Polite Dissent

I’m upset and depressed. One of my original comic pages has turned up missing. On the walls in each of my exam room, I had a framed Air Force commendation, a super-hero calendar, and a framed page of original comic art.

Today I noticed that a Silvestri-signed X-Men page is gone.

I don’t think a patient took it, as it’s rather bulky — maybe the cleaning staff? Regardless, it’s gone. I think I’ll have to take the other pages home too.

The areas where I have seen the biggest influence of prescription drug advertisements has been in arthritis pain medications and stomach/heartburn medications. Both of these diagnoses cause significant pain, so it’s easy to understand why patients would want quick relief and why advertisements would catch their eye. In both these cases, however, there are over-the-counter (OTC) or generic drugs that work just as well, if not better. These are also some very expensive drugs. Insurance companies provide limited formularies, with only one or two of these expensive drugs on them, and even then you have to jump through hoops to prescribe them. I have to routinely tell patients who want a particular arthritis pain medication that they must first have tried, and failed, two other pain medications before they can get the ones they want. That’s two months of waiting, and most patients are very unhappy with that.

I have a fair number of patients who come in seeking allergy relief after seeing ads. Again, prescription allergy medications are expensive drugs. In this case though, there are no really good OTC or generic equivalents. There are still insurance restrictions, but not as strict as those for arthritis and stomach medications.

Occasionally, I’ll see a patient who comes in inquiring about an anti-depressant after seeing advertisements. This is the area where I actually see some benefit from ads. Many people have depression, but don’t realize they have it, aren’t sure it can be treated, or are embarrassed to admit that they are depressed. The ads help reassure patients and remove some of the stigma of being on anti-depressants.

Finally, I have seen absolutely no changes in my practice due to advertisements for high blood pressure or cholesterol medications. This makes perfect sense. Neither high blood pressure of high cholesterol have specific symptoms, so patient are not going to go out of their way to seek treatment.

In a given week, about 10-15% of my patients are clearly influenced by advertisements, while at least another 30-50% show are familiar with the ads. I generally dislike the idea of having prescription drugs advertised nationally, with the possible exception of anti-depressants. However, I prefer well-regulated prescription drug advertisements to the misleading and sometimes dangerous advertisements and infomercials for “nutritional supplements”, alternative “medications” and diet aids. But that is a rant for another day.

Here’s the page that was stolen (only full sized and black and white). It is page 8 from Uncanny X-Men #243, art by Mark Silvestri and Hilary Barta. There is a blue ballpoint-pen signature from Silvestri on the bottom, and a black ink signature that says “Barta ‘90″ from the inker.

click on graphic for a larger image

If anyone sees it in person or for sale, please let me know. A suitable reward will be offered for all assisting in its return.

The second issue of M.D. is a lot darker than the first issue. Only one of the four stories can really be considered to have a traditional happy ending. The art continues in the intricate style E.C. comics were known for, and the lettering has the familiar blocky look.

The cover shows two doctors assisting a victim at a car crash, a scene that never appears in the comic. M.D. #2 is dated June-July 1955 and had the cover price of 10?.

The first story, “The Balance”, is about Bobby, a young boy who develops leukemia. Since the story was written before chemotherapy was available, treatment options were limited. Bobby is admitted to the hospital and given injections of cortisone to suppress the white blood cells and transfusions to build up his number of red blood cells. He does well at first, but then his symptoms return and worsen. He slips in and out of a coma and eventually dies. When the doctor tells his parents the sad news, his pregnant mother panics and runs down the hall, slipping and injuring herself. She is taken for an immediate c-section, and ultimately delivers a healthy set of twins. Looking at his new children, Bobby’s father remarks: “It’s strange, isn’t it doc…how things work out? Twins! A boy…to take the place of the one we…we lost…and the girl we’ve wanted for so long.”

The type of leukemia Bobby has is never stated, but is most likely Acute Lymphocytic Leukemia (ALL). It is a cancer of precursor white blood cells, which grow so dramatically that they choke out all the other blood cells. The treatment of leukemia has dramatically improved in the past fifty years, and the diagnosis is no longer the death sentence it once was. Hospital conditions and policies have improved as well. Family is considered important, and Bobby would not have had to die all alone.

This story does show a fair amount of sexism with the mother repeatedly referred to as “frail” based on nothing more than the fact she was female and pregnant. The father’s last line and the thought repeated by the doctor that a dead child can be “replaced” is misguided and strikes me personally as somewhat repugnant.

Herbie, a child with cerebral palsy, is the focus of the second story “Different”. Feeling that his family would be better off without him, Herbie runs away. He knows his mother will miss him, but he doubts his brothers will even notice he is gone because they always make fun of him. His father mostly ignores him, and just the other day forbade him from going outside so the neighbors wouldn’t know he had an “idiot child.” Herbie is found by a kindly policeman and taken to a wise family doctor. The parents are brought in to see the physician who lectures them sternly about Herbie: “If Herbie were an idiot, he wouldn’t have been hurt by the things you said about him and did to him! Your son, Mr. Struthers, is a bright, sensitive, intelligent boy!” Chagrinned, the parents ask for help. The doctor informs them that there is no surgery or medicine that can cure Herbie, but with intensive therapy, he can lead a more normal life. The parents agree and Herbie starts therapy, improving a little each day.

This story is a good narrative about cerebral palsy, both then and now. The treatment remains essentially the same today, and the prejudice faced by people with cerebral palsy continues.

In “A Case for the Books”, the third story, the elderly cabinetmaker Gustaff suddenly loses most of the vison in his right eye. He goes to see the local Family Doctor, who sends him on to an eye specialist in the city. The specialist tells Gustaff that he has ocular hypertension and that the high pressure in his eye is damaging the optic nerve and could lead to permanent blindness. An operation is required to reduce the pressure. Gustaff agrees, and a small hole is drilled in his eye to reduce the pressure. The operation is successful and Gustaff regains his vision. Instead of money, the doctor asks for a handmade bookshelf in payment.

The term ocular hypertension fell out of favor in the 1970s because it was vague and meant different things to different people. Today it refers to someone who has elevated eye pressure but no other symptoms. Gustaff had progressed beyond this to a severe case of glaucoma. Caught early enough, glaucoma can be treated with eye drops. If it progresses too far, an operation is required. Modern glaucoma operations are similar to the one Gustaff had, though lasers are used.

In the final story, “Even For a While”, Augie has constant severe headaches, nausea, and visual changes. The local doctor suspects he had a brain tumor, and sends him to a specialist at the hospital. The specialist runs a battery of tests and confirms that Augie has a tumor. An operation is performed, and the cancer removed successfully. After recovering from his surgery, Augie thanks everyone for caring so much about him, especially considering the fact that he is a murderer set to die in the electric chair in a few weeks.

Our diagnostic tests are better today, so the several days of tests Augie went through would not be required. The ethical issue raised by this story is left up to you.

In addition to the four stories, there are also two text pieces in the comic. The first one, “Fever Fighter”, tells of an American army physician named William Gorgas who served during the Spanish-American War and while the Panama Canal was being constructed. Gorgas was the first to realize that yellow fever was spread by mosquitoes. He was one of the first to realize that malaria was also spread by mosquitoes. He was ultimately named Surgeon General of the Army.

The second text piece tells of Edward Jenner and how he discovered smallpox vaccination. This story has always fascinated me, not just because the eradication of smallpox is one our greatest accomplishments, but because of some of the ethical issues involved in Jenner’s original experiment. His subject was an eight-year old boy who was first injected with cowpox, then smallpox. How ethical is it to experiment on a child? Did they, and could they, give consent? What if Jenner had been wrong?

The stories in this issue are not nearly as wordy as those in the first issue were. In fact, the story on leukemia and the one on ocular hypertension could have used more explanations. The mix of medical conditions this issue is good because it shows that no matter how much medicine changes over the years (leukemia, glaucoma), much of it stays the same (cerebral palsy).

For someone who complains so much about not getting a vacation, Dr. James Kildare manages to take one in both issue #8 and issue #9 of his comic. Both issues feature photo-covers and a 12? cover price. 32-pages of story are provided, but there are no Jungle Doctor back-up stories or text pieces. The inside front cover is taken up with advertisements, not the “Little Medics” vignettes seen in Dr. Kildare #7.

In Dr. Kildare #8 (October - December, 1964), James Kildare takes a week of vacation at his friend’s beach house. He gets in a little surfing, but then the weather turns poor, so he relaxes inside. He meets Stacy, a spoiled rich girl who nearly runs him over with her expensive boat. She repeatedly hits on him, but he rebuffs her, thinking that she is simply too irresponsible. Going into town, he meets two fishermen, Captain Bob and his son Joey. Kildare and Bob get along well, but Joe dislikes Kildare because he’s sweet on Stacy himself. “My boy Joe’s crazy about her, but she won’t give him a tumble,” Captain Bob says, hopefully meaning something different than I read into his comment.

After being turned down by Kildare yet again, Stacy goes off in a huff, ignoring his warning about a thick fog. Lost in the fog, she steers erratically and causes Captain Bob’s fishing boat to crash onto the dangerous shoals. Joe is trapped in the boat’s hold, his legs crushed by a fallen beam. Stacy jumps in her boat and goes to get Kildare. He comes out to the fishing boat to help Joe. He, Bob, and Stacy can’t move the beam off Joe’s legs, so Stacy goes to get help from the Coast Guard. Finally, just as the tide has risen so high that Joe’s life is in danger, the Coast Guard arrives and helps lift the heavy beam off his legs. James diagnoses Joe with two broken legs and sends him to the hospital. Stacy apologizes for her wild ways and helps Captain Bob buy a new boat.

Not a great story by any means. Kildare is in the story, but more as a bit player than a main character. He reacts, he doesn’t act. The only medicine is the diagnosis of two broken legs, and almost anyone could have done that. The art is fair. Kildare is drawn to resemble his television counterpart most of the time, but in several panels he bears an uncanny resemblance to Fred Gwynne. Once again his hair is a bright blond, despite a photo-cover showing “Dick” Chamberlain’s brown hair.

In Dr. Kildare #9 (April - June, 1965), James Kildare and two other residents head up to the mountains for a weekend of skiing. Once on the mountain, a blizzard sets in, closing the roads. A bus has gotten stuck down near the city, so James and the others ski off to help anyone who might be hurt. On their way, they are met by a group of rescue workers who tell them of two injured skiers trapped high on the mountain in an unheated cabin. Kildare tells his associates he’ll go with the rescue team to the cabin and they should continue on to help the bus.

Kildare does his best to keep pace ascending the mountain, but falls behind. One of the rescue crew stays to help him, but they get lost in the blizzard. Helping each other up a steep slope, Kildare slips, but his companion manages to grab him. In the process, he wrenches his shoulder, but Kildare diagnosis it as only a sprain and puts the arm in a sling. They hurry on to the cabin where they meet the other rescuers. One of the skiers is fine, but the other has a broken leg. Kildare splints the leg, and the team hauls the injured skier down the mountain on a sled.

When Kildare, the rescue crew and the skiers arrive back at the lodge, they discover his friends aren’t back from the bus yet. They hurry off to help them, and discovers the bus almost completely buried by an avalanche. He and the others manage to dig out the bus and rescue the people inside, but only just in time as another avalanche sweeps the bus away. Kildare and his friends return to the hospital the next morning, uninjured, but exhausted from their “vacation.”

Again, there was not much medicine in this story: a sprained shoulder and a broken leg. Kildare was a main character this time, not just a bit player. The art is similar to issue #8 in that most of the characters look like their TV counterparts, but every once in a while, Kildare sports Gwynne’s unmistakable chin.

These two issues were some nice light reading, but not the medical adventures I had hoped to find. Nonetheless, they make a good way to close out Flashback Week (and now I need a vacation!).

Fred Gwynne and Dr. James Kildare: Separated at birth?

I’m off to St. Louis for the weekend (fun! fair! fireworks! family!), but should return on Sunday. I hope everyone else has a fun holiday weekend.
Please remember these important safety tips:

1. Do not put fireworks in any holes where they do not belong.
2. Poison ivy should not be used as toilet paper.
3. Do not pet the snakes.
4. Do not feed the bears, raccoons, or Rob Liefeld.
5. Do not drive if you’ve had more than 2 beers, and do not even attempt to stand if you’ve had any of Aunt Betty’s special fruit punch.
6. Do not play “God Bless the USA” more than two times in a row (there are plenty of better patriotic songs available, so please choose one that does not butcher the English language) (and that does not include Toby Keith’s abhorrent “Courtesy of the Red White and Blue“).

The Polite-wide and I had a nice time in St. Louis with my parents. It was their anniversary, so we took them out to dinner at one of their favorite restaurants, The Blue Water Grill, and had an excellent meal. My mother and wife split this enormous chocolate-sampler dessert, and both reported that they could not eat another bite of chocolate (which is one of the signs of the Apocalypse, I believe). We returned to my folk’s house after dinner and caught the end of the NASCAR Pepsi-Cola 400. It was a surprisingly good race. I’ve never been a fan of the restrictor plate races (Daytona, Talladega), because the tracks seem to favor pure chance over skill. The new aero packages and smaller gas tanks seemed have allowed skill and strategy to return, and the race was exciting to watch (plus Bobby Labonte finished in the top 10, keeping him near the top overall).

Managed to stop into a comic shop near my parents yesterday. I was pleased and disappointed. I was pleased that they were plainly offering the FCBD comics (well, the gold ones) — plus what seemed to be some left over from last year. I was disappointed by their selection of comics overall. They had Marvel, DC, Dark Horse and Image. Not much else. Their idea of an independant was Thundercats. I asked for Demo #7, because I didn’t see it on the shelves. I had to patiently explain what it was and who published it. And no, they didn’t have it, because (and I quote here): “Those artsy books don’t sell.” Well, if you don’t offer them, they won’t sell! Buying comics off the internet doesn’t seem so bad now.

This morning, I got up before the crack of dawn and drove to the St. Louis waterfront to run a 10K (6.2 mile) race. It was the fourth 10K I’ve run in downtown St. Louis, and every one has followed a different route. I was pleased with my effort, and my (nearly) daily runs seem to be paying off. Not once during this race did I my usual “Now why did I think this was a good idea?” thought cross my mind. All participants received a commemorative medal too, which was a nice touch.

We drove back to central Illinois tonight, and have been watching the city foreworks from our porch for the last 45 minutes. I can hear them outside the window and they’re still going on now. Pretty good fireworks for such a small town.

Sunday Blog-o-Bits:

1. Check out the CDC’s infectious disease trading cards. (Brought to my attention by the Steve Jackson Games’s Daily Illuminator, the source for interesting links of all sorts.)
2. There is an excellent new illustrated Solomon Kane book out. It collects all of Robert E. Howard’s Kane stories, plus it contains some material I’ve never seen before, such as an alternate version of Solomon Kane’s Homecoming. If you are a Solomon Kane fan, a Howard fan, or just interested in classic pulp fiction, you need to check this book out.
3. It’s Independence Day. When’s the last time you watched 1776?
   My favorite line from the movie: “I have come to the conclusion that one useless man is called a disgrace; that two are called a law firm, and that three or more become a Congress! “

Detective Comics #795 Monsters of Rot, part 2: Knee Deep
Andersen Gabrych, writer
Pete Woods, penciler

In Detective Comics #795, Batman and the Tarantula are investigating a particularly nasty disease known as the mugre. Batman ultimately determines that it is a bacterial infection from the rainforests of Central/South America.

To treat the Tarantula for an exposure to the infection, he injects her with Cipro. He also gives some of the same drug to Commissioner Akins to administer to any sanitation plant employee who may have come into contact with the disease.

Cipro (generic name: ciprofloxacin) is a potent antibiotic and is effective against a wide variety of bacterial infections.

However, I am concerned that:

1. Batman administers it by intramuscular injection. Ciprofloxacin is only supposed to be administered orally or by IV, not by injecting it into a muscle.
2. Batman only used one dose. Bacterial infections need several days of antibiotics to clear up.

The Polite-wife and I went for lunch today at one of my favorite casual restaurants: Buffalo Wild Wings. This was on eof my favorite places in Indianapolis when I was in residency, the they opened up one in Las Vegas that we went to at least once or twice a week. Now they’ve opened up one in Peoria. It’s a twnety minute drive, but worth it.

They have twelve different sauces of varying flavors and intensities. I recommend the “Caribbean Jerk” and the “Smoky Southwest”, although the new Captain Morgan flavored sauce is quite good as well.

What more is there to want? Good food, good drinks, multiple TV screens, and NTN trivia?

mmmm…hot wings…

One of the most important aspects of medicines and one that is frequently shown incorrectly in comics, TV shows and movies is how the medication is given to the patient. The most common ways of administering medication are orally (by the mouth), intramuscularly (injected into muscles), or intravenously (injected into veins).

Medicine taken by mouth takes about 30 minutes to work. It has to be digested in the stomach or small intestine, enter the bloodstream, and then reach its target organ.

Intramuscular (IM) injections place the medications into muscles (similar to a vaccination) where they are absorbed into the bloodstream. These medications generally work faster than oral medications, but slower than intravenous drugs. On average, an IM injection takes about fifteen minutes to work.

Intravenous (IV) medications are injected directly into the bloodstream. They work quickly with effects in 5-10 minutes. Usually, these medications are injected through IV lines already in place, though skilled individuals can inject medications directly into the veins.

Not every medication can be given every way. Some medications can only be given one way, though most have several different means of administration. Additionally, oral doses usually need to be much higher than IV or IM doses due to digestive and metabolic effects.

In addition to the common methods of administering medicine, there are other less common ones including inhalation and trans-dermal.

Some medications can be inhaled. Inhalation is quick, with the medicine traveling from the lungs to the bloodstream in a matter of minutes. Very few medications can be used this way, and it’s hard to get a consistent dose with inhaled medications.

Some medications can be given transdermally, or through the skin. This is usually done with patches, but can also be done with gels or creams. Skin absorption is a slow process, and works best for slow drugs with a steady level, like hormones or medications for chronic pain.

There are several other methods of giving medication that are only used in certain circumstances and will not be covered here (except to again point out that atropine should never never be injected directly into the heart).

Case Studies:

1. Oral: Hourman (Rex Tyler). Miraclo would not be the instantaneous drug it is supposed to be
2. Intramuscular: GOOD: In Amazing Spider-Man #508, Ezekiel injects Peter with a neuromuscular agent. It takes several minutes for it to take effect, and Peter grows weaker as it the drug takes effect. BAD: In Detective Comics #795, Batman injects the Tarantula with Cipro, a drug that should not be given intramuscularly. In JSA #17, the medications Dr. Mid-Nite injects inot Black Canary take effect immediately.
3. IV: Usually shown in hospital situations, it has been shown (among others) in recent issues of Hellblazer. No exemplary (or terrible) examples.
4. Inhalation: Batman gases a Checkmate agent in Batman: Gotham Knights #40, and in Avengers #69 the Red Skull uses a narcotic gas to knock everyone out. In real life, the Moscow police used a narcotic gas to subdue the terrorists holding theater patrons hostage about 2 years ago. The results were mixed.
5. Transdermal: Hourman II (Rick Tyler). Miraclo would work even slower as a patch than as a pill. No “hour of power” here.

Imagine that two kids walk into a toy store. The first is a spoiled brat; his parents will buy him whatever he wants. He gets toy after toy after toy, not because he necessarily wants them, but because they’re cool and he wants what the other kids have. A month later, the toys are scattered over the floor of his room, broken and forgotten.

The second kid chooses just one toy. Probably not the fanciest or most expensive, but it’s the one that he wants. He cherishes it and plays with it every day. It might wear out eventually, but even then he’ll repair it and keep playing with it.

The Batman titles have become home of the spoiled kids. Every writer wants all the toys, but doesn’t play with them well. First in Batman was Hush, where Loeb and Lee brought out every character they could get their hands on. Immediately after that was Broken City, where Azzarello and Risso, not to be outdone, trotted out an impressive list of villains themselves. Switch over to the current storyline in Gotham Knights current storyline, and once again villain after villain is being added to the storyline. That’s three storylines in one year that feature most of the heavy-hitters from Batman’s rouge’s gallery.

Isn’t it about time that the Batman writers and editors realize that quality is better than quantity?

Bring back the second kid; the one who cares about his toys.

As I’ve mentioned repeatedly in previous posts, I have been unimpressed by recent storylines in the Batman titles. Wouldn’t it be nice to know beforehand exactly how bad a particular story arc is going to be?

I hereby introduce S.C.R.U.B.S. (Scoring Concerning the Readabilty/Unreadabilty of Batman Storylines). It is a scoring system designed to give a quick determination of whether a particular Batman title storyline is going to be particularly bad. It is not designed to identify good storylines, just highlight the ones likely to be bad.

Scoring is easy, consisting of 4 areas of considerationsfor Basic SCRUBS (length of storyline, identity of Batman, side-kicks/guest stars and villains). Special modifiers are added in Advanced SCRUBS. The Basic SCRUBS score can be figured out from advance solicitations and no significant advance knowledge is needed. The Advanced system is more accurate, but requires more in-depth knowledge of the storyline. Once the Basic or Advanced score is determined, the Final Score table will show whether the storyline is worth reading. Scores are also comparable to one another: a storyline with a score of 14 is worse than one with a score of 7, and a storyline scoring 31 will be much worse than either of them.

Examples:

• In Knight Moves in Batman: Gotham Knights (#38-40), a 3-part storyline where Batman and the Huntress fight Checkmate before the Huntress ultimately agrees to join the organization. This would score 10 points: 3 points for number of issues, 2 points for the Huntress (as she was a major character ), and 5 points for her acting out of character.
• Batman: City of Lights would score 18 points. 4 points for being an 8 issue limited series, +3 for Batgirl (as she is a main character), +4 for a new villain, +2 for the death of a minor character, and +5 for Batman acting out of character.
• I don’t even want to calculate the score from Hush

With just a little work, this system could be adjusted to fit other super-hero titles as well. Reading Previews will give us enough for Basic SCRUB scores, and reviewers could put Advanced SCRUB scores in their reviews. With the use of SCRUBS, bad Batman storylines can be avoided!
(I admit this is tounge in cheek — mostly — but I still think it could work.)

When I interviewed at Saint Louis University School of Medicine, one of the things that most impressed me was this enormous room filled with a variety of anatomical mannequins. I had been worried about learning how to draw blood and perform other procedures on frail old ladies, but clearly this room was the answer to my concern: we would learn on mannequins.

Of course, I was wrong. We only used that room once, and then just for the OB practical exam. On the other hand, we didn’t have to learn to draw blood on little old ladies; we learned on each other.

In the middle of our second year of medical school, it was time for us to learn to draw blood. A full six-hour Glucose Tolerance Test was to be run on every student, and we were going to draw the blood for the test ourselves. A glucose tolerance test is an older test used to diagnose diabetes or similar problems with sugar metabolism. It is used most commonly in pregnant women in their second trimester to test for gestational diabetes. A standard sugar load is ingested and then the blood sugar level determined at regular intervals afterwards.

The class was divided into thirds; the first third went Monday, the second, Tuesday, and the third on Wednesday. As usual, I ended up in the first group.

Early Monday morning we showed up at the second floor histology lab. We were given a glass of Glucola to drink based on our weight. Glucola is this sickly sweet syrupy beverage that gives a specific sugar load. Ours was this cloying root beer flavor and was one of the most disgusting things I’ve ever had to drink. It took all my effort not to gag, but I managed to get it down.

An hour later, and then every half-hour after that, we had a tube of blood drawn. We would take turns and draw blood from each other. Watching the other students, you quickly learned who you wanted, or more importantly did not want, to draw your blood.

The first draws were the hardest. My classmate would rest their arm on the table, and I’d wrap a rubber tourniquet around the upper arm. They’d pump their fist a few times to make the arm veins stand out. I’d poke around with my finger to make sure I found a good vein that wouldn’t move or roll on me. I’d swipe the skin with an alcohol swab to kill any germs. Taking a needle and a vial, I’d carefully slide the needle into the vein and pop the vial onto the back of the needle. Once the blood was flowing well, I removed the tourniquet so they wouldn’t get a large hematoma when the needle was withdrawn. After the tube of blood was full, I carefully pulled the needle out. The needle is razor sharp and can cut the skin fairly deeply if it’s pulled out at the wrong angle. A bandage was applied, the vial was labeled and turned in, and then it was my turn to grit my teeth and be the patient.

The blood draws at the end of the day were easier because I could follow the previous needle marks — just like runway lights — and find the vein easily.

Six hours and eleven blood draws later we were done. We had learned how to draw blood, and would learn the next day whether any of us were diabetic (nope). As I climbed in my car for the drive to my apartment I prayed that no cop would pull me over, because he’d never believe my story about the needle marks up and down both arms.

Drawing blood is not a skill I use frequently. There are trained medical technicians and phlebotomists who do the job much better and quicker. However, there have been situations when labs were needed immediately or when I was the only one available that have made me glad that it’s a skill I possess.

The United States Postal Service team handily won the team time trial today at the fourth stage of the Tour de France, catapulting Lance Armstrong into the lead and the coveted yellow jersey. Former teammate (and now competitor) Tyler Hamilton also did well, but Jans Ullrich fell far behind for this early in the Tour.

There are still several stages left that favor sprinters before the mountain stages begin, so Armstrong will probably lose the lead in the next day or two. Baring catastrophe, he should be able to regain the lead on the mountain stages.

This is a good beginning to the Tour for Armstrong and the rest of the Postal Service team.

Since I have some vacation I have to use before the end of August, the Polite-wife and I have decided to attend the Wizard World Chicago convention in August (well, I decided to go and she — for some reason — has decided to accompany me).

I attended the Chicago Comic-con several times in the ealy-90s, but no big conventions since then, so it should be an interesting change experience.

If anyone else is planning to attend, let me know…

Please note: Using big words does not make you seem smarter, especially if you put them together in an apparently random fashion. This applies not only to reporters, fiction writers, (probably some bloggers), but also to game designers.

This particular passage from last month’s issue of Dungeon (#112) caught my eye:

The entire room is dark gray, and the walls and ceiling seem almost to loom with an oddly latent malignancy.

Does this description make sense to anyone? Malignancy I can understand, but what makes it latent? And then, if it is a latent malignancy, what makes it so odd? I would consider all latent malignancies odd, but apparently that’s not the case.

Laura’s experience with blood draws is a common experience.

There are some abilities in the medical field that are more art than skill in the hands of an expert. Blood drawing is one of those abilities.

Some people are simply horrible and cannot draw blood. It’s clearly a skill they lack. I admire their persistence, but please find another job that doesn’t inflict as much pain on innocent people. On one occasion, I’ve had to stop the phlebotomist at the blood drive (With a “You know there’s a nerve down there, too?” spoken between gritted teeth) and place the needle myself.

Others people are experts, and could probably get blood out of a turnip. In my experience, the best individuals at drawing blood are anesthesiologists and pediatric nurses, especially those from the nursery. However, the best phlebotomist I’ve ever seen in action was a secretary.

There was an elderly gentleman on the floor. He was having a rough night and I desperately needed to draw blood from him. He had just lost his IV, and none of the nurses could get a blood sample or place the IV. Expert nurses from the ER and pediatric floor were called, but their luck was no better. Anesthesiology tried and failed. I was at the front desk discussing the possibility of a central line with the nurse and anesthesiologist when the floor secretary got up, washed her hands and walked into the patient’s room. Two minutes later she came out with two tubes of blood and told us his IV had been replaced. As we all stared at her in open-mouthed shock, she nonchalantly resumed typing orders into the computer.

I never did figure out her secret.

JSA #62 Redemption Lost, part 3
Geoff Johns, writer
Don Kramer and Tom Mandrake, pencilers

After a battle with the Spirit King, Mr. Terrific collapses and stops breathing. Dr. Mid-Nite and Hourman rush him into the nearby medical clinic.

Hourman: Is he–?
Dr. Mid-Nite: Breathing again. His pulse is fluttering. He’s having a heart attack.

There appears to be a common misconception here. Heart attacks and cardiac arrhythmias (bad heart rhythms) are two entirely different things. A heart attack is caused by the death of part of the heart muscle, and an arrhythmia is caused by a problem in the conduction of the heartbeat itself. Both can be fatal. Bad heart rhythms don’t cause heart attacks, but heart attacks can sometimes cause bad rhythms.

Dr. Mid-Nite pulls out the defibrillator and shocks Mr. Terrific’s heart back into a normal rhythm, but this does nothing for the underlying heart attack. Other than placing Mr. Terrific on oxygen, Dr. Mid-Nite never treats the heart attack itself (no aspirin, no nitrates, no beta-blockers, and no “clot-buster” drugs). Ideally, Dr. Mid-Nite should be treating both the arrhythmia and the heart attack.

Lingering concerns:

1. If his “pulse is fluttering”, why is the heart monitor showing a flatline? Any rhythm strong enough to create a pulse would be visible on the monitor.
2. The nasal cannula is drawn much better than normal (almost correctly).
3. I’m unclear on why Mr. Terrific was having a heart attack in the first place. He was attacked by the Spirit King (using the Flash’s body), but he managed to get his own licks in at the end of the fight. The Spectre intervenes, and suddenly Mr. Terrific is unconscious in Hourman’s arms. Was there a clot? Was it the trauma? He did receive a solid blow to the upper chest, could this have ruptured some coronary arteries? Or was it John’s incorrect assertion that a cardiac arrhythmia (most likely caused by trauma) caused aheart attack?
4. I hope the JSA has good health insurance. Mr. Terrific is the second member to suffer a heart attack. Dr. Mid-Nite himself experienced one in JSA #19 after looking into Johnny Sorrow’s face. At least they both healed quickly.

On the non-medical side, I felt this issue was a bit of a let down. The two issues leading up this had been strong, and the zombie attack was (of course) great. Having the Spirit King possess Jay Garrick again and then attacking the new Mr. Terrific was a stroke of genius. Then the issue ends with a deus ex machina courtesy of the Spectre. I’m not fond of deus ex machina in my comics, but if it’s going to happen, it should be because of someone on the team, not a visiting player. Ultimately, the JSA served no purpose in the story arc other than getting themselves beat up.

After realizing that both Mr. Terrific and Dr. Mid-Nite had suffered heart attacks, I began to wonder exactly how many injuries JSA members had suffered. Digging through my comic boxes, I dug out my issues and added up the totals.

My research showed what I suspected; it is very dangerous to be a member of the JSA (especially Wildcat, who seems to be a magnet for injury). Maybe not as dangerous as being a red shirt aboard the Enterprise, but close. It’s also dangerous just being an associate of the JSA.

This list covers JSA issues #1-62, JSA Annual #1, JSA: Our World at War, and Hawkman #23-25 (the Black Reign crossover). Main characters are in bold, associated characters are in italics.

Sorry for the late ramble today. A quick and nasty thunderstorm blew in and knocked out our power for much of the afternoon. Most of the weekend has gone toward outdoor tasks. I’ve been working on building a butterfly garden in the backyard. When we moved in late last summer, the air was thick with Viceroy butterflies. I hope to entice them back by builing a nice garden for them. I’ve ordered some native plants especially for butterflies from the Missouri Wildflowers Nursery. I got the garden laid out and hand tilled most of the soil yesterday. Today, I dug out the rest of the ground and started placing the edging. Then the rains came. Hopefully it’ll be dry enough tomorrow for me to finish the edging and start laying in some top soil.

Sunday Blog-o-Bits:
1. The Tour de France continues. Lance Armstrong maintains sixth place, 9 minutes and 35 seconds back, but watch for his comeback once the Tour hits the mountains. OLN did move their daily coverage back and hour ’til 8PM central….arrgh!!

2.A nice brawl in NASCAR today. In all my years of NASCAR watching, this is the first actual baseball worthy bench-clearing brawl I’ve seen. An occasional tantrum, punch, or scuffle, but never a full brawl.

What’s wrong with this picture? (Cropped from the cover to Emma Frost #10, art by Greg Horn)

I was reading this month’s Dungeon Magazine (#113) where I noticed they had poster map of the new D&D campaign world, Eberron . What little I’ve read of Eberron sounds intriguing. Then I saw the name of the continent on the map: Khorvaire.

Khorvaire? What’s the other continent? Edsel? Pinto?

I can only assume it’s unsafe at any speed…

(I’m not really showing my age here; our next door neighbors had a Corvair when I was growing up in the 80s. I actually thought it was a pretty cool car. This was long before I had ever heard of Ralph Nader and his original claim to fame.)

Batman: Gotham Knights #53
A. J. Lieberman, writer
Al Barrionuevo, penciler

In this issue, Hush joins Dr. Mid-Nite as one of the few physicians portrayed in comics who are actually shown practicing medicine.

Hush travels to Star City, where he rescues Prometheus from a battle with Green Arrow. Green Arrow had shot Prometheus 3 times: once in each shoulder and once in the thigh.

In a hotel room, Hush initially has Prometheus icing his shoulder, and then encases his whole body in bags of ice. An IV is placed and running some sort of fluid. Hush removes the arrows and sews up the incisions. He injects Prometheus with morphine to kill the pain.

First, Hush has good suturing skills. He gives an excellent demonstration of vertical mattress sutures.

Sutures come in two main varieties: running and interrupted. In a running suture, a knot is tied at one end of the incision, enough stitches are placed to close the wound, and then a second knot is placed at the far end. Running sutures are fast and not as irritating to the body as interrupted sutures (there are fewer knots). Therefore they are good when speed is an issue, or internally when fewer knots are better. On the other hand, running sutures aren’t as forgiving, and one break will re-open the entire wound.

In interrupted sutures, each stitch is tied and knotted separately. Interrupted sutures are easier to line up and give better cosmetic results. They are slower to tie, but sturdier because one stitch can break without affecting the others.

Hush is using a special type of interrupted suture known as a vertical mattress suture. These are good for closing gaping wounds without putting undue pressure on the incision (note that the knots are not over the incision). They can leave a bigger scar sometimes and can be a pain to take out, but are a good choice in this instance.

I’m unsure what the purpose the ice is serving. There is anecdotal evidence that lowering a patient’s temperature slows bleeding, but if it is lowered too much the bleeding worsens. The temperature must be tightly controlled, not like it is here. More importantly, individuals who have lost a great deal of blood are at increased risk for hypothermia, so icing Prometheus is not a good call.

Finally, it would be a lot easier on Hush if he’d just inject the morphine in the IV already there, rather than trying to inject the vein.

A childhood love, but still one of my favorite candies. Large amounts of caffeine and Smarties helped me survive my ER night shifts during residency. I keep a jar of these around the house to stave off the occasional hunger pain.

As any true Smarties afficionado will tell you, you have to eat them in the proper order. I prefer white-orange-yellow-green-purple-red.

A note to European readers: Smarties here in the U.S. are much different from the European candy-covered-chocolate treat of the same name.

My most common diagnosis of the past two weeks has been poison ivy. I didn’t see much of it when I was stationed with the Air Force in Nevada (which makes sense, because “poison ivy” and “desert” don’t exactly go together). But here in Illinois I’ve been seeing a lot of it. At least 2 or 3 patients a day for the past two weeks.

Most people just have a few spots, but some have severe rashes. I’ve seen poison ivy in the eyes, nose, mouth, and less pleasant-to-mention places.

Treatment is straightforward and easy, but I still itch for at least an hour after seeing each patient.

Prevention is the key word. “Leaves of three, let it be” is still good advice. If you get some of the sap on your skin, wash it off with lots of soap and warm water. Pay special attention to under the fingernails, and wash the clothes in hot water because the sap can remain on the clothes for days.

As part of the third year of medical school, each student had to take a 3-month Surgery rotation. There were 3 choices for your Surgery rotation. You could choose Group A (the “I know I want to be a surgeon” group), Group B (the “I may want to be a surgeon” group) or Group C (the “no way in Hell am I going to be a surgeon” group). I was the poster child for Group C.

My 3-month rotation was made up of one month of Pediatric Surgery, one month of General Surgery at the VA hospital, and two weeks each of Vascular Surgery and ENT Surgery. The Pediatric Surgery was intense, but at least we were not expected to take call. The residents were fun to work with and the attending physicians instructive. The VA rotation was easily the most miserable month of my life. Unfriendly residents, unpleasant physicians and a grueling call schedule. I found Vascular Surgery interesting, and the surgeons were friendly and helpful. I was able to do my first stitching of a real patient during this rotation. The ENT rotation also went smoothly. I had bartended the ENT Christmas party the year before, so I knew all the residents and instructors (and how much they drank).

In addition to the surgeries and routine patient care, there were daily lectures, monthly multiple-choice exams, a 12-page paper, and a take-home 60-question test. We were supposed to study for exams, write the paper and answer the questions in the free time we had left over from our 16-hour days at the hospital. I would get home at 9 PM, study and write for an hour or two then climb into bed and fall asleep, only to wake up a few hours later to get back to the hospital for pre-pre-rounds at 4 AM.

The take-home test consisted of the same 60 questions that had been used every year for at least the last decade. If you knew the right people, you could get answers to the questions that had been handed down from student to student for the same length of time. Dr. K-, the chairman of the Surgery Department, graded each set of answers. Rumor had it that he just picked 10 random answers and awarded a score based on those answers alone. Almost everyone received a score of 7/10 or 8/10.

I didn’t know the right people, but one of the other students on my VA rotation did. Unfortunately she discovered that the answers were on three diskettes and she did not have a computer. Being the nice guy I am, I offered to print out the answers for her as long as I could copy the diskettes. She agreed and I was in business.

The first sign of trouble was when I realized that there were nearly 100 files on the diskettes. Whoever had written the answers had saved each page as a separate file. They had saved some as text files, some as RTF, and some as DOC files. Sometimes different formats for the same answer.

Then, as I printed out each page for the other student, I would skim the answers. My heart sunk as I found mistake after mistake. Not subtle mistakes, but obvious ones — like having the heart on the wrong side of the chest. I found that I had to read each answer closely, carefully ascertain which portions were right and which were wrong, and then correct each mistake I found. It was a tedious process, but after two weeks of hard work the test was finished.

As I turned in my answers, I realized that I had spent more time poring over answers and correcting mistakes than I would have if I had just answered the questions on my own. Truly crime does not pay.

On the bright side, I scored a 9/10, where everyone else using the same answers scored a 7/10.

I’ve just upgraded to Comicbase 9. I’ve only been using it for a couple of days now, but I’m not sure how much I like it.

For the five years I’ve been using Comicbase, I’ve always been pleased with it. The new version has a fairly drastic change to the basic look of the program. No longer are there two pages per title (one with cover images, one with issue information), but one page that includes all the information. The interface is more streamlined, which I definitely appreciate. The speed, however, seems to be slower. This is particularly an issue when I exit the program and the database is backed up. This process now takes nearly five minutes and most of my processor cycles. I can’t do much else but wait for it to finish.

The new features look interesting. I haven’t played with the “higher-definition pictures” much, but I look forward to being able to track multiple connections. I also need to learn how to sync it with my PDA.

First impression: Nice extras, prettier pictures, but slower.

If you’re interested at all in politics, follow this link. It leads to a short quiz that allows you to compare the views of 4 different political parties (Democrat, Green, Libertarian, Republican) on 7 issues. The trick is that the views are not labeled by party, so you are just looking at position statements and choosing the one you agree with the most. Do the short version first (takes about 10 minutes), then the long version (takes maybe 5 minutes, because you did all the hard reading the first time around) which gives you a score regarding each party.

Fascinating. Showed pretty much what I expected (mostly left with a fair amount of libertarian and green), though a little more skew to the right than I had anticipated.

(Brought to my attention by the fine folks at AMCGLTD.com)

My first issue of the new monthly Comic Buyer’s Guide arrived today, horribly mangled by the postal service. I haven’t read it front to back yet, but I’ve read enough of it to form some definite opinions.

At 290 pages, the magazine has a definite heft to it, and the binding is nice. It’s clearly designed for the magazine rack. The title is large and there’s a prominent picture of Spider-Man on the front. The front cover blurbs were a little “magazine-y”. Examples: “Are comics shrinking? Analysis inside!” and “The Purr-fect Guide to Screen Catwomen.”

The interior layout is improved with cleaner fonts and better graphics. About half the pages are black and white newsprint, while the rest are a heavier color stock. Page numbers are prominently displayed, and the ads – even the cheesy ones – are better looking than ever.

Nearly every columnist has migrated from the weekly edition to this monthly one, with an appropriate increase in page count. Tony Isabella does well with his pages, and Peter David’s column, while interesting, would have been better served at half its length. It’s particularly nice to see “Mr. Silver Age” on color pages, but it seems a waste for Captain Comic’s “Canceled Comics Cavalcade” to be in color while the rest of his column is in black and white. The letter pages are still included, but are now located in the back. I guess that’s more traditional for comics, but I always liked them up front. The comic strips are back, for better or worse, though I didn’t see any Fred Hembeck.

The review section has increased in size. With nearly instantaneous reviews available online, monthly reviews strike me as archaic. In general the reviews online are longer and more in-depth than the blurbs available in the CBG. I’d rather see the space used for more columns or historical articles. The manga/anime section has also increased in size, but should still be several pages longer.

There were several interesting feature articles. The best concerned the actresses and voice actresses who have played Catwoman, while the one relating the history of Catwoman was far too superficial. The section on comic book movie trailers also struck me as too superficial and uncritical.

My biggest concern with the monthly magazine is the inclusion of the price guide. Do we really need this on a monthly basis? A price guide just reinforces the idea that comics exist mostly as a collectible item. It also takes up nearly one-third of the magazine. And is a price guide for super-hero collectible card games really necessary?

Overall it is an impressive looking magazine. Production values are clearly improved, and content essentially the same as the weekly incarnation, only more so. There seems to be a concerning trend toward the superficiality in articles; I’d rather have fewer longer articles than more short ones. At this point I can’t recommend it over the weekly version, but I’ll certainly give it a few more months to catch its stride before I decide for sure.

Sir Isaac Newton was a man ahead of his time. Not only was he one of the leading scientists and mathematicians of the 17th century, but he also foresaw today’s top-heavy comic book storylines. His famed Laws of Motion not only apply to basic physics, but also to comic book storylines.

1. Inertia – A bad storyline will always be a bad storyline.
   Corollary: A good storyline will not always stay a good storyline, but can quickly degenerate into a bad storyline. (This is mostly due to the Second Law of Thermodynamics: “entropy increases”.)
2. F = ma – The Force to publish a story is equal to the Marquee Artists involved. The more big names attached to a project, the more likely it is to get published despite the storyline. See also Doom Patrol, X-Force, Batman: Hush.
3. Action/Reaction – For every good storyline on a given topic, there will also be an astoundingly bad one. Consider that for every good Mystique storyline on bio-engineered viruses, there must also exist a Cable/Deadpool.

Aquaman #19 American Tidal, part 5
Will Pfeifer, writer
Patrick Gleason, penciler

Using some of Aquaman’s DNA as a template, mad scientist Geist has made a “self-replicating strand of DNA” and introduced it into San Diego’s water supply. His plan is to give everyone gills to save them from a coming environmental disaster.

Brilliant idea, only it won’t work.

First, there is the matter of isolating the correct part of Aquaman’s DNA. How does Geist know which of the genes in Aquaman’s DNA are responsible for breathing underwater? There are 46 chromosomes and each chromosome contains tens of thousands of genes. How does he know which gene (or genes) it is?

Assuming that Geist did isolate the water-breathing gene and replicate it, his plan still won’t work. Putting DNA (even self-replicating DNA) into the water supply will get nothing but digested and excreted DNA. We eat and drink many foreign DNA particles every day, but nobody’s started expressing cow genes or kiwi genes.

The DNA needs to be delivered to the correct part of the body for it to work. Getting gill DNA into the spleen wouldn’t do any good; the gill DNA would need to get to the respiratory system. The gene would need to get into the respiratory cells, and then into the cells’ nuclei and incorporated into the chromosomal DNA. Loose strands of DNA floating around are ignored by the body; to be useful they need to be hooked up into the cells’ genetic machinery.

In a nutshell, this situation is the problem with gene therapy. Scientists have identified the broken genes in many diseases such as sickle cell anemia, muscular dystrophy and phenylketonuria. They even have correct copies of the genes. But how can you get the improved genes to the right cells in the people who need them and have them work properly? No one has come close to figuring that out yet.

Assorted nitpicks:

1. I don’t even want to know what he’s injecting down Lorena’s naso-lacrimal duct, or why. Since the duct opens into the throat, injecting into it would do nothing but get his concoction into her throat. Why not just pour it down her mouth in the first place?
2. Then he listens to her heart with a stethoscope, but puts his ear on her chest to listen if she’s breathing. You have a stethoscope buddy, use it. She has gills now so her lungs wouldn’t be working anyway.

Two recent comic books have dealt with poisons produced by various members of the animal kingdom.

First, in 1602 #3, Clea is leading Peter Parker through Dr. Strange’s house. Indicating a porcupine fish, she says:

That fish, when dried and ground, causes a man to become insensible and to feel no pain.

Porcupine fish, pufferfish and related fish contain a poison known as tetrodotoxin. It is a very potent neurotoxin (nerve poison). In low doses it causes a tingling and numbness of the tongue and mouth. Higher doses cause tingling and numbness of the face and extremities and then paralysis of the limbs. Higher doses yet cause worsening paralysis, difficulty breathing, and a drop in blood pressure. Mental impairment, convulsions, cardiac arrhythmias and death may occur. The line between a safe dose and a toxic dose is very thin and easy to cross.

Tetrodotoxin does cause a numbness, but it’s the “I hit my funny bone and now my arm is tingling and numb” kind of numbness. That’s quite a bit different from feeling “no pain.” At extremely high doses, that kind of anesthesia may be possible, but so is death. It’s not a chance I’d recommend taking (but then I’m not the Sorcereor Supreme). As a side note, I’m unclear if drying the fish would have any affect on the toxin.

In Harley & Ivy #2, Poison Ivy defeats Burn by pelting him with mud containing Poison Arrow frogs. He keels over and lies rigid in a mud puddle. Glaring at him, she says:

Just touching one brings instant paralysis. You’ll be able to move again in a couple of hours.

Ivy is overstating the power of the frog’s toxin. Different Poison Arrow frogs (also known as Poison Dart frogs) have different toxins. The most potent, batrachotoxin, is extremely powerful. A single frog has enough to kill 50-100 people. However, the toxin needs to get into the bloodstream to work. The toxins cannot be absorbed through the skin unless the skin is cut or otherwise broken open. There are differing opinions whether swallowing the poison has any affect.

The skin around the mouth (and skin in more “southern” regions) is better at absorbing medications, so a couple of frogs to the kisser may have gotten the toxin into Burn. I’ll give Ivy the benefit of the doubt, but even then the toxin wouldn’t work instantaneously, it would take several minutes to kick in.

She’s partially right about the symptoms. Low doses of bratrachotoxin cause irreversible muscular contractions; higher doses lead to cardiac arrhythmias and death. Some of the less potent frogs contain weaker toxins cause the muscular paralysis she describes.

It has come to my attention that hospital computer programs are either:
1) Created by a programmer who has no knowledge of medicine, or
2) Created by someone who knows medicine, but has no knowledge of programming.

Our hospital recently instituted a new computer program to record patient information. Before, there was a 1 page sheet in the chart that showed al the pertinent vital signs: temperature, blood pressure, pulse rate, respirations, daily weight, intake, output and so on. Sure it was hand written, but it was simple to find and simple to read.

Now, the computer prints out a daily summary for the patient. This contains the identical information that has always been available, but in 6-pages of computerized printout. Same information, thicker charts, harder to find data. Just because something can be computerized doesn’t mean it should.

The printout is full of useless charts and graphs. My favorite is the computerized temperature graph that is printed at the top of the first page. The temperature scale runs from 80 degrees to 107 degrees. 80 degrees! I’ve never seen a temperature under 95. And on the other end, 107 degrees is way too high to be practical. If the patient does spike a fever, it still shows up as a straight line because the scale is so poorly thought out.

I’m sure there is a good program out there somewhere. And in ten years, we just may have it here.

The Polite-Nephews are in town this week. Like all of the Polite-Wife’s family, they hail from Nevada. They’ve never seen a cornfield or a herd of cows. The Midwest has been quite a change of pace for them. I think their favorite activity so far has been catching fireflies at night.

The older nephew, at age 12, has just started to appreciate comic books. From movies and TV, he was aware of Spider-Man, the Hulk and a few others. He spent the first several days here paging through my collection of trade paperbacks.

As a treat, when we went to Springfield today (to visit the Lincoln historic sites), we swung by one of the comic book shops there and let him pick out a few issues of his own. He was a little miffed when the Polite-Wife checked out the ratings on each book he wanted to make sure they were age appropriate. It was the first time that I had shopped for comics with a child, and the ratings did help us purchase appropriate titles. Ultimately, we ended up with several issues of Justice League Adventures, Spider-Girl, and Shonen Jump. (As for myself, I ended up finding complete runs of How Loathsome and Pirate Club.)

Now he wants to stop at comic shops when we visit St Louis next week. I think we’ve created a new comic book fan. Christmas shopping just got easier.

To: Marvel Comics
From: Scott
Subject: Witches #1

Please put me on your mailing list regarding arbitrary character changes.

Last I remember, Jennifer Kane was a scantily-clad heterosexual with a chunky boyfriend (Legion of Night). Now she’s apparently a lesbian, though still scantily clad. Certainly people come out of the closet all the time, but despite following Dr. Strange’s tales closely I must have missed the memo on this one.

Once upon a time, Topaz was a platinum blonde empath brimming with confidence (Dr. Strange: Flight of Bones and Strange Tales Vol. 2). Now she’s a raven-haired dark-skinned mystic of unclear ethnicity and poor self esteem. Changes in sexual preference I can understand and accept, but changes in personality and ethnicity?

If an ethnically and sexually diverse team is needed, then create some new characters. Don’t simply rewrite older characters to fit the need of the moment. Some of us like our continuity.

During residency, one of my favorite mindless pursuits was watching One West Waikiki. It was originally broadcast on CBS in 1994-1996, but I ended up watching it late night on the Lifetime Channel.

One West Waikiki was a police drama set in Hawaii concerning police detective Mack Wolfe (played by Richard Burgi, later to play The Sentinel) and medical examiner Dawn Holliday (Cheryl Ladd). Imagine Crossing Jordan set in Hawaii — without the angst — but with a strong cheese factor thrown in.

It was a great show for a mind not in the mood to think.

UPDATE: Look…One West Waikiki Fanfic!

What’s wrong with this picture (from JSA #17, art by Sadowki & Bair, words by Goyer & Johns)?

JSA #10 Wild Hunt
Geoff Johns and David Goyer, writer
Steven Sadowski, penciler

This is not really a medical review as much as it is a common sense review.

As this issue of JSA begins, Wildcat is taking a leisurely bath, recuperating from wounds suffered in previous issues. Note that in the picture to the left, he is clad only in a towel with his left arm in a cast.

(Why was he soaking in the bathtub while wearing a cast? That’s just asking for trouble. There’s nothing worse than getting the padding under the cast wet…bleah! But that’s only a side issue.)

The Injustice Society attacks the JSA headquarters, but Wildcat manages to defeat them one by one and drive them off. As the picture on the right shows, during the battle he not only manages to put his costume on, but manages to put it on underneath his cast!

Apparently misogyny and pugilism are not Wildcat’s only talents.

Ilyka provides us with A Purely Feminine Perspective on Spiderman 2, in which she takes issue with Mary Jane’s portrayal in the movie, focusing among other things on Kirsten Dunst’s hairstyle, nose, and propensity for wet clothing.

‘Nuff said.

Lance Armstrong took back the lead today in the Tour de France with 5 stages left. While his performance in the recent stages have been formidable, the bigger issue has been his lack of competition. At this point only Ivan Basso is really close enough to challenge him. Potential challengers Iban Mayo and Tyler Hamilton have dropped out of the Tour, and Jan Ullrich is nearly 7 minutes back.

Still, two of the five remaining stages are time trials, and that should make for some exciting riding.

Just finished reading JLA #100 and all I can say is bleah!

Contrived plot, needlessly convoluted story telling, absurd characterizations, and poor medicine. I can’t believe that I actually preferred the Claremont/Byrne run and now I’m looking forward to the next issue by Austen. Wow, never thought I’d type that phrase.

I’ll try and present my complaints more coherently after I recover.

Captain America and the Falcon #4 Two Americas, conclusion
Priest, writer
Bart Sears, artist

While Captain America battles a fake Captain America in the middle of a hurricane, the Falcon (Sam Wilson) contacts Robbie Robertson about a mysterious drug known as AVX used by the fake Captain. Robbie tells him:

AVX was some kind of cellular regeneration formula — a super steroid…AVX is water soluble – the body can’t store it – he’d sweat it out in time – like Vitamin C.

Twice more the reader is informed that for Captain America to succeed, the faux-Cap needs to sweat the drug out of his system.

Vitamin C is indeed water soluble. However it is not excreted to any appreciable amount (if at all) by the sweat glands. Like most medications, the kidney does the bulk of the work excreting the drug. The only reference I could find to sweating out vitamin C was in a single dubious looking “nutritional” website. All of the medical texts and articles I could find referred to renal (kidney) excretion.

Unlike vitamin C, anabolic steroids are generally water insoluble, so the idea of sweating them out makes even less sense. Like vitamin C, steroids are excreted by the kidneys.

To give Priest some credit, as mentioned in previous posts steroids (like hormones) are a good medications for transdermal administration (patches).

Kinetic #4 Mom
Kelley Puckett, writer
Warren Pleece, artist

This issue of Kinetic, as the title suggests, focuses on Tom’s mother. The first part of the issue shows how Tom’s illnesses have hampered her social life. She returns home from her date and prepared his medicine only to come across Tom lifting the heavy furniture as if it were made of paper. In dealing with Tom’s miraculous recovery, she shows denial, then anger, then acceptance. She realizes that with Tom’s improvement in health, she is able to have a social life again. But still, at the end of the day, she comes home to pick up Tom’s mess.

The story continues its very slow progression. Nothing new is revealed of Tom’s abilities this issue, where he is more of a peripheral character than a star. The art is properly subdued yet still manages to be expressive. The limited palate helps to emphasize the story, rather than hampering it as in other Focus titles. Kinetic continues to be an fascinating and well-written title, but I am concerned for its continuing existence given the slow extinction of the rest of the Focus line.

In terms of medicine, Tom and his mother hypothesize that the reason he had a seizure in the end of issue #2 is that his condition was improving, and the medicine actually caused the seizure. This suggests that he is on carbamazepine (Tegretol), the only common seizure medication that can — in the right circumstances — cause seizures. Other seizure medications do not cause seizures. They are actually used quite commonly for conditions including migraine headaches and chronic pain.

My review of Kinetic #1 and #2 are here, and #3 is here.

While a physician in the Air Force, I was proud to be the doctor assigned to the 820th RED HORSE squadron. A unit of combat engineers, in peacetime they performed charity missions in various poor countries around the Caribbean and South and Central America. On deployments to nice places, I provided telephone medical support. However, when the squadron was assigned to particularly unpleasant places, I got to go along.

So it was that I found myself deployed to a tent city in a muddy field outside the airport in Cap Haitien, Haiti with 80 RED HORSE personnel and 30 Army MPs. Our mission was to perform major construction and electrical repairs to a local orphanage. The RED HORSE medical team consisted of me and Technical Sergeant K-, an experienced and easy-going medical technician. We had a hospital tent, several crates of supplies, and an ambulance.

On most days, TSgt K- would drive to the job site on the far side of town, while I stayed at camp. However several times a week I would find myself driving the ambulance to and from the job site. Despite the fact that I had free reign to use both the ambulance’s sirens and loudspeaker, I loathed the days I had to drive.

First, the Haitian roads are horrid. Foot by foot they randomly change between pavement, dirt, gravel, or mud. Potholes are extremely common. Not your run of the mill potholes, but ones deep enough and sharp enough to easily blow a tire. As if that weren’t bad enough, the roads were extremely narrow and twisting with rusting cars parked haphazardly and livestock wandering up, down, and across the streets.

Second, I drive a small car. I like small cars. I hate driving large vehicles with a passion, yet here I was driving through the streets of Cap Haitien in a wide bulky ambulance.

All was going well until one fateful afternoon when we were heading back to camp. An Army Humvee was leading the caravan followed by a dump truck, two deuce-and-a-halfs and then me driving the ambulance. A second Humvee brought up the rear.

We left the orphanage and drove through the streets without incident. As we neared the airport, we turned onto a side road leading to our camp. The airport was surrounded by an 8-foot tall chain link fence. We would drive through a gate in the airport fence then take a turn and pass through a fence of concertina wire before entering our camp. At least, that was how it was supposed to go.

I misjudged the airport gate and there was this horrendous metal screech as the passenger door of the ambulance encountered the gatepost in the chain link fence. There was a momentary pause, and then the ambulance surged ahead on its way without slowing. I was embarrassed, but relieved since it appeared that no significant damage had been done. Then I glanced in the rearview mirror and noticed the gunner in the Humvee behind proudly holding up my passenger side mirror over her head like a trophy of war while grinning from ear to ear.

TSgt K- drove the ambulance for the remaining month of the deployment.

What’s wrong with JLA #100 can be summed up in one sentence describing the plot of the issue:

Faced with a vague and dubious threat, the JLA decide the only way to defeat it is to lie to the entire world.

To expound upon this theme:

1) The Storyline:
Mother Earth is upset at mankind. We know she is upset because Major Disaster is crying. That’s not all! Sister Superior, leader of the Elite, strolls into the JLA headquarters and tells them that Mother Earth is angry. Major Disaster, a former villain, channels Mother Earth with an ability he’s never shown before and lets the JLA know that she is mad because mankind cannot get along with itself. She will destroy the world in 2 days unless things change. Wonder Woman agrees, saying that the records on Themyscira point out that Mother Earth has wiped out mankind many times before (though how anyone remained alive to take notes is never discussed).

Faced with this threat, the JLA decides its best course of action is to deceive the entire world secretly teaming up with the Elite in a plot clearly pilfered from Alan Moore’s Watchmen.

The next day, as the Senate is debating (though why they’re in the dome of Capitol is never explained, although that would explain why the room they’re in looks nothing like the Senate chamber), the Elite break in and attack. The JLA respond, but are soundly trounced by the Elite.

Wonder Woman appears before the UN explaining that the Elite are too powerful for the JLA to defeat alone and they need the help of the entire world to defeat them. Though apparently she means only the help of the world’s military – so much for a mission of peace. And what about countries like Luxembourg with no military, aren’t they going to feel left out?

The next time the JLA and Elite meet, both teams are teleported to some desert where the world’s military is standing in a circle. A circle so small that people cannot help but shoot each other, never mind the large weapons on the tanks and APCs. And the howitzers. And the airplanes flying overhead. Still the soldiers fire anyway. In the end, it doesn’t matter that the military is there at all, as it is the JLA that defeats the Elite. Mother Earth appears and says she is satisfied.

An age of peace settles over the Earth. The JLA lies again, telling the world that the Elite are so dangerous that they will be imprisoned in a secret prison in the moon, but they are really allowed to go free (and set up the Justice League Elite miniseries).

2) The Story Telling
In an attempt to appear clever, this story is told as a mix of current action and flashbacks. The only thing gained by this approach is so that the writer can pull a “gotcha!” at the end, surprising the reader with the fact the JLA and Elite were working together, something that was blatantly telegraphed for the last half of the comic.

3) Questions and Concerns:

• I find it hard to believe that the JLA, especially Superman, would so quickly and easily agree to lie to the world. The true extent of the threat is never determined; the JLA is depending on the word of some semi-villains and a reformed villain.
• How many times has the JLA been defeated by enemies at first, only to rise up and win on the second attempt? Hundreds! Why should the world believe that this time is any different? The JLA has defeated entire armies and space armadas, why should they need help against four opponents?
• What good are normal foot soldiers going to do against super-powered villains? The Human Defense Corp had special training and weapons and they still routinely got slaughtered.
• What kind of name is “Hat”? Have all other good names been taken so we’re down to items of apparel? I can see it now: “Look out, it’s the mighty Culottes!”
• We prove to Mother Nature that we can all get along by taking a large group and beating up on a much smaller group? So armies fighting each other are bad, but Mother Earth thinks bullies are OK?

JLA #100 Elitism
Joe Kelly, writer
Doug Mahnke, penciller

As the JLA and the Elite battle, Sister Superior describes Coldcast’s powers:

“A biological equivalent of an E.M.P. Shuts down neurons by rendering electrons inert.”

This makes little sense because electrons have next to nothing to do with nerve conduction.

Impulses are transmitted along neurons by the use of sodium ions. Impulses are transmitted between neurons by chemical messengers. Electrons are not directly involved in either process. It’s true that sodium ions have an absence of an electron that gives them a positive charge, but any phenomenon shutting down this process would kill people outright because sodium ions are crucial not only in nerves, but in almost every other area of the body. For example, the beating of the heart is controlled by sodium ions.

Plus, from a purely physics point of view, doesn’t messing with sub-atomic particles sound like a bad idea?

Lance Armstrong continues to dominate in the Tour de France. He won today’s final individual time trial by a commanding margin of over a minute.

He has all but won his sixth Tour de France, and this year seems his easiest win. Not only was Armstrong in excellent condition, but he had the benefit of the best team of cyclists in the Tour. Even more important, his chief rivals performed poorly for most of the Tour, with two of his main competitors dropping out entirely.

Tomorrow is the final stage as the Tour heads into Paris. Other than the sprinters vying for the green jersey, there is no real racing going on the last day. If you get a chance, watch the final laps around the Champs Elysees.

Strangers in Paradie #36 Requiem
Terry Moore, writer and artist

Anna has some questions about Strangers in Paradise #36 involving the fight to the death between Tambi and Bambi. The first involves Bambi’s kick to Tambi’s head, and the second concerns the end of the fight when Bambi is shot and subsequently dies.

In the beginning of the fight, Bambi lands an impressive looking kick to Tambi. Tambi is facing forward, toward the reader, but has her head turned towards her right when Bambi delivers a kick to the back of her head. Tambi rolls with the kick and gets right back up.

If Bambi’s kick had been more to the left side of Tambi’s head, she would have had a better chance of breaking Tambi’s neck. As it was, the kick she lands looks more impressive than it actually is. Plus, Tambi points out there is no strength behind it (and I quote: “You kick like a girl!”). As for what went “Krak”? It’s unlikely that it was Tambi’s skull or spine since she’s not showing any signs of injury, so it might have been Bambi’s leg (she’s on the ground for pretty much rest of the fight), or some really tough shoe leather. More likely it’s just a bad sound effect.

Later, Bambi is shot in the upper back and is seen clutching her left side with blood pooling behind her and more blood oozing out of her mouth.

Bullet injury depends a great deal on the velocity of the projectile. A high velocity projectile will go straight in and out. A lower velocity projectile can bounce around inside a person doing serious internal damage. Sometimes these bullets come out, but usually they remain inside. I suspect Bambi was shot with a low velocity bullet that did some significant left-sided lung damage. She’s clutching her left because of the pain and difficulty breathing on that side. The blood coming from her mouth is from this injury to her lungs. Most of her bleeding is coming from her back. She has some blood on her front, but most of this is due to her moving around after she was shot. Based on where she was shot, her aorta was probably injured and that’s why she’s lost so much blood and dies so quickly.

The Kesel and Kesel Hawk & Dove series remains one of my all-time favorite comic book series. In its 28 issue run there were several excellent issues, and Hawk & Dove #5 is one of those issues.

Two storylines compete in this issue. In the first, Hank Hall (Hawk) and his girlfriend Ren are enjoying day at the beach when Sudden Death, a minor league villain, tries to pick up Ren. He is unaware that he is trying to steal Hawk’s girlfriend and a nicely explosive battle commence. This is the first issue to hint at what is under Hawk’s costume, and it’s not exactly Hank Hall. Sudden Death makes another appearance a year or so later, but remains a wannabe villain.

Meanwhile, Dawn Granger (Dove) is recuperating from the flu and is visited by the ghost of the original Dove (Don Hall). The conversation between the two does a good job of showing how this Hawk and Dove series is firmly built on Steve Ditko’s original.

The script is by Karl and Barbara Kesel. The art is low key but appropriate by Chris Wozniak, with Karl Kesel on the inks.

Sadly, the series was a victim of Armageddon 2001 and ended after 28 issues and 2 annuals. There was another Hawk and Dove series in 1997, but it bore no relation to the previous series and was quite lackluster. Hank Hall (as Monarch, then Extant) has been seen in the several Armageddon 2001 mini-series, Zero-Hour, and recently JSA. Dove has shown up in recent issues of JSA as well.

Remember back in 1997, when an episode of Pokemon was accused of causing seizures in Japanese children? Recent follow-up research has shown what was suspected: the show caused seizures only in people who were already prone to seizures, but not in the general population.

A certain percentage of individuals have always been susceptible to seizures caused by lights flashing in just the right way. This is nothing new. There are instances during the Vietnam War of seizures being triggered by the light flickering through rotating helicopter blades.

The Pokemon episode was simply another one of these situations. Similarly, this is why videogames carry seizure warnings.

These situations do not cause epilepsy as much as they uncover a susceptibility to seizures that was already there.

(I’ve seen that episode at a convention, and all I can saw is “Wow, that was actually painful to watch.” Not because of the script, but because of all the bright flashing lights…no seizures for me, though!)

In the comments section of my recent post on Aquaman #19, Matt Rossi brings up an excellent point that I had missed entirely. It’s important enough to bear repeating:

How can Aquaman’s DNA be used to give people gills if he doesn’t have gills himself?

Speaking of gills, I just don’t think they’d work in people. A technologically based gill may be possible, but a biologically based gill doesn’t make sense.

I know sci-fi shows (remember SeaQuest DSV?) and comics show tiny slits in the neck for gills, but those wouldn’t be nearly large enough for human gills. Just like our lungs, surface area is very important in gills. Our lungs are designed for an oxygen rich environment (air contains 21% oxygen at sea level) and take up most of the ribcage. Water has much less oxygen (0-5% depending on temperature), so how large would gills need to be in humans?

Fish have different hemoglobin that grabs oxygen tighter than ours. This allows them to function at lower oxygen concentrations. Theoretically, human hemoglobin could be modified, but then a whole host of other modifications would need to be made down the line as well. For example, the myoglobin in muscle would also need to be modified or muscles would never get enough oxygen to function. Essentially every organ would need some genetic modification.

Finally, fish are cold-blooded and need much less energy (and oxygen) to survive. Notice that there are no warm-blooded animals with gills. All warm-blooded animals have lungs, even the aquatic ones.

Daredevil #1-8 “Guardian Devil”
Kevin Smith, writer
Joe Quesada, penciler

In a brilliant post over at Peiratikos, Rose does an excellent job of summarizing “Guardian Devil” and highlighting all that she finds wrong with the storyline. Her points are all excellent and she sums up the flaws in the story better than I could. What I remember most about the storyline was the senseless death of Karen Page and the worst d鮯uement in comics history. Rose’s post did remind me of all the questionable medical aspects of the story that I had blocked out…well, until now:

1. Foggy’s new client is seeking a divorce because her husband had her sterilized without her knowledge and she didn’t know it until her last gynecological exam. This is ridiculous. Sterilization requires surgery, and you’d think someone would know if they suddenly developed a scar and a sore abdomen. It sounds like the patient had a hysterectomy, which is a significant surgery with a good sized scar and at least a week of recovery. It turns out later the client was lying, but they should have been suspicious from the start.

2. Matt Murdock can hear a pair of heartbeats, so he knows the young mother and baby are nearby. It’s nice that Quesada’s art correctly shows the baby’s heartbeat as significantly faster than her mother’s, but why is he showing EKG waves? EKG waves are purely electrical in nature and could not be heard, even by Daredevil.

3. Daredevil takes a tranquilizer dart to the neck and quickly slumps into unconsciousness. As mentioned in a previous post, intramuscular injections take time to have an effect.

4. There is a hallucinogenic toxin on the cross Mr. Macabes hands Matt Murdock. If Matt absorbs it through the skin on his hands, why didn’t Mr. Macabes? And don’t tell me he had gloves or latex on, because Matt’s heightened senses would have felt that. Speaking of gloves, why did Dr. Strange get affected by the toxin when he was wearing them?

5. To deaden the sound of the baby crying, Mysterio has placed her in a vacuum chamber and now she only has twenty minutes to live. Does this make any sense? Yes, a vacuum chamber would block the child’s sound, but the child would also be dead from lack of oxygen and lack of air pressure. However, in the twenty minutes it takes to pump the air out, the chamber would not yet be a vacuum and Daredevil could still hear the baby and rescue her.

6. Mysterio has a brain tumor and lung cancer, both inoperable. Yet, when he is shown without his helmet on, he has a clear surgical scar along the side of his skull. And where did all his hair go? He had a full head of hair when he left prison a year before.

7. The young mother is drugged, kidnapped, and “artificially inseminated.” It takes more for artificial insemination to work than most people realize, including hormone treatments beforehand to maximize the chances of conception. The timing has to be just right too. This one is possible, but highly unlikely.

8. On the bright side, Quesada is one of the only comic artists to draw a nasal cannula correctly.

9. Her parents were killed by Mysterio’s men “before [they] could order a blood test…” I’m unclear as to which blood test is used to test for an Immaculate Conception. If you learn nothing else from this post, please remember that there is no blood test for virginity. Or maybe her parents were going to DNA test every male in the greater NYC area?

10. Finally, in one of the last scenes of the storyline, Matt is standing in front of a hospital nursery and says he can feel the breathing of the babies through the window glass. He says he can feel the glass expand with their exhalation, and shrink with inhalation. Even if this were physically possible (which I doubt), this presupposes that all the babies are breathing in unison in some weird Children of the Damned sort of way.

I just finished reading Eric Flint’s 1632 last night. I found it quite a good book and hard to put down. I’ve always liked writers that manage to combine historical figures with fictional characters convincingly (and I think Tim Powers does it best; read The Anubis Gates or On Stranger Tides and tell me who is real and who is made-up).

1632 falls into a genre (or probably a sub-genre) that I really enjoy. The modern-people-get-stranded-back-in-time (or on-a-desolate-planet) –and-build-a-civilization story. I like the idea of reading about people like me (only more clever and resourceful), who are used to the conveniences of modern life, forced to rely on their wits and other skills to not only survive, but flourish. It probably speaks to the repressed pioneer in me.

Besides 1632, other books in this genre include:

• Janissaries by Jerry Pournelle
• Castaways in Time by Robert Adams
• Island in the Sea of Time by S.M. Stirling
• Freedom’s Choice by Anne McCaffrey

(and all their sequels)

“Hello Mr. Crusher. I’m Adam Kimberly with the A-1 Job Placement Service. I understand you’re looking for a job. What skills do you have to offer?”
“Well, I’m pretty good at intimidation and beating people up.”
“Excellent. Do you have any weapon skills?”
“Yeah. I’m an OK shot with a pistol, but I’m real good with a baseball bat or a lead pipe.”
“How about skulking?”
“So-so. I know how to skulk, but it’s not one of my better skills. I’m more of a direct action kind of guy; threats and violence are more my areas of expertise.”
“What are your feeling on individual thought and initiative?”
“Huh?”
“I think we have something for you. It turns out that internationally-known villain Dr. Browbeater is looking for some new thugs. You’d be perfect for the job.”
“Browbeater. Yeah I heard o’ that guy. Wasn’t he put in jail by Captain Heroic?”
“He was let loose on a technicality. Apparently he’s the ruler of some small nation so he has diplomatic immunity.”
“Oh. Were there any complaints from his previous thugs?”
“No. No complaints whatsoever.”
“Could I talk to one of his previous thugs? Get a handle what the job would be like?”
“Umm, no. That isn’t possible.”
“Wait…he isn’t one of those guys who kills his underlings when they mess up or his plans go wrong, is he?”
“Umm…there may be a waiver or two you’ll need to sign. But the pay is good, and there’s a retirement plan.”
“What good is a retirement plan if I’m floating face down in the river?”
“Did I mention the excellent medical insurance?”
“Medical insurance? Is there a dress code?”
“You’re expected to wear black clothes and sunglasses at all times. Even at night. Dr. Browbeater will cover the costs of the uniform, of course.”
“Well, that does sound pretty good. Where do I sign?”

My office schedule was light today, but it was still a very hard day. It was one of those days where you have to deliver Bad News. There was a “Eureka!” moment at first when I read the results of the test, because I knew there was something wrong and I managed to discover what it was. Then there’s the dawning realization of what this result will mean to the patient. Then there is a little guilt for being pleased with myself that I found the answer when the answer is clearly so bad. Then I worry about how the patient will handle the news and the best way to tell them.

Through hard experience, I’ve found the best way to deliver bad news is to be straightforward and not beat around the bush. Explain the situation simply and clearly. Don’t entrust the job to co-workers; do it yourself. I’ll be honest and answer any questions they have to the best of my ability. If I don’t know the answer, I’ll get them to someone who can. Most of all I offer support and let them know that I will always be available for them.

Delivering this kind of news is a skill I’m still working on. Each time I do it, I learn a little more so I can do it better the next time. But I’m always hoping there won’t be a next time.

When I was 12, I went to my first science-fiction convention: RoVaCon 7. It was a small convention held at a high school in Roanoke, Virginia. We lived about 45 miles away and I convinced my father to take me for my birthday. He agreed and two weeks later, my dad and I, along with my friends Kevin and Steve, piled into our old Chevy Malibu station wagon and drove the hour to Roanoke.

The main guests were William Tenn and Laura Banks. William Tenn is one of the best short-story writers in science fiction and has become a favorite of mine (though could someone please explain his story Wednesday’s Child to me). At the time, Laura Banks was best known for being one of the two female followers of Khan in Star Trek II. I think that’s still her main claim to fame. Other guests were there too, including Richard Preston and Kelly Freas, but I have no memory of seeing them.

While my friends and I wandered the dealer’s room (the gym), entered the coloring contest and just meandered about, my dad stayed in the auditorium listening to the various speakers and watching the movies.

It was a fun day, and I have many good memories of the con:

• I bought my first comic book back issue: Uncanny X-Men #146, the 2nd issue of the three-part Dr. Doom/Arcade storyline. I paid one dollar for it.
• Even though we felt we were “too old” to enter the coloring contest, my friends and I entered it anyway because they gave candy to anyone who entered, and – well – it was candy and we were 12! They had a picture of their mascot, Rover (a dog in a bubble helmet) for us to color. I decided he must be an alien dog, so colored him green. I won second place and a ribbon, but no more candy.
• We drove down the street to the local Hardee’s for lunch. Kevin became upset when he realized he had been given sweetened tea instead of unsweetened tea. Steve said “I’ll unsweeten it for you!” and proceeded to pour a whole shaker-full of salt in the tea. General hilarity ensued, though I don’t think my father thought it was all that funny.
• I watched what is probably the worst science-fiction movie ever made: Robinson Crusoe on Mars. My father disagrees, stating that Santa Claus Conquers the Martians was much worse, but come on, it has Pia Zadora in it, so it at least has that going for it.
• I only caught the end of William Tenn’s talk, but I wish that I had heard more. I remember that he was talking about the difficulties of time travel. Not the technical difficulties, but all the cultural differences that would cause problems for the time traveler. Interesting stuff, even to a 12 year old.

Since then I’ve been to about thirty other convention of varying themes. I’ve never failed to have a good time, but that first small convention still ranks as one of the best.

Marvel Knights Spider-Man #3 and #4 Down Among the Dead Men, parts 2 and 3
Mark Millar, writer
Terry Dodson, penciller

I don’t always criticize medical scenes in comics, sometimes I even compliment them. This is one of those rare times, and a double-header at that.

After a ho-hum start, Marvel Knights Spider-Man came into its own in issues #2 and #3. A few brief medical items of interest came up in these issues as well.

First, I thought the Owl’s thug kvetching about his Crohn’s Disease in issue #2 was worth a chuckle. The details were right on the money too.

Second, after a rough fight with Electro (and what was with his mask? bolts up, bolts down, bolts up…), Spider-Man is rushed to the hospital in issue #3. The medical scene was portrayed well. Sure there were some small nit-picks (e.g. the EMTs not mentioning which arm was injured; Spider-Man going straight to surgery instead of being triaged in the ER), but overall it was handled skillfully. The surgeon was absolutely right to cut Spidey’s mask off, secret identity or not, because examining the patient – and I mean all of the patient – is key in traumatic injuries.

I just spent a pleasant hour watching Teen Titans and Justice League Unlimited on the Cartoon Network.

I don’t know if it was a new Teen Titans or not, but it was the episode I had expected ever since they introduced Terra. The Judas Contract ring a bell?

Justice League Unlimited has potential. It seems to be set up like Global Frequency, but with super-heroes (and J’onn as Miranda Zero). There were quite a few heroes: Superman, Batman, Wonder Woman, Martian Manhunter, Flash, and Green Lantern (sporting his new Avery Brooks look) were back as the headliners. Green Arrow, Captain Atom, and Supergirl played key roles in this episode as well. I also spotted Hawk, Dove (though I would have preferred the female Dove), the Creeper, Sand, Mr. Terrific, Atom Smasher, Atom, Gypsy, Aquaman (should keep Laura happy), Obsidian, Booster Gold (but no Blue Beetle), Vixen, Wildcat (should keep Dorian happy), Zatanna, the Question, Fire, Ice, Orion, Vibe, Black Canary and the Star-Spangled Kid and S.T.R.I.P.E. I’m sure there were some others I missed.

The episode was consistent with most past episodes. Good, but not great. The art and voices were good, but the plot had some serious holes in it (for instance: it only took one-half of a containment rod to stop a nuclear reaction of that size?) Green Arrow came off well, and this was the first time his boxing glove arrow actually made sense to me.

I didn’t like the new “rock opera” style muisc though. Bring back the old music!

Just because I have to, I did notice a few medical errors: John Stewart’s nasal cannula was drawn wrong, and what was that pump for? Accordion-style pumps are only used to breathe for a patient, and John was breathing on his own just fine.

UPDATED: Remembered three other heroes in attendance: The Elongated Man, Crimson Fox, and the Vigilante (the cowboy one).

UPDATED (2 Aug 04): Aztek was present as well (thanks to Johnny Bacardi)

UPDATED (2 Aug 04): Full list here.