and we all scrubbed in to the surgery.

The surgery went well, and the infant was delivered quickly and without any difficulty. The attending turned to the youngest resident. “Steve, have you ever sewed up a C-section?”

“No, sir,” he said.

“It’s all yours,” the attending replied, removed his gloves and gown, and stepped out of the room.

The trick to a C-section is that there are many different layers involved (OK, the real trick is to get the baby out – that’s definitely first). You need to sew up the uterus, the peritoneum, and then the skin itself. Sometimes multiple layers of suture are placed in the uterus or the skin. An experienced physician can do this quickly, and sew up all the layers in no more than 5 minutes. She will usually staple the skin layers, as staples heal well, and are fast to put in and easy to take out.

Steve, however, was anything but experienced. Slowly, very slowly, he began to examine every square inch of the uterus. He took the needle holder and suture and made a very small, precise stitch. He looked closely, and then took another stitch. This laborious process was repeated for the sixty tiny stitches he used to close the inner layer of the uterus. He then started on the outer layer, using a slightly bigger suture, but the same slow routine. By the time he was finished with the uterus and started on the peritoneum, we had been in the OR for over an hour.

I started to get very sweaty. The gown, mask, and cap that everyone has to wear in the operating room are always very warm, but this was worse than usual. I developed a cold sweat and then began to feel a little nauseous as well. I took a deep breath to clear my head, and took a firm grip of the table to steady myself.

Meanwhile, Steve continued his slow, precise suturing.

My sweats got worse. I started to shake and get a little light-headed. I gripped the table tighter, and concentrated on what Steve was doing.

He had finally finished repairing the peritoneum and moved on to closing the skin. Please, I prayed, use the stapler. Instead he picked up more suture and carefully measured the incision before he started in with another tiny stitch. He took a second stitch then stopped, eyed the incision critically, and pulled both stitches out.

Sweat was pouring down my face and my vision was blurring. I was feeling dizzy but I was determined to make it through the C-section. Steve had started again and placed three stitches in the incision. He stopped, measured, and placed two more stitches. Another pause, then another stitch. He stopped again and ripped the last stitch out before starting again. He had repaired barely one inch of the eight-inch incision.

At this point, it was taking all my effort to stand upright. I had visions collapsing face first into the operating field. I stepped away from the table, ripped off my surgical mask, gown, and gloves and bolted from the room. I stumbled down to the doctor’s lounge and collapsed on the couch.

After five minutes, I got up and crawled to the fridge. Opening it, I found a can of Coke and quickly drank it down. After another half-hour and another Coke, I felt strong enough to leave the lounge. I returned to the ward, where Scott had just finished the C-section. I walked up to him and apologized for breaking scrub and leaving the OR.

“You left?” was his puzzled reply. He was so intent on suturing that he had never even noticed that I had left. He teased me about leaving the OR for the rest of the rotation.

I should have kept my mouth shut.

I love video games. I have been playing video games for close to two decades now, and own a few (ahem) game systems. As I get older, however, I find that fewer and fewer games are appealing to me.

In some cases, the subject matter itself, or the way it is portrayed, is offensive. Some genres and titles just don’t interest me (football games, for example). Most of the problem is that I’m just not getting my money’s worth out of games anymore. Ironically, it’s not because they’re too short, but instead they are too long. When I was in school, or even residency, I had a lot more free time. When I was off duty, I was free. No “home call”, no family, no house to take care of. Then, I could spend 90+ hours finishing Final Fantasy VII. Now, that’s no longer practical. I need games that don’t go on forever. Games that don’t require a hint book. Games that I can finish before I lose interest.

The industry needs to pay more attention to the desires of mature gamers. We need games that are playable, fun, and finishable. Mature gamers may not be as numerous as younger gamers, but I suspect we have a great deal more money.

I would like to see games that:

• Can be finished in a few good weekends (around 30 hours of gameplay).
• Have a gentle learning curve and a logical control scheme.
• Are replayable (hidden areas, power-ups, etc.)
• Have good graphics and a good storyline.
• Are divided into manageable areas and have a good save system.

True, some companies make “budget games” that are shorter, but they generally are of shoddy quality all around. I want to see big budget games that can be enjoyed by people with limited time (and in some cases, limited abilities).

The two Ratchet & Clank games are good games. The basic game takes just about 20-30 hours, but there are many areas to go back and explore after the game itself is finished. Saves are logical, and finishing a level is a good nights play. The graphics are good, the voice acting excellent, and the story line in engrossing with lots of humor.

Primal is also a contender. The game is longer, but allows you to save anywhere. The graphics are excellent, and it has the best voice acting I’ve ever heard. The captivating story is easy to follow yet captivating.

The new Pitfall games does not come close. The control scheme is awkward and the save game scheme poorly thought out. The levels vary from simplistic to near-impossible-to-figure-out-what-the-designer-had-in-mind. The story and graphics are childish.

The score…. Ratchet & Clank 1 & 2: good. Primal: good. Pitfall: Bad. A game industry that listens to mature players: Important and needed.

Another dreary Sunday in Illinois, so the long bike ride gets put off again. I managed to get a moderately-long very-fast ride in yesterday, so all is not lost, but I was looking forward to a nice long ride today. On the bright side, the rain gives me an excuse for not mowing the lawn.

The Polite-wife and I went to see Harry Potter and the Prisoner of Azkaban last night. It was excellent and enjoyable from start to finish. This was the best of the Harry Potter moviesso far, and the new director gives it a much more cinematic feel than the previous movies. I particularly liked his subtle way of showing the seasons changing by focusing on the Whomping Willow without having to explicitly state “It’s fall now.” The acting was superb. I think this is one of the fist movies I’ve seen with Gary Oldman where (spoiler warning) he was not the bad guy.(end spoiler). David Thewlis (who played Professor Lupin) was also good — I know I’ve seen him somewhere before but I’m sure where, and IMDB did not help this time. In terms of cameo roles, I liked seeing Dawn French (of French & Saunders and Vicar of Dibley fame) as one of the paintings, and Peterson from Red Dwarf as Ron’s Father.

Michelle at the Underwear Drawer has some excellent thoughts on medicine, a life in medicine, and medical blogging. If you have any interest in medicine, go read it (the comments too). The Dr. J quote is wonderful. There are certainly days when I wonder whether a life of clinical medicine was the right choice, but then I realize that there’s absolutely nothing I would rather be doing. So, right choice! It’s certainly true that some physicians make a great deal of money, but I can guarantee that none of those doctors are primary care doctors (family practice, internal medicine, pediatrics). No one goes into primary care for money, but rather for the enjoyment of the job.

Other Sunday Blog-o-bits:
1. Three weeks until the Tour de France!! (Go Lance!)
2. The Food Whore. An enjoyable blog by a caterer. A fun read, particularly if you’ve ever worked in catering or the restaurant business (I had to pay for college somehow!). Thanks to Ilyka for the link.

Fantastic Four #73 (Third Series) 5th Wheel, part 2
Mark Waid, writer
Casey Jones, artist

In Fantastic Four #73 (or #502, depending on which numbering system you use), Reed Richards and Johnny Storm traveled back in time and cut a sample of hair from Victor von Doom’s head. Reed then uses the DNA from this sample to make armbands protective against Castle Doom’s defenses in Fantastic Four #74.

The problem is that hair is composed of protein molecules and not cells and has no DNA. Hair samples can have DNA if they are pulled out or fall out, as most of these hairs still have the follicle attached, which does have cells and DNA.

However, Reed cut a hunk of Doom’s hair off with a laser – leaving no follicles, and no DNA. (Now maybe Doom had bad dandruff, so some scalp flakes were in the hair sample allowing Reed to get the DNA he needed. This bad dandruff would have led to awkward teenage years and rejection after rejection from the girls. His self-esteem plummeting, Doom had no choice but to flee Latveria for schooling in the U.S. Furthermore, the teen angst he experienced due to his bad dandruff could have been the spark that led him to seek revenge and world domination. And to think that Dr. Doom’s megalomania could have been cured by a bottle of Selsun Blue…)

As Dr. Midnight’s associate Nite-Lite gives Hourman and Wildcat a tour of the Cross Medical Clinic, he explains why they have a room full of high-tech equipment:

Last year, a self-aware strain of Camel Pox callin’ itself the seeing plague blinded three-hundred people in Portsmouth…Doc says we gotta be prepared with more than a pair of eye scissors and aspirin.

Camel Pox is a real disease caused by a virus closely related to Smallpox. It causes fever and mouth sores on camels. There have been no cases of Camel Pox infecting humans. There is some concern that it is close enough to Smallpox to have the potential to infect humans if it mutates (or is mutated) the wrong way.

A cluster of infection from a mutated Camel Pox virus is well within the realm of possibility. I would expect symptoms similar to its effects in camels, but with a self-aware virus, I guess anything is possible. (But why does a virus calling itself “The Seeing Plague” cause blindness?)

The Adventures of Pete & Pete was a great half-hour comedy that used to be shown on Nickelodeon (and now sometimes appears on Noggin). It follows the adventures of two brothers both named Pete. The older Pete is in high school and a reluctant conformist, while the younger Pete is in junior high and a serious rebel. Their parents were pretty much the typical clueless sit-com parents, but each brother also had their own group of friends – and enemies. The older Pete’s best friend was Ellen, and his enemy “Endless” Mike. The younger Pete has best friend Nona (played by Michelle Trachtenberg…better known as Buffy’s sister, Dawn), and a group of adversaries including Pit-Stain and Hair-Net.

The show had a definite surreal quality about it, and never took anything seriously. Show subjects included turtles, curfew, dating, adult jobs (ugh!), bowling, fishing, lawn care, ice cream, and tricycle racing.

Guest stars were common. Adam West had a recurring role as the junior high principle and Steve Buscemi played Ellen’s father. Other guest shots included Michael Stipe, Debbie Harry, Iggy Pop, Janeane Garofalo, Bebe Neuwirth, Syd Straw, LL Cool J, Frank Gifford and even Hunter S. Thompson.

Some of the best episodes include “Time Tunnel” (using Daylight Savings Time as a means for time travel), “35 Hours” (Dad and Mom go on vacation; Pete and Pete sell the house), and “Last Laugh” (Pete is determined to pull an April Fool’s Day prank on the Principal).

Ostensibly a children’s show, there was a great deal of mature humor and clever cameo roles. If any show is deserving of the DVD treatment, this is it!

JSA All-Stars #5 An Hour at a Time
Geoff Johns and David Goyer, writers
Adam DeKraker, penciler

This this issue focuses on Rick Tyler, the current Hourman and son of the original Hourman. While there is some decent medicine in the story, there is an abundance of bad medicine, plus some serious logical errors as well.

Rick is talking to his mother about his reformulation of the drug Miraclo, which gives him his “hour of power”:

It’s a homeopathic solution now. Delivered through a transdermal patch in my glove.

The fact that Miraclo is “homeopathic” makes no sense. Based on an 18th century medical theory, homeopathic medicines follow two basic principles: the Law of Similars, and the Law of Infintessimals. According to the Law of Similars, to treat a particular symptom a substance that causes similar symptoms is used (for instance, you’d use a substance that causes a fever to treat a fever). The Law of Infintessimals states the more dilute a solution is, the stronger its effect. Homeopathic solutions are diluted by orders of magnitude to such an extent that it is statistically unlikely that even one molecule of the original substance is left in the final preparation.

Leaving aside the scientifically dubious claims of homeopathy, let’s focus only on the Law of Similars. Super-powers are not a symptom. How can you “treat” super-powers by using another substance to cause them? I suspect the writers are using “homeopathic” to mean natural, or non-synthetic, but the terms are not interchangeable (they mean very different things). As it stands, Rick’s comment is technobabble at its worst.

Transdermal administration of Miraclo is a possibility. Many drug preparations are available now that are absorbed through patches on the skin. However, the absorption of medicines through the skin tends to be a slow process, and is best for long term steady-state drugs (like hormone replacement or pain killers). It wouldn’t be fast enough to give Rick his power when he needed it.

Next, in the middle of lunch, Rick has a premonition that a man is going to commit suicide by jumping from the top of a nearby skyscraper. He rushes to stop the man.

After racing to the top of the building, Rick has a sudden realization that he has an addictive personality. This makes sense. There are certainly people who have problems with addiction after addiction. It makes since that Rick, who was once a drug addict, now gets his kicks from the adrenalin rush of being a hero.

Speaking of Rick racing up to the top of the building, why did it take so long? It took him over 50 minutes to get from the 1st floor to the roof (80 flights of steps). It took me 47 seconds to climb 5 stories (10 flights) of steps at the hospital this morning. At that rate, it should take 12:32 to reach the top of an 80-story building. Admittedly, this calculation does not take fatigue into account, but 1) I walking briskly, not running; and 2) I didn’t have Miraclo surging through my body. It should not have taken Rick that long to get to the roof.

The numbers make even less sense when they are broken down further:

It took nearly two minutes per floor for the first six, but only six-seconds per floor for the last 22. It seems that I was right about transdermal being slow, and it took over 50 minutes for the drug to kick in.

Finally, let me point out the “count-down clock” in the issue is not counting down Rick’s hour of power, but instead the amount of time until the man jumped to his death. Rick’s hour started at least a minute and 16 seconds later. The whole ending, where Rick runs out of power just as the man jumps, is contrived. He still had at least a minute of power left.

After picking on Hourman in JSA All Stars #5 last night, I now turn my attention to JSA All Stars #6, where I get to pick on one of my favorites, Dr. Mid-Nite.

JSA All-Stars #6 Out of the Shadows
Geoff Johns and David Goyer, writer
Stephen Sadowski, penciller

In the prologue to the story, the Spectre states that Dr. Mid-Nite (Pieter Cross) “lost his residency after exposing an insurance scandal”. Assuming Dr Mid-Nite is practicing medicine legally, he must have completed at least his first year of residency training, as this is required to obtain a medical license (some state require two years). Addendum: According to the Washington State Department of Health, two years of residency are required for a full medical license if the physician graduated after 1985. Foreign medical graduates face extra requirements. Pieter mentions that he was born in Norway, but it has not been explicitly stated when he came to the U.S.

Exploring the scene of a gas main explosion, Pieter finds a pregnant woman trapped in a subway car. Carrie, the pregnant patient, informs Pieter that she cannot move because her water just broke. In other words, the membrane holding the amniotic fluid which surrounds the infant has ruptured. Generally, delivery comes shortly (but not immediately) after the rupture, but this is quite variable. Note that Carrie says nothing about contractions, or “being in labor”; other than the rupture of the amniotic membrane, there is nothing more to suggest that delivery is imminent. It would be a good idea to move her to a safer location prior to childbirth.

Dr. Mid-Nite uses his ultrasonic vision to check out the infant. His ultrasound is extremely detailed, much more than current technology, but then he has always been ahead of the curve. There seems to be quite a bit of amniotic fluid surrounding the infant for a mother whose water just broke.

Next, Pieter uses a spray to sterilize everything around them. How necessary is this? Opinions vary. Childbirth is an inherently messy and non-sterile situation. Certainly, extra precautions and cleanliness never hurt. The most important thing (particularly for the mother) is for the doctor to have clean hands during the delivery. However, Dr. Mid-Nite never washes or sterilizes his hands, despite handling debris, skin, and clothes before delivering the baby.

Pieter offers Carrie the narcotics meperidine (Demerol) or butorphanol (Stadol) for the pain, which she declines. Meperidine is not used much in the U.S. for pain control during childbirth, but butorphanol is still common. Generally, narcotic drugs are avoided because they have the potential of slowing the infant’s respiratory drive. As noted in a previous post, offering narcotics to this patient is legally questionable.

Dr. Mid-Nite successfully delivers an infant girl. Umm, where’s the umbilical cord?

After the delivery, Dr. Mid-Nite escorts Carrie and her new daughter to medical help:

The child’s fine. But the mother has a fractured ankle. Minor lacerations. And they both need oxygen stat.

If the infant is fine, then why does she need “oxygen stat.” Same for the mother; if she only has a fractured ankle and minor lacerations, why does she need oxygen.

Maybe they both suffered smoke inhalation, in which case oxygen is an appropriate therapy…but then the infant wouldn’t be “fine”, and Dr. Mid-Nite should have mentioned smoke inhalation in his report to the medics.

To end on a good note, Pieter did swaddle the infant, keeping it warm. This is very important in newborns, as they have poor temperature regulation.

I was sitting at my table in the hospital tent early one Wednesday evening, typing on my laptop, and trying not to think about the 120 degree heat we were experiencing on our deployment in the Arabian Peninsula.

The tent door opened, and Gene, one of the vehicle maintenance sergeants, came in.

“Doc,” he said. “Something funny’s going on with my right eye.”

“What’s that?”

“I haven’t been able to see well out of it for the last couple of days. There’s one spot where I can’t see at all.”

I beckoned him over to sit down on the cot and looked closely at his eye.

“Did you injure your eye? Or get anything in it?”

“I don’t think so.”

I did a quick exam, and both eyes moved and responded normally. I got out my ophthalmoscope, and looked at his retinas. This is a difficult exam to do under the best of circumstances, and in a bright hot tent it was particularly difficult. Both retinas looked pretty normal, though there seemed to be a slightly pale spot on the right.

I did a confrontation exam, which revealed that he had a fairly significant blind spot in the upper outer quadrant of his right eye.

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Less than a week after my postive review of She-Hulk, the latest All the Rage column suggests that Paul Pelletier will be taking over as penciller. I understand that many people are turned off by the current artist Juan Bobillo. I like his waif-ish drawings, and think they compliment the intellectual/lawyer side of the character well, but I can see that they are an acquired taste.

While I am sorry to see him go, Pelletier has shown that he can draw a good She-Hulk (in Incredible Hulk #412, for instance). He’s great at the action shots, but I’ll be interested to see how he does with the courtroom scenes. On the other hand, much of The Negation was characters sitting around and talking, so it can’t be much different than that.

Good luck to Bobillo, I’ll keep an eye out for him, and welcome to Pelletier.

My medical review of issues #1 and #2 of Kinetic can be found here.

Kinetic #2 Stupid Pretty
Kelley Puckett, writer
Warren Pleece, artist

This issue starts out with Tom in the hospital after having suffered what seems to be some kind of seizure at the end of issue #2. The doctors refer to Tom as having suffered a grand mal seizure. A grand mal (or gran mal) seizure is also known as a generalized tonic-clonic seizure or a major motor seizure. It is what most people think of when they think of seizures, with the patient suffering rigidity and then jerking of the whole body. Tongue biting, loss of postural control, and incontinence are common.

However, Tom is showing no evidence of the muscle activity associated with a grand mal seizure. He instead seems to be having a petit mal seizure. This is also known as an absence seizure, and is characterized by a prolonged staring spell with a vacant expression. Like a grand mal seizure, loss of body tone and incontinence are common.

If he was having a grand mal seizure, I’m impressed that the nurses were able to place an IV; it can be challenging enough on a quiet patient, let alone one who is jerking and thrashing.

Seizure patients are extremely tired for hours after a seizure, but Tom doesn’t seem to be experiencing this post-seizure tiredness, and is actually rather garrulous.

Overall, the book proceeded along at a pace that can be generously referred to as glacial. By the end of the third issue, Tom is just beginning to realize that he has some sort of poorly defined superpowers.

I’m also a little puzzled by his mother’s attitude. For the first two issues, she was clinging to Tom, and not letting him have any freedom. Suddenly – the day after a seizure requiring a trip to the hospital – she’s leaving him alone.

I’m enjoying the comic. It has a complex character in Tom, and it’s interesting seeing him come to terms with the changes in his life. The art, especially the coloring, is bland with a very limited palate, but I suspect that’s intentional to show the bleakness of Tom’s life. I look forward to reading more issues of Kinetic, but I worry that its slow pace will not allow it to build enough of an audience to continue.

Medical errors show up commonly in hospital scenes. Tubes and wires running to and from the patient look impressive, but most are drawn incorrectly and probably not needed at all. Patients are commonly shown receiving oxygen, either by a face masks or nasal tubes known as nasal canulas.

This first lesson is going to focus on supplemental oxygen delivered by nasal canula because it is seen commonly in comics, and almost always wrong.

First, does the patient need to be on oxygen at all?
1. Do they have a lung condition (asthma, emphysema, pneumonia)
2. Do they have a heart condition (angina, heart attack, congestive heart failure)
3. Did they just undergo extensive surgery (especially if they were weak or sick to begin with)?
4. Is the patient a pregnant trauma patient?
If then answer to all these questions is “no”, then the patient probably does not need extra oxygen.
As a side note, a nasal canula can only provide up to 45% oxygen. Anyone who needs more oxygen then that will need a special face mask. Nasal canulas will not help someone who cannot breathe on their own; those people need to be intubated and placed on a mechanical ventilator.

Second, is the nasal canula shown correctly?
It needs to provide oxygen to both nostrils. It should be looped behind the ears (like a pair of glasses), then down the neck. The main reasons for this are comfort and mobility. Nasal canulas are already uncomfortable; they shouldn’t be pinching the nose or requiring tape to be held in place. It’s also important for the cannula to stay in place as the patient moves around in bed, or walks around.

Examples:
1. District X #1 – Officer Kucharsky suffered a grazing head wound. His lungs and heart are fine. He does not need to be on oxygen. Additionally, his nasal canula is drawn wrong as well, only providing oxygen to one nostril.

2. Daredevil #58, 59 (current series)– Daredevil was beaten up, but probably does not need oxygen (unless he suffered a pulmonary contusion or broken ribs and is not breathing deeply enough). The canula, while it goes in both nostrils, would not be comfortable and would fall off if he moved.

3. X-Treme X-Men #31 – The patient has a dual pronged nasal canula, but it is not looped around correctly and is taped in place. (And why is there a thick tube going to the eye socket? Ewww!)

4. The Dreaming #9 – Bridget is in a coma, and is hooked up to oxygen (but by very uncomfortable looking dual nasal canulas taped in place). I doubt she even needs oxygen: sShe’s not pregnant, and has no heart or lung problems.

5. Gen 13 (second series) #2 – Kudos to Chris Claremont and Ale Garza here (though I’ve picked on both of them before). Hamza is in a coma, but is correctly shown to not need supplemental oxygen.

When I started collecting comics, there were two titles that I collected religiously: The X-Men, and The Micronauts. The Micronauts started out as a line of science fiction toys with interchangeable parts, but soon became a comic published by Marvel. I was a big fan of the toys, but the star-faring tales in the comic really fired my imagination. The comic related stories of the Micronauts, heroes from another dimension (the Microverse), who traveled to Earth where they were only six inches tall. It may sound silly in retrospect, but it was handled very well (and I was only eleven at the time).

The Micronauts consisted of: Commander Rann, their leader and possessor of the psychic “Enigma Force”; Marionette, princess of Homeworld and lover of Rann; Acroyear, King of the warrior planet of Sparta; Cecilia, Acroyear’s queen; Bug, insect-like warrior from the planet Kalikak; and the robots Microtron and Biotron.

Since defeating the evil Baron Karza in issue #11, they had been exploring Earth in their ship, the Endeavor.

The series reached its creative peak in issues #26, 27, 28, which featured the Micronauts and S.H.I.E.L.D. battling the combined forces of Hydra and Baron Karza.

In Micronauts #26, the Micronauts travel to the S.H.I.E.L.D. Helicarrier and find themselves in the middle of a Hydra assault. Acroyear and Cecilia aid S.H.I.E.L.D. in combat against Hydra. Bug gets lost in the Helicarrier, and discovers a laboratory devoted to the Microverse. Inside, he discovers Dagon, another Acroyear warrior, and revives him from suspended animation.

Commander Rann and Marionette look for the S.H.I.E.L.D. psychics, who seem to be the root of the disturbance. They find more than they bargain for when they discover that Baron Karza has returned from the dead. Marionette is apparently killed by Karza, but actually returns to the Microverse where she takes command of the rebel forces there.

In Micronauts #27, Baron Karza explains his plans, but Shaitan — Acroyear’s evil brother — is not happy that he is being excluded. S.H.I.E.L.D. and the Micronauts determine that Karza’s and Hydra’s plans hinge upon a certain world famous amusement park in Orlando, Florida. They travel there to confront them.

As Acroyear, Cecilia, and Bug aid S.H.I.E.L.D. in fighting Hydra, Commander Rann flies off in search of Baron Karza. Dagon, Microtron and Biotron stay behind guard the ship, but Biotron is slain — apparently by some of Karza’s dog soldiers. Rann confronts Karza, only to be defeated and have the Enigma force ripped from his mind.

In Micronauts #28, S.H.I.E.L.D. and the remaining Micronauts make their last stand against Hydra. At the last moment, Shaitan betrays Karza, allowing the rebel fleet from the Microverse to arrive on Earth and save S.H.I.E.L.D. Acroyear confronts Karza, but is not powerful enough to defeat him. He summons the Worldmind, the soul of his planet of Spartak. This act, while granting him great power, also causes the destruction of Spartak. Esmera, queen of the planet Kalikak, attacks Karza with her “suicide sting”, allowing Acroyear an opening to defeat him. The Micronauts and S.H.I.E.L.D. win, but at a high cost: Commander Rann is in a coma, Queen Esmera is dead, and Spartak has been destroyed.

The writing by Bill Mantlo is exciting and action packed. Smaller stories that have been building for over a year are successfully merged to form a powerful narrative. The characters are larger than life, but then, so is the conflict. The dialogue is overly dramatic at times, but since when has Nick Fury every talked in a normal manner? The art by Pat Broderick is sometimes busy and the inking can be muddy, but it conveys the excitement and action well.

The covers are thrilling and eye-catching, especially compared to today’s flat poster-like covers. The cover to #26 shows Nick Fury grappling with a Hydra agent in front of a large Hydra Symbol. The Micronauts rush to assist in the foreground, while Baron Karza, eyes glowing red, stands powerfully in the back.

The cover of issue #27 shows Commander Rann and baron Karza locked in combat, with a psychedelic red background that seems to have been drawn on a Spirograph.

Finally, issue #28’s cover shows Karza and Acroyear in combat while the rest of the Micronauts look on. The type on the cover is dramatic as well: This issue: Rann – Doomed! Karza – Defeated! The Planet Spartak Destroyed! Be There!

In addition to the stunning stories and covers, there are some classic ads in these comics. There ads for joke products and magic tricks are well represented, as are the Hostess mini-comic ads; the ones in these issues feature Daredevil and the Human Torch. Charles Atlas has an ad, of course, as does PEZ. On the back covers are ads for Monogram models, LEGO expert sets, “132 Roman Soldiers just $2.98”, and who can forget that you could make money by selling America’s favorite paper: Grit.The in-house ads are for Roger Stern and Frank Miller’s Doctor Strange, and two new comics: Captain Universe, and Dazzler!

Rereading these comics twenty-plus years later, they still hold up well, and are as exciting now as they were then. The.Micronauts had some good stories after this (and more mediocre one), but never again reached the level of epic greatness these issues represented.

I finally got around to updating the blogroll. I added a bunch more Comic Blogs (or mostly- or frequently-comics blogs). One, I had to abbreviate (and you know who you are), because the name seems to be a paragraph in and of itself. The sites on my blogroll are those that I visit daily. If your name’s not up there, it probably means that I haven’t stumbled across your site yet. I have yet to find a comic blog that I actively dislike (or even passively dislike).

The sites listed under Political Blogs I read daily as well. Some I frequently do not agree with, but they are always well written and give me something to think about. Life would be boring if we all thought alike.

I haven’t added anyone new to the Medical Blog list yet because I am extremely picky in this area. There are many good sites out there, but too many seem to espouse medical views (as opposed to political views) I do not agree with and cannot condone, or have some obvious agenda. So for now, just enjoy Michelle’s blog for your medical-entertainment blogging (besides this one, of course!)

I may not have as much search-term excitement as Grotesque Anatomy, Peiratikos, or Progressive Ruin, but due to the medical/comic nature of this blog, some interesting search terms do show up. Some also seem to show up that seem to have nothing to do with either medicine or comics.

I hope those who stumbled across my site looking for actual medical advice found a good site (I recommend FamilyDoctor.org), and maybe decided to pick up a comic book along the way.

Here are some of my favorites so far (search terms in bold, my comments in italics):

• super pubic catheter I assume they’re looking for “suprapubic catheter”, though “super catheter” does bring to mind rubber tubing wearing spandex and a cape
• pityriasis rosea caused by vicodin use well then, don’t use the vicodin (but don’t worry…it doesn’t cause PR)
• e-bay empty narcotic bottles is this even legal?
• shrek godmother incest I got nothing to add to this
• classic philosphical arguments how this got directed to my site, I have no idea
• batman catheter rubber suit this one stands on its own
• dr doom degree I’ll proudly claim this one
• tusky the walrus I’ll claim this one too
• multiple hairs coming from human follicles feels like wire looks like worm I hope they found some help

First off, HAPPY FATHER’S DAY!!

It’s been a busy weekend. I was on call again (and next weekend too!) as the partner is on vacation. The landscapers came on Friday and re-seeded our front and side lawns, and totally redid the back yard. So the Polite-wife and I have been running out every 15-minutes for the past two days moving sprinklers.

Yesterday was our front-desk receptionist’s wedding. It was a nice smalltown-midwest wedding, which means lots of beer at the reception (not me, I was on call). The rest of the office gang was there too (except the big boss, who is on vacation), and a nice time was had by all. No Jordan Almonds, though. What’s a wedding without Jordan Almonds?

Only one Blog-o-Bit this week (been busy tracking mud in the house):
1. Two weeks until the Tour de France! Interesting news this week, with a book being published suggesting Lance was blood doping with Epogen (a drug that increases red blood count and thus oxygenation of the blood), and Lance threatening to sue the publisher for slander. Between him and Marion Jones, it should be an interesting summer for drug testing…

I am really getting sick of “decompressed” storylines. First of all, what does decompressed mean? Were the previous stories compressed? I suspect it’s just a fancy way of saying “padded out for at least three extra issues.”

I have nothing against multi-part storylines. Suddenly, however, every mainstream comic seems to be churning out stories in five- and six-part story arcs. The trouble is that the storylines can’t support that long an arc. What would have been a great two- or three-part story is stretched and padded so much that the readers lose their interest part way through. I find it hard to justify spending my hard-earned money on books that go nowhere fast.

Some books can handle the longer arcs better. Sandman could pull it off, and Fables handles it well. Most other books don’t.

I’ve been getting more and more irritated about these long storylines, but what brought it to a head was Supreme Power #10. It took 22 pages and $2.99 to say “Princess leaves cave, goes to Hyperion. Doctor Spectrum wakes up in cocoon, talks to naked finned woman; then he leaves.” Three bucks for that? There was more story between commercials in Babylon 5! Sure, there was some nice art in the issue (and lots of fan service) by Gary Frank, but that still comes nowhere close to salvaging the issue. My money and I are going elsewhere.

Sean at Attentiondeficitdisorder Too Flat, and his missus at Lexapropriate Ramblings (and I have to say that I love that name) are hosting a contest to determine which comic their cat likes best.

Unfortunately (or fortunately), I have minimal artistic skill, so I have no hope of winning their contest. However, I will match my cats (and their reading habits) against their cat.

WARNING: Gratuitous cat photos follow
Read more…

The House of God is an autobiographical “novel” of a physician’s intern year at a large New York City hospital. It was written in the 1970s when all residents, regardless of their specialty, shared a common first year. An intern would routinely (and legally) work 100 hours/week at that time and carry a heavy patient load.

Things had improved by my residency in the 90s, and have improved even more today. Don’t misunderstand me, the intern year is still the hardest year of any physician’s life, but it’s at least a little easier today than it was thirty years ago.

Still, the House of God is a terrific read. Portions of the book are scary, some are haunting, many are hilarious, and several are heart-breaking. It stands as a testament of what it took to be a doctor in the 1970s, and what it still takes today.

Plus, it’s very funny.

One of the banes of my existence as a medical student was the type of student known as a gunner. “Gunner” was the term for the medical student who sat in the front row and never missed a class. They used at least three different colors of ink to take notes, and their text books had more highlighting than text. They lived in the library going over their notes time and again. These were the students who would ask question to make themselves look good.

Some teachers loved gunners, some hated them, but most just put up with them. Remember, all of our teachers were medical students once themselves, so they know what being a gunner meant.

We had close to fifteen gunners in my class. Most of them were easy enough to ignore. One gunner, however, earned the enmity of our entire class. Her name was Becky. Socially, she was a very nice person. Put her in a classroom though, and she lost all of her social skills and became obsessively focused on the lecture and her grade. What set her apart from the other gunners was how she dragged the whole class down with her.

A perfect example of this was Gross Anatomy (the class, not the movie). After our first Anatomy exam, she told the professor that his questions were “too easy.” Take it from me, they weren’t too easy. I passed the test, and did modestly well, but it took all my meager skills to pull it off.

Becky’s comment offended Dr Y-, the Anatomy professor. He had been teaching Anatomy for thirty years, and was originally going to retire before my class started. No other professor could be found who was willing to teach anatomy though, so he stayed on to teach my class. He had this huge database of thousands of anatomy exam questions, each rated 1-5 (with 1 being easy and 5 being incredibly hard). A normal test was mostly questions rated 3, with some others thrown in for color. After Becky’s comments, the test questions went from an average of 3 to an average of 4 to 5. The class score dropped by over fifteen points. Thanks a lot Becky!

Sometimes, the teacher got the last laugh. One of our Histology exams had three “E: none of the above” answers in a row. After the test, Becky stormed up to the teacher and complained that the test was “educationally invalid” because of all the none of the above answers. The teacher merely nodded and smiled.

The next Histology exam featured two full pages of none of the above answers.

One of the concluding ideas of the Hush storyline in Batman was that the Riddler knew that Bruce Wayne was Batman, but that it didn’t really matter because nobody would believe him because he was the Riddler.

Barely a year later, the Joker is saving the Riddler’s life in Batman: Gotham Knights because he wants to find out from the Riddler who killed his wife. Clearly he believes what the Riddler will tell him about this, so why wouldn’t he believe him about Batman?

It seems to me that Loeb just wrote himself into a corner in Batman, then decided it didn’t matter and went for the easy way out.

Speaking of the current Gotham Knight storyline. It’s trying to make Hush into a more fearsome villain, and for the most part it’s succeeding, but Hush still has a long, long way to go. I have to ask: why bother? Hush offers nothing other villains with more style don’t already offer. Sure, he’s better then Benedict Arnold, but just barely (and Arnold’s a snappier dresser). Again, it seems that DC has painted itself into a corner by promoting Hush, and is now trying to prove (to us, and to themselves) that he is a good villain. Please don’t. Just stop now. Please!

As anyone reading my last post can surmise, I was not a big fan of the Hush storyline in Batman. It was overwrought, underdrawn, and padded in terms of both characters and storyline. Sure, Jim Lee can draw. But remember when he used to draw action instead of pin-ups? Remember when characters were added to the story to add substance, not to give the artist another character to draw (and DC Direct another statue to sell)? Sigh.

Still, I would have loved to be a fly on the wall when Jeph Loeb was pitching the story to Paul Levitz, President of DC…

Jeph: Paul. I’ve got this great idea for a new Batman villain…Hush!
Paul (whispering): What’s his name?
Jeph: Hush!
Paul (still whispering): I’m being as quiet as I can!
Jeph: No, Hush is his name!
Paul: Oh. What are his powers?
Jeph: He’s a neurosurgeon!
Paul: A neurosurgeon?
Jeph: He’s the best damned neurosurgeon in the whole world!
Paul: Oh. Who is he?
Jeph: I’m going to introduce Bruce Wayne’s best friend from childhood in the first issue. That’s who Hush will be! I’ll fool everyone!
Paul: So you’re going to fool everyone by having him be the obvious choice?
Jeph: Exactly!
Paul: Oh. And what sort of costume will he have?
Jeph: It’s brilliant in its simplicity and originality: He’ll wear a trench coat and have bandages around his head!
Paul: So Batman’s new villain will look like the Unknown Soldier.
Jeph: And I’ll have Two-Face seek redemption by getting plastic surgery!
Paul: Didn’t Frank Miller already do that in Dark Knight Returns?
Jeph: No, he copied me.
Paul: What?
Jeph: You see, Dark Knight Returns is set in the future, and therefore will happen after my story. Thus, Miller copied me!
Paul: I don’t think that-
Jeph: And I’ll have Catwoman, Superman, and Krypto. And there’ll be Poison Ivy, Harlequin, the Joker, Clayface, Huntress, and Killer Croc! I’m even thinking about bringing back Signalman! And Benedict Arnold!
Paul: Jeph, how are you going to get people to buy this alleged “masterpiece.”
Jeph: I’ll have Jim Lee do the art.
Paul: Well, OK then. Sounds good.

In the comments to yesterday’s post on the Riddler and Hush, Dave Lawson brings up the point that the Riddler is keeping quiet because of the threat of Ra’s Al Ghul, not because other villains wouldn’t believe him. Dave is right, in Batman #619, Batman does threaten the Riddler with the League of Assassins.

However, the exchange I was referring to occurs on the page before that, where Batman confronts the Riddler about knowing his identity. Batman tells the Riddler that he knows he won’t tell others because “a riddle is worthless if everyone knows the answer.”

Umm…I guess that’s true. But:
1) The Riddler already told Thomas Elliot. What’s one or two more? I’m sure Batman’s identity is worth some big money to the right people.
2) Batman’s identity is a secret, not a riddle. The two are not the same thing.

In terms of Ra’s and the League if Assassins:
1) Surely Batman’s villains have figured out his “no kill” clause by now. Wouldn’t this lessen Batman’s threat (because telling Ra’s would be essentially the same as killing the Riddler)
2) Thanks to Death and the Maidens, Ra’s is now dead…

Clearly, I misinterpreted the end of Hush and parts of my original post were wrong. Batman has no fear that the Riddler will expose his identity — not because no one will believe him (as I originally thought), but because Batman believes the Riddler will tell no one. (And if he does, he’ll tell Ra’s who was using his Lazarus pit).

The rest of my post still stands. The ending of Hush is still indicative of Loeb taking the easy way out, and this ending is even more full of holes than what I thought originally. My concern with Batman: Gotham Knights still exists. If Batman’s identity is a riddle, then so is the identity of the Joker’s wife’s killers, and he would be as loathe to share it.

Dave does bring up another good point: what happened to Jason Todd’s body?

I have been thoroughly enjoying the discussion of the Greatest Villains at the Howling Curmudgeons (and Shane’s list as well at Near Mint Heroes). As usual with these discussions, I find that I agree with almost everyone, but I do have to come out on the Anti-Anti-Monitor side of the debate. And the pro-Deathstroke side.

There is one thing that I feel makes a great villain that I find missing from the list. Different posters and commentators have come close to it, or hinted about it, but I don’t think anyone has stated it explicitly: Motivation.

Why the super-villain is doing his deeds is as important to me as what he is doing, and how. Generally speaking, the better the motivation, the better the villain. Certainly motivation is not the only criteria of a great-villain, but it is one of the most important ones.

A few scatter-shot examples of Good Motivation:

1. Dr Doom wants to rule the world, sure, but more than anything else, he wants to defeat Reed Richards, the only man who may be his better.
2. Magneto wants to make the world safe for mutant-kind (and if without the Homo sapiens, all the better).
3. Deathstroke may have started out as a standard killer-for-hire, but then became more complex. There were his two sons (one good, one evil) he had to kill, and his love/hate relationship with his ex-wife. All excellent motivations for his activities.
4. Kestrel wants to kill Dove because she represents everything he isn’t, and he believes that he and Hawk would be inseperable as brothers without her.
5. Zoom in the recent Flash storyline wants Flash to experience the pain of losing someone important to him, so he’ll understand where Hunter is coming from.

Posting will be on the light side this week as my partner is off on vacation and I find myself covering not only our hospitalized patients but also an overloaded clinic schedule. And did I forget to mention all the letters, lab results, and X-rays? Sigh…

I’ll still post at least something every day, it’ll just be less in-depth than usual (well, as in-depth as I get anyway). I plan on having some more Medical Reviews and True Tales up this weekend.

Plus, I’ve got to finish my squid story for John…

I have been watching anime for many years. When I first was shopping for anime, there weren’t many choices available: Bubblegum Crisis, Kimagure Orange Road, Vampire Hunter D, and not much else. VHS was the only option, and you had to choose between subbed or dubbed. They always came in these real bulky plastic packages, too.

Thankfully, things have changed. There are hundreds of titles available now, and with DVD you can have subbed and dubbed (at the same time if you want – and that’s always fun, because the translations rarely agree). The voice acting is much better now as well.

One thing hasn’t changed for me. In my mind, one of the most important parts of the anime experience to is the opening credits. This can make or break a show for me.

What makes a good opening? A near perfect combination of music and graphics is important. Important aspects of the show should be shown, but not much plot given away.

A good opening will make me stop the DVD and re-play the credits. I will want to watch the “clean” opening and closing in the extras. God help me, I’ll sometimes watch the previews of that anime just to hear the music.

Here are my favorite openings in alphabetical order:
• Big O – The silhouette graphics over the psychedelic backgrounds are eye-catching. The theme music (sounding suspiciously like Queen) is hard not to sing along with.
• Full Metal Panic – Light music, but easy to sing along to, even if your Japanese is poor or non-existent. Clean graphics introducing the crew, villains, and robots (of course!). The opening animation changes in the later episodes, but the music stayed the same. Both animations are good, but I prefer the original.
• Gunsmith Cats – Jazz music with a simple color palette. Girls, guns, cars, and explosives – what’s not to like? The explosive kiss and firing range heart are nice touches too.
• Martian Successor Nadesico – Another classic opening done right. Upbeat music, introduction of the crew, and of course – robots!
• Star Blazers – What can I say, I’m a sucker for this show. I can still sing the entire lyrics twenty-five years later.
• Witch Hunter Robin – The rock chords are a nice change from the usual upbeat themes, and the graphics hint at some of the mysteries of the show.

Runners up:
• Neon Genesis Evangelion
• Vision of Escaflowne
• Gasaraki

In the first issue of Batman: City of Light, an innocent bystander is critically injured while Batman skirmishes with thugs. Batman becomes haunted and obsessed by the injured bystander.

In issue #2, while riding the subway, Bruce Wayne is recalling the injured patient in the hospital room. The patient’s head is bandaged and he’s wearing a cervical collar and an oxygen mask. An electrocardiogram (EKG) tracing is superimposed over the picture.

Given the patient’s traumatic crush injury, a bandaged head makes sense, as does a cervical collar, as he probably has a broken neck. If he sustained rib fractures or pulmonary contusions, oxygen would be important, so the mask makes sense. The EKG tracing is nonsense. A traumatic crush injury can certainly injure the heart, giving an abnormal EKG, but the one shown makes no sense at all. It’s no more than a random collection of lines.

In the beginning issue #3, Batman visits the patient in the hospital. While the patient’s head is still wrapped in bandages, he no longer is wearing the cervical collar. In fact, his neck appears to be bent at a pretty steep angle in the first panel. Apparently his broken neck is all better now. He also has no oxygen mask.

There is a cardiac monitor at his bedside, but I see no leads running to the patient. The heart rhythm pictured is still bizarre, but an improvement over the previous issue.

At the end of the issue, Batman visits the hospital again. This time the patient has a nasal cannula delivering oxygen (but drawn incorrectly) and the oxygen tubing appears to be coming down from the ceiling. His oxygen requirements appear to vary wildly, from full mask to nothing to nasal cannula.

As Batman watches, the patient’s heart stops. “No” says Batman, and hits the wall in frustration. (“Wham!” says the wall).

In one of my favorite butchered medical cliché the doctor runs in and says: “Oh my God, he’s red-lined.” No, he’s flat-lined. Red-lining is something you so to a very fast car or motorcycle. There’s a big difference.

At no point does anyone attempt CPR or any form of resuscitation on the patient. The patient is young and should stand a good chance of survival. It’s bad medicine not to attempt to revive the patient. Batman, and certainly the doctors and nurses, should know better.

Looking more like the movie Scotty than the TV show Scotty?

Having a wardrobe malfunction?

The answer to your prayers is here: Klingon Karbs

I apologize for the dearth of posting yesterday and today, I seem to have fallen a bit under the weather. (And yes, I am aware of the irony of a doctor being sick. You can stop giggling now, Polite-Wife.)

In the meantime, as Spider-Man 2 is opening Wednesday, take a look back at some of my Spider-Man columns (if you missed them the first time around)…

• Amazing Spider-Man #3: A Medical Review (the origin and first appearance of Dr. Octopus)
• Amazing Spider-Man #10: A Medical Review
• Amazing Spider-Man #39: A Medical Review
• Aunt May’s Radiation Sickness
• Just How Frail is Aunt May?

As I was putting away comics today, I ran across Avengers #81 (current series), the “climax” of the Lionheart of Avalon storyline.
For those of you who need to be reminded of the story (the pain! the pain!): in this scene, the Scarlet Witch and the new Captain Britain are being attacked by the Black Knight and Morgan le Fey while attempting to rescue Brian Braddock.

Another cloudy cold Sunday in central Illinois. Apparetnly, there’s a law of nature that Sundays in this area can’t be nice days. No big deal this week, as I’ve got a great deal of reading to catch up on, and I’d just as soon lounge on the comfortable couch in the den.

Good news! Our new grass has finally started to grow. The backyard now looks like a giant Chia-Pet.
Better News! My partner comes back tomorrow! No call for 2 weeks!!

Sunday Blog-o-Bits:

1. Just over 1 week until the Tour de France!
2. I know I mentioned my concern about Bible-inspired diets a few weeks ago. Now comes news that the academic credentials of author Jordan Rubin are all from non-accredited correspondance “diploma mills” (third item down). This is not the first time this has happened, John Gray, author of all those “Men are from Mars, Women are from Venus” books also has mail-order academic credentials.
3. From the Hypnosis in Media site is a look at hypnosis and mind-control involving comic books and comic book characters. Other comics are discussed here. A very thorough listing that seems to be accurate as far as I can tell. Maybe I’ll be able to find a good mind-control story after all.
4. Finally, for all you war-gamers, or those interested in military history, check out the Armchair General. In addition to good historical articles, it also offers readers the chance to find out what would have happened if they had been in charge in famous battles (I fare…poorly).

As this coming week marks the celebration of the birth of our nation, I thought it would be a good time for a slight change of pace. This week, I’ll take a look back at some of the classic medical comic books from the 1950s and 1960s.

So, climb in your time machine … push Malcolm McDowell out of the way … turn left at Sherman and Mr. Peabody … sneak past Homer and his time machine/toaster … zoom past the TARDIS (wave at Adric, Teegan, and Nyssa — mmm, Nyssa) … and starting tomorrow: FLASHBACK WEEK!

I would like to thank John Jakala at Grotesque Anatomy for naming my story, Untrue Tales of Medical School: The Squid, as one of the winners in the Street Angel Squid Contest.

If you haven’t been following along from the beginning, you’ve been missing some great art and stories. Initial post is here, and follow-ups are here, here and here.

My favorites have been Graeme McMillan’s Kirby-esque “Cosmic Sky-Skating Street Angel vs. The Space Squid”, Ed Cunard’s Rap Battle, Steve Mohundro’s Wally Wood-pencilled story, and Libby’s (slightly) Hentai story.

After Fredric Wertham’s infamous Seduction of the Innocent and the subsequent congressional inquisition, Entertaining Comics (EC) had to regroup. They could no longer publish the comics such as Tales from the Crypt and The Vault of Horror. Instead, they introduced a “new direction” in their comics. One of these titles was M.D. First published in 1955, it lasted for 5 issues.

The initial page of the first issue discusses the philosophy of the new series:

It is dedicated to Mankind’s Tireless and unceasing battle against disease, and to the man who fights that never-ending battle day after day after day…your Family Doctor…your M.D.

It goes on to state:

This, then, is the theme of “M.D.” It will contain stories of people…people who are helped by their Family Doctor and his associates in the Medical Profession. It will deal frankly and honestly with the diseases and misfortunes that beset people. It will deal graphically and candidly with the treatment they receive. At times, the stories will be poignant…at times they will be sad…at times they will be grim. But at all times, they will be true to life!

[All punctuation is verbatim].
A copy of the Hippocratic Oath closes out the first page.

The opening story, The Fight for Life, is a sweeping history of disease and medicine from prehistoric times until the modern age (well, 1955). Full of hyperbole and generalizations, the story nevertheless works because of the intricate and eye-catching art.

The next three stories each deal with a patient with a different medical condition. The particular condition and its required treatment are highlighted at the start of each story.

The first of these stories is Janie Some Day, which tells the story of Janie, an orphan who has a congenital bone infection in both of her legs. She’s been in heavy plaster casts for her whole life. Dr. Kendall is able to cure her left leg, but is unable to save her right leg which has to be amputated. Of course, the kindly doctor never tells Jenny that she’s going to need an artificial leg; he leads her to believe somehow her original leg will grow back. When she finds out the truth, she is heartbroken. But then Dr. Kendall shows her that she will not need an ungainly wooden leg, but instead an ungainly plastic pink one. She lives happily after ever, and Dr. Kendall and his nurse exit the scene with tears of happiness in their eyes.

The next story, To Fill the Bill, concerns the Saunders. Mr. and Mrs. Saunders are having some financial difficulties, and have been unable to pay their doctor’s bill. Mrs. Saunders begs her husband to pay the doctor at least a small amount, but her husband states that the phone bill is more important. She asks him how he would like it if his company paid their phone bill instead of paying him? He laughs and brushes it off saying, “Don’t be crazy! I belong to a union! We get paid first! Or else! You think I’m nuts?! You think I’d sweat over a machine all day, and get paid off in promises…!” Apparently irony is lost on Mr. Saunders.

In the midst of this argument, their daughter interrupts, saying that their son has swallowed a safety pin. Panicked, the husband realized that he must call the doctor for help. Upon receiving their telephone call, Dr. Bennett grabs his bag and runs from his office to the Saunders’s house, telling a passerby to call an ambulance. Upon arriving at the house, Dr. Bennett finds little Bobby unable to breathe and turning blue. He performs an emergency tracheotomy on the kitchen table and then fishes the pin out with a pair of tweezers. As Bobby is taken off to the hospital, Mr. Saunders sheepishly hands a check to Dr. Bennett and apologizes for not paying the bill. Dr. Bennett refuses the check, telling Mr. Saunders that helping Bobby is all the payment he really needs, and he knows Mr. Saunders will pay when he can. The story ends with the neighborhood cop saying, “I always say ‘You can never really pay ‘em enough!’ ”

The final story, The Antidote, while featuring a patient with acute appendicitis, is actually focused on Dr. Anders. As the doctor returns home after a long day, a patient accosts him, saying that the doctor must help his sick son. Dr. Anders replies that he has a consulting neurosurgeon flying into town that he must meet with, but he allows the patient to drag him along to examine his son. He finds the child in the throes of acute appendicitis. He sends the patient to the hospital and sets up an operation with a top surgeon, but the family insists that he attend the surgery as well. Reluctantly, Dr. Anders agrees, and scrubs in. The surgery goes well, and he goes to tell the family the good news. The father insists that he stay at the patient’s bedside through the night, but the doctor begs off, saying that he must meet with the neurosurgeon. The father accuses Dr. Anders of having no emotions as he leaves for his appointment. Dr. Anders realizes that the father is hysterical due to the stress of his son being sick, and tries not to let his words get to him. In final panels of the story, as Dr. Anders finally meets with the neurosurgeon, we find out the patient the specialist is in town to see is the doctor’s sick wife.

In addition to the stories, there is also a one-page text feature giving the history of Dr. William Morton, the dentist who discovered the effectiveness of ether as an anesthetic.

The art is what is to be expected from EC comics: intricate and highly detailed art with typed lettering.

The stories are designed to tug on the heartstrings. The first with the story of the poor crippled orphan girl. The second story has the selfless doctor who runs through the city to save the life of a child, not caring that his parents haven’t paid their bill. The last story tells of another selfless doctor, arranging the best care for a patient, all the while delaying his meeting with the specialist in town to save the doctor’s wife’s life.

The narratives tend to be unrealistically didactic at times. Dr. Kendall explains to six-year old Jenny that she needs to exercise her leg because the muscles “ need to re-attach themselves as distally as possible. ” As Dr. Bennett is saving young Bobby’s life, he’s explaining the anatomy of the trachea to his mother.

Overall, the stories hold up pleasantly well for a nearly fifty year-old comic.

This post covers the medical aspect of the first issue of M.D., published in 1955 by EC. A summary of the comic itself can be found in my previous post.

For the most part, the medicine in this comic holds up very well fifty years later. Technologies and medications have certainly improved since 1955, but I refuse to hold that against the writers and artists.

The first story about the history of disease and medicine is fairly light and inconsequential. I take issue with the statement: “As soon as man developed enough intelligence to distinguish metabolic disease from parasitic infection…the practice of medicine began in its crudest form…” The practice of medicine began long before we could tell metabolic disease from parasitic disease. We still have trouble differentiating the two sometimes even now. Malaria wasn’t proven to be parasitic until 1897, and only recently has Lyme Disease been shown to be parasitic in nature.

The second story, Janie Some Day, is the one I have the most problems with. First, I am not sure what “congenital osteomyelitis” refers to. Osteomyelitis is a bone infection, and congenital means that the patient was born with it, but I can find no references in the medical literature to “congenital osteomyelitis”. Admittedly, my resources do not go back as far as 1955, and it may have been common terminology then. At one point, Dr. Kendall refers to Janie’s condition as an infection of the bone by tuberculosis. Certainly, tuberculosis can infect bones – usually the spine, but leg bones can be infected too. Tuberculosis can also very rarely (300 cases, ever) be transmitted congenitally. So, Janie could have had this tuberculosis passed from her mother that infected her leg bones, but I suspect the writer is referring to something else.

I am more concerned about Dr. Kendall’s treatment of Janie. He has her leg amputated, and misleads her into thinking she won’t need an artificial leg. Another time, he knows her left leg is healed, but keeps the cast on two extra months just to be “absolutely sure”. At best, Dr. Kendall is misguided, at worst he is a cruel and sadistic man. Either way, I’d suggest the orphanage needs to find a better doctor.

The third story where little Bobby chokes on a safety pin could happen as written today, but I suspect the parents would call 911 long before they’d call the doctor. Note: If your child is choking, please call 911 before calling my office.

The last story is fine. The treatment of acute appendicitis remains an emergent operation. Anesthesiology has advanced remarkably since the 1950s, and we no longer use “ether dripped onto the large gauze pad over the patient’s nose and mouth.”

It is fascinating noting the changes in medicine in the fifty years since this comic was published. Anesthesiology and medications have improved, but the basic procedures remain the same. Two of the three medical stories deal with doctors making house calls, a unlikely occurrence in today’s society. There is also no mention of insurance or HMO anywhere. Hmmm…

As much as I enjoy the respect that is shown to my profession, the comic’s fawning adoration of the Family Doctor is almost creepy. I fully expected the doctors to turn water to wine the way the stories nearly deify them.

Except for poor little Janie, I was pleasantly surprised to find how well the stories hold up medically today, almost fifty years they were first published.

One of my favorite obscure singers is Tom Smith, the self-described “World’s Faster Filker.” I first ran across his music six years ago while looking for some Heather Alexander CDs at a small Sci-Fi convention. I have since acquired all of his CDs and listened to him in concert at three different conventions, and my appreciationfor his music has only grown.

His work is mostly humorous, though he does write some serious songs. Many of his best works are parodies. All his songs are easy to sing along to, and feature incredibly clever word play and occasionally painful puns. His topics generally include Sci-Fi, fantasy, comic books, movies, and fandom in general. He has also written the official song of Talk Like a Pirate Day.

My favorite songs are Superman Sex Life Boogie, 500 Hats (a song that manages to cover nearly every Dr. Seuss book. Sung to the tune of 500 Miles, by the Redeemer), Five Years (the entire Babylon Five plot, to the tune of Barenaked Ladies One Week), Rocket Ride (about old classic SF/fantasy/comics versus their shallow modern versions), and I Want to be Peter Lorre. All three of his albums available on CD (Debasement Tapes, Plugged, and Tom Smith and his Digital Acoustic Compilation) are highly recommended and available at hissite.

Last night in the wee hours of the morning, Samantha, our “main cat”, awoke us by sitting outside our bedroom door and yowling. Cat owners will tell you that cats have several different vocalizations, each with a different meaning (such as “feed me”, “look what I caught”, or “pay attention to me!”). This was not a sound we’d heard before.

We sprang from bed to make sure she wasn’t injured. As soon as she saw us, she bagan purring and wrapping herself around our legs. We petted her and comforted her until she calmed down and went to sleep. We went back to bed, puzzled by her behavior.

This morning we discover there was a small earthquake in our area last night. Coincidence? I don’t think so.

The Dr. Kildare comic was published by Dell sporadically from 1962 to 1965. It was based on the television series starring Richard Chamberlain as Dr. James Kildare, an Internal Medicine resident at Blair General Hospital. Dr. Kildare #7 has a 12¢ cover price, and is dated Sept-Nov 1963. It has a photo-cover of star “Dick” Chamberlain and is titled “Emergency, Dr. Kildare…The Shipyards are Engulfed in Flame!” It offers 32 pages of four-color excitement, with the only ads being on the back cover.

The medicine in the story is quite accurate. The opening scenes do a good job showing how different state-of-the-art medical care was forty years ago. The writing is good, but the story tends to be overdramatic in parts, with Dr. Kildare always being in the middle of the action, even the firefighting sequences. The art is above average, with the main characters always looking like their television counterparts. The color choices are a little off, with Kildare’s hair always a bright blond, despite the fact that the photo-cover shows him to have brown hair. Additionally, his scrubs always stay a bleached white, despite running around burning buildings filled with ash and smoke.

The main story is a 27-page story titled “Trial By Fire“. In the opening scene, Dr. Kildare examines a man who fell off a building and injured his head, ribs and leg. A depressed skull fracture is seen on the x-ray, which suggests that their may be some brain damage as well. To determine whether there is any bleeding around the brain, a lumbar puncture (spinal tap) is performed. The spinal fluid shows blood, so an intracranial operation is performed to stop the bleeding in the skull.

Today, we don’t rely on skull x-rays and spinal taps to determine brain injuries. CT scans of the head (which were not available in 1963) show brain damage and any bleeding. Utilizing special medications and tiny clips, many intracranial bleeds are able to be stopped without invasive operations.

Next, Dr. Kildare is called to the waterfront, where a tanker boat and some buildings are on fire. Impetuously, Kildare rushes into a burning apartment with the firemen to save a girl and her father. They are able to rescue the girl, but her father has passed away. “The father was dead before we left the room,” laments Kildare. “Heart failure.” This is a bold call – not that the patient is dead, I assume he would be able to recognize that, but that he is able to determine the patient died of “heart failure” after only a cursory exam.

Next, Kildare joins several firemen as they cross a boom and spray down the burning tanker with water. One of the firemen falls off the boom, but Kildare treats his wounds successfully. Tired, he returns to the hospital only to hear that the tanker fire has flared up again with some of the firefighters trapped inside. Returning to the waterfront, Kildare dons an asbestos suit (this was before asbestosis was recognized as a disease) and goes inside the burning tanker. A firefighter is pinned by a metal beam that has fallen, crushing his hand. Ultimately, Kildare has to amputate the fireman’s two crushed fingers. Kildare returns to the hospital more desperate than ever for a vacation.

The comic contains more than just the Dr. Kildare story. The inside cover contains two brief “Little Medics” vignettes showcasing children and first aid. The first strip has two Boy Scouts hiking when one is bitten by a rattlesnake. The other scout places a tourniquet on the wounded limb, cuts a cross over the bite, and squeezes out the venom. Next, he runs to the nearest house and calls the zoo, as they are most likely to have “anti-venom serum”.

This treatment, or the more commonly taught treatment of sucking the poison out of a snake bite, was the recommended first aid treatment for many years. I suspect this was only because no reliable authority actually looked at what the Boy Scouts and other outdoorsmen were teaching. Over the past several years the recommendations have changed. The tourniquet is appropriate, but cutting, squeezing, or sucking the wound are all counterproductive. Intricate field treatment is not necessary; simply get the injured person to the ER as soon as possible. In the early 1960s, our modern emergency room system was not in place, so zoos were the most likely places to carry antivenin.

The second Little Medic vignette deals with a boy who breaks his leg while biking. His sister makes a splint for him out of available materials. Good advice both then and now.

There is a text feature, Lady Doctor, about Sally, a young woman who wants to be a doctor. There is a small amount of sex bias in the story, but overall it is a well written story that would be encouraging to any young woman desiring to become a physician.

The last story is “Jungle Doctor: Dangerous Waters”, about a doctor and his assistant deep in the heart of Africa. It is more of an adventure tale than a medical strip. The story is formulaic, and you wonder why African natives are screaming for help in English. It also ends abruptly, as if the artist suddenly realized he was on the last panel.

The medicine shown in the Dr. Kildare #7 is all well researched and accurate for the era. We treat head trauma and snake bites differently today, but the illustrated treatments were state-of-the-art in 1963.

Daily, we have pharmaceutical representatives (hereafter called “drug reps”) stop by our office to talk to my partner or me. Their job is to convince us that their drug is best, and we should prescribe it above all others (a tough job, as I almost always prescribe time-tested and trusted generics).

They also bring samples of their medication for us to hand out. This is important, especially for our low-income or elderly patients.

To convince us to use their drugs, they will bring out charts and reports and studies to prove their point. Unfortunately, I find that many of these studies and reports are flawed, biased, or both.

I don’t blame the drug reps for the bad data (because it’s provided by their home office), but I will take the time to make them sweat and squirm about it.

I simply cannot stand misleading statistics. I find it unethical and immoral to intentionally mislead people. Most individuals, even educated ones, are surprisingly naﶥ about statistics, and don’t realize how easy it is for them to be misled. It’s not just physicians who need to be wary of bad data, but the public as well. Most of these studies also show up in television and print ads for the medications.

Here are some common situations:

1. Unequal Comparisons: Yesterday, a rep pulled out a graph showing 10 mg of his statin (a type of cholesterol drug) compared to 10 mg of all the other statins. According to the chart, his drug was far above the rest. Impressive? Not really, because the comparison was very misleading. 10 mg of his drug is its standard dose, but 10 mg of the other drugs are only half-strength or quarter-strength doses, so of course his drug came out on top. It’s like taking a full shot of Jack Daniels, a watered-down shot of Jim Beam and a watered-down shot of Wild Turkey and asking which is stronger.
   Unfortunately this is a very common tactic: studies that compare a high dose of one drug against weaker doses of its competitors.
2. Differing Definitions: There are three main osteoporosis drugs. Each one claims that they are the best, but each drug measures “best” differently – one measures bone density, one measures hip fractures, and one measures spinal compression fractures. It’s nearly impossible to effectively compare drugs when each company defines the solution to best fit their specific product. Which is best? It’s not clear, but I have my suspicions.
3. Anecdotal Evidence: One of the drug reps loves to use anecdotal evidence provided by a local cardiologist. “Dr. McE- put this patient on our drug and their cholesterol dropped by one-hundred points!”
   Anecdotal evidence is fine to illustrate a point, but it carries very little weight. It is the weakest type of evidence; it is the statistical equivalent of a story your cousin’s neighbor’s hairdresser’s son told. Drug reps know this, yet some continue to present anecdotal evidence as if it were better than real scientific studies. (Note that this is the same trick most weight loss drug/diet ads use, with the small-print disclaimer “results not typical”.)

Let it be stated that I like the drug reps individually and socially; I’m just not fond of their job and the tricks some use.

Ben Casey was published by Dell from 1962 to 1965. There were 10 issues total, all with a 12¢ price and a photo-cover. The comics were based on the Ben Casey television show that aired on ABC from 1961 to 1966. Ben Casey #9, titled “Crisis at 59 West!!!”, has a date of October-December 1964 and contains 32-pages of story. The writing and art are mediocre. The regular characters are drawn and written well, but the other characters seem more two-dimensional caricatures than anything else.

As the story begins, Dr. Zorba persuades Dr Casey to come for a ride in his new sports car. As they are driving, another car nearly runs them over and then crashes into a tree. Casey and Zorba drag the unconscious driver out of his car and transport him to the hospital. As they arrive at the hospital, Casey tells his co-worker that he suspects the patient is suffering from a case of paroxysmal cerebral dysrhythmia.

It turns out the patient is Junior Van Cleve, the son of rich and arrogant Cassius Van Cleve, a major hospital donor. Mr. Van Cleve arrives and immediately begins to throw his weight around. Soon he and Casey butt heads, and Casey finds himself forced off the case, or the hospital won’t get its annual donation check from the Van Cleves.

Meanwhile, the tests Casey has ordered come back and prove that he was right about Junior’s diagnosis. Of course, he and his fellow physicians can’t come right out and tell the patient what the diagnosis is. Instead, they throw around a succession of medical terms that were already archaic forty years ago.

Rich Mr. Van Cleve accuses Casey and the medical staff of making things up because they have diagnosed his son with 1) paroxysmal cerebral dysrhythmia, 2) recurrent disturbance of brain rhythm, 3) psychomotor seizures, and 4) psychic variant seizures. Of course all these terms mean the same thing: Junior has epilepsy.

Mr. Van Cleve refuses to believe this because “everyone knows it only effects [sic] half-wits and criminals!”

Incensed, Van Cleve decides to transfer his son to another hospital, but as they are leaving the hospital Junior suffers another seizure and Casey saves him. Van Cleve’s personal physician finally arrives and tells Mr. Van Cleve to back off, that Casey had the right diagnosis and treatment all along.

In the end, Mr. Van Cleve comes around and even offers Casey a position as Junior’s personal physician. Casey thanks Van Cleve, but says he’d rather stay where he is. “Hmmm,” says Mr. Van Cleve. “Until I locked horns with that Casey character, I thought the younger generation couldn’t even spell grit and determination! But he…You’ll have my check in the morning!”

This comic is more of a character story than a medical story. Most of the narrative concerns the conflict between Ben Casey and Mr. Van Cleve. What little medicine is shown is a mixed bag. The epilepsy is diagnosed correctly. While Casey and his co-workers use a great deal of technically correct terminology, most of it is horribly out-of-date, even for the 1960s (but this is done to set up a plot point). In terms of negatives, I’m surprised that Casey would drag the unconscious patient from the car without supporting his neck; he should know better considering that he is a neurosurgeon. Speaking of neurosurgeons, why is a patient with seizures being treated by a surgeon instead of a neurologist?

Finally, take a second and look back at Mr. Van Cleve’s last statement, where he praises Casey’s grit. Could this be it? The first of the grim and gritty comics? My vote is yes.

Excelsior!
‘Nuff Said.