Polite Dissent

Can you solve the “Mystery of the Million-Dollar Briefcase?”

Honestly, it’s not really that much of a mystery — reading between the lines, I think it’s really about a lonely guy with an unfortunate name, unfettered imagination, and too much time on his hands. And the neighbor he decides to stalk. Sounds like a FOX sit-com.

Libraries were one of the more popular themes in the DC Comics’ public service ads of the 1950s and ’60s. Others include:
Get YOUR Ticket to the Treasury of Books!
Your Free Trip Around the World!
The World of Adventure in Books
Your Pass to New Worlds!

Remember, tomorrow’s super-villain is today’s stalker.

This ad is from 1967, making it one of the last PSAs of DC’s program. It also provides more support of my contention that most of the later PSAs were boring and lame.

This PSA can be found in DC Comics from June 1967. The script, like most of DC’s PSAs, is by Jack Schiff. Once again, frequent collaborator Sheldon Moldoff provides the art. This particular image is from Superman #197.

More PSAs

Tags: comics psa library mystery briefcase jack schiff sheldon moldoff

Hawk and Dove #3 is a disappointment. It’s no more than a book long fight scene. That’s not necessarily a bad thing — if the art and writing are up to the task — but sadly that’s not the case in this comic.

Most of the issue focuses on Hawk’s battle with Condor. Dove and Swan are relegated to a few pages – and the denouement occurs off screen. Deadman makes an appearance as well, saving Judge Hall and the President (yes, that was supposed to be President Obama last issue) and then helping Hawk in his fight. Along the way, a few meager clues about Condor and Swan (and Hawk and Dove) are doled out and there’s a last page reveal – literally – but it’s not really worth the wait.

The art takes a step back in this issue. Certainly Rob Liefeld can generally draw exciting fight scenes, but only if they’re fairly short battles. He has a limited number of stock fighting poses in his arsenal, and the list is quickly exhausted in this issue of nothing but battles. Backgrounds appear and disappear at random, and even when present, don’t always make sense (why are there port holes in the kitchen?) Other problem scenes include one Condor where bites the head off of a secret service agent — but somehow manages to sever the head in a completely straight horizontal line– and the climactic return of Dove, with a strike that, as drawn, is clearly superficial — not the near fatal blow it’s supposed to be. For a quick preview of the problems with the art, just take a glance at the front cover. While Dove and Swan are imaginatively posed, their planes of intersection don’t work at all. Swan is missing her cape, and her right arm. And look: nobody has feet.

On a scale of 1 to 5 deformed Captain Americas, with 1 being good and 5 being execrable, this art on this issue rates 3.5 deformed Captain Americas, meaning each issue has been worse than the one before.

Swan makes a big deal of singing her “swan song” — apparently misunderstanding the metaphor and not realizing that a swan song is something you perform just before you die. And no, you can’t sing a swan song for someone else, that’s not how it works.
This issue provides more evidence that Hawk and Dove are more-or-less human under their costumes, a change from their pre-New 52 incarnation.
Rob Liefeld should not draw Deadman again. Ever.
With the conclusion of the Dove and Swan fight happening off panel, I’m just assuming it’s really Dove at the end and not some subterfuge. She sure talks like Dove, but I’ve been fooled before.
Meanwhile, Deadman and Dawn are also appearing over in Justice League Dark. Even though it’s only a few scenes, it’s more satisfying — artistically and emotionally — than either character’s appearances in Hawk and Dove.

All Previous Hawk and Dove Reviews

Tags: comics hawk dove condor swan sterling gates rob liefeld

scene from Amazing Spider-Man #673

Clint, the appendix is on your right side, not your left.

The writers should have taken the extra week they had off from the World Series and used it to tighten up the lousy science in this episode of Fringe.

The Plot: Peter has a meeting with Walter but it doesn’t go well, with NuFringe’s Walter not being as confident or comfortable as the Walter Peter new.

Meanwhile, the single remaining Shapeshifter 2.0 is back, this time tracking down a former Massive Dynamic scientist, who she locates and kidnaps at gunpoint. She needs his expertise in “cellular replication” in order to permanently fix what’s wrong with her body. She spins a sob story about being a melanoma patient in remission and he agrees to help her. At the lab she has set up, he injects her with some of his serum and she loses control of her shapeshifting and takes on the appearance of his wife. Now the scientist realizes something bad is going on and tries to kill her by making a toxic serum. She stops him and forces him to make the correct serum.

Agent Lee pulls Olivia in on the scientist’s case because he realizes it involves a shapeshifter. They aren’t making much progress until Peter volunteers his help. He is able to analyze the data disk the team recovered from the dead shapeshifter in episode 1 and use it to track the remaining shapeshifter and the scientist to her lab.

The Fringe team arrives at the lab just as the scientist finishes the new serum. The shapeshifter grabs it and sprints for the roof. Olivia follows but is told by an injured agent that the shapeshifter jumped off the roof into the harbor. Of course — and everyone saw it coming — the injured agent wasn’t really an agent but instead the shapeshifter who, once again, manages to escape. As the episode ends, she pulls out an old typewriter — like those used in previous seasons to communicate with the alternate dimension – and makes contact with her mysterious boss.

Peter has a second meeting with Walter. This one goes better, at first, until Walter denies Peter, telling him that he is nothing more than temptation that must be avoided.

1. Knitting the Raveled Sleave of Care
Sodium thiopental (i.e sodium pentathol, “truth serum”) is a barbiturate and can be used as an inducer of anesthetic. Using it to induce sleep, however, is a little better than Michael Jackson doing the same with Propofol, but not by much. Adrenalin may counteract some of the effects of the thiopental, but isn’t by any means a sure counteragent.

2. Phantom Itch
“Copied genetic data of healthy cells…and used it to replace the damaged ones.” The DNA of cancer cells is abnormal, so that makes a little sense, but Nina also mentioned using the process for people with amputations, and there’s no abnormal DNA in amputated cells; it’s just missing.

3. This Week, in NüFringe
We learned that Nina was a foster mother to Olivia and her sister after their mother died

4. Pluck the Heartstrings
Stage IV melanoma is melanoma with distant spread. The prognosis is dismal and there are no good treatments.

5. Larry, Darryl, and Darryl
Newhart gas station in Vermont — really?

6. Some Restrictions Apply
Restriction enzymes cut DNA strands into smaller pieces (of course, it’s DNA in the lab, not DNA still bound up in chromosomes and all the associated molecules). It would lead to massive cell death, in which case internal hemorrhaging is the least of your worries.

7. Inherited versus Acquired
Despite what Peter says, copying DNA – and even every molecule — exactly won’t duplicate a person. For a quick example, say I lost an eye in a barfight – that’s not going to be reflected in my DNA or molecules – so an identical copy of my genetic material is still going to leave the shapeshifter easy to spot.

8. Sherlock She’s Not
Olivia is smart enough to spot a smudge of grease under a victim’s fingernails, but not enough of a detective to see through the shapeshifter’s clumsy masquerade as Agent Warrick?

This episode didn’t do much for me, from the clumsy understandings of genetics to the worthlessness of Olivia’s vaunted detective skills. The Fringe Doomsday Clock advances one minute towards midnight.

This week’s Fringe cipher was: STILL.
A list of all previous Fringe reviews is available here.
Karl will has much more to say over at his blog.

This week, Fred had the high score with 13 points. Jinksb, SMEL, and wkmaier all tied for second with 12 points. Dr. R was in fifth with 10 points.

There was significant change in the overall standings this week. SMEL moves into first with 25 points. 4287, Harvey, and wkmaier are tied for second with 22 points. FlowerPower is in fifth with 21 points. If you have 18 or more points, then you are in the top 10%.

Click here to see the full scoreboard.

Chase and Taub are back on the team this week, which makes the episode much easier to watch (because the medicine sure isn’t helping)

Bob Harris, small town businessman and philanthropist collapses while in flagrante delicto with the local beauty queen. He has her bring him to the hospital where he is diagnosed with ventricular fibrillation, though there is no other sign of heart disease. He initially claims he was at his desk when the attack happened, but later admits to the affair when confronted with the evidence (fresh rug burns on his knees). The team decides to run an exercise test to see if another attack will occur. Initially, they get no results, but when Chase adds an emotional component to the stress, Bob collapses with a seizure. The team’s initial differential diagnosis is viral myocarditis, Brugada syndrome (an inherited abnormal heart rhythm), or pheochromocytoma. House suggests photic epilepsy (more commonly called “photosensitive epilepsy” — seizures brought on by flashing lights), but an EEG is negative, so he goes back to Park’s suggestion of a pheochromocytoma. While Chase and Adams run tests for the tumor, Park and Taub check out the seedy motel where Bob had his tryst. The pheochromocytoma tests are negative, but the patient now has a large mass on the right-side of his neck. Park and Taub find an abundance of pathogenic material at the hotel, including traces of fusobacterium necrophorum, which confirms House’s suspicion that the patient has Lemierre’s syndrome (an infected thrombophlebitis of the neck). The patient is started on Augmentin (amoxicillin + clavanulate) and surgery to remove the infected clot is scheduled. However, the surgery reveals no clot, but an enlarged lymph node. Adams suggests lymphoma. Chase obtains a biopsy and the patient’s vital signs plummet. Adams checks his eyes and notes yellow sclera, indicating liver failure to her.

With the new symptoms, the team formulates a new differential diagnosis. Lymphoma has been ruled out because the biopsy was negative. Alcoholism and withdrawal is suggested, but House is sure Bob still has an infection of some sort. He wants to use high doses of broad spectrum antibiotics to kill whatever infection it is. Adams is concerned that his plan will kill the patient’s already compromised liver. Chase suggests a liver transplant, and then the antibiotics. Since time is short, a partial liver transplant from a living donor is suggested. Most of the population of Bob’s small town come to the hospital to be see if they would be good donors for the liver transplant. Most leave after Bob confesses a number of sins, from cheating on his wife to ripping off customers at his car repair shop to stealing scholarship money. None of the remaining townspeople are good matches for his liver. House wants another CT of the liver, and surprisingly, this one shows that the liver is healing.

The team now suspects Bob is having an allergic reaction of some sort. He reacts strongly against the wheat sample, though he has no history of wheat allergy and blood tests don’t confirm the allergy. A latex allergy is considered but tests were also negative for that. Bob’s allergic reaction worsens, with large strips of his skin now tearing off. The team diagnoses Stevens-Johnson’s Syndrome and report that there’s nothing they can do as, according to the team, most medications exacerbate the confession. Not comfortable with leaving the patient alone, Chase sits besides him during the night. Bob tells Chase he has one last confession to make: he tells Chase he is a murderer, having killed his business partner and several others. This is over the top enough for Chase to realize that a large part of the problem is in the brain, with the patient confessing to crimes he has never committed. A brain scan shows an aneurysm. Taking this along with his other symptoms, House recognizes that Bob has Kawasaki’s syndrome, an autoimmune disease (in this case apparently induced by carpet cleaning chemicals Bob was exposed to through the rug burns). After treatment, Bob is feeling good enough to start lying to his wife.

As usual, major complaints are in red, modest complaints are in blue, and nit-picking ones in green:

A patient with a suspected systemic infection is not going to be a candidate for a liver transplant.

House’s team was bizarrely satisfied with the diagnosis of Stevens-Johnson syndrome (SJS), and never explored the all important question of what set it off?
Looked more like toxic epidermal necrolysis (TEN) than SJS to me, though admittedly most subspecialists consider TEN a very severe type of SJS.
The hallmark of SJS is the involvement of mucous membranes, none of which were involved in this patient (at least the ones we could see).
Corticosteroids haven’t been implicated in SJS, though they have rarely in TEN. In fact, they are one of the main treatments of the condition.
Narcotic pain medications are not known to cause SJS or TEN, so there was no reason to withhold them from the patient.

A lymph node biopsy, especially for something like lymphoma, takes the entire node, not just a little bit of juice from it.

Augmentin/Amoxicillin + clanulate is not the proper antibiotic for Lemierre’s syndrome.
Scanning the neck (CT scan or ultrasound) to evaluate the clot — or at least to make sure it exists – is recommended before surgery.
Patient was missing the pharyngeal/peritonsillar signs and symptoms seen before Lemierre’s.

Park complains about the length of time it takes to get culture results back (a valid point), yet she is the one who supplied the surprisingly fast results from the hotel room.

There was no good reason (other than to advance the plot, so make that no good medical reason) to repeat a CT scan of the liver so soon after the first.

You don’t confirm skin allergy test results with blood results. The skins tests are generally more definitive.

This week’s medical mystery was moderately intriguing, admittedly mostly because of its illicitness. I give it a B+. The final solution fit, but was quite a stretch, about average for the last few seasons of House. It earns a C. The medicine started out decent, but rapidly degraded. The treatment of SJS was nearly medieval. And why did it take the team so long to realize his confessions were a symptom? They were quick to consider altruism a symptom just two episodes ago. I give the medicine a grade of C-. The soap opera was much better this week — and most of that is due to the return of Chase and Taub. It’s good to have them back. A-.

The review of the previous episode of House
A list of all prior House reviews

Batwing #2 “We Have Blood On Our Hands”
Judd Winick, writer
Ben Oliver, artist

Batwing rushes to the hospital with a severely wounded victim. The emergency department team begins treatment immediately:

A good start to the resuscitation. Blood pressure of “eighty-palp” means that the patient’s systolic pressure is 80 (the top number in blood pressure, usually at least 100), and the diastolic pressure (the bottom number, usually around 80) can’t be read by the machine, but can be felt (hence “palp” for “palpable”). Placing two large IVs, one in each arm, is standard of care for emergency treatment. The large IVs allow fluid and blood to be given quickly. “Four units of O-neg” means to give the patient four units (roughly 2 liters) of O-negative blood (the universal donor; the patient needs the blood now and they don’t have time to test for the exact blood type match). This comic does follow what I call the “Final Thought Intubation Rule” — do not intubate the patient until they can deliver a final confession or clue.

The patient is in ventricular fibrillation (v-fib), a dangerous and usually fatal heart rhythm. Nice to see them starting CPR. Defibrillation is key in the management of ventricular fibrillation (the name should be a clue), so shock the patient fast and often while they remain in ventricular fibrillation. 200 joules is the usual starting setting, followed, if unsuccessful, by 300 and then 360 joules. If more shocks are required after that, the setting stays at 360 joules.

There are a few slightly different treatment algorithms for ventricular fibrillation — some recommend giving Epi (epinephrine) early, some recommend waiting to give it until after three unsuccessful shocks. (A nitpick: would they really use the term “Epi” here? The name epinephrine is only used in the U.S., everywhere else in the world they call it “Adrenalin”.) Amiodarone is used in treating ventricular fibrillation, but is generally not recommended until later in the algorithm if the patient is not responding to the usual treatments.

Did you notice that the patient apparently slipped into asystole (flatline) or PEA (pulseless electrical activity) after the first shock — notice how they keep saying “no rhythm.” If this is indeed the case (and there’s just text and a generic resuscitation scene in the comic; we don’t get to see the actual monitor), then the patient no longer shows a “shockable rhythm” and they should have stopped treating for v-fib and switched to treatment of asystole. (In other words, don’t shock a flatline — but bear in mind this patient is likely dead no matter what they do, he was just too severely injured to survive.)

An enjoyable episode of Fringe, but then, episodes featuring time travel usually are. (What would have made it even better would have been if the crew had managed to place a red Swingline stapler in Raymond’s house.)

The Plot: A series of strange time-related events have appeared around Boston. They all seem to relate to events that happened four years before. An apartment complex suddenly shows signs of fire damage, but the fire happened four years ago and the damage was long since repaired. A five year-old girl is reverted back to infancy. A freight train appears on a track abandoned four years before.

The Fringe Team is called in and brings along Peter, suspecting that the time effects are somehow the result of him reappearing in our universe. Mapping the disturbances, the team is able to discover that the effects seem to originate from one particular block. Soon, they are able to identify the specific house, but it is surrounded by a time bubble that will disintegrate anyone who enters it. Walter builds a portable Faraday cage that Peter is able to use to enter the house.

Inside the house are Raymond and his wife Kate. He is an electrical engineer and his wife is a theoretical physicist – or was, as she now suffers from severe Alzheimer’s disease. Raymond has used her notes on time to build a machine responsible for creating the time bubble surrounding the house. He brings the time in the house back four years, before Kate’s Alzheimer’s kicks in. Currently, his machine isn’t quite finished because Kate hasn’t finished her time equations, so it only works for a handful of minutes. That’s enough for him to bring her back to work on finishing the equations so the time bubble can become permanent. When Peter arrives, he confronts Raymond about the side effects of the machine, including the imminent deaths of hundreds of people in an underwater transit tunnel. Raymond agrees to shut off the machine, planning on building it again later. He knows that Kate has finished the equations so his next machine should be work perfectly – only, instead of writing down the finished equations, Kate blotted out all her previous work so Raymond can never build the machine again.

As the episode ends, Peter tells Broyles that his appearance in this universe provided the spark Raymond’s machine needed to work – this makes Peter think that he has appeared in the wrong universe.

1. Better Than Sylvia Brown
Peter is able to recognize that something is “growing geometrically” from just a single event?

2. Sure Natural Radiation is Good, but Organic Radiation is Much Better
Despite what Peter says, neutron radiation does occur naturally. (I’d go into a more thorough debunking of Fringe radiation here, but Karl’s always been better at that than me, so I’ll just link to him earlier than usual.)

3. The Fools-Gold Spiral
Fibonacci’s sequence creates something very close to the Golden Spiral, but it’s not quite the same thing. (A true Golden Spiral has a growth factor of phi. The Fibonacci sequence approaches this, but never quite reaches it.)

4. Time Keeps Flowing Like a River
Apparently, time is an electromagnetic wave and can be blocked by a Faraday cage (but walkie-talkies cannot be blocked by time bubbles or Faraday cages. Seriously, at that point Peter was so close to Olivia, why not just pop his head out of the bubble and talk to her?)

5. Steady Hands
Apparently Walter and Peter can both hand draw perfect Golden Spirals without mechanical aid. Must be genetic.

6. Caged Rat
Faraday cages consist of fine metal mesh which block out certain wavelengths of electromagnetic waves depending on the size of the mesh. Whatever Peter was wearing wasn’t a Faraday cage.

7. Ahead of Its Time
How long has Walter’s house been abandoned, because that look’s like a recent model flat screen TV.

8. Old Friends
This is the third episode Burlap Bear has been mentioned in. (Previous episodes 1-16 “Unleashed”, 3-07 “The Abducted.”)
The airplane in the old house looks like the one Peter bought after arriving from his universe into ours (episode 3-15 “Subject 13.”).

9. Gratuitous Product Placement
Sprint for the win.

A somewhat cliched story, but an enjoyable hour nonetheless (plus it’s always enjoyable to see Stephen Root). The Fringe Doomsday Clock retreats a minute, returning to 11:52

This week’s Fringe cipher was: LIVING.
A list of all previous Fringe reviews is available here.
Karl has more to say over at his blog.

A high scoring week as a bunch of people had syphilis as a choice. Dr. R was first with 15 points. Seven different players had 14 points , and more had 13 and 12 points.

Dr. R takes the lead with 33 points. Yerkiet makes a surge into second with 32 points. mbrigdan is third with 31 points and SMEL drops to fourth with 27 points. Alex51, brism19, and 4287 are tied for fifth with 25 points. If you have 21 or more points, then you are in the top 10%.

Click here to see the full scoreboard.

A disappointing episode, as the ones that try to make a broad point (this time: all parents screw up) usually are. There were a few clever moments — who am I kidding, there was one, maybe two clever moments, and the rest was rushing from one imagined crisis to the next

Ben is a teenager working, quite ineptly, as a clown at a kid’s birthday party. After an altercation with one of the kids and their father, he develops the sudden paralysis of an arm and a leg and is admitted to House’s service with a diagnosis of TIA (Transient Ischemic Attack, i.e. a “mini-stroke.”) The team is puzzled why a healthy teenager would have such a condition. The initial concerns are drug use or endocarditis (an infection of the heart valves). A transesophageal echocardiogram is ordered — it shows no heart valve problems, but it does reveal a thickened pericardium (the membranous sack that surrounds the heart). The differential now includes syphilitic vasculitis, histoplasmosis, or Sjögren’s syndrome. The tests for the first two were negative, so House orders Ben started on immunosuppressants to treat the Sjögren’s.

While Taub sets up the medication, Ben develops a bloody nose, then a bloody cough. Taub reports that Ben’s platelet count is low and suggests DIC (disseminated intravascular coagulation). Park reports a low red blood cell count and suggests a retropeitoneal bleed (bleeding into the tissues behind the abdominal cavity). Adams reports few white blood cells and suggests an infection. House notes that the entire blood count (platelets, red cells, and white cells) is low and reports that Ben has aplastic anemia (a condition where the bone marrow stops production of any kind of blood cell). He has Ben started on platelet transfusions and orders bone marrow testing on Ben and his relatives to prepare for a bone marrow transplant. A short time later, Ben complains of back pain and his blood pressure drops. It turns out that he is having an allergic reaction to the platelet transfusion. House orders a more specific kind of platelet transfusion so there will be less chance of a reaction. Ben suddenly starts gasping for breath and after a perfunctory physical exam, Taub announces that he has a pleural effusion (fluid building up around the lungs). A chest tube is placed, but rather than returning blood, it drains an transudate (which to me looked more like an exudate), which Park takes to mean our old friend liver failure is back. The team now has a prolonged and mostly pointless argument about whether the liver failure is due to a failure of protein synthesis or high ammonia levels. House suggests feeding Ben a high protein diet to purposefully worsen the liver, and his symptoms (heart failure or coma) will let the team know which problem he had (because this is so much quicker and easier than running a ten-minute blood test).

Of course, things quickly go from bad to worse. Ben’s left eye starts bulging out and needs steroid injections to resolve. The team now suggests angioneurotic edema, anasarca, or Burkitt’s lymphoma. House suspects that later is the most likely, so starts Ben on chemotherapy. While receiving his therapy, Ben crashes and develops multiple organ failure. The team initially suggests multiple aneurysms or cholesterol emboli as potential causes. But then Ben’s estranged and in-fact-thought-dead father stops by, and House recognizes the abnormal gait of someone with tabes dorsalis, a sign of syphilis. This causes him to realize that the father sexually abused Ben as a youngster and infected him with syphilis, which is what caused his current symptoms — well, that plus the antibiotics causing a Jarish-Herxheimer reaction (severe symptoms caused by multitudes of bacteria dying off and releasing toxins into the bloodstream).

This week’s episode was particularly weak in differential diagnoses. After the first round, they quite trying, and the newer diagnoses just explained the latest symptom and not the previous ones, so the original admitting symptoms were usually left unexplained. As always, major complaints are in red, modest complaints are in blue, and nit-picking ones in green:

Once again, House is starting chemotherapy on a patient without even confirming the patient has cancer, let alone what type he has. There is no generic chemotherapy; it is specially tailored to the specific cancer.

A few simple blood tests would determine the likely cause of the liver failure, though it is quite possible if not very likely to have poor synthesis and high ammonia livers. Despite what House says, it would be quicker too than feeding the poor patient protein and waiting for it to be processed by the liver and have an effect.

Worst diagnosis of the episode: retroperitoneal bleed. How does that even come close to explaining the TIA symptoms?

A pleural effusion is not “bleeding into the lung.” It is bleeding around the lung, a not unsubtle difference.

I have my doubts that the syphilis tests (likely an RPR or VDRL) would be negative in Ben’s case. Those tests are known for their false positives, not false negatives.

If Ben’s white count is so low as to suggest aplastic anemia, why was he not placed under neutropenic precautions?

The effusion should have been clear, not cloudy (and I’d expect it to be a little bloody as a result of the brutal chest tube placement as well).

This week’s medical mystery was a little interesting, but not terribly compelling. I give it a C. The more I think about the final solution, the less it makes sense. Ben had latent syphilis that suddenly, in the space of a minute, exploded into neuro- or at least cardiosyphilis? Really? And the Jarish-Herxheimer symptoms are a poor match as well. It earns a D. The medicine was poor as well, and was more reactive than actually thought out. I give it a C-. The soap opera, at least among the patient and his family, and among the team was interesting, though Taub surely knows that House cares nothing for his daughters’ well-being. The House/Wilson/Foreman aspect, though at times amusing, just reminded me of what a sad defeated man Wilson really is. I give the soap opera a B.

The review of the previous episode of House
A list of all prior House reviews

No, this public service ad is not about the possibility of an NBA season this year, but about how famous athletes overcame their physical handicaps to become champions.

Of course, these athletes are being used as examples by a minimum-wage soda jerk lecturing school students about studying harder, so I’m not sure they’re really the best choices. Maybe something more to do with math and science, and less to do with inborn athletic potential.

Never trust a guy who uses the word “fellers.”

Maybe if you spent more time studying and less time at the soda fountain, you’d pass.

After Vic’s lecture, all the kids gave up on math and science and instead worked hard at athletics, where they failed and had to take a job under Vic as junior soda jerks, allowing Vic to be promoted. Soon he ran the pharmacy, and then in a few years, a whole chain of pharmacies. He retired a rich man thanks to his devious plan of giving school children unrealistic expectations.

This PSA can be found in DC Comics from January 1967. The script is by Jack Schiff with art by Sheldon Moldoff. This particular image is from Superman #193.

More PSAs

Tags: comics psa school test athlete jack schiff sheldon moldoff

A disappointing episode of Fringe. The writing was choppy and the science sloppy; it felt only half finished.

The Plot: Olivia wakes up at night with a bad migraine. She heads to a pharmacy to refill her prescription and on the way home she passes an all-night diner where Agent Lee is sitting; it seems he has bad insomnia since joining the Fringe Team.

Across town, a man is heading home late at night and has the strange sensation he is being followed. Just as he makes it to the front door of his apartment building he is attacked. When the police arrive a few minutes later, they find him dead, and white as a sheet – drained of all pigment. Unsurprisingly, the Fringe Team is called in. Walter suggests the victim may have been scared to deat,h and Agent Lee finds blood on some broken glass, evidence of their mystery suspect. The blood is identified as belonging to an infant who died 22 years ago. Visiting the hospital where the baby was born, the team learns the baby had an unknown genetic condition, and didn’t really die, but instead was kidnapped by a company known as Cyprox, an old subsidiary of Massive Dynamic. Olivia visits Nina Sharp who admits Cyprox performed genetic experimentation on Eugene (what the baby was named), but insists the experimentation saved his life. He disappeared after a lab fire ten years before and they had assumed he died.

Meanwhile, another body has been found at another apartment complex. The building is locked down and the lights shut off. Walter has determined that Eugene can be seen under ultraviolet light and so groups of FBI agents search the building with UV lights and dogs. Olivia falls in a hole and Eugene rescues her, but then runs off. The team continues to search the building, but calls it off after there is no more sign of Eugene. They do find his hidden apartment and lab in the basement. Olivia speculates that Eugene just wants to be seen. A short time later, Eugene, now looking normal, enters the elevator at the apartment complex and has a short conversation with Julie, the object of his infatuation. As she leaves the elevator and the doors close, Eugene collapses to the floor, twitches, and dies.

Later that night, Olivia is getting ready to head out to the all-night diner to meet up with Agent Lee when she is knocked out by a gas pumped into her apartment. Two men enter her apartment, disable the security cameras, and inject her with a red medication. They mention that she’ll be out for a couple of hours, and wake with a massive headache. As they leave the room, we see Nina Sharp standing by, supervising the entire operation.

1. Not Quite Thirty Minutes Or Less
It takes more than 4 days to get genetic testing done, especially if so many “experts” are involved.

2. Let’s Digitize The Tests We Didn’t Perform
I realize this may or may-not or may-sometimes be our universe, but hospitals don’t keep DNA databases. And even if they did, why would it be online when the episode made the point of explicitly mentioning that all the hospital records from that era were on paper?

3. It’s A Hard Knock Life
Did Baby Boy Bryant didn’t have any parents? (The name is what you’d expect in a hospital file; all newborns are “baby-boy-mothers-lastname” or “baby-girl-mothers-lastname”).

4. Sorry Jean Valjean
A person’s hair turning white from a sudden fright is a myth. At most, theoretically, you could change the color of any hair that is newly growing, but the color of hair that’s already emerged from the follicles cannot be changed (excluding Clairol and Just for Men, of course).
What exactly was the pigment drained through? The pores? Capillaries? What?
More importantly, if Eugene is pigmentless, how does he see? The retinas require pigment to function.

5. Unclear On the Concept
I’m unclear how Eugene stealing other people’s pigment was returning himself to his original condition, since he was born without any pigment.

6. Ennui
In this entire episode, the Fringe Team accomplished nothing. Seriously: if they had not become involved, Eugene would have talked to Julie and died, just like he did after they became involved. They saved no lives; they prevented no crimes. There’s nothing quite like watching the characters of a TV show so completely not matter.

7. Mischief Managed
No octopus or chameleon can mimic that complicated an environment. They “blend in”, they don’t disappear. It’s camouflage, not the One Ring.

8. Spotting Scorpions
Why not bring in decent sized UV lights rather than those dinky little flashlight ones? It would be very easy to miss someone with one of those, especially the way they were haphazardly swinging them around. The ones we use in our office are easily four times the size of those, light, and portable.

The plot was too sloppy, let alone the science, for this to be considered a good episode, let alone the advertised mid-season finale. The Fringe Doomsday Clock gains two minutes to midnight.

This week’s Fringe cipher was: DAVID.
A list of all previous Fringe reviews is available here.
As always, Karl has more to say over at his blog.

This week, yarnpiggy leads the way with 13 points. Cyndi, Karatesocks, Nextsundayad, and Synth tie for second with 6 points.

Overall, Dr. R retains the lead with 37 points. Yerkiet is still in second and has 35 points. mbrigdan is third with 32 points. James H is fourth with 31 points, and Alex51 is fifth with 30 points. If you have 26 or more points, then you are in the top 10%.

N.B.: This week’s scores also contain the two corrections from last week’s scoring.

Click here to see the full scoreboard.

A promising episode derailed by a story decision more suited to Grey’s Anatomy or Chicago Hope than House. The B storyline was better.

Two cases this week: the team tackled the case of a moody teenager, while House looked into the death of a four year old boy.

The team takes on the case of Iris, a fourteen year-old girl who was admitted to the hospital with an idiopathic anaphylactic reaction. The first thoughts are hereditary angiodema (a genetic condition leading to swelling of the face and airways), systemic mastocytosis, pheochromocytoma (a tumor that secretes stress hormones, like adrenalin), or an anaphylactoid reaction to opioids. They start out by checking a catecholamine panel (high in cases of pheochromocytoma) and an expanded opioid screen. Taub learns that Iris’s mother has been secretly slipping diazepam (Valium) to her daughter to calm her down, telling her they were vitamin pills. When Iris suddenly begins throwing up, the team starts to rethink their diagnoses. A quick exam reveals some mild abdominal pain and breast tenderness. They run a pregnancy test, even though she insists that she’s never had sex. About this time, she develops numbness in both arms. The pregnancy test comes back positive, explaining away many of the symptoms. To work up the paresthesia (numbness), the team considers the possibilities of a cerebral tumor, vasculitis (inflammation of the blood vessels), multiple sclerosis, or HIV-related mononeuritis mutiplex. The tumor and HIV seem the most likely, so a blood test and MRI are ordered, but both are negative.

In the meantime, Iris’s paresthesia has resolved, but she now has bruises on her upper arm. The team investigates the possibility of clotting disorders such as thromobocytopenia (low platelet count), vitamin K deficiency, or scurvy (severe vitamin C deficiency). The tests for these conditions are negative, but a search of her room at home turns up a hidden stash of love letters and hardcore pornography. When confronted, Iris admits to having a boyfriend and reports that the porn is his. She also explains that he snuck into the hospital and beat her the night before, explaining the bruises. In the middle of the conversation, she develops a sudden attack of tunnel vision, which resolves spontaneously. Chase suggests a TIA (transient ischemic attack — a “mini-stroke”) and an MRA is ordered. House, stopping by, has a moment of inspiration and tells Iris her boyfriend was hit by a car. She angrily tells House that he’s lying because she is the boyfriend. It turns out that she has dissociative identity disorder (multiple personality disorder, to the layperson), and the boyfriend is just one of her personalities. Hypnosis reveals the trauma that split the personalities was the car accident when she was two that killed her father. Snips of memory from that accident (strawberries, an eight ball) caused her initial allergic symptoms — in one personality at least. It seems each personality was exhibiting different symptoms, and that’s why they would come and go so quickly. When she develops severe vaginal bleeding, the team realizes that she still has an unexplained medical ailment. They find that the symptoms that are consistent across all three personalities are the pregnancy, the high blood pressure, and the vaginal bleeding. Bearing this into account, the differential now consists of preeclampsia or an ectopic pregnancy (a pregnancy outside the uterus), but an ultrasound reveals no embryo. She is ultimately diagnosed with choriocarcinoma, a cancer of the placenta (or rarely, very rarely, a choriocarcinoma can be found in other reproductive tissue).

Meanwhile, House is obsessed with discovering the cause of death of a four year-old who died five years before of an unexplained kidney disease. Berger’s disease is suggested initially but when House learns that the lungs were also involved, he considers lupus and Wegener’s granulomatosis, but those avenues of inquiring prove pointless. Next he focuses on heavy metal poisoning, particularly arsenic, lead, and mercury, but his tests are negative. In the end, after a confrontation with the dead boy’s grandfather, mother, and mother’s new-husband — combined with an earlier comment from the boy’s father said — House realize that the boy had been partially deaf and was suffering from Alport syndrome, a genetic condition affecting kidneys and hearing.

As usual, major complaints are in red, modest complaints are in blue, and nit-picking ones in green:

As far as I was concerned, the episode was going along fairly well, but then lost all momentum and semblance of coherence when the diagnosis of dissociative identity disorder (DID) was introduced. It introduced more questions and generating more handwaving than it solved. For example:
What trauma caused the boyfriend personality?
Nobody noticed Iris’s changes in personality? Not just no one at home (explained away by the Valium), but no one at the hospital noticed a change in personality with a change in symptoms?
Iris’s main personality was aware of the boyfriend much more than she should have been if it were a true case of DID.
DID in young patients is not unheard of, but very rare. But a two year old? You can’t blame the Valium for Mom missing a decade of symptoms unless she started Iris on Valium as a toddler.

Three positive HCG tests and no one ran a quantitive test (tells how much HCG there is. Can be helpful in dating the pregnancy, or discovering if something else, like a choriocarcinoma, is going on), or checked an ultrasound for dating. How far along the pregnancy is is an important topic, especially when considering preeclampsia, ectopic pregnancy, or even morning sickness.

I don’t think pregnancy is a “symptom” of a condition. A positive HCG test may be, but that’s not what they were discussing during the differential. They also forgot to mention all the symptoms they explained away by blaming that same pregnancy (vomiting, abdominal pain, breast tenderness, abnormal periods).

Another House episode this season overcome by real world events, in this case the recent news that the most famous of all multiple personality cases, Sybil, was faked – casting doubt (more doubt, anyway) on many of the more extreme DID cases.

A patient taking diazepam would not have a “clean tox screen,” she would be positive for benzodiazepines.

An expanded opioid screen is not better at telling if a person is on opioids or not, it just shows which opioid they are taking. If the initial tox screen was negative for opioids, then the expanded screen would be too.

It was more of a symmetrical neuritis than a mononeuritis multiplex.

For the second week in a row, Park suggests the most ridiculous diagnosis: scurvy. Really? Easy bleeding, sure, but no other symptoms match.

Like most of this season’s episode, this week’s medical mystery was mildy interesting, but little more. I give it a C+. The final solutions to both medical mysteries fit, at least better than usual. They earn a B+. The A-storyline had sloppy medicine, and that was before they added in the multiple personality aspect. The B-storyline was better, but not enough to save the episode. I give it a D+ (the plus is from the B-storyline). The soap opera wasn’t compelling this week. How many times can we see Foreman stew over where to draw the line with House, and how many times can Wilson ineffectually hem and haw. It was particularly hard to accept the hard ass Foreman this week after we say him sharing a beer with House at an out-of-town boxing match last week. The soap opera earns a C-.

The review of the previous episode of House
A list of all prior House reviews

Precognitives have never had it easy have they? Ask Cassandra, or ask poor Asher Cobb here:

scene from The Sixth Gun #14

All previous Psychic Nosebleed Zen posts.

Dashford Dartwell. With a name like that, you’re destined for soap operas – or super heroics.

One night there is an explosion in the lab of Dr. Moss, chemistry professor and father of Dash’s girlfriend. Dash rushes in and the professor tells him that he has successfully invented a Metabo-Catalyst.

He tells Dash: As yet, I don’t know it will do. It might give extraordinary speed-strength-ANYTHING!
I must make human tests!

To which Dash replies: How about some lab testing, or at least animal studies before human studies. Have you talked to the IRB? How about making them on me?

That’s right, Dash has just witnessed the metabo-catalyst cause a lab explosion, yet volunteers to test the chemical concoction – a mixture even the inventor admits he doesn’t know what it will do – on himself¹.

Of course, this is the Golden Age, so Dr. Moss’ Metabo-Tablets grant him super-strength, super-speed, and super-agility. So Dash uses his newfound powers to stop crime and right wrongs – right? Well, not exactly, first he uses his chemically-enhanced abilities to set four world records and help his college (Dravrah) defeat its rival (Elay)^{2, 3}. Then, only when personally threatened by gangsters, does he decide to use his powers to fight crime.

NOTES:
1. It could be that Dr. Moss can’t stand Dash and this was all an elaborate ploy to kill him.

2. It’s bad enough that Dash uses his chemically-enhanced powers to gain an unfair advantage in the game – after all, the Flash did essentially the same thing in his first appearance – but the coach knows what he is doing and does nothing to stop him or even tell him that it’s unethical.

3. Dravah and Elay. Really. Are they in Yvi Eugael?

4. Admittedly, he does spend two of his next — and final — three appearances fighting crime (the third is a reprint of his origin).

This week, Akshay R, James H, and Kevin Lighton won with 8 points. Roxanna was fourth with 7 points.

Overall, James H takes over the lead with 39 points. Dr. R drops to second with his 37 points. Yerkietand mbrigdan are tied for third with and has 35 points. Roxanna moves into fifth with 32 points. If you have 29 or more points, then you are in the top 10%.

Click here to see the full scoreboard.

What started out as an intriguing courtroom thriller ended up a barely mediocre episode of House

Tommy is a forty year-old prosecutor who develops sudden severe chest pain in the middle of a court case. He is admitted to the hospital where a heart attack and anxiety are ruled out — with no clear cause of chest pain remaining, he is admitted to House’s service. The team’s initial differential diagnosis includes shingles, asthma-induced pneumothorax (a collapsed lung) or poisoning (particularly chlorine poisoning). House thinks poisoning seems the most likely, so has the team alkalinize the urine, and then interview his wife and search the house. No poisons turn up in the search, but Park and Adams find a hidden bunker filled with guns. Now Chase and Adams think that this is a sign of paranoia, but Park doesn’t think he’s paranoid. Taub, wisely, sits this one out. The new differential diagnosis consists of cocaine abuse, Fahr’s disease, or atrial fibrillation due to hyperthyroidism or sleep apnea. House has all the suggestions checked, but everything comes back negative.

Park notices a bleeding sore on Tommy’s leg, which he tells he didn’t know about. He starts running a fever as well. The team thinks tuberculosis is possibility, as is systemic sclerosis (better known as scleroderma, an autoimmune disease). House decides to go with Taub’s suggestion of sclerosis; he orders a skin biopsy and starts Tommy on enoxaparin (a blood thinner). The treatment doesn’t help and Tommy starts having hallucinations and suffers a psychotic break. Park thinks he has an infection like tularemia and Adams thinks he has GAD autoimmunity. Chase thinks all of the patient’s symptoms are psychiatric or self induced. House favors Adams, and starts Tommy on immunoglobulin and corticosteroids. Tommy continues to get worse with his fever getting higher. Adams wants to up the steroid dose, but this time House agrees with Park and has Tommy checked for a number of infectious diseases, including sporotrichosis and meningococcemia.

Without warning, Tommy goes into anaphylactic shock. Chase performs a tracheotomy, but it doesn’t help because the airway blockage is below the cricothyroid membrane. There are some tense moments (as least I assume they were tense, all we got was a commercial break), but Chase and Taub manage to open the airway and get him hooked up to a ventilator. The team is at a loss for a cause when Park suggests that Tommy’s symptoms are the result of squamous cell carcinoma (a type of skin cancer) along with paraneoplastic syndrome. The team is getting ready to obtain a skin biopsy when House has one of his Eureka! moments and realizes that Tommy has severe diphtheria. One of the classic symptoms of the disease is a pseudomembrane which blocks the airway, and this explains the respiratory arrest. His other symptoms have also been associated with the disease, albeit very rarely. Some antitoxin, and he should be as good as new (though still paranoid).

As usual, major complaints are in red (red caduceus), modest complaints are in blue (blue Vicodin), and nit-picking ones in green (green pencils):

A patient with non-cardiac non-anxiety chest pain is not a big mystery; they’re a dime a dozen. Once the patient’s chest pain is determined to be non-cardiac, there’s no reason to admit the patient (unless something life threatening is going on, which is not the case with Tommy – at least at this point). The rest of the work-up can be done as an outpatient.
There are many common causes of chest pain that are non-cardiac and non-anxiety (gastrointestinal and musculoskeletal are common, for starters). An ER of that size would see at least a dozen such patients a day. There is no reason House would be intrigued by such a pedestrian complaint.

Notice how, for once, House held off starting broad spectrum antibiotics (or any antibiotics) and waited for tests to come back first – only because if he had given the antibiotics earlier the case would have been solved too quickly. Acting out of character in order to advance the plot is not the sign of a well written mystery.

Do they intend to biopsy the entire chest looking for this squamous cell cancer, or is there a suspicious lesion on the chest just asking to be biopsied – and if that’s the case, why didn’t someone spot it or mention it sooner?

Severe enough diphtheria to cause fever, pseudomembrane formation, skin lesions, chest pain, and hallucinations, but somehow there are no upper respiratory symptoms or swollen lymph nodes?

Giving someone Xanax and noting no chest pain, even when lying to the patient, does not rule out anxiety. For instance, what if they only have anxiety in high-stress situations like a courtroom? What does giving them Xanax in the artificial surroundings of the hospital accomplish?

It was not anaphylaxis, it was respiratory distress/arrest. They are not synonymous. You’d think the team would notice there were no other symptoms of anaphylaxis.

The main symptoms of Fahr’s syndrome are disorders of movement, none of which the patient had.

Once the airway blockage has been cleared, why is Tommy on a ventilator? There was never any indication or any reason given why he was unable to breath for himself.

Someone with a bad infection may worsen on corticosteroids, but giving someone with GAD autoimmunity antibiotics is not going to kill them.

If the EKG was normal and the cardiac enzymes were normal, why proceed with a cardiac catheterization?

Schizoid and schizophrenia are not the same thing.

As I mentioned above, the medical mystery this week was routine, boring even. Chest pain is exceedingly common and this case would not pique House’s interest. I give it a D. The final solution fit, but really only if you accepted the fact that the doctors on the team are idiots and borderline incompetent. I give it a C. The medicine diagnoses seemed more random than logical with many of them fitting the patient poorly, if at all. And did I mention House acting out of character? I give it a weak D The soap opera was better this week with all three storylines (Foreman, Park, House/Wilson) clicking. I give it a B+.

The review of the previous episode of House
A list of all prior House reviews

If his “brain had left his body,” he wouldn’t have a pulse — because after all, the brain controls the pulse (not to mention there’d be a big hole in his head and quite a mess on the floor).

I think Batman’s actually referring to the victim’s “higher consciousness*” (however you wish to define that term), though what pupil response had to do with “higher consciousness” is a mystery to me (and how can Batman even judge the pupil’s response when he’s behind the patient?).

*Yes, this becomes one of those mind-downloaded-into-a-computer story. And a giant ape is involved as well.