Polite Dissent

It’s the first of the December, and that means it’s time to start my Fifth Annual Comic Book Cover Advent Calendar Countdown. Each day I’ll post another holiday-themed comic book cover, slowly filling up the advent calendar. As always on my calendar, the issue number of that day’s comic tells you how may days remain until Christmas.

To start us off this year, here is Tick Tock Tales #24, introducing “Flying Freddy, the Model Pilot.” Not only is his flying so bad that he knocked off Santa’s hat, but he apparently wiped out two reindeer as well (three if you count Rudolph).

Tick Tock Tales #24 (Magazine Enterprises, December 1947 )

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24 Days until Christmas!

It all starts when Captain America receives a note from Keith, a member of his Teen Brigade. Keith plays on his high school baseball team and is concerned about the team’s star pitcher Mitch. Recently, Mitch has started performing poorly, wheezing, and acting very anxious. Keith also tells Cap that he saw a strange man on a street corner giving something to Mitch, but Mitch wouldn’t tell him what it was. Keith is worried about Mitch and asks Captain America to check it out, especially with the big state championship game coming up.

After getting the note, Captain America decides to head down to the championship game. Mitch is pitching, but he’s not doing well. The opponents are getting hit after hit. Shaken up, Mitch loses control and beans the next batter, knocking him out. This nearly starts a riot, but Captain America is there to sort things out. After it becomes evident that Mitch has been using illegal drugs, Captain America decides that he needs to talk to him. Scared, Mitch flees from the scene, and while running through town encounters the dealer who sold him the drugs in the first place. The dealer offers him more, but Mitch slugs him. Of course, he then runs into a bunch of guys from the other team and the obligatory fight-scene-that-needs-to-be-broken-up-by-the-starring-hero occurs. In the end, Mitch learns his lesson and swears never to do drugs again.

All in all, a decent PSA comics, not even counting the aliens. Didn’t I mention the aliens? See, the whole thing was actually a plot by aliens who want to overthrow the Earth. These aliens have been watching us for some time and are concerned that humans have too much spirit and determination and would put up too much of a resistance to invasion. The alien leader thinks drug addiction might be a good way to subdue the humans, and to test his theory he chooses four random people and tries to get them addicted to drugs. Mitch was the first of these four. And Mitch’s drug dealer — an alien in disguise. So you see that Mitch’s rejection of drugs not only saved his own life, but the lives of everyone else on Earth as well (though the other three experimental subjects are never mentioned — I guess they were saving them for the sequels).

Captain America Goes to War Against Drugs was published by Marvel Comics in 1990, with cooperation with the Federal Bureau of Investigation. It was written by Peter David, with interior pencils by Sal Velluto and cover pencils by Jazzy John himself.

The 2008 Comic Book Cover Advent Calendar Countdown continues. With 23 days remaining until Christmas, today’s cover is Polly Pigtails #23. I don’t know much about Polly Pigtails, other than it was published in the mid-40s and was billed as “The Magazine for Girls.”

Polly Pigtails #23 (Parents’ Magazine Institute, December 1947 )

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23 Days until Christmas!

An enjoyable episode of House; one of the better of the season. A good mystery, and the medicine was generally decent. Some nice battle of wits soap opera as well.

Emmy, a thirty year-old fitness instruction, is filming an infomercial when she experiences sudden difficulty breathing and collapses, breaking her ankle in the fall. She is admitted to House’s service for evaluation and all the initial tests were normal. Taub suspects her of steroid use, Kutner mentions environmental allergies, and Cuddy suspects exercise induced asthma. The last seems the most likely, so the team sets about to recreate Emmy’s episode, the best they can with her broken ankle. Sure enough, while in the middle of exercising, she once again collapses and is found to be pulseless.

Kutner suggests she may have Carcinoid syndrome. A CT is obtained which shows no carcinoid tumor, but does reveal that she has had gastric bypass surgery in the past. This catches the team by surprise, and has them rethinking their differential diagnosis: now diabetic neuropathy (nerve damage caused by diabetes) and sleep apnea are added. Thirteen suggests gastrointestinal malabsorption leading to a low potassium, but Kutner takes it one step further and thinks Emmy may have SIBO (small intestine bacterial overgrowth) in a blind loop of bowel, and that these bacteria are making their way into her blood stream causing her symptoms. They test her stool, but there is no evidence for bacterial overgrowth or fat malabsorption.

House decides to rethink sleep apnea, and has Kutner and Taub run a sleep study. During the test she sneaks out, and the pair find her exercising on a treadmill, her ankle still in a splint. They also notice she is bleeding from the ankle and never noticed — she has lost sensation in her foot. The differential now includes multiple sclerosis, Parkinson’s Disease, and transverse myelitis (a crosswise inflammation of the spinal cord). House orders a nerve conduction velocity test (NCV), but while setting it up, Taub realizes that she is losing muscle strength in her arms. This again changes the differential, and the team considers myasthenia gravis, botulinum toxin exposure, other toxins, or heavy metal poisoning. House has them start her on chelation to treat her suspected heavy metal toxicity, but there is no change in her condition. The latest differential consists of a corornary-cardiac fistula (an abnormal connection between the coronary arteries — which supply blood to the heart muscle — and the interior of the heart), Austrian syndrome (meningitis, pneumonia and endocarditis caused by the Pneumococcus bacteria), or Guillain-Barre Syndrome (an autoimmune disease of the peripheral nervous system). The latter fits the symptoms the best, so she is started on the treatment for Guillain-Barre, plasmaphersis.

When Emmy starts hallucinating, the team realizes that the Guillain-Barre diagnosis is wrong as well. Thirteen favors a diagnosis of CNS lymphoma, but Taub is suspicious she has a prion disease (a rare type of disease caused by infectious protein particles. The best known example is probably mad cow disease). House wants a brain biopsy, but Cuddy won’t let him until they’ve ruled out other brain tumors by non-invasive means. The initial tests come back negative and House decides to perform the brain biopsy himself. However, when he and Taub enters the room, they find Emmy up and about, feeling good. Taub informs House that there have not been any new drugs, but that she did eat a piece of chocolate cake from the cafeteria. House now realizes the cause of her condition — she has hereditary coproporphyria. This is an inherited disease that House tells her can be controlled by a high carbohydrate diet. When she was fat, she ate that type of food all the time, so suffered no ill effects, but now that she is slender and eating healthy, the symptoms have caught up with her. He recommends resuming the high carbohydrate diet, but she chooses to continue her low calorie diet and take medication to control her symptoms.

Major complaints are in red, minor in blue, nit-picking in green. Overall, not too many big errors this week, but many of the diagnoses were quite a stretch.

You don’t test for SIBO with a stool study. You need an aspiration of fluid from the small intestine to evaluate or a hydrogen breath test. Plus, if she has a blind loop of bowel, how are the bacteria from it going to end up in the stool to be tested?

She was pulseless, but they never specifically said what her rhythm was. If it was asystole or PEA, then defibrillation was wrong. Otherwise, it was probably right. (And I’m still not too clear on why she coded in the first place).

The time course was off again, but in different way than usual. Emmy must have been several years out from her surgery — she had the weight to lose, the muscles to tone, the fitness guru-ness to obtain, and the informercials to produce and distribute — and only now does she start to have symptoms?
And she never had symptoms with a low carb diet while trying to lose weight before her surgery.

Diet alone is not the best treatment for severe CHP attacks. A drug known as Hemitin also helps.
A high carbohydrate diet is recommended by some physicians. Most doctors recommend a healthy balanced diet with high carbs only during acutre attacks.
Abdominal pain is a key symptom of coproporphyria.

Several episodes this season where diagnoses are made by looking at the urine color and they miss the classic purple urine in this one?

The medical mystery was good this week and deserves an A. The final solution was fairly clever, though a bit of a stretch, and earns a B. The medicine, though again quite a stretch at points, was good overall and also earns a B. The soap opera was well done, both in terms of House/Cuddy and Thirteen. I give it an A, with extra credit for Cuddy’s comment about House’s balls.

Last week’s House review
A list of all prior House reviews

Only 22 days remaining until Christmas, and today’s cover for Advent Calendar Countdown is Fat Albert #22. I never read the comic, but I always loved the show, especially the later episodes featuring the adventures of Fat Albert’s favorite super-hero, the Brown Hornet.

Fat Albert #22 (Gold Key, December 1977 )

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22 Days until Christmas!

A fairly low scoring week, but most of the players gained at least one point.

Louwrens has this week’s high score with 9 points.

Overall, Sable Hope takes the lead to herself at 38 points. Ash is in second with 34 points, and JockM right behind at 32 points. The Erskine holds fourth with 27 points, and Dogma-Central and Harvey are in fifth with 25 points.

Full scores are available here..

The plot threads of various recent episodes begin to pull together, but it seems like an incredible amount of work for a relatively modest pay off. Plus the bad and imaginary science we’ve come to expect.

The Plot:In the middle of the night at a bank in Philadelphia, and mysterious gang of bank robbers disable the security system. They set up the frequency machine seen at the end of Episode Eight (”The Equation”) and use it to turn one of the walls of the bank vault permeable. A trio of robbers enter the vault, steal the contents of a safety deposit box, and exit back through the wall — all except one robber who gets stuck in the wall when it turns solid again. His compatriots shoot him and leave him behind.

Agent Dunham and team are called to the scene. She recognizes the robber as someone who used to be in her unit in the Marines. Dunham talks to the robber’s estranged wife and realizes that she never knew him, Agent Scott did, and his memories are mixing with hers. Peter Bishop recognizes that the numbers of the stolen safety deposit boxes are related to something Walter says every night as he falls asleep. Walter recognizes the numbers as a Fibonacci sequence, and then realizes the boxes being stolen are his — he just doesn’t remember what he hid there. Peter is able to prey lose a memory and it seems that Walter invented a machine that can reach back in time and pluck someone from anywhere, anywhen. He never used it himself, but recognized it could be dangerous, so hid it away.

Meanwhile, in Germany, Mr. Jones (from Episode Seven) is meeting with his lawyer. Jones clearly is up to something, and he seems to be coordinating the bank robberies back in the U.S.

The FBI traces the robbers to their final bank, but just misses their theft. They are able to track down the thieves immediately afterward and capture one. He doesn’t divulge any information until Peter scares him with the fact that he has gotten radiation poisoning from frequency machine used during the thefts. He tells them about an upcoming meeting at a field in Westford. Looking at the map, Dunham recognizes the name Little Hill (from Episode Seven, again) and realizes that the meeting must be occurring at Little Hill Field. She and the FBI mount a raid on the field.

At the same time, the thieves set up the machinery stolen from Dr Bishop’s safety deposit boxes and use it to pluck Mr. Jones from prison in Germany. He arrives safely at Little Hill Field. They also kidnap agent Dunham because Jones has something in mind for her.

1. Lot of Hassle
It seems the thieves are going through an incredible amount of hassle to break one man out of prison in Germany. Certainly with all their money and technology, there would be an easier way. Their plan is something Rube Goldberg would come up with if you gave him an iPhone and a loud radio.

2. Shaking Hands
Tremor is a rare symptom of radiation poisoning, and generally only shows up as a late symptom during the secondary phase of high dose and lethal radiation poisoning. The robbers would be a great deal sicker by that point.

3. It’s A Secret
Patient Confidentiality doesn’t quite work the way the doctor thinks it does. It applies to what the doctor has learned and deduced through patient interview, examination, and testing. It also applies to what the doctor is told in confidence. I can’t imagine that who the patient hangs out with and talks in the hospital qualifies, especially when any random orderly can tell you.
For the record, according to Washington DC statutes, patient confidentiality can be broken when they are outweighed by “interests of public justice.”

4. Big Bird
Hepea is a made up disease. For one thing, Bird Flu did not become important (and was not known to be transmissible to humans) until the ’90s, well after the time when Walter was locked away in the asylum — so how did he learn of it? And how did Peter catch it? Even more, why would a doctor in the 1930s be a key expert when it was 60 years before there were any human cases.

5. The Eyes Have It
Once again, we hit the last thing seen by the eyes before death cliché (last seen in Episode Two), only this time with color printing.

Just three weeks until Christmas, and today’s cover features Popeye and Wimpy (and what looks like Henry) on the cover of King Comics #21.

King Comics #21 (David McKay, December 1937)

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21 Days until Christmas!

Watched Rudolph the Red-Nosed Reindeer last night…again. It’s still one of my favorites, probably tied with The Grinch. After watching the show last year, I felt inspired to update the story a little. So, yeah, I posted this last December, but it still holds true today:

Today’s comic featured on the 2009 Advent Calendar Countdown is another Golden Age classic from December 1937. Yesterday it was Popeye, today it’s the Katzenjammer Kids (and family) in Tip Top Comics #20.

Tip Top Comics #20 (St. John, December 1937)

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20 Days until Christmas!

Me? I must have made that statement at least a dozen times. Trust me, it never gets any easier.

It’s December 6th, so that means only 19 days remaining until Christmas. Today’s cover is one of my favorites on this year’s countdown: Pinky and the Brain #19.

I’ve reproduced the little Christmas poem on the cover here, just in case you have trouble reading the tiny dithered text:

His eyes how they twinkled,
His stature, quite puny.
His costume was wrinkled,
His elf was a looney!
I head him exclaim,
his droll little mouth curled,
“Merry Christmas to All,
I’m Taking Over the World!”

Pinky and the Brain #19 (DC Comics, January 1998)

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19 Days until Christmas!

I was reading through a stack of old Image comics when I came across this gem of a scene from Backlash #5. Not only has Backlash been captured and chained up (those WildStorm villains did always seem to have a thing for chains), but the evil Mindscape is trying to destroy his mind. Given that the series lasted for another 27 issues, I’m willing to bet that Backlash survived.

All previous Psychic Nosebleed Zen posts

Tags: comics medicine nosebleed backlash image wildstorm

There are so many Dennis the Menace Christmas comics I could probably do an entire advent calendar featuring them, and never repeat a cover. Maybe I’ll do that next year…for some of these countdown numbers, new covers are getting hard to find. Anyway, with only 18 days left until Christmas, here is Dennis the Menace Pocket Full of Fun #18.

Dennis the Menace Pocket Full of Fun #18 (Fawcett, 1933 1973)

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18 Days until Christmas!

There are some strange murders in a small southern town, and Velma, the beautiful newcomer, is suspected of being a vampire (after all, the local medical examiner staked his reputation on it). She is arrested by the local police and chained to a bed. A young policeman named Mike is assigned to watch over her and see if she turns into a vampire when the sun goes down.

Velma talks to Mike and confesses that she indeed is a vampire. She blames it on a family curse (she explains that she is the seventh daughter of a seventh son of a cursed noble line). However, she tells Mike that a complete blood transfusion can beat the curse. He agrees to her plan and raids the local blood bank for the needed supplies and performs the transfusion. Sure enough, the transfusion works, and she does not turn into a vampire. Velma is released, and shortly thereafter she and Mike fall in love and get married.

A happy ending? If this were a romance story, sure — but this is a horror comic, and happy endings are few and far between. While the blood transfusion does work, its effects are only temporary. The rest you can read for yourself…

According to first part of this story, vampirism is an inherited condition. Likely recessive (this is yet another reason why cousins shouldn’t marry) with low penetrance (the number of people with the correct genes who actually express the condition).

Later in the story, the vampirism is passed from person to person via bite, which suggests an infectious cause. Both inherited and infectious? There are certainly infectious diseases that can be passed from mother to child (syphilis, herpes, CMV, HIV etc.), but nothing like this.

This story, “One Door from Disaster,” appeared in Web of Mystery #27 (1954) and was showcased on The Horrors of It All blog.

Other Comic Book Transfusions

Richie Rich is featured in today’s comic cover. I’ve never been a big fan of Richie. In my opinion, he’s the rudest character in comics: not only is he always rubbing his friends’ noses in how much money he has, but he’s totally oblivious to how impolite it is. (Plus what’s with those legs? Looks like he has chronic lymphedema).

Richie Rich Dollar$ and ¢ents #17 (Harvey Comics, February 1967)

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17 Days until Christmas!

Buzzy’s back for another public service ad, and this time he’s imposing his sense of style and decorum on other students, willing or not. There will be no individuality while Buzzy is around!

Seriously, would you take fashion advice from a guy in a bowtie? (My theory: had Buzzy not intervened, Bob would have gone on to create the original grunge rock sound and made millions of dollars. Instead, he wound up penning songs for Pat Boone. Thanks for nothing, Buzzy!)

This PSA was written by Jack Schiff with art by Win Mortimer, who seemed to be the team of choice for the Buzzy PSAs. This ad could be found in a variety of February 1952 DC Comics including Action Comics #165, Batman #69, and Superboy #18.

More PSAs

Tags: comics psa buzzy dance jack schiff win mortimer

Just 16 days remaining until Christmas, and today’s cover features videogame icon Sonic the Hedgehog, who has had more than his share of comic books (at least 17 titles in the U.S. alone). That’s almost as many as Wolverine…and more than Hawk and Dove (hint, hint).

Sonic the Comic #16 (Fleetway/Quality, December 1994)

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16 Days until Christmas!

Two good episodes of House in a row, what are the odds? Sure, the medicine was a little sketchy, but overall it was pretty well done.

Natalie is a sixteen year-old overweight high school student and the victim of frequent bullying. At the school Christmas show, she develops visual hallucinations and vomiting. After admission to the hospital, she is found to have liver failure as well. The initial differential diagnosis is Wilson’s Disease, alcohol abuse, or something the other kids slipped her. Sure enough, some of the kids in the choir do admit secretly giving her a hallucinogenic mushroom. Additionally, a search of Natalie’s locker reveals a large bottle of acetaminophen (Tylenol) — an over-the-counter painkiller than can cause liver failure — raising the possibility of a suicide attempt. Natalie denies any suicidal thoughts or intentions, but Cuddy wants to go ahead and start her on acetylcysteine, the antidote for acetaminophen poisoning.

Next, Natalie develops a rapid heart rate and increased blood pressure, along with pulmonary edema (fluid filling up in the lungs). The differential now a toxic exposure (glue sniffing is mentioned), or infection. When House discovers she has been volunteering at a homeless shelter, he sends Taub to check it out. He returns suspicious that Natalie might have TB (tuberculosis) because one of the residents there has a severe case of it. About this time, Natalie has a seizure. Cuddy remarks that Natalie’s liver functions are very bad; she suspects hepatic fibrosis. Other possibilities mentioned include a severe mold allergy or a fungal infection. House has the team test for the allergy (the prick test) and start her on antifungal medication. The allergy test is negative. One of her “friends” from school visits and drops off some homework for her. He mentions that she used to be a heavy drinker, but stopped a few months ago. This again raises the specter of alcohol abuse, or possibly even alcohol withdrawal as it can cause seizures. Cuddy wants to start benzodiazepines (“benzos”) because they help with alcohol withdrawal, but her parents refuse. House decides to go ahead and start them, but not for alcohol abuse, but for her seizures (“wink, wink” — though they are used to treat seizures as well).

Natalie now passes out and is found to have a dangerously low heart rate. The differential shifts to multiple endocrine neoplasia, a hypothalalmic brain tumor, or leukemia. Wilson and Cuddy want to start treatment for the suspected leukemia, but House wants to wait for a bone marrow biopsy to confirm the diagnosis. Cuddy remains concerned that they may be missing something. She mentions autoimmune disease, particularly microangiopathic vasculitis (inflammation of tiny blood vessels such as capillaries and arterioles). When House tells her about a clinic patient of his, she has her own Eureka! moment and realizes that Natalie has eclampsia (toxemia of pregnancy). It was not caught initially because Natalie gave birth prematurely several weeks before her symptoms appeared and eclampsia has been known to occur several weeks postpartum. Unfortunately, the damage to her liver and heart are permanent and it is likely that Natalie will die in the next few days, particularly when the transplant committee turns down her case. On the bright side, Natalie’s daughter has miraculously survived — she was found by a homeless couple — and now Cuddy wants to adopt her.

The medicine was not particularly deep this week, but there was nothing I’d consider a big error. Minor complaints in blue, nit-picks in green.

Giving antifungal medications — which are universally hard on the liver — to a patient in liver failure is not a good idea.

You don’t give chemotherapy for leukemia without first determining what type of leukemia it is.
Surely the leukemia showed up on an ealier blood count. They did check a blood count, right?

Acetylcysteine is used for treating acute acetaminophen poisoning, not for treatment well after the fact.
Checking an acetaminophen level first would be a good idea — it’s an easy test.

Magnesium sulfate is the treatment of choice for seizures due to eclampsia (of course, it helps to know that you are treating eclampsia). Benzodiazepines are not as effective, though they do work.

What shot was Cuddy giving Natalie in the leg when she was having the rapid heart rate and high blood pressure? Any “code” medication should have gone in the IV (faster action).

Yes, eclampsia can occur after delivery — I was taught that it could occur up to six weeks later (and you’ll notice it was one of my original predictions for the show). The β-HCG (the hormone checked for in a pregnancy test) drops after delivery, and within a few weeks it generally is back to normal, so it is entirely possible to have eclampsia without a positive pregnancy test.

The medical mystery was modestly interesting this week and deserves an B. The final solution was good and earns an A. The medicine was shallow (lots of jumping to diagnoses that make little sense, no good testing), but not terrible. I’ll give it a weak B. The soap opera was well done — Wilson yanking the team’s chain and Cuddy’s happy ending were both high point, though I don’t buy Foreman/Thirteen — so I’ll give it an A-.

Last week’s House review
A list of all prior House reviews

Back to the Golden Age for this next comic. Only fifteen days to go until Christmas!

Calling All Kids #15 (Parents Magazine Institute, December 1947)

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15 Days until Christmas!

Another low scoring week.

Both Chris and Vercingetorix had this week’s high score with 12 points.

Overall, Sable Hope remains in the lead with 38 points and Ash stays in second with 34 points. JockM is right behind at 32 points. The Erskine gains some points but stays in fourth with 30 points, and Harvey takes sole control of fifth with 26 points.

Full scores are available here..

What can we learn from this scene?

1. Atomic Bunny has an abnormally large stomach (pelvis to upper rib cage).
2. The carrot magically shows up in color on an x-ray — which are black and white/grayscale.
3. Atomic Bunny really needs to learn to chew his food.

What would a comic book cover advent calendar be without Archie? Particularly an Archie with a mullet from the year 3000? Now we don’t have to wonder!

Archie 3000 #14 (Archie Comics, March 1991)

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14 Days until Christmas!

Only thirteen days remain until Christmas, and that means today’s advent calendar countdown requires a #13, and here it is: Oni Double Press #13 featuring Paul Dini’s Jingle Belle, a character who’s been featured here many times before.

Oni Double Feature #13 (Oni Press, September 1999)

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13 Days until Christmas!

This somewhat misleadingly titled article is actually about Richard Adams Locke and his role in the Great Moon Hoax of 1835.

It’s a fascinating subject, and this article only gives a small taste of the sensation the “moon discoveries” caused.

For more information, check out:
The Museum of Hoaxes: The Great Moon Hoax
History Buff: The Great Moon Hoax of 1835
Wikipedia: The Great Moon Hoax

Just twelve days to go until Christmas, and that means today’s advent calendar features a Christmas-themed twelfth issue.

Funny Folks #12 is a great example, and one of my favorite covers on this year’s calendar. There’s something about hitching a ride on Santa’s sleigh that seems quite appealing right now.

Funny Folks #12 (DC, February 1948)

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12 Days until Christmas!

Threshold is one of those great villains that you love to hate. From his initial appearance in Gen13 through his time in DV8 and later, he didn’t have a single redeeming bone is his body. Sure, you could make excuses: he saw his parents murdered before him, his sister tried to seduce him, his cyborg boss fed him drugs and used him as a sexual plaything…but his malignant personality was too deep to be explained away that easily. He was pure malignant evil.

In this scene, Threshold is fleeing as fast as he can after trying to kill all the other members of DV8 (by blowing up their helicopter over the middle of the ocean) and then attacking I.O. headquarters.

All previous Psychic Nosebleed Zen posts

Tags: comics medicine nosebleed threshold dv8 gen13 wildstorm

Fourteen days down, just eleven to go until Christmas!

Yogi Bear #11 (Gold Key, January 1963)

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11 Days until Christmas!

No longer just limited to comic books, genre movies, and science fiction television, the psychic nosebleed now appears on half-hour situation comedies.

In this scene from the upcoming season premiere of Scrubs, Dr. Cox tries in vain to resist the infectious smile of the hospital’s new chief of staff Dr. Maddox, played by Courtney Cox Arquette.

All previous Psychic Nosebleed Zen posts

Tags: comics medicine television nosebleed scrubs

Only a mere 10 days until Christmas. Today’s cover comes courtesy of one of the better black and white comics of the 1980s, The Trouble with Girls. It concerns Lester Girls, who wants to do nothing more than live out a nondescript quiet white-picket fence life. Unfortunately, that’s not to be, and Lester keeps finding himself with more money and beautiful women than he knows what to do with. It’s recently been re-released in trade paperback and is well worth your time and money to track down and read.

The Trouble With Girls #10 (Eternity, May 1988)

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10 Days until Christmas!

With things getting a little hectic and stressful as Christmas nears, I thought it was time for a little levity (very little, I’m afraid) in the form of a funny animal public service ad.

Peter Porkchops was one of DC Comics’ most popular funny animal characters. He first appeared in Leading Comics, and then headed up his own title for 62 issues. Gone, but not forgotten, Peter resurfaced in Captain Carrot and his Amazing Zoo Crew where he became the super-hero Pig Iron.

This PSA is from June 1953, during the height of Peter’s popularity. This particular copy was found in Action Comics #181. It was written by Jack Schiff with art by Otto Feuer, who is credited with creating Peter Porkchops.

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Tags: comics psa peter porkchops captain carrot jack schiff otto feuer

Today’s entry in the Comic Book Cover Advent Calendar should probably just be called “A Fan Service Christmas.”

Battle Vixens #9 (Tokyo Pop, September 2006)

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9 Days until Christmas!

I hope it goes without saying that Batman’s recovery is nothing short of miraculous: in less than two years, he manages to go from struggling to breathe to a full return to crime fighting, none the worse for wear. As the late night infomercials say, “results not typical”.

For the purpose of this post, I’m going to focus on the period initially after the injury where he is under the care of first his faithful butler Alfred, and then neighborhood physician Dr. Shondra Kinsolver.

I. The Injury
To start off, let’s take a close look at what happened to the Dark Knight. There are two mechanisms of injury here. First, Batman’s spine is hyperextended; it’s bent backwards farther than any back is meant to go. Second, Bane is driving his knee into the back, pushing the spine forward.
[click here for an annotated image.]

II. The Doctor’s Assessment

Dr. Kinsolving: These x-rays clearly show a fulcrum-type stress fracture. Not at all the kind of trauma sustained in a car crash.

Dr Kinsolving is both right and wrong.

She’s right in that the way the injury was explained to her (a car accident) does not match the injury she observes (blow from behind). Alfred tries to explain it away, but she’s already suspicious.

However, she’s wrong in the way she herself describes the injury. While Bane’s knee was used as a fulcrum to break Batman’s back, what he suffers is not a fulcrum fracture per se. Those are a type of Chance fracture and occur with hyperflexion (the back bending forward too far), not hyperextension.

It’s not really a stress fracture either. Those can occur in the spine, usually with an increase in repetitive trauma (for instance, athletes who increase their workout), or with trauma. However, stress fractures of the spine don’t occur in the verterbral body, and do not occur with the kind of trauma Batman experienced.

Despite what she says, I don’t seem much of a fracture on the x-ray she’s holding up, unless it’s the diagonal line on the vertebra. If that’s what she’s referring to, it doesn’t match the type of injury she’s describing, or the one Batman suffered. [click here for an annotated image.]

(Based on the mechanism of injury, I’d predict that Batman suffered a fracture/dislocation injury. There was some spinal breakage occurring, but most of the injury is from one or more of the vertebrae being pushed forward into the spinal cord, injuring it).

III. Steroids
Steroids are a good treatment for spinal cord injuries. Bear in mind the term “steroid” generally refers to one of two related, but distinct, classes of medication.
1. There are the infamous anabolic steroids. These are the ones that cause an increase in muscle mass and have been abused in most major sports; Bane’s own drug Venom is a particularly fast acting and potent anabolic steroid.
2. Then there are the glucocorticoids (a type of corticosteroid). These are potent anti-inflammatory and immune suppressing drugs. They are used for asthma attacks, poison ivy, autoimmune diseases and other conditions where it is important to calm down inflammation or the immune system. This is the class of steroid that is used in treating spinal cord injuries; it reduces the swelling and improves the recovery.

Decadron was not developed for or “specifically made” for spinal cord injury. It has many medical uses and was around a long time before anyone thought to use it for spinal trauma.

Additionally, it is not a controlled substance and is easy to obtain with a prescription. We have a large supply in a drawer in our office. I suspect the writer is confusing it with an anabolic steroid — which is a controlled substance.

Only 8 days left until Christmas, and I figured it was finally about time to use a super-hero cover. Today’s cover comes courtesy of The Sensation She-Hulk #8, co-starring Nick St. Christopher (wink, wink).

The Sensational She-Hulk #8 (Marvel Comics, November 1989)

Click on the cover for larger view

8 Days until Christmas!

In his super-hero work with Wildstorm and Marvel, Warren Ellis has repeatedly returned to the concept that extra chromosomes can lead to super-powers. Sure, it’s mostly comic book science-fiction, but there is some real science behind it — science that Ellis mostly gets right.

DV8 #8
The team stumbles across a forgotten Soviet town populated entirely by children. Of course, these aren’t normal children, but children who were experimented on and are now genetically — and in many cases, mechanically — enhanced.

Sublime talks to one of the girls who recognizes DV8 as kindred spirits. The girl tells Sublime that they both have “three-strings” which Sublime realizes means that they are triploid — they have three sets of chromosomes instead of the normal two.

It is not clear if the Soviet children were born with three sets of chromosomes or theirs were altered later. The story suggests that either may be true. DV8, however, were born with their “Gen-Factor” and so if we are to believe the little girl, were born triploid.

Triploidy has been known to occur in humans, but always results in severe birth defects with the unfortunate child usually dying within a few hours after birth. In fact, the defects in triploid fetuses are so severe that the vast majority (50,000:1) are miscarried. While the idea that a third set of chromosomes grants the DV8 team and the Soviet children super-powers seems a clever concept, it is far from the unfortunate reality of triploidy in humans.

ULTIMATE HUMAN #1

In this series, Bruce Banner comes to Tony Stark looking for help in controlling his transformations into the Hulk. Looking at the data Bruce provided, Tony mentions

Is this polyploidy I’m looking at? More than two sets of chromosomes? It might account for increased cell size…

Polyploidy is an SAT-word for individuals or species that have more than 2 sets of chromosomes. If you want, you can get even more specific: three sets (triploidy), four sets (tetraploidy), five sets (pentaploidy), six sets (hexaploidy), and so on, but polyploidy is a good generic term.

Polypoloids are important in agriculture and a very common finding in plants. It is estimated that at least 70% of flowering plants are polyploid. Special techniques and chemicals are used by horticulturists to create polyploid plants. This tends to dramatically increase the size of these plants and their resultant fruits and vegetables.

On the other hand, polyploidy is rare in animals. It can be found in some of the lower species (flatworms, leeches) and even some amphibians; but requires reproduction through parthenogenesis. In higher animals, polyploidy is extremely rare – especially in mammals. There have been attempts to breed polyploid cattle, but they never worked out well. However, the animals did have greatly increased muscle mass over their normal ancestors.

In this case, I like the polyploid idea. It explains — as well as anything else — why the Hulk’s muscles are so ridiculously huge, and it has at least a little basis in reality. It opens up some other questions (such as, is the Hulk sterile?), but these are probably best left unanswered.

ASTONISHING X-MEN #25
The X-Men have discovered at least two people who apparently have mutant powers, but don’t register as a mutant on any of their scans. After obtaining a tissue sample, the Beast is able to determine that the individuals in question have had a third set of artificial chromosomes added their genome. He tells Cyclops that “functional triploids do not occur in human nature” (which is true, but maybe somebody should tell DV8). He then goes on to explain that these new chromosomes with their misplaced x-gene is what is allowing them to remain undetected.

An artificial triploid is a clever concept, and not entirely in the realm of fiction. Yeast artificial chromosomes have been around since the early 80s, and bacterial artificial chromosomes were developed 10 years later. In 1997, artificial human chromosomes were developed. These are small mini-chromosomes – they can only hold a handful of genes — that are only stable for about six months. Far from what the Beast was describing, but still closer than most comic book genetics.

The Beast’s comments in this issue raise some interesting points:

How do you get that third set of chromosomes into every cell in the body? Or does it only have to be in certain cells — in which case the Beast got lucky with his tissue sample.

Beast mentions that the mutant gene sits on the 23rd chromosome. Interestingly enough, the 23rd chromosome is the sex-chromosome…so the x-gene must be on the X-chromosome, but is it also on the Y? Are female mutants more powerful?

Only 1 week left until Christmas! I hope you have all your shopping done…

For today’s cover, we dip back to the Golden Age and find another hitch-a-ride-on-Santa’s-sleigh cover, a common theme.

Marge’s Little Lulu #7 (Gold Key, January 1949)

Click on the cover for larger view

7 Days until Christmas!

A concept that shows up in medicine from time to time is the Metabolic Equivalent, or met. It is important when dealing with sports physiology, weight loss, and cardiac stress testing.

This page from The Brave and the The Bold #46 (February-March 1963) does a nice job of illustrating the concept.

For today’s Christmas Cover (less than a week to go!), a second holiday cover from the Maze Agency, the best mystery comic book ever.

The Maze Agency #6 (Comico, May 1989)

Click on the cover for larger view

6 Days until Christmas!

Only 5 days to go until Christmas — it’s just round the bend! And speaking of “round the bend,” here comes the Disney Christmas Train, featuring Mickey, Donald, his nephews, and Scott’s bad segues.

Walt Disney’s Christmas Parade #5 (Gold Key, February 1967)

Click on the cover for larger view

5 Days until Christmas!

A mere 4 days until Christmas, and for today’s #4 cover, I dip back into the super-hero bag for Generation X #4. This was a great series, at least for the first year or two, with good writing, interesting characters, and good Bachalo art. It was a fun comic, something sorely missing in today’s mainstream X-titles.

Generation X #4 (Marvel Comics, February 1995)

Click on the cover for larger view

4 Days until Christmas!

Another psychic nosebleed from the early WildStorm era. In this scene from Backlash #2, the Daemonite Lord S’Ryn takes over the command of the villainous organization The Cabal from the soon-to-be-late H’Tarh.

All previous Psychic Nosebleed Zen posts

Tags: comics medicine nosebleed backlash daemonite

Three days left until Christmas, and the second super-hero cover in a row. Today’s cover comes straight from Gotham City, where the Riddler seems to have fallen victim to (or more likely, perpetrated) that most feared of Yuletide disasters: the Christmas tree fire.

The Batman and Robin Adventures #3 (DC Comics, December 1995)

Click on the cover for larger view

3 Days until Christmas!

scene from The Authority: Human on the Inside (By John Ridley and Ben Oliver)

Jack Hawksmoor has been seriously injured in a battle with the mythological Erinyes. In this scene, the Engineer is telling him the full extent of his injuries.

What medical error (or errors) are in the scene?

Previous picture quizzes

With just two days to go until Christmas, the Advent Calendar Comic Cover Countdown features a great cover that features two of this year’s themes: 1) Funny Animals, and 2) Super-Heroes.

Merry Christmas from Hoppy the Marvel Bunny!

Fawcett’s Funny Animals #2 (Fawcett, January 1941)

Click on the cover for larger view

2 Days until Christmas!

It’s Christmas Eve! Just one more day to go until Christmas, and this year’s penultimate Advent Calendar cover is Bugs Bunny’s Christmas Funnies #1!

Bugs Bunny’s Christmas Funnies #1 (Dell, November 1950)

Click on the cover for larger view

1 Day until Christmas!

Christmas Day is here! And to celebrate the final day of Scott’s 2008 Comic Book Cover Countdown Advent Calendar is an obscure title from 1960 combine both space and Santa (and no, it’s not Santa Claus Conquers the Martians).

A Christmas Journey Through Space (Western Publishing, 1960)

Click on the cover for larger view

Christmas Day!

This causes a reaction from his own Gen-factor (which leads me to believe that he must be a lot of fun at I.O.’s annual Christmas party).

All previous Psychic Nosebleed Zen posts

Tags: comics medicine nosebleed deathblow gamorra

scene from The Incredible Hulk #373 (by David and Keown)

Polite Dissent returns to its regularly scheduled programming on Wednesday with my annual review of the best and worst comic book medicine of 2008.

It’s that time again: time to look back on the absolutely worst examples of comic book medicine, both real and imaginary, over the past year.

Worst Depiction of Medicine:
While there was a bunch of mediocre and questionable medicine, there was nothing horrible — at least until the Emergency Room scene on Batman: Legends of the Dark Knight #200 was reprinted in the Batman: Going Sane trade paperback. link #1 link #2

Worst Doctor:
She’s not technically a doctor, but she was acting as one in X-Men Legacy #209, so that counts. The worst doctor of the year was the Omega Prime Sentinel for her plan to revive Professor Xavier from his coma. Far from “jump starting” his brain, her plan would have instead caused him to suffer a massive seizure. And did I mention that she confused volts and amps? Not a good idea when you’re a cyborg. link

Worst Single Medical or Scientific Concept:
The complete mess made of the concept of the genome — confusing the term with both individual genes and genealogy — in Ultimate Origins #1. The idea can be done right (see Warren Ellis), but this was painfully bad. link

Worst Imaginary Medicine or Treatment:
Superman using his heat vision to keep Lois’s heart beating (and then the fact that he kept looking away from her) in Final Crisis and Superman Beyond. No, Don’t ask, I can’t explain it either. link #1 link #2

Dishonorable Mentions:
Hulk’s retina scan.
The continuing mistaken belief that the speed of thought is faster than the speed of light.
Peter Parker being unconscious, yet “alert”.

In what may be a surprise, Catwoman’s missing heart didn’t make the list. There were certainly some problems with the medicine in the storyline — mostly nit-picking and logistical — but ultimately I was willing to accept the fact that Mr. Freeze’s science allowed Hush to pull it off.

Later today, the “Best Comic Book Medicine of 2008″.

Previous “Worst of the Year”: The Worst Comic Book Medicine of 2007 The Worst Comic Book Medicine of 2006 The Worst Comic Book Medicine of 2005 The Worst Comic Book Medicine of 2004

After looking at the Worst Comic Book Medicine of 2008 earlier, now I’m going to celebrate the Best Comic Book Medicine of 2008.

Best Depiction of Medicine:
The hospital scenes in Blue Beetle #31.link

Best Doctor:
Doctor Mid-Nite finally got the chance to strut his stuff as the preeminent physician of the DC universe, showing up not just in the Justice Society of America, but also having medical assistance roles in Detective Comics, Blue Beetle, and Terra.

Best Single Medical or Scientific Concept:
Slim pickings again this year, but I’d say the best and most realistic medically-driven storyline this year was Sadie’s marked personality changes after suffering brain damage, as seen in David Lapham’s Young Liars series. link

Best Imaginary Medicine or Treatment:
Warren Ellis’s fascination with super-heroes and polyploidy (additional sets of chromosomes), as seen in both Ultimate Human and his run on Astonishing X-Men. link

Special Mention:
Best New Doctor: Dr. Faiza Hussain, the Excalibur-wielding physician from Captain Britain and M.I. 13.
Best Medically Accurate Art: Rags Morales in Nightwing #148.
Best Technobabble: Mandarin’s scientist in Iron Man #24, when he tried to explain how Maya had disguised the Extremis code by hiding it binarily in protein complexes in the genetic structure..

Previous “Best of the Year”: The Best Comic Book Medicine of 2007 The Best Comic Book Medicine of 2006 The Best Comic Book Medicine of 2005 The Best Comic Book Medicine of 2004