Polite Dissent

With the help of a recently discovered Kryptonite meteorite, Luthor creates a special liquid Kryptonite serum. Anyone who drinks the serum will emit Krytponite radiation.First Luthor tests the serum on a monkey¹, and when that works, he drinks the serum himself.

Giving off green Kryptonite radiation, Luthor confronts Superman, who becomes too weak to stop him. Not willing to admit defeat, Superman dons a lead suit and flies after Luthor, but the villain expected this and has placed a satellite in orbit around Earth that changes all lead to glass2, rendering Superman’s protective suit useless.

Superman has another trick up his sleeve and fools Luthor into believing that Superman has become immune to Kryptonite (he has himself strung with hidden wires, like a marionette). Thinking his serum is now useless, Luthor drinks the antidote to the liquid Kryptonite³. This allows Superman to capture him and haul him off to jail⁴.

NOTES:
1. The Kryptonite monkey eventually escaped Luthor and returned to the zoo, making Clark Kent’s visit there a painful experience for him. Luckily, there was a lead water pipe nearby, and he could lure the monkey into it. I can only assume Kent was there to investigate all the zoo animal deaths related to lead poisoning.

2. Wouldn’t this be a self-defeating satellite, since all the lead in its solder would turn to glass?

3. Once Luthor realized Superman was faking his Kryptonite immunity, why didn’t he just drink the serum again?

4. Which is strange, because Luthor actually commits no significant crime in this story — certainly nothing requiring jail time.

Sadly, nothing this exciting happens in the actual issue.

This is the final chapter in the original Korvac storyline, and by the end of the issue, though Korvac is defeated, all the Avengers save Thor and Moondragon have been laid low. Thor transforms to Dr. Donald Blake so he can save his teammates (although all we see him do is approach Iron Man), and Moondragon sulks off, using her mental powers so none of the Avengers will remember what actually happened. A whole issue of nothing but CPR chest compressions would have been more exciting.

While that is a striking cover by Dave Cockrum (and much better than the interior pencils), let me point out that the medicine is wrong. Blake is using a technique known as the precordial thump where a solid blow is given over the heart. It’s a real technique, but only has very limited use. The precordial thump should only be employed in the event of a witnessed cardiac arrest, and only at the beginning of resuscitation. When you come across someone who is already down, and has been for some time, then the precordial thump is not the right choice (standard CPR would be a better option, or maybe calling 911). [More about the precordial thump and comic books]

A quick little almost-wordless public service advertisement today.

I’ve got nothing to add to this one, other than the fact that I like the look of Henry Boltinoff’s ultra-clean linework. Boltinoff did many of the gag strips found in the back of DC’s Silver Age comics. He also drew the syndicated can-you-spot-the-difference strip Hocus-Focus (which my newspaper still publishes, despite the fact that Boltinoff died a decade ago). As far as I know, this is the only PSA he did for DC comics.

This PSA can be found in DC comics from July 1958. The script is by Jack Schiff and the art, as already mentioned, is by Henry Boltinoff.

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Tags: comics psa litter bug jack schiff henry boltinoff

Once again celebrating the head mirror, an artifact seen more often in comic book depictions of doctors than in real life. Now available in 4-D.

This anonymous — and soon to be a casualty — doctor is not only rocking the head mirror look, but is also sporting the “I shoulda been a chef” white coat.

Here’s a bonus head mirror for certain unnamed other bloggers…

What’s the error in this scene from Firestorm #3, featuring the origin of of the villainess Killer Frost?

Previous picture quizzes

Apothecarius Argentum was a manga published by DC imprint CMX. The story takes place primarily in the quasi-medieval kingdom of Beazol and features the Princess Primula and her Royal Apothecary, Argent.

Argent is something of a contradiction, being both a Basilisk and an apothecary. An apothecary is simply another name for a physician. Basilisks are rare individuals who were fed increasing doses of various toxins as children until they became immune to all poisons. Unfortunately, this process turns the Basilisks themselves toxic to anyone who touches them. Thus Argent is both a healer and a killer.

The initial volumes of the story took place in Beazol, but later volumes have had the characters travel to other countries. Recently, Argent has traveled to Castoria, looking for a fabled gem that is said to cure a Basilisk of their toxic nature.

Most of the medical scenes are found in the first third of the book; the last two thirds contain stories focusing on political maneuvering and rescue missions.

1. Anesthetics
The anesthetic used by Lulu for the dental extraction mad is made by “mixing minerals or metal with nitric acid.” She also mentions that some people “deliberately inhaled the fumes to become intoxicated.” What she is describing in Nitrous Oxide (i.e. laughing gas). Traditionally, it was produced by pouring nitric acid over iron filings. It can be used as an intoxicant – in fact it was used in such a way long before its anesthetic properties were discovered.

She mentions another anesthetic gas that is both stronger and more dangerous than nitrous oxide. This could be either chloroform or ether (she’s probably referring to ether, as that was mentioned in the previous volume).

2. Claviceps
Lulu keeps some moldy rye, which she tells Argent she uses to treat migraines. This mold is the fungus Claviceps pupurea, which contains the potent chemical ergotamine. Until about twenty years ago, ergotamine was the primary treatment for severe migraines. While it is still used a little today, most migraine patients now take the safer and more reliable Triptan drugs (Imitrex, Zolmig, Maxalt, etc.). Ergotamine can also cause uterine contractions, and has been used since the Middle Ages to induce abortions. For this reason, it is a Category X drug, and should not be taken during pregnancy.

3. Placental Abruption
An abruption occurs when the placenta pulls away from the wall of the uterus. This can be life threatening to both mother and child. The placenta is literally the lifeline for the baby, so if it is injured in any way, the baby’s life is at risk. An abruption can also cause a severe hemorrhage and lead to the mother bleeding to death. Mild abruptions can be treated with bed rest and observation, but severe cases require an immediate caesarean section.

Previous Apothercarius Argentum annotations
Other manga medical annotations

I’m featuring an old comic book public service ad today, from spring 1944 — five years before DC started their monthly PSA program.

In this era, deep in the middle of World War II, waste paper PSAs were very common in comics. For example, here’s one by Batman and Robin, and another with Captain America.

This PSA can be found in DC comics from both April and May, 1944. The art is by George Roussos, but it is unclear who wrote the script (though some suggest our old buddy and frequent PSA author Jack Schiff).

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Tags: comics psa waste paper superman world war ii george roussos

Thanks to a succesful polio vaccination program — and let’s hope it stays that way — so ads like these don’t make a come back. [1][2][3][4]

an old comic book ad about polio

scene from Uncanny X-Men Annual #3 by Asmus and Bradshaw

First off, this is one of the better drawn hospital scenes I’ve seen in quite a while. The bed and medical equipment are drawn well and it is clear that the artist did his research.

That being said, there are few nit-picks worth mentioning, purely as teaching points (a few of them are even classics that I mentioned in my needs-to-be-updated common medical errors posts [1][2]):
1. While I congratulate Bradshaw on the correctly drawn nasal canula, it shouldn’t go under the bandages.
2. There should be no bubbles in IV bags — they are closed systems.
3. Speaking of IVs, the IV in the left arm goes to different places in the two panels.
4. Blood and other IV fluids require gravity and fluid dynamics to work right — they flow down from the IV bag to the IV canula and into the patient. The fluids won’t be able to flow up the length of vertical tubing seen here.
5. I applaud Dr. Rao for counting the ulnar pulse, but most people use the radial pulse (on the thumb-side of the wrist) as it is stronger and easier to find.

Secret Hearts #133

Sadly, I’ve never been chased down a hospital hallway by a cute blonde.

But I can always hope.

In my experience, science fiction comics — particularly those at least partially dystopic in nature — tend to have the best thought out and most entertaining fictional drugs.

Example #1: Transmetropolitan
Example #2: American Flagg
Example #3: Smileezys from the Flesh stories in recent issues of 2000AD

Another waste paper public service ad from the World War II era, this time starring the World’s Finest team: Batman, Superman, and Robin.

Click on the image for the full ad

There is supposed to be a similarly themed Wonder Woman PSA from the same year, but I haven’t had any luck in tracking it down so far.

This PSA can be found in DC comics from spring 1944. This particular image came from Batman #22, cover dated April/May 1944. The Grand Comics Database credits Jack Schiff as the writer and Jerry Robinson as the artist.

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Tags: comics psa waste paper superman batmanrobin world war ii

Look at the picture — you know the doctor’s trying to subtly slip his stethoscope on so he can’t hear what’s going on behind him.

The Spirit #15
David Hine, writer
Moritat, artist

Honey Steel, the protagonist/villain of The Spirit #15 has decided to commit suicide by starting a fire and then taking a handful of pills.

Which pills did she take? Conveniently, the artist provides us with a panel showing two nearly empty bottles of carbamazepine 100mg tablets.

Carbamazepine (brand name Tegretol) is a drug with three official uses: seizure prevention, treatment of trigeminal neuralgia (chronic pain of nerves of the face), and treatment of bipolar disease. It has a number of unofficial “off label” uses as well including treatment of depression, attention deficit disorder, restless leg syndrome, post-traumatic stress disorder, and neurological pain conditions.

Drowsiness is a common side effect of carbamazepine at normal doses, and can be quite severe — up to and including unconsciousness — in an overdose situation. It is entirely believable that the overdose would cause Honey to pass out. Of course, in real life, it wouldn’t happen quite so quickly and there’d be other nasty effects of the overdose such as nausea, vomiting, slurred speech, ataxia, blurred vision, tremors, and seizures.

Would the carbamazepine overdose alone be enough to kill Honey? Quite possibly. High levels of carbamazepine cause some nasty cardiac effects including AV blocks and arrhythmias.

Looking over the prescription bottles, we can glean a few more facts.

First, since 60 pills were prescribed, this tells us Honey is taking carbamazepine 100MG twice a day for a total of 200MG a day. That’s a tiny dose of carbamazepine – not high enough for seizures or bipolar. Trigeminal neuralgia takes a lower dose than the other two condition, but even it requires more than 200MG/day. I’ll admit I don’t know the doses for the off-label uses of carbamazepine since I don’t prescribe it for them.
The prescription is from Dr. Cobra, one of the Spirits archenemies, and the villain who “killed” Denny Colt, giving birth to the Spirit.
Dr. Cobra fails my Quack Doctor test:

A few thoughts on this scene from Daken #6:

1. The EMT speaks truer than he intends — if the heart stops, you CAN’T resuscitate someone by defibrillating it. It falls under that whole “don’t shock a flatline.” In other words, it’s a defibrillator — it stops fibrillation (i.e. bad heart rhythms) — it’s not a jump-startinator.

2. That being said, removing all extraneous metal — like a handcuff and metal briefcase — before defibrillating is a good idea.

3. It’s all a moot point though, as it’s not a real resuscitation, it’s a sting.

An environmental public service ad today, courtesy of Adventure Comics #346 from July 1966.

Starting with an LBJ quote potentially limited how many times this PSA could be used, though it didn’t end up being important as DC has finished their monthly PSA program before he left office.

The use of quotation marks makes me think that almost all the text of this PSA is from a speech or proclamation by LBJ, though a quick internet search doesn’t turn up any matches.

This PSA can be found in DC comics from both July 1966. The script is by Jack Schiff (with significant help from LBJ) with art credited to Sheldon Moldoff (though I’m a little suspicious that credit is incorrect as it doesn’t look like typical Moldoff to me).

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Tags: comics psa nature lyndon johnson jack schiff sheldon moldoff

scene from Captain America: Hail Hydra #2

Two observations, and a couple of explanations — and recommendations — for artists drawing IVs:

1. Two IV catheters going into the same site — ouch! If two IVs are needed, either piggy-back them, or use a Y-connector to link their tubing. Only one catheter per site.

2. A third IV with its tubing dragging the floor. The same IV tubing is generally used from bag to bag, so when a bag is empty, the IV tubing is just switched to another bag and not left to hang. If it’s an IV bag that hasn’t been used yet, then there would be no tubing attached. (It’s possible that it’s an old IV bag from a site that was discontinued, so the tubing wasn’t going to be used again — in that case, hanging it like that is just tacky and unclean.)