Polite Dissent

What exactly goes into Joker Toxin (aka Joker Venom, Smile Venom, Joker Juice, and sometimes, Smilex)? The recipe seems to have changed over the years:

1991
HUNTRESS: “Just tell me if any dimethyl silicate has changed hands lately. You know it Charley -– the poison the Joker makes his Smile Venom from.”
Dimemethyl silicate is most commonly found in cosmetics. For instance, it’s a common ingredient in lip gloss.
Source: Wonder Woman #282 (Admittedly, this story takes place on Earth-2)

1993
BRUCE WAYNE: “Some strange compound of chlorides and hydrocolloids with a protein catalyst.”
This one is little more than medical technobabble as all three terms, while real, are maddeningly vague. (FYI: Wikipedia entries on chlorides and hydrocolloids).
Source: Batman: Legends of the Dark Knight #50

2006
DR KOWALSKI: “I had never seen anything like the neurotoxin before. It blocked the calcium and potassium channels and also placed the victim in anaphylactic shock.”
More technobabble, but, like the best technobabble, there is just enough real science present to give it a whiff of truth: calcium channels are found throughout the body, but are especially common in nerves and muscles, and potassium channels are found in nerves and the heart muscle. Anaphylactic shock is a fatal allergic reaction — for example, people who die from bee stings.
Source: Batman: Legends of the Dark Knight #200

2010
BATMAN: “The most lethal element of authentic Joker Venom, hydrogen cyanide, is absent. strychnodide is present, though. It causes the muscle contractions that produce the hallmark grin.”
Hydrogen cyanide is a very real, very fast, and very deadly toxin (its symptoms don’t really match Joker Venom though). Strychnodide is a fictional derivative of strychnine.
Source: Detective Comics #867.
Though this is the first mention (to my knowledge) of this Joker Venom recipe in an actual comic, this combination of toxins was first mentioned in a DC Heroes Role Playing Game supplement in back in 1993 (DC Technical Manual: S.T.A.R. Labs 1993 Annual Report — I scanned in the relevant section here.).

Let’s take another look at Shadow of the Bat #50, where Batman is facing Narcosis, a villain who has created a special gas — a “patented” combination of Ketamine and Acetylcholine — to cause horrific nightmares.

First, the Ketamine:

Ketamine is a sedative and an anesthetic which I’ve covered extensively before. It is a strong tranquilizer and it has been known to cause nightmares, so its inclusion in Narcosis’ nightmare gas makes a certain amount of sense.

Now the Acetylcholine:

Acetylcholine is a neurotransmitter. In other words, it is a chemical messenger used to pass information between two nerves and it is also used to pass information between nerves and muscles. It has multiple effects within the human body. It causes skeletal muscles to contract. It activates the parasympathetic nervous system which, among other things, increase gland excretions and cause the heart to slow down. Within the brain itself, acetylcholine is associated with REM sleep — a state known for its vivid dreams — but its exact effect is not entirely clear. When the body moves from other stages of sleep into REM sleep, acetylcholine production — which had been suppressed — increases, so there is a rise in the level of acetylcholine. Dreaming also increases in REM sleep, but there is mixed evidence that it is the acetylcholine itself that causes the dreams. Some researchers say acetylcholine causes dreams, some say it causes REM sleep, some say it’s the other way around, and some say it’s all just coincidence. For now, I’ll just point out that while it’s true that all three situations (REM sleep, vivid dreaming, high levels of acetylcholine) exist at the same time, correlation does not equal causation. I’d give Narcosis a mixed grade on this (if the acetylcholine gets to the brain, it may cause increased dreaming which may cause nightmares) except for one thing:

The bigger problem with Narcosis’ use of acetylcholine in his gas is the effects of the neurotransmitter on the other parts of the body. Sure, it might cause nightmares, but who cares when you’re having severe cholinergic symptoms (salivation, urination, lacrimation, defecation, nausea, vomiting), uncontrollable muscle convulsions, and cardiac symptoms. Frankly, nightmares are the least of your worries.

Batman: Shadow of the Bat #77 “Arwin’s Theory of Devolution”
Alan Grant, writer
Mark Buckingham, penciler

Streptomycin, a potent antibiotic, will indeed kill off the bacteria E. coli — and it’s particularly effective in a Petri dish, where you don’t have to worry about nasty side effects such as kidney damage and deafness commonly seen with such antibiotics.

However, the description of how the bacteria evolve resistance to the antibiotic is a little off:

The mutation in question (resistance to Streptomycin) occurred before the antibiotic was ever added. It may be a recent mutation, or it may be an old one, but when it occurred isn’t important — all that matters is that some bacteria in the dish have the mutated gene and are resistant to the antibiotic.

Once the Streptomycin is added to the dish, the non-mutated bacteria — those susceptible to the antibiotic — die off, leaving only the mutated bacteria to reproduce.

The surviving bacteria don’t “mutate rapidly” to pass along the gene because simply being one of the few bacteria that survived guarantees that their genes will be passed to the next generation. In other words, the mutation has already occurred, no more is required for survival¹.

In all fairness to the writer, these words are spoken by a college professor who is clearly more than a little nuts. So it is likely the character who misstates the science, and not Grant.

Notes:
1. There will of course be the usual random assortment of new mutations that may occur within any generation of bacteria.

The inhabitants of the Lost Valley of the Bird-Men have learned how to surgically attach giant wings to humans, allowing them to fly. All it takes it a few stitches and a large supply of the miracle drug Serum Alpha. Unfortunately, the evil Gravio family has cornered the market on Serum Alpha so they are the only ones in the Valley who can fly, a fact they use to their advantage by raiding and robbing from the remaining ground-bound populace.

All hope is not lost! A dissident member of the Gravio family has smuggled out enough Serum Alpha for one person. The villagers decide that Batman is their best chance, so they kidnap him and bring him to the Lost Valley.

He agrees to the surgery and a large pair of bat wings is grafted onto him.

He proceeds to take on the Gravios and defeats them all by executing an undeniably awesome plan which consists of: 1) divebombing with giant bat wings, and 2) gas capsules from his utility belt. In the end, it really wasn’t much of a fight — but then, this is Batman we’re talking about. In the end, the villagers thank Batman, surgically remove his wings, and return him to Gotham City.

“The Flying Batman” by David Vern and Sheldon Moldoff, from Batman #82

Good call Batman.

Exelon (rivastigmine) is a drug that is used to treat dementia when it is associated with Alzheimer’s disease or Parkinson’s disease. It is not a miracle drug by any stretch of the imagination, but it has shown some modest success at delaying the progression of dementia, and some patients experience significant improvement of their symptoms.

Note that Exelon is only approved for Alzheimer’s dementia and Parkinson’s dementia, not for other causes of dementia. This is not to say that it isn’t being prescribed for other kinds of dementia, it is, but these uses are strictly off label and not approved by the FDA.

So not only is the head mirror worn wrong (as usual), but:

1. The doctor is a psychiatrist, so why does he need a head mirror anyway? (Other than peering into the deep recesses of the human soul, that is).

2. The head mirror is unexpectedly giving off light (Remember a head mirror only reflects light, it does not generate light itself. Anyway, the mirror focuses light, so any light reflected would be narrowed, not spread out. And even if the head mirror was flipped over so the convex side was showing, while that would almost explain the spreading light, that side’s not reflective).

And yes, that is Batman in a straitjacket — but that’s a story for another day (basically, one of Batman’s villains rigged the bat-radio to give Batman bad enough nightmares to make him think he was going insane. Insane in that goofy 1950’s way, that is: laughing maniacally. It only took two days in the asylum for the “world’s greatest detective” to figure it out. Read it yourself if you can track down a copy of Batman #84. On the other hand, don’t — it’s not a very good story. In fact, the Batman of the late ’40s/early ’50s had very few good stories).

A mysterious Sleeping Sickness strikes Gotham City, yet strangely it is affecting only the contestants in the “Queen for a Day” beauty pageant. The doctors who examine the patients confidently declare that the women have contracted a “rare but harmless” disease that will cause them to sleep for three or four weeks before recovering. They place each victim in a glass case so that the “medical profession can observe this rare malady.”

Batman is instantly suspicious as the first victim was none other than Selina Kyle, better known as Catwoman. He believes she is faking the illness, but the guard watching over her case swears she has been asleep the whole time.

With all the contestants asleep, it looks like no one will win the Queen for a Day contest, but luckily, Selena Kyle manages to recover from the sleeping sickness in time to win. Batman stops her just before she is about to claim the prize – a bottle of perfume that just happens to be full of smuggled diamonds

It turns out that Catwoman was behind the Sleeping Sickness (I know, quelle suprise!). She had discovered a chemical that caused the Sleeping Sickness; she gave herself a small dose, and then in a display of pure Scooby Doo science, she rigged a couple of movie projectors in her case to make it look like she was still inside when she sneaked out to give the other contestants larger doses of the chemical. Her convoluted plan was to win the Queen for a Day contest so she could claim the perfume bottle where her overseas associated associates had hidden stolen diamonds.

Batman, of course, was too clever for her.

Me, I wonder what kind of quacks they have in Gotham City: they can’t identify a disease (but are quick to claim it is “harmless”), never realize their prime patient is faking (or even absent!), and yet voyeuristic enough to place their patients in glass cases. My advice: never, ever seek medical care in Gotham.

“The Sleeping Beauties of Gotham City” from Batman #84 (June 1954)

Tags: comics medicine head mirror batman catwoman sleeping sickness

This week’s episode was a bit of a letdown after last week’s Over There, Part 1 (and the several great episodes leading up to it). It wasn’t bad, but it wasn’t terribly good — or very Fringe-y at all. It seemed like it was an episode designed to get everyone in place for next season, rather than a fitting ending for this one.

The Plot: Olivia and Bell are searching hospitals, trying to find Walter. Olivia sees the alterna-Fringe team arriving and realizes that they must be in the right hospital. Bell stalls them while Olivia finds Walter and escorts him out of the hospital.

Peter meets with his father, who tells him that he wants to repair the rift and save both universes, but that he’ll need Peter’s help. He asks him to take a look at the power source for his “fix-the-rift” device ( power source that looks amazingly like an original XBox).

Walter, Olivia, and Bell stop just long enough to shill for Kentucky Fried Chicken, and then they head out again. Walter and Bell are off to Walternate’s old Harvard lab to build a device to let them cross back over into our universe while Olivia heads back to the city to look for Peter.

Alterna-Olivia has questions for the Secretary of Defense and he admits that yes, the people who crossed over are our doubles, only evil (or, more correctly, eeeviiilll). Sensing a connection between her and Peter, he asks her to escort him to his new apartment. Alterna-Oliva arrives back at her house, only to find Olivia waiting for her. They exchange some family history (Mom dead? No? Sister dead? No? Niece?) before getting to the inevitable fight. Alterna-Olivia is the stronger fighter, but Olivia decks her with a convenient piece of wrought iron. She then cuts and dies her hair so that she looks just like alterna-Olivia. Just about this moment, alterna-Charlie shows up at her doorstep and tells her that there’s been a power surge in Walternate’s lab and they’re supposed to check it out. Olivia tells him they’ve got a new mission, and that’s to move Peter to safety. They arrive at Peter’s apartment and Olivia warns him what Walternate is up to. Alterna-Charlie realizes something’s wrong with Olivia, but not in time to stop himself from being clobbered. After hearing his father’s plans, Peter tells Olivia he doesn’t belong in either universe — but then she kisses him and poof! — problem solved.

Olivia, Peter, Walter, and Bell arrive in front of the theater where they crossed over in the previous episode. A minute later, the alterna-Fringe team arrives. Peter and Walter move his machine inside and set it up while Olivia and Bell hold off the alterna-Fringe. The battle is chaotic, and at one point Bell finds himself confronted by two Olivias — and then clobbered by one of them. When he comes to, he finds the battlefield in flames and Olivia tells him she had to use one of his experimental grenades to save their life. The two of them hustle inside the theater to meet up with Walter and Peter. Walter is still complaining that they won’t have enough power to cross over, but Bell tells him not to worry. Bell explains that he has crossed the dimensional gap so many times his structure is unstable, like trillions of atom bombs, and he will provide the power for crossing over, even though it will cost him his life. The machine is activated and Peter, Olivia, and Walter cross back into our dimension.

A little while later, as Astrid is fattening him up with pie, Peter tells Walter that he’ll stay around for at least a little while. Meanwhile, it becomes apparent that the Olivia who crossed over was actually the Alterna-Olivia, and the real Olivia is locked up in the alternate universe.

1. And Flash Gordon Was There in Silver Underwear
I have to give alterna-Olivia props for her great choice of ring tone on her home phone.

2. Watch It Wiggle
The Quarantine Zones looked like the Jell-O bus from Fringe’s third episode “Ghost Network”

3. Answer Me That, Mr. Green Lantern
The show continued to hint at the subtle differences between the two worlds. I wish I had been able to see more of the comics that were framed in Peter’s apartment, but here’s the one I did catch:

That’s the original cover to Green Lantern #76 (April 1970, cover by Neal Adams) on the left, and the alterna-version on the right.

4. Full Stop
I’m sure it will be hand-waved away with mentions of “door stops” and William Bell’s atom power, but Walter seemed quite insistent that they needed Olivia’s abilities to cross back over. Does alterna-Olvia have the same abilities, or was that just papered over? In other words, was alterna-Olivia exposed to Cortexiphan too?

5. I Thought They Were Twins
Is there anyone who didn’t realize that was alterna-Olivia who helped Bell up? There was nothing even remotely subtle about it. And it never crossed Bell’s mind — who had just seen two Olivias — that this may be the wrong one? (Yes, I’m sure it will be handwaved away because she “knew about the grenade” — but maybe alterna-Olivia, unlike real Olivia, actually has some investigative skills).

6. Frankly My Dear
They never did explain Olivia and Frank’s “last night” comments from last week’s episode.

Not a bad episode, but rather anti-climactic compared to the last several. The Fringe Doomsday Clock stays in place and ends the season at 11:56

Tags: television fringe alternate universe peter olivia

UPDATE: Here’s the other alternate world comic book covers:


The originals are Crisis on Infinite Earths #7 (with Superman holding a dead Supergirl), Superman #75 (”The Death of Superman” — the “Collector’s Cover” shows a bleeding Superman symbol), Justice League #1 (with Guy Gardner instead of Jonah Hex), and Batman: The Dark Knight #1 (”The Dark Knight Returns”).

From DC’s “The Source” blog.

The Brave and the Bold #31 “Small Problems”
J. Michael Straczynski, writer
Chad Hardin and Justiniano, pencilers

The Atom is called to Arkham Asylum to treat a neurological problem the Joker is having. He has to shrink down to microscopic size, enter the brain, and release an “experimental chemical” at a specific location to cure the Joker.

There are many, many problems with this comic. I’m all for Fantastic Voyage homages, but it is obvious that Straczynski has no understanding of how the brain or nervous system actually functions. A twelve year old with access to Wikipedia and five minutes to spare could write a more accurate — and no less engaging — story.

The main stumbling block is Straczynski’s misunderstanding of synapses — the junctions between nerve cells*, where one cell passes a signal to the second cell. These synapses can be either chemical (a message molecule known as a neurotransmitter carries the impulse from the first cell to the second cell), or electrical (the two cells are connected by channels which allow an electrical signal — ions, really — to be passed from the first cell to the second cell).

I’ll just touch on a few of the bigger errors here:

What the doctor here is describing is not particularly rare at all. When too many synapses fire off, you have a seizure. If it involves part of the brain, it’s a partial seizure; if it involves most of the brain, it’s a generalized seizure. If the seizures happen repeatedly, then it’s considered epilepsy. If it is a seizure that cannot be stopped, then it is called status epilepticus, and yes, it can lead to brain damage and death (but it’s not rare: 42,000 deaths a year). • If the Joker really were in status, he’s be dead long before the Atom ever got there.

This is some horrible, horrible technobabble. I know everyone uses “the brain = a computer” metaphor, but it’s just that: a metaphor; a figure of speech. The brain is not really a computer — it is orders of magnitude more complex and you can’t “reboot” it. For one thing, I’d want my brainstem to keep working no matter what, since it controls such things as the heartbeat and breathing. • “Synaptic array at the microscopic level” is redundant. All human synapses are microscopic.

Straczynski seems to think that all synapses are electrical in nature, but that is not true — in fact, chemical synapses are much more numerous; electrical synapses only show up in certain pathways where speed is important — reflexes, for instance. He spends most of the issue confusing the two types of synapses. “Synaptic gaps” occur in chemical synapses; electrical synapses are tied together by ion channels. Chemical synapses are involved in the higher processes, like memory. Electrical synapses transmit ions from one nerve cell to another through channels in the cell membrane — there is no “electrical pulse” or lightning bolts (as drawn in the comic) between the nerves. The rest is just more technobabble.

For a better “The Atom in somebody’s brain” story, I recommend The Brave and the Bold (original series) #115, where the Atom controls a brain-dead Batman to solve his murder.

*There are also synapses between nerve cells and other cells, such as between a nerve cell and a muscle cell.

With the Vancouver Winter Olympics in full swing, I thought now was a good time for “sportmanship” public service ad, courtesy of Batman, Robin and Action Comics #141.

Though this PSA is ostensibly about sportsmanship, the main focus is actually on prejudice, with a little patriotism thrown in for good measure. Still, it’s a good PSA, even if the title is somewhat misleading.

Click on the image for the full ad

For some good reading on good sportsmanship and the Olympics, check out this article on the Pierre de Coubertin medal (the “True Spirit of Sportmaship” medal).

This PSA was found in DC comics from February 1950. Written, as always, by Jack Schiff, with art by frequent PSA collaborator Win Mortimer.

More PSAs

Tags: comics psa batman robin sportsmanship olympics jack schiff win mortimer

Yesterday marked the 100th Anniversary of the Boy Scouts of America and to commemorate the occasion, here’s a Boy Scouts of America public service ad from Worlds Finest #46 (June/July 1950).

More PSAs

Tags: comics psa superman batman boy scouts

Another DC Comics Public Service Ad teaching about science — this time the topic is “The Atom” — more specifically radiolabeling (using radioactive isotopes to mark certain chemicals, which can then be traced), since that is what most of the vignettes depict.

As usual when dealing with these science PSAs, I have some questions and concerns:
Did the Brazilian doctor use radiolabeling to find the tumor (such as a bone scan or PET scan), or did he use radiation to treat it?
By 1959, there was already a Yellow Fever vaccine available, which would probably do more to eradicate the disease than making radioactive mosquitoes (wasn’t that a SciFi SyFy movie?)
The fourth panel is what really worries me. I think they’re using radioactive fertilizer in Canada to grow mutant tobacco plants.

Click on the image for the full ad

This PSA was found in Batman #128 as well as the other DC comics from December 1959. This ad was written by Jack Schiff. There is some debate about the identity of the artist, but most sources list Lou Cameron.

More PSAs

Tags: comics psa atom isotope mosquito jack schiff lou cameron

Stories from the Golden Age of comics generally had a great deal more death than comics today where super-heroes have their vows against killing. More often than not, Golden Age villains died at the end of the story (especially if they were mad scientists or crime bosses), often in a poetic manner. Even Batman and Superman, while they usually didn’t kill the villains outright, often did nothing to stop their easily preventable death.

However, of all the Golden Age heroes, Doctor Fate had the highest body count. Here’s a quick tally of all the opponents he killed in just his first year of appearances:

Appearance	Comic	Body Count
1	More Fun Comics #55	1 mad scientist
2	More Fun Comics #56	(no one)1
3	More Fun Comics #57	1 sorcerer
4	More Fun Comics #58	1 sorcerer + “thousands” of fish
5	More Fun Comics #59	large alien spaceship
6	More Fun Comics #60	medium-sized enemy spaceship2
7	More Fun Comics #61	an entire planet3 + 1 mad scientist
8	More Fun Comics #62	1 mad scientist
9	More Fun Comics #63	1 sorcerer
10	More Fun Comics #64	1 Mayan god + 1 unfortunate explorer
11	More Fun Comics #65	underwater city
12	More Fun Comics #66	1 criminal

Notes:
1. While not killed outright, Wotan was chained to a rock for eternity within a hidden cavern deep in the earth — like Loki, only without the venomous snake.
2. It was piloted by tiny men, so that counts double, right?
3. An entire inhabited planet destroyed, forty years before Phoenix was essentially put to death for the same actions.

It’s that time again: time to look back on the past year and find the best — and worst — that comic book medicine has to offer.

Previous “Best of the Year”: The Best Comic Book Medicine of 2008 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

Previous “Worst of the Year”: The Worst Comic Book Medicine of 2008 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

Batman #5

see also: “Anesthesia? Batman don’t need no anesthesia!”

Only three days left until Christmas, and what would a Comic Book Cover Advent Calendar be without a visit from Santa’s rebellious daughter, Jingle Belle? This year, issue #3 of her Dark Horse series is featured.

Jingle Belle #3
(Dark Horse Comics, February 2005)

Click on the cover for larger view

3 Days until Christmas!

Read more…

Only four days remain until Christmas, and today’s Advent Calendar Countdown Comic Book Cover is another Golden Age funny animal title. This one features hippos, monkeys, snow, and palm trees.

Funny Picture Stories #4
(Centaur, December 1937)

Click on the cover for larger view

4 Days until Christmas!

Read more…

It’s December 6th, so that means only 19 days remaining until Christmas. Time for another Santa cover, this one just a little bizarre, courtesy of Peter Milligan’s Shade the Changing Man and cover artist Jamie Hewlett.

Shade the Changing Man #19 (DC Comics, January 1992)

Click on the cover for larger view

19 Days until Christmas!

This year’s Comic Book Cover Advent Calendar (so far).
One year ago, the cover was Pinky and the Brain #19.
Two years ago, the cover was The Strangers #19.
Three years ago, the cover was Captain Marvel #19.
Four years ago, the cover was Comic Cavalcade #19.
Five years ago, the cover was Batman and the Outsiders #19
Don’t miss Yet Another Comic Blog’s annual advent calendar

The criminal who discovered Jor-El’s super-power pills has escaped from prison and rumor has it that he has hidden one last pill somewhere. Superman, Batman, and Robin rush off to capture him before he can reach the pill, but the criminal slips by them. Batwoman (the mini-skirted all-but-incompetent Silver Age Batwoman, not the current one) decides she wants in on the act. She manages to find the villain and grabs his pill before he can swallow it. She then swallows the pill herself — and with her new super-powers — returns the criminal to prison.

Now that Batwoman has super-powers for the next twenty-four hours, how do you think she decides to use them? Stop crime, right? Wrong. She decides she is going to use her super-powers to discover the identities of Batman, Robin, and Superman.

So, not only does Batwoman — an alleged super-hero — not use her new powers to fight crime, but instead she uses them to betray the confidence of other heroes. Nice going.

Batwoman follows Batman and Robin as they drive around Gotham City in the Batmobile. They give her the slip — or at least they think they do — but as soon as they drive into the Batcave, there she is waiting for them. She tells the duo she used her x-ray vision to find the Batcave, and now, based on the mansion above the cave, she knows their identity. Next she sets out to discover Superman’s.

Batwoman catches up with Superman when he is saving a small town from an avalanche. She follows him, hoping he’ll lead her to his secret identity. He tries to scare her away by flying through a lightning storm, walking through an artillery proving ground, and floating over Niagara Falls, but none of it works. Finally, he decides what his only option is to expose her to the thing every woman is scared of: mice.

Superman’s plan works and he sneaks out through the basement, drilling through the ground, making sure to stay below veins of lead-bearing ores, but Batwoman is able to track him by sound. When he emerges from the ground, she tells him that he has fallen into her trap. She’s lured him away from his job for the whole afternoon, and since she saw what block of Metropolis he came from, all she has to do now is find the office in that block where a worker has been missing all afternoon. When she shows up at the Daily Planet, Lois tells her everyone has been there the whole day (but she only mentions Clark, Jimmy, and Perry — so in the Silver Age the Daily Planet apparently only employed four people). At this point, Batwoman’s twenty-four hours of powers are up and she admits defeat in figuring out Superman’s identity — but at least she knows the true identities of Batman and Robin. Not so fast, says Superman:

And just in case you were wondering:

Story from World’s Finest #90 (September/October 1957), by Edmond Hamilton and Dick Sprang

Tags: comics medicine kryptonite superman batman robin batwoman jor-el pills

Another tale of strange Silver Age medicine, this time from World’s Finest #87:

A new masked and super-powered bank robber appears in Metropolis and Superman tracks him to his lair only to find that the robber had been waiting for him with a chunk of kryptonite.

A few months before, our robber realized that if he wanted to be a successful criminal in Metropolis, he needed to find some kryptonite. He spent months tracking down every meteor¹ that landed nearby, looking for elusive chemical. He lucked out: not only did he find kryptonite, but he also found a box with some pills in the meteor. There is a note with the pills that reads “These radioactive capsules to be used only if needed to renew our super-powers on Earth. [Signed] Jor-El”

The robber took the kryptonite-embedded box back to his lair. He swallowed one of the pills, gained super-powers, and went on a crime spree. Then he lured Superman to his hideout and exposed him to the kryptonite. Leaving the Man of Steel for dead², the criminal flies off to commit more robberies.

Of course, Superman’s not quite dead yet — he takes his last bit of energy and uses his heat vision to break the water pipe in the ceiling, sending water cascading down on the box of pills, washing all the kryptonite away³. Able to stand up again, Superman grabs the box of pills and swallows one, figuring he needs the super-powers they’ll provide since his have been stolen by the kryptonite. Too late, he discovers that some kryptonite dust had gotten in the pills when Krypton exploded — the same explosion which sent the box to Earth. Now he’ll be completely powerless until the chemical leaves his system⁴.

Thinking quickly, Superman calls Batman and Robin. When the duo shows up, he gives them each one of the super-power pills, and they fly off to capture the robber. Since they’re not used to their new powers, not only do they let the villain escape, but they cause some serious property damage. Undeterred, Superman trains them in the use of their powers and they fly off again to capture the robber.

Meanwhile, Superman — using his crafty reporter skills — has discovered the robber’s new lair. Unfortunately, the robber catches Superman in his hideout and pulls out a gun, shooting him in the chest. About this time, Batman and Robin arrive and capture the villain, who is still gloating over Superman’s body. Could the Man of Steel be dead? Of course not. It turns out that while Superman may have been powerless, his suit was still invulnerable and it blocked the bullet, saving Superman’s life. It’s all a moot point now anyway, as the kryptonite has worn off and Superman has regained his powers. He gives the super-power pills to Batman who promises to keep them safely hidden away in the Bat-cave⁵.

Notes:
1. Yes, technically he was searching for a meteorite, not a meteor, but I’m sticking with what’s written in the comic for this review.
2. If I were a criminal who gained his super-powers through a pill, I would take the pills with me instead of leaving them behind. Sure, leave the kryptonite-encrusted box — just take the pills.
3. Apparently kryptonite is water soluble.
4. Kryptonite or not, shouldn’t the pills have given Superman super-powers? They were developed to give Kryptonians who lost their powers (like Superman) temporary powers. He took one after losing his powers temporarily from kryptonite exposure, so why should more kyrptonite dust in the pills stop them from working? It’s not like they’re affected by kryptonite — Batman and Robin got powers despite the kryptonite in the pills.
5. As far as we know, the pills are still there. Or at least, all but one of the pills…

Tags: comics medicine kryptonite superman batman robin jor-el pills

The synthesis of heme (an important part of hemoglobin and red blood cells) is a complicated process requiring eight different enzymes. If any one of these enzymes is not working correctly, then a chemical known as porphyrin builds up and the person is said to have porphyria. There are several different types of porphyria depending on which enzyme isn’t working correctly. Generally, the porphyrias can be grouped into two classes: the acute (or hepatic) porphyrias, and the cutaneous (or erythropoetic) porphyrias.

The acute porphyrias cause severe abdominal pain as well as neurological and psychological symptoms. Some of them have cutaneous (skin) symptoms as well.

The cutaneous porphyrias, as the name suggests, have primarily skin symptoms. Photosensitivity — a painful rash when exposed to light — is a common problem.

In the late seventies and early eighties, several papers and a book or two were published suggesting that porphyria was the basis for vampire and werewolf legends. There is a certain undeniable logic behind the idea. People with porphyria do not venture out in the daylight, which explains the sunlight aversion of vampires (and werewolves, to a lesser extent). The disease can cause a thinning of the lips and gums, exposing more of the teeth, giving the individual a more bestial appearance. Historically, porphyria was treated by having the patient drink animal blood. Additionally, increased hair growth can be seen in some cases of porphyria and the psychiatric symptoms can lead to strange behaviors and increased violence.

It’s an interesting hypothesis, but I’m skeptical. I’m certain that people unfortunate enough to have porphyria were accused of being vampires or werewolves, but I don’t buy the idea that the entire legend is based on the disease. The theory seems to pick and choose the symptoms of different porphyrias to support the idea, creating a hodge-podge disease that doesn’t actually exist in nature (or if it does, would be extremely, extremely rare). Drinking animal blood does not equate to a blood lust — people with porphyria may understand that blood helps their symptoms, but they don’t actually crave it. The theory also describes the modern depiction of vampires — which is quite different from the how our ancestors understood them. For example, the vampire’s violent aversion to sunlight — a main part of the porphyria link — is a twentieth century embellishment to the vampire.

I’m not alone in my views as the majority of the scientific and medical community has dropped the theory (and I’m sure most have even better reasons than the ones I mentioned.) This hasn’t stopped the “porphyria = vampirism” link from appearing in pop culture over the past several decades. I’m pretty sure I remember it showing up as a side plot in an episode of St Elsewhere in the ’80s. More recently, the idea has shown up in the Batman and Detective Comics annuals as well as this week’s episode of Castle.

In the back-up story in the Batman and Detective annuals, the Gotham City Blood Bank is vandalized and robbed, and there is also an attempted murder or two. The villain — or is it villains? — is revealed to be someone with porphyria who believes that they are a vampire.

In one scene, some blood found at the crime scene is sent off to the lab and is returned with a diagnosis of porphyria.
Here’s my annotated version of that scene:

1. DNA testing — DNA and genetic testing is one of the best ways to diagnose porphyria. However, it’s a specialized test that is only run by certain labs and it takes more than just a day or two to get results.

2. There’s been DNA testing, but they still refer to it by the general term “acute hepatic porphyria” rather than which specific porphyria it is. That’s the point of the DNA testing: to pinpoint the exact enzyme deficiency.

3. I don’t think there’s any doubt where the information from this first paragraph came from, and it’s a nice accurate paragraph. [link fixed]

4. The second paragraph is a mess though, referring to a largely abandoned theory as if it were fact. The inaccurate “blood craving” is mentioned. And what is “pale pallor?” By definition, someone with pallor is pale.

I will point out that for the most part the writer makes it clear that it is the villain who believes in the porphyria/vampirism link — and other than the lab report shown above — does not seem to endorse the connection herself.

Batman Annual #27, Detective Comics Annual #11, “Darker than Black” by Mandy McMurray and Kelley Jones

In Castle, an insane individual who believes himself to be a vampire screams out in flames and starts to smoke when exposed to sunlight. This is later explained away as porphyria.

Now, sunlight can be painful to people with severe cutaneous porphyria, but the skin rash (blisters, usually) take several minutes of exposure to develop — and that’s in the most severe case. The skin never smokes though, that’s simply ridiculous, even for Castle.

Posting resumes tomorrow with a look at vampires, werewolves, and porphyria (see the recent Batman annuals and this week’s Castle)

In the closing panels of Red Robin #4, Tim Drake is stabbed in the abdomen with a sword by the villainous Widower. In the next issue, it is revealed that his injury required the removal of his spleen.

Found in the upper left aspect of the abdominal cavity, the spleen is roughly the size of a grapefruit and serves several important functions: It removes old and damaged blood cells from the circulation, as well as removing harmful bacteria. It assists the immune system by acting as a large lymph node. It stores extra blood to act as an emergency reserve in case of severe blood loss.

Both blunt and penetrating abdominal trauma can injure the spleen. Penetrating trauma can lead to splenic lacerations. Blunt trauma can rupture it. Unfortunately, the spleen is very difficult to repair — it was once described to me as having the consistency of a sopping, water-logged sponge. Imagine trying to sew that back together. Often the only treatment for a severely damage spleen is splenectomy (removal of the spleen), leaving the patient asplenic (without a spleen).

The main concern in people lacking a spleen is an increased risk of infection. This is not just a slight increase in risk, but a significant increase in the risk of serious infections. In the worst case scenario, there is a condition known as OPSI (overwhelming post splenectomy infection) that can be fatal within just a few hours.

Asplenic individuals are susceptible to a wide variety of germs, but the three most concerning are:

1. Bacteria that have a thick protective capsule. These bacteria include pneumoccocus (a cause of pneumonia and other infections), meningococcus (a cause of meningitis), and Haemophilus influenzae (another cause of meningitis, among other nasty infections).

2. Capnocytophaga canimorsus, a bacteria found in dog bites.

3. Parasites that like to hide within red blood cells (malaria is the main one, but also babesiosis and ehrlichiosis, rare tick-borne infections).

Asplenic individuals need to be aggressively immunized against the riskiest bacteria. They will require the pneumococcus, meningococcus, and Haemophilus influenza vaccines. The pneumoccocal vaccine may need to be repeated every 5 years. Additionally, pediatric patients who lose their spleen need to be started on daily broad spectrum antibiotics for the next 2-5 years. Those who are considered particularly high risk for infection may need daily antibiotics for the rest of their life.

Tags: comics robin trauma spleen asplenic infection

I’ve had several people ask me what I think, medically, of the game Batman: Arkham Asylum and I’m happy to oblige. If posting to the blog seem light this week, you can blame the game.

Overall, it’s a great experience. Though I’m a big fan of video games, it takes a lot for a game to really suck me in to its world completely, and Batman does that (the previous game that pulled this off was the first God of War). The setting, character design, and storyline are all appropriately creepy and the voice acting — especially Kevin Conroy and Mark Hamill — is excellent. Playing the game, I really feel like Batman — I see a crowd of thugs and think, “I can take them, easy,” just like Batman should.

Admittedly, the game isn’t quite perfect:
Riddler’s voice seems flat and tinny, but I just blame this on him using a jerry-rigged radio transmitter.
The final confrontation with Harley Quinn was a definite anti-climax.
Once Poison Ivy joins the big baddies, the atmosphere becomes more cartoony and loses much of its creepiness.

Even with these (admittedly minor) flaws, I’d consider it the best solo super-hero video game.

Dark Elektra #1

A “cracked inner ear?” There really is no such term — most people would refer to it as a skull fracture or more specifically a temporal bone fracture.

Frankly, the whole sentence is awkward — she specifically mentions which arm bone is broken (the humerus), but doesn’t mention which foot bone was broken (there are quite a few; for all we know it could be a broken pinky toe; which is no big deal for anyone, let alone a resurrected ninja). Of course, this should really come as no surprise as the woman works for Norman Osborn, whose grasp of anatomy is rather poor.

Batman: Widening Gyre #1

I hate to disagree with Ivy, but her “homeopathic” would not even work on humans — unless you count the placebo effect — because the entire “science” behind homeopathy is pure quackery.

I suspect writer Kevin Smith meant to say “herbal” instead of “homeopathic”. It’s an all too common mistake, as is using the term homeopathic as a general term for non-traditional medicine (see also Vaughan and Bendis), but the terms are not interchangeable and mean very different things (not that you could tell by what is sold as “homeopathic medicine” in you local drug store).

Here’s a quick scorecard:
Herbal remedy — might work.
Homeopathic remedy — expensive water/quackery.

I’ve spent too much time today playing Batman: Arkham Asylum to put up a proper post, so enjoy this not-really-taken-out-of-context panel (it’s from an old comic about a couple who fake typhoid fever to pull a scam, and, as twist endings would have it, end up catching the disease themselves).

One of America’s leading nuclear scientists has been struck down by the mysterious Virus X. Traditional medical treatments have been unsuccessful, so the Army needs Aquaman’s help. Their plan is to reduce Aquaman to microscopic size using a shrink ray, and then inject him into the scientist where Aquaman can confront the virus directly.

Aquaman agrees and is quickly shrunk and injected into the scientist’s bloodstream. Once there, he quickly spots the evil octopus-looking Virus X in the middle of chowing down on some red blood cells. The body’s white blood cells swoop in to attack the virus, but it is too strong for them and easily shrugs off their feeble blows.

Discovering that his telepathic powers work on the white blood cells, Aquaman decides that advanced tactics are required, and he quickly lines the white blood cells up into battle formation and throws a coordinated assault against the virus.

It is a close, vicious battle, but once again, Virus X proves too strong for the body’s defenders. Aquaman and his army flee down the bloodstream with the virus in close pursuit. Aquaman now realizes that a flank or rear attack is his only viable option. He traps the virus by physically closing one of the heart valves so it can’t follow. Meanwhile, he and his troops make a complete circuit of the body’s circulation which brings them back to where the virus is trapped, allowing them to attack it from behind.

The battle is “brief but furious” but in the end Aquaman and his army are victorious.

With the virus vanquished, Aquaman swims off and exits the body through the same hole the hypodermic needle left when it injected him — and once again, America’s nuclear science is saved.

This story is from Adventure Comics #200, published in May 1954, which means that it predates Fantastic Voyage by a dozen years (and predates the fairly similar Batman: The Brave and the Bold episode “Journey to the Center of the Bat” by even more). I know there’s an Astro Boy story with a similar theme from around the same time, but I’m not sure which one came first.

I suspect this is an entirely different “Virus X” than the one that causes “Kryptonian Leprosy” and felled Superman in Action Comics #363-366 (storyline reviewed here and here).

Apparently the scientist’s disease was caused by a single virus — but what a virus it was! It’s the same size as a heart valve (about the size of a quarter).

I don’t think forcibly closing a heart valve, even “momentarily,” is going to be at all good for the scientist’s heart. And it also brings up a question: With the valve closed, will there be enough arterial flow and blood pressure to push Aquaman and his army through the circulatory system?

From 1944, this is an untitled wartime public service ad starring Batman and Robin…but mostly Alfred.

Like most PSAs from this era, this ad deals with recycling paper for the war effort.

If you’re not clear why, Alfred explains it well in the ad.

Click on the image for the full ad

This PSA was found in Adventure Comics #91, published in April 1944.

More PSAs

Tags: comics psa buzzy old folks jack schiff win mortimer

From the medical point of view, Rags Morales has traditionally been one of the most accurate comic book artists. So it pains me to see that he has fallen victim to the “more is better” approach to hospital wires and tubing in this scene from Superman/Batman #55.

Let’s look at the good and the bad:
Clark is intubated (has a breathing tube down his throat).
…but also has a nasal cannula delivering oxygen.
Clark is receiving blood in an appropriate IV location.
There is a cardiac lead on the left-side of the chest
…but there is also one on the right-side of the chest, the right arm, and the forehead.

Lex Luthor’s brilliant plant is to use his special maser ray to erase Batman’s mind and then transfer Superman’s mind into Batman’s mindless body. Now that Superman’s mind is no longer housed in an invulnerable Kryptonian body, Lex will physically pummel him until he dies.

I hope it comes as no surprise when I reveal [Spoiler Warning!] that through a cunning plan of their own, Superman and Batman are able to avoid the fiendish trap and defeat Luthor. In hindsight, they really didn’t have to put as much effort into it as they did — Luthor’s plan was flawed at a very basic level.

Luthor seems to believe that light (and similar forms of electromagnetic radiation) are transmitted through the pupil, across the eye, and then down the optic nerve into the brain itself. This is a very common misconception. In reality, the light never reaches the brain because it never passes beyond the eye.

Sorry Lex, your plan is defeated by basic anatomy and physiology. Better luck next time.

This scene is from Batman #293, part of the “Where Were You on the Night Batman was Killed?” storyline reprinted in the book The Strange Deaths of Batman. You really need to pick up this book, if nothing else for the color reprint of The Brave and the Bold #115, the infamous story where the Atom literally jumps into the head of a brain-dead Batman and steers him around, solving crimes and taking out bad guys.

Caleb Ketchum is a three-time loser. He started out as a college chemistry professor, but quit because he wasn’t making enough money. Instead, he sets up shop as an exterminator, using his chemistry knowledge to invent a special termite-killing spray. When this didn’t bring in the money either, he advertises his skills to the local mob bosses through an ad in the paper. They take him up on his offer and use his super-termite spray as a to kill guards and unfortunate passers-by during robberies.

Things go well at first, and Ketchum is making more money than he ever dreamed. Who knew crooks made more than college professors or exterminators? He’s running low on Cacobane though, the rare chemical that forms the basis for his super-termite/death spray.

Unfortunately for Ketchum, pharmacist Bob Benton — alias The Black Terror — has discovered the Cacobane connection. The chemical was detected at the crime scenes (apparently it’s not so rare that police don’t test for it), and Bob realized that Cacobane was also in the termite spray he bought from Ketchum. He puts two and two together and realizes that Ketchum is participating in the robberies.

When a local hoodlum comes in to buy some more Cacobane, the Black Terror follows him to the crooks hideout.

Unfortunately, the Black Terror and his sidekick Tim are caught by surprise and knocked out. They are locked in a cage with giant mutated termites while the crooks escape. (Did I fail to mention that Ketchum also used his knowledge of chemistry to mutate and breed giant termites?) As deathtraps go, the glass-cage-with-giant-termites is pretty lame and the Terror (and Tim) quickly escape and catch the crooks including Ketchum, the failed chemistry professor/exterminator/criminal. Bob Benton — super-hero and super-pharmacist — saves the day again.

The best part of the story? This surreal panel featuring poisonous gas, giant termites, and money.

Sadly, the giant termites never actually participated in the robberies, or the story would be have been that much more awesome.

This story, “The Man Who Betrayed Himself,” is found in America’s Best Comics #26 (May 1948).

More Black Terror (super-pharmacist in action!) stories

Tags: comics medicine black terror bob benton pharmacist cacobane termites

Have a little fun today, courtesy of Batman Sells Out to Claritin™:

My wife and I sat down to watch the new Wonder Woman animated movie this weekend and both thoroughly enjoyed it. The plot is straightforward: it’s a re-telling of Wonder Woman’s origin and her first trip to the “Man’s world” after being raised entirely on Themyscira. Along with returning Steve Trevor to America, she also must battle the machinations of Ares, God of War.

The voice acting is good, though it took me about an act to get used to Alfred Molina as Ares — I kept hearing him as Tevye (if only he had broken into a rousing rendition of Tradition). The main flaw to me was that Steve Trevor was a rather lightweight character with frat-boy morals, and it was hard to see him being at all attractive to Diana. (And where did an isolated Bronze-Age society come up with an invisible jet?)

Now I’m not saying it’s genre-redefining film by any stretch of the imagination, but it’s a solidly enjoyable super-hero movie with a hint of a female empowerment theme. My wife (Wonder Woman knowledge level 1/10) seemed to enjoy it as much as I (Wonder Woman knowledge level 7/10) did — she even specifically mentioned how much she liked it, which is an unusual thing for her to say about an animated film. Our nineteen-month-old son was even able to sit still and watch it for twenty minutes in a row — the first time he’s done this for a show that wasn’t the Backyardigans. There were some intense battle scenes in the beginning and end of the movie that I wouldn’t let him watch, so bear that in mind when watching it with kids.

For the record, here’s my Top Five Direct-to-Video Animated Films.

1. Batman Beyond: Return of the Joker [Uncut Version]
2. Justice League: The New Frontier
3. Wonder Woman
4. Batman: Mystery of the Batwoman
5. Batman: Mask of the Phantasm

Tags: comics wonder woman dvd batman

Bruce Banner is lured to Europe by Victoria Frankenstein, the great grand-daughter of the infamous Victor Frankenstein. She has brought Banner to Europe to help her revive her great grandfather’s creature, who has been steadily decaying over the years. Using his superlative knowledge of medicine and anatomy (which is all the more impressive because he is a physicist), Banner helps her repair the creature. One stormy night, the full extent of her plans becomes clear when she sedates Banner and hooks him up to a machine to transfuse his gamma-irradiated blood into the creature. It is his blood, along with about a gazillion volts of lightning, that will revive the Frankenstein monster.

Her plan is a success. Not only is the monster reborn, but now he is gamma-irradiated as well. As for how the story ends, you’ll have to read the comic for yourself…

Scene from the first story in The Monster-Sized Hulk Special, by Jeff Parker and Gabriel Hardman. It’s a good, fun story — but in terms of classic monster transfusions, I still think the one where Batman transfuses a vampire is the best.

Other Comic Book Transfusions

This public service ad from 1952 offers a great example of how much the language has changed in subtle ways over the past 50 years. In this ad, the term welfare wagon is used in a positive light, meaning “helping others within the community.” Nowadays, the term is still in use, with several connotations, none of them particularly positive.

In the book Comic Book Nation: The Transformation of Youth Culture in America, the author proposes that this PSA has “Superman himself endorse a program of national social welfare.” I think that’s reading a bit much into the ad. To me, while Superman seems to be advocating some form of community welfare, it is a combination system of both private and government programs (he refers to “taxes” suggesting a governmental approach; but the hospital is having a fund drive, which suggests non-governmental funding), and one more locally based than national is scope. Overall, I think Superman is just proposing that “neighbors help neighbors”, whatever the system.

Click on the image for the full ad

This PSA was written by Jack Schiff with art by Win Mortimer. This ad could be found in DC comics from Jun 1952 including Batman #71, Superboy #20, and Action Comics #187, the source of this scan.

More PSAs

Tags: comics psa superman welfare jack schiff win mortimer

Detective Comics #693 “Systemic Shock”
Chuck Dixon, writer
Staz Johnson, penciler
Published January 1996

I hope everyone looked at the Arkham Asylum Employment Application, because this scene follows immediately from that image and gives you good reason not to trust Poison Ivy’s cooking (like that isn’t common sense).

Psychiatrist #1: And you grew these greens on the grounds?
Poison Ivy: And strictly organic, doctor.
Psychiatrist #1: I love fresh radishes.
Psychiatrist #2: Um…they’re tangier than I’m used to.
Psychiatrist #1: Mmf…Chmmf…They’ve got a real bite to them. Almost like–
Psychiatrist #2: FFT! [choking sound]
Psychiatrist #1: WFFT! [choking sound]

Jack in the Pulpit (Arisaema triphyllum) is a common forest plant in the western half of the United States. It is well known for its unique flower that looks like a preacher standing in a pulpit (hence its name).

Native Americans used Jack in the Pulpit as a food source, but they were careful only to consume the plant once it was dried or cooked. The raw plant is extremely irritating to the mucous membranes of the mouth and throat. It contains calcium oxalate crystals — which are extremely irritating to the tissues of the mouth causing swelling and a burning pain. Mild mouth or throat irritation is the most common, but there have allegedly been cases where consumption of the raw plant has led to a severe swelling of the throat, causing the victim to asphyxiate (which is what seems to be happening here. Poison Ivy seems to have found an uncommonly potent variety). If swallowed, the plant can also be extremely irritating to the stomach, causing nausea, vomiting, and severe abdominal pain; it is said to have caused deaths in this manner as well. According to my most reliable medical botany text, human deaths from Jack in the Pulpit are just rumored; there have been no confirmed deaths from eating the plant.

There are a couple problems with Poison Ivy’s plan (besides her lucking into finding an extremely toxic variety of the plant): While eating raw Jack in the Pulpit causes irritation of the mouth, gums, and throat, the irritation is on the inside of the mouth. The cheeks won’t swell up like a puffer-fish. Pushing a narrow straw through the lips won’t help anyway because –
1) It’s the throat swelling that’s cutting off the airway, not the lips.
2) The straw is too narrow for good air exchange (which seems to be a common comic book theme).

Before Superman perfected his “keep the heart beating with heat vision” technique, it appears he experimented with other resuscitation methods including this one, which he used to restart Professor Hamilton’s heart in Action Comics #667.

This technique seems to involve rubbing the chest very fast and…um…OK, I actually have no idea what Superman’s trying to accomplish here. But it sure seems to work — maybe it will show up in the next revision of ACLS.

Actually, I think that Superman’s powers would work against him in a resuscitation situation:
1. Super strength: It’s be too easy for him to apply a little too much pressure and crush the ribcage.
2. Super speed: He’d have the tendency to compress the heart too fast. CPR requires steady measured beats. With his speed, he’d essentially be mimicking ventricular tachycardia, if not downright ventricular fibrillation.

So if you’re down for the count and a super-hero shows up, you better pray it’s Batman and not Superman — I bet he’s got a Bat-AED in that belt of his.

Comic book writers have a tendency to try to tie everything together in a neat little package. Depending on your point of view, this can be a good or exasperating (I tend towards the former). I find it particularly interesting when writers take this approach when dealing with comic book medicine. A good example is what I like to call the “Venom Family Tree.” In it, we see 60+ years of comic book continuity linked by the drug Venom.

NOTES:
1. Miraclo is the pill that gives Hourman his power and was first mentioned in Adventure Comics #48 (March 1940). In JSA All-Stars #5 (Nov 2003), Hourman II revealed that he had made a new non-addictive version of Miraclo that worked via a skin patch. In JSA Classified #17-18 (November 2006), it was revealed that Venom was based on Miraclo.

2. Venom is an addictive super-steroid that was first mentioned in Legends of the Dark Knight #16 (March 1991). Side note: it wasn’t called Venom at that time — that was the name of the storyline. It is best known for giving the super-villain Bane his power. There have been at least a second- and third-generation of Venom, each more powerful and more addictive than the last.

3. Decahydrabolin, better known as Steroid A39, is the drug that gave the current Dr. Mid-Nite his powers. In Doctor Mid-Nite #1 (1999), he mentions that it is a derivative of Venom.

4. Slappers are a transdermal version of Venom that appeared in Batman Beyond, so are undoubtedly non-canon.

5. Nandrolone is a real-world anabolic steroid. In Nightwing #114 (January 2006) it was mentioned as a precursor of Venom.

I’m pretty sure I’m missing a few more Venom derivatives, but I’ll fill them in as I run across them again. Some day, when I have way too much time on my hands and I’m feeling masochistic, I’ll take on the Super Soldier Serum family tree.

Detective Comics #619 “Rite of Passage, Part Two: Beyond Belief”
Alan Grant, writer
Norm Breyfogle, penciler
Published August 1990

Tim Drake’s parent’s have been kidnapped and a mysterious tape sent to the Gotham Police demanding a ransom. Batman notices a faint odor on the tape and uses it to help track down the criminals.

Batman is at least partially correct. Jimsonweed (aka Thornapple, Devil’s Trumpet, Ditch Weed; scientific name Datura stramonium) is thought to have originated in Central America (though some experts suspect India) and spread from there. Now it is a ubiquitous plant found worldwide, not just Central America. In fact, the name Jimsonweed is thought to be a corruption of Jamestown Weed, another name of the plant, and proof it was found in Virginia from the early days of American history. Here’s a map of the plant’s distribution in the U.S. alone.

More proof that the drug is known worldwide: it shows up several times in the manga Apothecarius Argentum.

Over the years, medications made from Jimsonweed have had a number of uses. Most well known, as Batman notes, was its use in treating asthma. The 1899 Merck Manual mentions stramonium (a medical name for Jimsonweed) when discussing the treatment of asthma:

Unfortunately, the line between a safe dose and a toxic dose was very thin when dealing with Datura and there have been quite a few deaths attributed to its use. For this reason, the FDA declared it “unfit for human consumption” and it is no longer used medicinally in the United States — but I suspect it is still used in a number of third world countries. Jimsonweed is also used by some people as a recreational hallucinogen, but again it is extremely easy to accidentally take a toxic dose.

Another interesting fact about Jimsonweed is the plant’s rumored use in the preparation of zombies. Also known as “Zombie Cucumber”, Datura has long been suspected as one of the drugs used to turn people into zombies. We’re talking the classic Haitian zombies here, not the modern brain eating ones. Since the Drakes’ kidnapper is a Haitian medicine man, this Haiti-Zombie-Jimsonweed connection is undoubtedly intentional, if unnoticed by Batman.

This was a free comic produced by DC Comics and Schering in 1999. Although generally well written and illustrated, the underlying concept makes this a very bad comic.

A rare white orchid is on display at the black-tie dinner at the Gotham City Botanical Gardens and Bruce Wayne (Batman) and Tim Drake (Robin) are there to keep an eye on it. The reason? Poison Ivy has recently broken out of prison and this is just the kind of plant she likes to steal. Sure enough, she shows up and Batman and Robin spring into action. Unfortunately Robin is so sedated from his over-the-counter allergy medication that he lets Poison Ivy escape with the orchid.

When Batman and Batgirl head out to track down Poison Ivy and the orchid, Robin wants to come along, but Batman grounds him because of his antihistamine-related grogginess. Robin starts to sulk, but Alfred sends him to his doctor who prescribes him a non-sedating antihistamine (Claritin, of course — this was published when it was a prescription-only drug). Thanks to his new medication, Robin is able to conquer his hay fever and avoid sedating side effects; he joins the battle just in time to redeem himself by capturing Poison Ivy and rescue the orchid.

As giveaway comics go, the story by Christopher Priest is quite well done and Joe Staton handles the art well. What keeps it from being a good comic is the fact that Batman is selling drugs. Batman. Is. Selling. Drugs. Look, I don’t mind using super-heroes on occasion to sell something: subscription, Hostess snack cakes, Underoos, etc. I understand that bills have to be paid. But I draw the line at using super-heroes to sell drugs, even ones as innocuous as Claritin. There are some lines that just should not be crossed.

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

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!

This year’s Comic Book Cover Advent Calendar (so far).
One year ago, the cover was Geeksville #3.
Two years ago, the cover was Archie’s Christmas Stocking #3.
Three years ago, the cover was Batman: The Long Halloween #3.
Four years ago, the cover was The Goon #3
Don’t miss Yet Another Comic Blog’s annual advent calendar

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!

This year’s Comic Book Cover Advent Calendar (so far).
One year ago, the cover was Batman Family #4.
Two years ago, the cover was Fantastic Four #4 (creepy variant cover).
Three years ago, the cover was Jingle Belle #4.
Four years ago, the cover was Street Fighter #4 (variant cover)
Don’t miss Yet Another Comic Blog’s annual advent calendar

I figured it was time to take a look at Batman: Knightfall, the storyline where Batman has his back broken by Bane, and then begins the process of recovery.

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.

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!)

Click on the image for the full ad

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

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)

Click on the cover for larger view

19 Days until Christmas!

This year’s Comic Book Cover Advent Calendar (so far).
One year ago, the cover was The Strangers #19.
Two years ago, the cover was Captain Marvel #19.
Three years ago, the cover was Comic Cavalcade #19.
Four years ago, the cover was Batman and the Outsiders #19
Don’t miss Yet Another Comic Blog’s annual advent calendar

The Drummer is thrown for a loop when he he caught in a dimensional shift along with the rest of the Planetary team. Unfortunately for him, when you’re tied into the electrical/information system of the entire planet, the change can be quite jarring.

Planetary/Batman: Night on Earth by Warren Ellis and John Cassaday

All previous Psychic Nosebleed Zen posts

Tags: comics medicine tv nosebleed planetary drummer

Buzzy’s back for another public service ad, and if that isn’t enough to get you excited, it’s also another of the “Gee, isn’t school swell” DC comics was so fond of putting out in the 1950s and ’60s.

Click on the image for the full ad

This PSA was written by Jack Schiff. Art once again by Win Mortimer, who as far as I can tell, drew all the Buzzy PSAs. This PSA was found in Action Comics #209, but can be found in other DC comics from October 1955 including Batman #97 (featuring “The Ballad of Batman and Robin”*), and Superman’s Pal Jimmy Olsen #8 (starring “Jimmy Olsen, Crooner” — maybe there’s a pattern here?).

* The words to the Ballad of Batman and Robin (at least according to the cover):

More PSAs

Tags: comics psa buzzy school jack schiff win mortimer

Detective Comics #849 “Heart of Hush, part 4 of 5: Scars”
Paul Dini, writer
Dustin Nguyen, penciler

This month’s issue of Detective Comics, which continues the story of Catwoman’s missing heart, answers some of the questions I raised last month, but leaves others unanswered.

1. The bizarre steampunk-ish machinery used to keep Catwoman alive without her heart is explained away as a machine designed by Mr. Freeze, utilizing his extensive knowledge of cryogenics. Her heart is kept alive in a similarly designed machine in Hush’s lair.
I consider that a reasonable explanation, at least from a comic-book-medicine point of view.
However:

2. Hush explains that after his own run in with heart problems (thanks to the Joker), he “set about learning all I could about the heart — ways to remove it, restart it, test how long it could be kept alive outside the body…”
That’s as good an explanation as we’re probably going to get — and considering Hush is “The Best Neurosurgeon in World” — I’m willing to accept that he’s super-intelligent enough and driven enough to become “Darn Near the Best Cardiothoracic Surgeon in the World” in just a few months.

3. It’s a shame that Dr. Mid-Nite and Mr. Terrific show up just to be stymied. What a waste of great characters.

4. Hush tells Batman that Joker triggered a massive heart attack. Unlikely. An aberrant pacemaker could trigger a fatal arrhythmia, but not a heart attack — that’s a flow problem, not an electrical one. (I go into this in more depth in a previous post about the topic.)

*As always, the phrase “The Best Neurosurgeon in the World” is ™ and © Polite Dissent.

Just how much of a badass is Batman?
 
He donates blood to vampires…voluntarily.

scene from The Brave and the Bold #195

The context: Batman is hunting gangster Johnny the Gun, and Andrew Bennett (aka I…Vampire) is hunting his ex-lover turned evil vampire Mary. Their paths cross when they discover that Mary has turned Johnny the Gun into a vampire gangster. A fight ensues, and Bennett takes the bullets meant for Batman (that, of course, just happened to be silver). Batman repays Bennett’s actions by donating enough blood to keep the vampire alive. I’d make my usual comment about blood types now, but do vampires even have blood types?

Other Comic Book Transfusions

Truly one of the most bizarre comic book transfusion stories ever, this one comes from The Brave and the Bold #141, “Pay or Die!”

Two Gotham City businessmen mysteriously explode, and the Batman is quickly on the case. He determines that both businessmen had defaulted on loans from a new loan shark in town, the mysterious Mr. Longreen. Using his famed detective skills, and the help of a seamstress with poor English,Batman realizes that the reclusive Longreen is none other than his arch enemy, the Joker.

Despite his vaunted investigative skills, the Batman has no clue where the Joker’s hideout is, so he enlists Alfred, his faithful butler. Alfred puts the word out on the street that he is badly in need of a loan and soon Mr. Longreen comes calling. He brings Alfred to his lair in an abandoned funeral home and provides him with the cash he needs — Alfred will just have to repay the load whenever asked, plus interest. The two of them drink a toast of wine to their business arrangement.

Upon Alfred’s return to Wayne Manor, Batman performs an extensive physical, but can find no evidence of explosives. Things start to go sour the very next day, when the Joker calls Alfred, demanding the payment of interest on his loan. Then he calls again, demanding payment of interest on the interest.

Finally, Batman is able to deduce the full nature of the Joker’s plot: he has adulterated the wine with specially timed chemical explosives so that whoever he drinks a toast with will explode a day or two later. The Joker remains safe because he took an antidote before he drank the tainted wine.

Just as the Joker and his henchmen are chortling about the butler’s impending demise, Alfred crashes in through the window and grabs the Joker, proclaiming that if he explodes, he’ll take the Joker with him. But wait! It’s only the Batman pretending to be Alfred, and now that he has the Joker in custody, he forces him to give Alfred a transfusion so that the antidote will protect Alfred as well. No more loans, no more explosions, and the Joker is off to Arkham (and as far as I know, Alfred never repaid the money, so he still has $50,000 of the Joker’s loot).

I know this story exists in the anything-can-happen world of Earth-B (a place where continuity — and often the laws of science –are ignored), but it seems to me there are some serious flaws in both the Joker’s and Batman’s plans:

1. How did the Joker know how to time his explosives? How did he know when — and if — his clients were going to default? The story tells us that one of the businessmen had been paying off the loan for six months before he finally defaulted. Did he have explosives in his blood the whole time? Or maybe he received a gift bottle of wine in the mail (except that the story states that the Joker always drank with his victim)? I’d think it was done by remote detonation if it weren’t for the Joker looking totally panicked when he sees Alfred in his lair, knowing that Alfred is going to explode in just a few minutes.

2. Transfusing the Joker’s “chemically tainted blood” into innocent Alfred seems cruel and unusual punishment for years of loyal — if at time sarcastic — service. Better hope the Joker is the same, or nearly the same, blood type as Alfred. And better hope the antidote is still in the Joker’s blood stream and still functions after the transfusion. Why not just get the Joker to reveal where the antidote is, and give that to Alfred?

Other Comic Book Transfusions

Detective Comics #848 “Heart of Hush”
Paul Dini, writer
Dustin Nguyen, penciller

There are lots of spoilers here, so don’t read past the warning sign unless you’ve already read Detective Comics #848, don’t plan on reading it, or promise not to whine about the plot being spoiled.

The key portion of the plot, in Haiku:

Catwoman captured
deprived of her heart by Hush
left at hospital

First of all, let me state what is hopefully obvious. This is no way resembles realistic medicine. It is what can be best described as “classic comic book medicine” — the same kind of medical science that attaches a man’s head to a gorilla’s body or turns someone into a man/bat hybrid. That’s not to say it’s bad, per se, just horribly inaccurate.

Without knowing where Dini is going with this, it’s hard to speculate precisely what’s happened to Catwoman (Selina Kyle), so I’ll make some educated guesses (and probably some less educated guesses as well).

There’s so much to address in this issue, I’ll just hit the highlights. If there’s anything I gloss over or miss, just mention it in the comments and I’ll address it.

Let’s start by looking at the final scene, with Selina attached to every (steampunk looking) machine in the hospital, including — presumably — the machine that goes ping, after her heart has been removed by the villain Hush.

Selina’s heart is missing, so she’s hooked up to either some sort of artificial heart or heart-lung bypass machine. Given the art, it’s hard to tell which. Selina has tubes bringing blood to and from the heart, and we can see blood in the various pumps, so that suggests a heart-lung machine. But on the other hand, why all the wires — especially that huge 220V cable — leading into the chest cavity unless there’s something in there requiring electrical power (and even so, that’s a hell of a lot of wires). I suspect the artist thinks that a heart-lung machine actually involves an artificial heart placed in the chest and doesn’t realize that all the pumping is performed externally.

How did Selina get hooked up to this monstrosity of a machine? According to Oracle, she was dropped off anonymously at Gotham General in an abandoned ambulance. Was she hooked up to any machines then, or just propped up — her heart missing? All that equipment couldn’t possibly fit in the back of an ambulance, so much — if not all of it — had to have been attached once she arrived at the hospital. Is this really the best equipment the hospital has? And why are a keg, a muffler, and R2-D2 (the same one from Werewolf by Night, apparently) as part of the machine?

Finally, a few thoughts on the de-heartification surgery scene earlier in the issue:

• Removing a heart — presuming one wants to put it, or another one, back — is an operation that takes more than one surgeon, even if they are the Best Neurosurgeon in the World* (and this is cardiothoracic surgery, not brain surgery).
• It’s nice of Hush to wear surgical gloves and a mask over his bandages (though he’s still missing eye protection and has too much exposed skin for him to be considered in surgical garb).
• Speaking of skin exposure, if Selina is “prepped and ready” for heart surgery, why is her gown still on?

*The phrase “The Best Neurosurgeon in the World” is ™ and © Polite Dissent.

Action Comics #719 “Hazard’s Choice”
David Michelinie, writer
Kieron Dwyer, penciler

This is a Superman comic from 1996 that I recently picked up in the quarter bin. It posits an interesting moral dilemma, but the more I thought about it, the more the contrived logic of the story annoyed me.

Lois is dusting her apartment and collapses after touching a Joker doll she has on her shelf. She is rushed to the hospital where the doctor tells Superman that Lois has been poisoned and only has 2 hours to live.

Superman flies off the Gotham and meets up with the Batman. The pair follows some blind leads but eventually end up confronting the Joker at Arkham Asylum. He presents Superman with a syringe full of the same poison that is killing Lois. The Joker tells the duo that if he is injected with the poison, his “chemically altered blood” will produce antibodies which can be used to save Lois. The catch is that the poison will kill him. Will Superman take a life to save Lois?

In the end, Superman realizes that he cannot take a life — even the Joker’s — and flies off to Metropolis to be with Lois. Of course, it turns out that it’s all a moot point. Lois miraculously recovers at the 2 hour mark. It seems the Joker’s toxin was never designed to be fatal and it was all a ploy by the Joker to trick Superman into taking a life. Superman is ecstatic that Lois survived, but she doesn’t seem particularly thrilled at his choice of the Joker’s life over hers.

Part One can be found here
The Joker has planted three bombs in Gotham City. The first was collapsed a building, sending hundreds of people to the hospital. The second bomb was defused in the nick of time by Batman. The third bomb is still out there somewhere in the city.

Batman appears in the Gotham General Emergency Room carrying an unconscious Joker. During the battle, the Joker accidentally inhaled his own Smilex and has collapsed. Batman needs him revived as soon as possible to reveal the location of the third bomb.

Dr. Koslowski (narrating): Dr. Singh decided to inject 5ccs of Adrenalin directly into the Joker’s heart. It was our only chance to save thousands of lives.

Injecting medication directly into the heart, despite what you may have seen in Pulp Fiction, is not a good idea. It’s too easy to lacerate a coronary artery (causing a massive heart attack) or inject the medication into the heart muscle (causing a fatal arrhythmia). It’s not done anymore.
Medically, we don’t call it “Adrenalin” in the United States, but instead use the term “Epinephrine”. That’s the third British medical term showing up in Gotham Central ER — definitely a British writer.
Speaking of Adrenalin, 5cc is too large of a dose.

Dr. Koslowski: At which point the Joker flatlined.

So what does the medical team do? They defibrillate him.
Once again repeat after me: Do not shock a flatline. It is a bad idea. It may work in comic book (like it does here), but in real life it doesn’t work and may actually make the situation worse.

Batman figures that the Joker’s abnormal physiology is messing with the antidote and the adrenalin, which caused him to develop an extremely high blood pressure and suffer cardiac arrest. Batman decides to lower the Joker’s blood pressure with medication and then try the treatment a second time. (No criticism here: it’s as good of an idea as any.)

Once again, the Joker suffers a cardiac arrest . This time, Batman himself jabs the Joker in the heart with a syringe full of Adrenalin. The second time’s a charm and it works! The Joker returns to consciousness and promptly escapes…which was all part of Batman’s plan; he wanted to trick the Joker into leading him to the third bomb.

Let’s count the medical errors in a mere eight pages: the Joker flatlines and is subsequently defibrillated, not to mention injected twice directly in the heart with an overdose of Adrenalin.

Note to self: Do not seek emergency medical care in Gotham City. Hold it until you reach Metropolis.

Medical criticism aside, Batman: Legends of the Dark Knight #200 is a good story. I like the idea of a night in the Gotham General ER told through the eyes of an intern, and the story handles this aspect well. I’d like to see more of Dr. Koslowski and Gotham General.

Batman: Legends of the Dark Knight #200 “Gotham Emergency”
Eddie Campbell and Daren White, writers
Bart Sears, artist

This comic’s a few years old, but it was just re-released as part of the Batman: Going Sane collection, so it’s fair game to discuss again. When it first came out — other than the unexplained use of a British medication name — I thought the medicine was good. However, on second review, while the authors do an excellent job conveying the feel of a hectic night in the ER, the medicine leaves a lot to be desired.

It’s a busy night in the Gotham General Hospital emergency room, and things get even worse when the Joker becomes involved. This story is told mostly through the eyes of Dr. Natalie Koslowski, an intern on the first day of her Emergency Room rotation.

A teenage gunshot victim is brought in and Dr. Singh, the head of the ER, puts Natalie in charge of the case:

Paramedic #1: Gunshot wound to the mid sternum, exit wound to back of the right shoulder. Blood pressure 100/50, Pulse 158, Respirations 36.
Paramedic #2: Unconscious upon our arrival.
Dr. Koslowski: Resuscitation. Establishment of airway and restoration of hemodynamics.

That’s a good start, Dr. K. But don’t forget the B of the ABCs of resuscitation (Airway, Breathing, and Circulation). Just getting an airway is not enough; you have to make sure the patient has good (or at least adequate) air exchange.

Dr. Koslowski: Symptoms suggest serious blood loss. Unless treated aggressively and in a timely manner it can lead to hypovolemic shock.

True, but take a look at those vitals. He’s already in hypovolemic shock.

Dr. Singh: OK. Let’s tube him, get blood gases, and 2 liters of O Neg.

Intubation is good — it establishes the airway mentioned by Dr. Koslowski (though frankly the paramedics probably should have intubated the patient before he got to the hospital).
Blood gases aren’t going to tell anything useful and are not going to improve the care of this patient one whit. Not to mention he’s being tubed, so his respiratory situation is changing (hopefully for better) and this will alter those blood gases.
Starting a blood transfusion is appropriate, but blood comes in units, not liters, in the United State. I suspect this is a second Britishism creeping into this American ER.

Finally, those paramedics didn’t do a good job at all. Looks like they wrapped the patient in a sheet, lashed him to a stretcher, and came to the ER. He should be intubated and have a couple of IV lines started already.

Two cops bring in their partner, who has been dosed with Joker venom and shows the classic white skin, green hair, and rictus grin.

Cop #1: Help us. Look like Sam’s inhaled Smilex.
Dr. Singh: Rose, quickly get up to toxicology on the fourth floor. They have an antidote but it must be injected as soon as possible after inhalation.
Cop #2: Does this stuff work, man? Sam’s got kids.
Dr. Singh: It works if we can administer it quickly enough…If we get to the victim within the hour, we normally expect a coma for twenty four hours. Much beyond that it’s touch and go.

If time is of the essence, why is the antidote being stored in a closed department on another floor? Wouldn’t it make more sense to store it in the ER — at least at night, when the Toxicology department is closed?

This is only story I can recall where Joker venom is considered treatable, and one of the few where it’s called “Smilex.”

Batman #677 “Batman R.I.P.: Batman in the Underworld”
Grant Morrison, writer
Tony Daniel, penciler

Arch-villain Doctor Hurt is explaining his plan to his villainous colleagues:

Librium (generic name: chlordiazepoxide) is a drug in the benzodiazepine class — in other words, it’s from the same class of medication as Valium, Xanax, and Halcion. Like all drugs in this class, it acts as a relaxant, a sedative, and an anti-anxiety medication. Librium is a fairly old drug and is not in common use today.

I find Librium to be an interesting choice of drug for Doctor Hurt to use. As previously mentioned, it is a fairly old drug (in this case, “old” means about fifty years) and it was the first benzodiazepine discovered. Librium is not nearly as potent as later benzodiazepines, and it requires a dose that is roughly 20-50 times higher. This is going to make a big difference when dosing someone by sword cut — an unreliable method at best. It’s got to be a lot easier to get 0.5 MG of Xanax into a wound compared to 25 MG of Librium.

Librium has a very long half life, with some of its metabolites taking over a week to be broken down by the body. This can make it dangerous to use as a daily medication because these metabolites build up quickly. However, Librium’s long effect after a single dose may be just what the doctor is looking for in this situation.

Benzodiazepines are primarily used as relaxants and anti-anxiety agents in anxious patients, and sleep aids in insomniacs. They can also be used as muscle relaxants, to stop seizures, and to ease alcohol withdrawal. I know of no benefit to hypnosis or trigger phase induction offered by these medications, by I’m willing to explain this aspect away as “comic book science.” Of note, all benzodiazepines are habit forming and can become addictive so I tend to prescribe them with caution. Librium isn’t used that much anymore, having been supplanted by newer and safer medications.

So why did Doctor Hurt choose Librium? Why not use a more modern medication that doesn’t require such a hefty dose?

script by Eddie Campbell and Darren White, art by Bart Sears

What’s the error in this scene from Legends of the Dark Knight #200?

I reviewed this issue when it first came out, and other than some geographic/medication concerns, I was impressed by it. Now that it has been re-released as the final part of the Batman: Going Sane TPB, the time seemed right to take another look at it — and I’m afraid that I was overly generous in my initial assessment. Expect that mistake to be remedied shortly.

Previous picture quizzes

Extolling the virtues of the United Nations was a common theme of DC Comics’ Silver Age public service ads; the subject came up quite a bit (and I’ve only reproduced a handful of them, there’s plenty more). Here’s one from December 1958 titled “Sharing — The United Nations Way!”

The subtitle almost makes the ad sound exciting (“A true story from the files of the International Labor Organization”), but don’t let that fool you — a best seller it’s not.

Click on the image to the right for the full ad.

Like many of the United Nations public service ads, this one strikes me as a little condescending — but admittedly it’s not as bad as some others. On the other hand, unlike several other United Nations public service ads, this one was never re-used — so maybe I’m not the only one who dislikes it.

This PSA was scripted by prolific PSA writer Jack Schiff, with art by this time by the George Roussos. This copy comes from The Brave and the Bold #21(starring the Silent Knight and Viking Prince — no Batman team-ups yet).

More PSAs

Nightwing #145 “Freefall”
Peter J. Tomasi, writer
Rags Morales, penciler

At the end of the Resurrection of Ra’s Al Ghul storyline, Al Ghul had been defeated by Batman and locked in Arkham Asylum. Batman had the asylum staff convinced that Al Ghul was a dangerously psychotic schizophrenic who required constant heavy sedation with multiple drugs. This way Batman figured it would be a long time before Al Ghul was a threat to anyone again. This may come as a surprise — but he was wrong.

In the recent Nightwing #145, Al Ghul surreptitiously grabs a pen dropped by a guard and uses it to lacerate his “brachial, ulnar, and radial arteries.” By the time the wounds are noticed, he’s already lost a tremendous amount of blood. The doctors at Arkham work feverishly to fix the lacerations and stop the bleeding, and they pump Al Ghul full of multiple units of blood to replace what he has bled out. This basically acts as an exchange transfusion. His drug-tainted blood has been lost and been replaced with fresh blood, eliminating the psychiatric drugs from his system. This allows Al Ghul to overcome the residual effects of the medication, slay the helpful doctors and nurses, and escape Arkham.

I give full credit to Al Ghul (and to writer Tomasi) for developing such a fiendishly clever plan. Assuming one ignores that fact that Al Ghul would have been too drugged up to conceive it — let alone carry it out — the plan should work well. The blood he lost would have been the blood carrying whatever drugs he’d been given, and the new blood transfused into him would have been drug free. For all intents and purposes, this would have purged the sedatives from his system — though probably not as fast as shown in the comic.

Al Ghul’s exchange transfusion plan wouldn’t work for every drug. For instance, drugs that are strongly bound to their receptors are likely to stay bound even with a transfusion. Additionally, drugs that are injected into the muscle and then slowly absorbed by the body (Depo Provera or Depo Medrol, for example), would see their levels drop right after the transfusion and then build back up as more drug is released into the circulation. Neither of these seem to apply in this case. While it’s never clear exactly what drugs Al Ghul has been given, the guards mention that he’s receiving them five times a day, suggesting that they are very short acting and should flush from his system quickly in an exchange transfusion.

A few nit-picks:
The brachial artery splits into the radial and ulnar artery, so it seems a bit redundant for Al Ghul to cut all three.

You don’t suture with your hands, you use instruments. But that could explain why the doctor seems to be so slow. He should have been long finished with his suturing by the time the seventh unit is transfused. Then again, he’s probably a psychiatrist who hasn’t sutured since medical school.

If the patient has lost that much blood, there should be multiple IVs running, not just a single bag of blood.

A unit of blood is 450cc. It looks like the nurse is just hanging the seventh unit, so he should have received only 2.7 liters by then, not 5.6

There are 5 liters of blood in the human body. That means it takes just over 11 units to completely replace someone’s blood. The doctor should have repaired the wounds in time for some of Al Ghul’s blood to remain, so he shouldn’t have needed the full 11 units (meaning some of the sedative would still be in his system, just very less concentrated). On the other hand, the doctor is clearly very slow, so Al Ghul might have needed more than the 11 units if he was still bleeding while they were transfusing more in.

What kind of asylum has their own blood bank? Wait, no need to answer that, it’s Arkham.

More Comic Book Transfusions

The good old days: when mad scientists could concoct evil drugs and schemes in their own basement labs. Nowadays, it seems to take at least a university lab — more commonly an entire industrial chemical research lab — just to create one marketable evil drug. Just ask Norman Osborne (especially the “Ultimate” version) — how many scientists did he have working for him?

In this scene from Detective Comics #61 (March 1942), an unnamed mad scientist has discovered a drug that makes people lazy. How lazy? So lazy that victims will be too tired to eat and will starve themselves to death. Like any good mad scientist, he has a scheme to make money off his drug (money which will be used for more mad science — that’s how the cycle works). He slips some of his drug to an important corporate leader, and then extorts money from his corporation or he won’t provide the antidote (and isn’t it nice how mad scientists always take the time to concoct an antidote?)

Unfortunately, the scientist chose the wrong company this time: a company where Bruce Wayne was sitting on the board of directors. As the scientist left, Wayne switched into his Batman persona and followed him back to his lab. In the scuffle that followed, the scientist managed to get the upper hand and forced Batman to drink his lazy drug. It worked just as promised:

Batman: Suddenly feel tired — lazy — need a vacation from fighting crooks — out to take a month fishing. Sooo tired — think I’ll take a nap…

Batman didn’t succumb as quickly as the mad scientist expected though, and he was able to secretly signal Robin, who managed to knock out the scientist and find the antidote for Batman (and presumably the CEO, though that was never mentioned). The fate of remaining supplies of the lazy drug was never mentioned either. I suspect that it’s still around. The next time you feel like staying in bed all morning and lazing the day away it just might be because somebody slipped you the lazy drug…

When last we saw Batman (in this blog, at least), he was smacking around a criminal lowlife who just happened to have a retained bullet that was too near his heart, and Batman inadvertently killed him with a punch.

Now the tables have turned and Batman’s in the same situation.

As The Brave and the Bold #100 opens, Batman is shot by a sniper. He survives, but the bullet has lodged inside his chest, right next to the heart. It’s one of those Tony Stark wounds that exist only in comic books: the bullet will kill him in less than a week, but it is too dangerous for any ordinary surgeon to remove. There is one doctor in the entire world who can save him, but that doctor is in Zurich and it will take him several days to get to Gotham City. In the meantime, Batman is bandaged up, placed in a wheelchair, and told not to move because even the slightest movement could dislodge the bullet and kill him!

A near fatal injury and confinement in a wheelchair might stop an ordinary super-hero, but not Batman. He is determined to capture the drug lord who had him shot. Using Green Arrow, Green Lantern, and Black Canary as his street operatives, Batman is able to foil the all of the drug lord’s schemes to import heroin into the country. Until the final confrontation that is, which takes place in the operating room with the Batman under anesthesia and the drug lord masquerading as the surgeon. You’ll have to figure out for yourself how that one ended (but as a hint, The Brave and the Bold continues for another 100 issues).

Notes:
For all you ballistics experts, the bullet is identified as a .30-06.
The doctor is saying that the bullet penetrated the pericardium — a fibrous membrane that surrounds the heart — and stopped just before it hit the left auricle, which is part of the left ventricle atrium.
Interesting x-ray machine that shows a perfect image of the heart and diaphragm, but no other organs (like the lungs or bones), and only the silhouette of the bullet.
Batman’s bandages are placed over his costume.
Much like the young Tony Stark, every four of five panels Batman makes a point to mention how much his chest his hurting.
Black Canary doesn’t come off very well in this issue. In one particularly memorable scene, she is unable to hear the Batman’s comm signal because she is in a beauty shop getting her hair done after it got ruined in the rain (which is ridiculous because her blond hair is a wig). Come to think of it, Canary didn’t come off too well in any of her appearances in The Brave and the Bold.
The Brave and the Bold #100 is by Bob Haney and Jim Aparo.

Batman dukes it out with Pete “Nails” Logan, a mobster wanted for murder.

scene from Batman #9 (February/March 1942)

I’m impressed that the doctor was able to deduce that Nails had been shot without seeing a bullet wound. And with just a stethoscope. I guess medicine was more advanced in 1942 than I thought.

(Make your own Tony Stark/shrapnel analogy here.)

I’ve discussed commotio cordis a couple of times, most recently in relation to Batman #672-674.

Commotio cordis is a rare and frequently fatal condition. It occurs when an individual receives a direct blow (blunt trauma) to the chest at precisely the right time in the cardiac cycle to stop the heart and cause a cardiac arrest. Children are more susceptible to the condition than adults.

Sports injuries are a common cause of commotio cordis, particularly thrown baseballs and softballs. Other causes include physical blows to the chest during a fight, steering wheel impact in motor vehicle accidents, and even the blunt force of bullets stopped by body armor.

The best, and really only, treatment for commotio cordis is immediate cardiopulmonay resuscitation, usually requiring defibrillation and cardiac medications.

Wikipedia has a good write up on commotio cordis

Commotio cordis has been in the news recently because of a lawsuit filed by a New Jersey family against several groups: a maker of aluminum baseball bats, the Sports Authority*, and Little League Baseball**. It’s an unfortunate story on many levels: Twelve year-old Steven was pitching in a baseball game when a line drive hit by the batter caught him square in the chest, causing his heart to stop beating. He was eventually revived, but remained in a coma for several weeks, and now has severe brain damage.

It’s a sad story and an unfortunate case, but personally I think it’s a stretch to treat it as cause for a lawsuit. I know that we Americans always like to blame someone when something goes wrong, but there are times that it’s not appropriate. This is one of those times.
There is no hard evidence that aluminum bats are any more dangerous than wooden ones, particularly in cases of commutio cordis (remember, it’s an issue of timing, not an issue of force).
There is an inherent risk of injury in playing any sport. Proper safety precautions will minimize this, but never eliminate it entirely. I am well aware of this whenever I go for a bike ride on the back country roads near me. Who knows what drunk-driving redneck may be out there weaving across the center line?***
And suing Little League because they endorsed the bat? Give me a break.

*The store where the bat was purchased
**Not because it was a Little League game — it was not — but because they “endorsed” the bat as safe.
***It would be like me, after getting hit by a reckless driver, suing Ford because the person was driving a Mustang and those can go faster than other cars. It may be true (arguably), but it really has nothing to do with the accident and injury.

I’m impressed that Vixen is able to tell that the dozens of dead people she stumbled across died of “cerebral hemorrhage” (bleeding in or around the brain) or a “burst heart”, since neither of these leave noticeable external marks or signs. Generally it takes an autopsy or some sort of radiology (e.g. x-ray or CT scan) to diagnose these.

This is a nicely dated PSA from 1960. While the message remains good, the examples — or at least the illustration of the examples — clearly show the era this PSA is from.

Click on the image to the right for the full ad.

While this ad was clearly written for kids, I think it reads as much as a warning about lax parenting; an alternate title would be “How Are Your Parenting Skills?” Mom shares a large part of the blame for every example of Jimmy’s misbehavior. He’s an eight year-old boy, he has the attention span of a gnat. He needs much more hands on parenting. She saw Jimmy “hot-rodding” with the shopping cart — why didn’t she stop him? Where was she when he was messing up the magazines or racing down the escalator. Her opening sentence shows the entire problem — she agrees to give Jimmy a reward despite his poor behavior. What’s he really learned in this day of shopping? He’s learned that Mom will still buy him a soda even when he’s a terror.

This PSA was written by Jack Schiff with art by Bernard Baily. It appeared in various October 1960 issue of DC comics, including Brave and Bold #32 (the source of this scan), Batman #135, Superman’s Pal Jimmy Olsen #48, Wonder Woman #117, and — of course — Sugar & Spike #31.

More PSAs

scene from Detective Comics #41 (Finger, Kane, et. al.)

Apparently Bruce Wayne has never heard of a “Phantom Limb” — a term in use since the late 19th century. Most people (50-80%) who have had amputated limbs will still feel the occasional sensation — pain usually, but itching is also common — in the missing limb. So it’s not really that surprising that the Colonel would unconsciously scratch his missing leg.

A more telling sign that it was not the real Colonel would be the limp, or lack thereof. Prosthetic limbs were notoriously bad in the 1930s and ’40s, so the Colonel should have a limp that would be very recognizable to his old friend Bruce Wayne.

Batman #672, #673, and #674 “Space Medicine,” “Joe Chill in Hell,” and “Batman Dies at Dawn” Grant Morrison, writer Tony Daniels, penciler Batman is shot point blank in the chest by the mysterious “Third Batman” (a police officer once trained to take Batman’s place if he were to die), which causes his heart to stop. Batman collapses, but is later revived when the Third Batman shocks his heart back into a normal rhythm. At this point, Batman exclaims: “My God — I had a heart attack — on the roof of the GCPD — “ There are a handful of problems with this scenario: #1. There is a difference between a cardiac arrest and a heart attack. A cardiac arrest occurs, as the name suggests, when the heart (cardiac) stops beating (arrest). Cardiac arrest can be caused by several different conditions, including a heart attack, an abnormal heart rhythm, trauma, and electrolyte abnormalities. A heart attack (”myocardial infarction” in medical-ese) occurs when one or more of the small arteries supplying the heart with blood are suddenly blocked and the heart can no longer obtain the oxygenated blood it needs to survive. The affected part of the heart muscle (myocardium) then dies (infarcts). If a large enough part of the heart dies, it can lead to a cardiac arrest and death, but it is certainly possible to have a heart attack without suffering a cardiac arrest. In the story, despite what he says, Batman suffered a cardiac arrest, not a heart attack. He developed an abnormal heart rhythm that degenerated into asystole (a flatline). This abnormal rhythm was brought about by direct trauma to the chest, a kind of commotio cordis (a condition which occurs when a blunt trauma to the chest happens at just the right instant in the heart cycle to disrupt the normal heart rhythm and cause a fatal arrhythmia and cardiac arrest. It is most common in children, and is thought to kills several Little Leaguers struck in the chest by baseballs every year. There have also been recorded cases of commotio cordis occurring in adults struck by a bullet who were wearing body armor, much like Batman in this situation). #2. After Batman slipped into asystole, he was brought back by the Third Batman using a defibrillator. I know I’ve covered this many time before, so everyone repeat after me: you don’t shock a flatline. It’s a bad idea — especially after several minutes of asystole have elapsed, as in this case. (Though Morrison is right that brain damage after a cardiac arrest starts at the five minute mark.) #3. The Third Batman appears to have defibrillated Batman through his uniform, which I always understood to be insulated. Or else he defibrillated him through the hole blown in his uniform, which would put the paddles in the wrong position to work. The art in the book actually suggests he defibrillated the right side of the chest (the wrong side), so I’m giving Daniels the benefit of the doubt and assuming he’s showing the moments leading up the actual defibrillation, as the Third Batman moves the paddles into position. Tags: comics medicine batman cardiac arrest defibrillation commotio cordisgrant morrison tony daniels

A mysterious disease has struck Metropolis. Citizens are turning purple and dropping dead. No cure is available and no one knows the cause of the disease. The populace is terrified and people are barricading themselves in their homes and refusing to venture outside. “Bring out your dead” carts parade through the city collecting the dead and dying.

Dr Travers, a young scientist, recognizes the symptoms as belonging to the “Purple Plague,”, a disease from the middle ages long thought extinct. He is able to isolate the germ and develop an “antidote” against it. Unfortunately, when he gives a demonstration of his serum to the local scientific society, it doesn’t work and he is derided as a fraud and kicked out of the organization.

Discouraged, Travers wants to give up, but Superman encourages him to continue his experiments. His chance for redemption comes when the young son of Dr. Greenley — the head of the scientific society — contracts the plague and only Travers’s serum can save him. This time, his serum works and Travers is readmitted to the society and his cure is distributed across the city, stopping the plague.

Notes:
1. This story is from Action Comics #19 (December 1939) by Jerry Siegel and Joe Shuster.

2. Though he plays a mostly sideline role, the actual villain of the story is the Ultra-Humanite, who is using the plague as a biological weapon against the city (though why he is doing this is never explained; he was probably just being a cranky mad scientist). I believe this is the Ultra-Humanite’s final appearance in his original body.

3. Swap the main characters with their similar counterparts, move the story to Gotham City, pad it out (about 20 times), and you have Batman: Contagion.

4. I’m disturbed by Clark’s near use of alliteration in the headline. He actually thought “vivid” was a good fit? He should have just gone with “mauve” for the full alliterative headline.

5. A single patient, be it a success or failure, simply isn’t enough evidence for or against Dr Travers’s serum. It’s concerning that a society of supposed intellectuals — scientists, physicians, and Superman — seem unable to grasp this fact.

6. There are several instances of questionable medical ethics in the story: The worst has to be Clark riding in an ambulance that is rushing to help a dying person so he can be the first reporter on the scene.

7. Speaking of Clark/Superman’s questionable actions, Superman steals the supplies Dr. Travers’s needs from a local chemical warehouse, instead of, you know, paying for them. He also punches a huge hole in their wall. I hope they have good insurance.

8. Dr. Travers cure is most likely a serum containing antibodies against the plague germ. When given to patients, it induces a passive immunity (as opposed to active immunity, where the patient makes their own antibodies against the germ) and provides several months of protection against the disease. This should be plenty of time for the epidemic to die off. (I’ve discussed passive immunity before, and here’s what the CDC has to say on it).

Tags: comics medicine plague golden age superman ultra-humanite passive immunity

In the pre-internet and pre-infomercial era, “Be Your Own Boss” meant something more than an ad for a hucksterish work-at-home gig of questionable value. In the case of this 196- PSA, it refers to developing time management skills. No website to check, enrollment fee to pay, or infomercial to watch. Well, there is a know-it-all older brother to listen to, but that’s the worst there is.

Click on the image to the right for the full ad.

This PSA is by DC’s PSA king Jack Schiff, with art by Bernard Baily. There are apparently both black and white and colored versions of the ad, but the only one I have a copy of (scanned from Brave and the Bold #30) is the black and white version. It can be found in various June 1960 comics including Action Comics #265, Batman #132, Sugar & Spike #29, and World’s Finest #110.

More PSAs

Tags: comics psa boss jack schiff bernard baily

I note 4 fairly significant errors in these panels from Superman/Batman #35 (script by Verheiden/Guggenheim, art by “Pat Lee”). How many can you find? More importantly, how many additional errors can you find that I missed?

I’ll post my answers around 1PM central time. Answers below:

Hint #1: I count one error in the art, two in the script, and error #4 could be blamed on either.

Hint #2: Check out the anatomy of the hindbrain.

My Answers:
1. No horizontal slice of the brain will show both the lateral ventricles and the eyes; they’re on different levels, and
2. neither of them (nor Batman’s finger) are anywhere near the Medulla Oblongota,
3. which is part of the hindbrain, not the forebrain.
4. and all this means Batman was wrong about Superman’s drawing being any good.

Previous picture quizzes

Tags: comics superman batman metallo brain picture quiz

There are quite a few comic characters who are animals raised up to human levels, but it rarely works the other way – there are only a handful of human characters who have truly taken on animal characteristics. Sure, there are those who dress up as animals (cough Wolverine cough), and the occasional lycanthrope, but few who are actually part animal.

Azrael was one of these characters, and a rather perplexing one. For those of you who may not remember, Azarael (real name: Jean Paul Valley) was a supporting character in the Bat-books of the ‘90s and even he had his own eponymous title for a number of years. Valley was a member of an obscure religious order — the Order of St Dumas — who had been trained and brainwashed since birth to become the ultimate assassin and “avenging angel” of the order. While investigating his origins, Azrael also discovered that he was more than human, or depending on your point of view, less than human. He was endowed with animal genes — strongly implied to be from the great apes — to increase his “physical prowess” and “cunning.”

Ras Al Gul gives Azrael the bad news in Azrael #30	The Gray Abbott explains what Azrael gains from his animal genes in Azrael #7

First of all, I was not aware that there is a gene for cunning. I’ve always thought intelligence was more multifactorial — definitely some genetic components, but with a great deal of experience and learning involved as well. (Or maybe he’s like the Tony Stark from Ultimate Iron Man with extra brain scattered throughout his body.) Regardless, I’m not sure there are any animals more cunning than humans — especially at Azrael’s chosen task — assassination (sure, other animals kill, but how many kill out of spite, or because someone else told them to?)

I’m no simian expert, but the great apes certainly do seem to have more “physical prowess” than humans — at least in their own environment. But replicating that is not just as simple as swapping muscle genes. Muscles don’t act alone; they need proper bone and nerve structure to function. It does little good to have “enhanced” ape muscles without the correct skeleton to support that – yet Azrael is always shown with a classic human build. I also question how much value animal genes would have in an urban environment (unless they were pigeon, cockroach, or squirrel genes).

The Gray Abbott explains how Azraels are made
(from Azrael #7)

It’s a little unclear how Azrael gained the animal genes. The Gray Abbott (the head scientist of the Order of St Dumas) explains that when an Azrael is created, a live human fetus is taken from its mother and gestated in a vat of ape amniotic fluid. That’s…rather disgusting, but amniotic fluid doesn’t transfer genetic material so it wouldn’t explain the animal genes.

Scott Beatty, in the Batman: The Ultimate Guide to the Dark Knight states “as a developing fetus inside a glass womb, Jean Paul’s brain and blood chemistry were genetically intermingled with animal fluids to enable greatly enhanced strength and agility.”

Again, that’s disturbing, but doesn’t explain how Azrael ended up with animal genes — but then a lot of it is technobabble…how exactly does one “genetically intermingle” fluids? There had to be more to it than just mingling amniotic fluid.

Tags: comics medicine azrael batman genes ape

scene from Superman/Batman #24 (Loeb, McGuinness)

Batman’s right, I don’t care if you are an other-dimensional female copy of Batman, it is simply impossible for the two of you to have identical DNA. There are those pesky little Y chromosomes — Batman has one, and you don’t.

I’ve tried to “no-prize” my way out of this one, but to no avail; differences remain.

On the other hand, I found it interesting that in an entire world of flipped genders (Superwoman, Miss Miracle, etc.), “Mother” Box was still Mother Box.

All-Star Batman and Robin #6
Frank Miller, writer
Jim Lee, penciler

There’s going to a spoiler or two here, so don’t read any farther unless you’ve already read the comics, don’t plan on reading it, or don’t care.

In All-Star Batman and Robin the Boy Wonder #9, Green Lantern takes a nasty blow to the neck that crushes his trachea. Medically, this is considered very bad, mostly because the trachea is quite important for breathing — it’s how air reaches the lungs. Batman performs an emergency cricothyroidotomy on him to save his life.

I’m sure everyone has seen a cricothyroidotomy, at least on TV. It’s shown up numerous times, most notably in an episode of M*A*S*H and an early ER episode. In the procedure, a hollow tube is placed through the cricothyroid membrane (a thin membrane just below the Adam’s apple) and into the trachea so that the patient can breathe through the tube (assuming, of course, that their trachea is crushed above this point). Cricothyoidotomies are reasonable for emergency short-term use, but are not good for long term treatment.

I have a few concerns about Batman’s technique, especially in regards to the tube he is using. These aren’t major concerns — he is improvising an emergency procedure after all — more nitpicks really.

1. Where the airway is concerned, you want to minimize the amount of resistance and maximize the amount of flow. Therefore you want a tube that is as wide and as short as you can get away with. The tube Batman is using appears too narrow — and much too long — to be used successfully for a cricothyroidectomy. Try this at home: get a standard drinking straw (not one of those thick McDonald’s ones) and cut it in half so it’s about 4 inches long. Now see how long you can breathe through it — both inhaling and exhaling. It’s not too easy, is it? Batman’s tube was even narrower than that.
1A. There is a special procedure known as a needle cricothyroidotomy that uses a very narrow tube, but it requires high-flow oxygen and is only good for about 30 minutes before the carbon dioxide builds up too much.
1B. That’s not saying the tube won’t work at all — it will — the ambulance just better get there fast.

2. My other concern is that Batman is purposefully using a jagged-ended tube. His plan is essentially to cut his way into the trachea with the sharp end. This is in contrast to the actual cricothyroidectomy procedure where the skin is cut horizontally, the membrane found, and then cut open vertically before the tube inserted. This allows the physician to make sure he’s in the right place, the anatomy is correct, and there aren’t any blood vessels or nerves in the way. Batman’s essentially plunging the tube in blind, hoping he gets it in the right place instead of taking an extra second or two to look. You can’t tell me that in his entire utility belt, Batman’s not carrying a cutting edge of some sort. He’s got medical tape and nerve gas in there, surely he’s got a blade.
2A. Plus, he’s going to have a skin and tissue plug in the tube, like biscuit dough in a biscuit cutter. It’s probably not big enough to stop it up, it’s just nasty and Green Lantern’s going to suck it into his lungs with the first breath.

Overall, not bad for improvising, but I’d still expect better of the Batman (though, come to think of it, maybe I shouldn’t expect more finesse from the “God Damned Batman”).

(Now how many of you read this issue and thought of me when you hit this scene?)

Tags: comics medicine batman green lantern cricothyroidotomy frank miller jim lee

In an exchange transfusion, a portion of the patient’s blood is slowly withdrawn and replaced with donated blood. Depending on the patient and the situation, the transfusion may involve just a small fraction of the patient’s blood, or enough to refill the circulation several times over.

Exchange transfusions are most commonly used to treat severe jaundice in newborns, but they can also be used in critical cases of sickle cell anemia, thrombotic thrombocytopenic purpura, and hemolytic disease of the newborn (a condition caused by a blood type incompatibility between mother and fetus). Exchange transfusions have also been used to cleanse certain drugs and toxins from the body.

A good example of this last use comes in Captain America #377, the penultimate issue of the Streets of Poison storyline. Cap had been caught in the explosion of a methamphetamine lab and the high levels of the vaporized drug somehow bonded with the Super Soldier Serum in Cap’s blood, causing abnormally aggressive and violent behavior. The only way to remove the drug is to perform an exchange transfusion. Unfortunately, this will also remove the Super Soldier Serum as well, rendering Cap powerless. (Don’t worry — the Super Soldier Serum eventually reasserts itself and everything works out well in the end, but that’s a post for another day.)

Comic Book science, of course, takes the exchange transfusion to the next level. For instance, what if a fluid other than blood is used in the transfusion?

In All-Winners Comics #1 (a classic Captain America story), Cap and Bucky face off against an army of “zombies” created by a mad Nazi scientist. These aren’t classic zombies, but instead transients and bums turned invulnerable through an exchange transfusion.

In the more recent Umbrella Academy #4, Vanya is experimented on by the Conductor of the Orchestra Verdammten and has her blood removed and replaced with a dark evil liquid. This transforms her into the villainous La Viole Blanche (aka The White Violin) who vows to destroy the rest of the Umbrella Academy…as well as the entire world.

The take home message is that exchange transfusions serve an important function in severe disease, unless you’re in a comic book and something other than blood is used. If that’s the case, run far far away as fast as you can.

Other Comic Book Diagnoses:
Frozen Solid
Brains! Brains!
Hypertrichosis
Xenografting
De-Aging
Can’t Get You Out of My Mind

Tags: comics medicine transfusion exchange transfusion captain america zombies umbrella academy

Disguised as hippies, Batman and Robin discover that their informant has been shot. So what is the first thing that Batman does?
1. Enters the room and notices that his informant has been shot and is slumped over the table.
2. Looks around the room to find any clues left by the victim.
3. Discovers clues conveniently held in the victim’s hands.
4. Discusses these clues at length with Robin, including “theorizing” what might have gotten your informant shot.
5. Finally, checks out the victim to see if he’s alive — then calls an ambulance.

I think Batman may need to re-evaluate his priorities.

(I’ve talked about the ABCs of trauma repeatedly — Airway, Breathing, and Circulation — but apparently Batman has his own ABCs: ANALYZE the crime scene, BANTER with partner, and then CHECK-OUT the victim.)

Click on the image to the right to see a full sized image

Scene from Detective Comics #371 (“Batgirl’s Costume Cut-Ups”), script by Gardner Fox, pencils by Gil Kane.

Tags: comics batman robin trauma

Swamp Fever

• The #3 cause of death in Gotham City swamps (fig. 1).
• Initial Symptoms: Chills, mustard yellow skin color (fig. 2).
• Incubation Period: 1-7 days
• Diagnosis: Best performed by librarians with Princess Leia hairstyles (fig. 3).
• Later Symptoms: Weakness and fainting (fig. 4).
• Treatment: Bed rest, stylish pajamas, and Chinese Oranges (fig. 5).

Education courtesy of Detective Comics #369 (from Showcase Presents: Batgirl ). Script by Gardner Fox, pencils by Carmine Infantino.

Tags: comics medicine swamp fever batgirl batman

Click on the image above for the full ad.

It turns out that Marvel wasn’t the only comic book company running the “Verb – It’s What You Do” public service campaign — DC had their own versions of the PSA, and — hard as it is to believe — they make the Marvel ads (starring Wolverine and Nightcrawler) look good by comparison. This ad is one of the lamest PSAs I’ve come across yet.

All they did was take a stock Justice League pose and add a few captions. And not a caption for every hero either, just a few. Apparently only Green Lantern, Batman, and Flash care if you get off your duff, the other four really couldn’t care less. Way to phone in the public service message, DC.

More PSAs

Tags: comics psa justice league verb

If the embedded video doesn’t appear, check it out here.

A change of pace today: a super-hero video PSA. From 1972, here is Yvonne Craig as Batgirl in a public service announcement for equal pay for women. It should come as no surprise that the U.S. Department of Labor (Wage & Hour Division) sponsored this ad. What may come as a surprise is that this PSA was produced 4 years after the Batman television show ended.

There is a slightly different, shorter version of the PSA also available on YouTube (thankfully, the picture quality is much better in this one).

In addition to Yvonne Craig as Batgirl, Burt Ward reprises his role as Robin and William Dozier narrates. Batman is played not by Adam West but by Dick Gautier (probably best known for playing Hymie the Robot on Get Smart, and — for all my Transformers loving readers — the voice of Rodimus Prime from the third season of Transformers).

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Tags: comics psa batgirl batman robin yvonne craig burt ward dick gautier adam west

A change of pace for today’s Advent Calendar cover — no super-heroes, no Golden Age funnies. Instead, just a couple of cats. Oh, and geeks too, apparently.

Geeksville #3 (Three Finger Prints, 1999)
3 Days until Christmas!
click on image for larger view

The entire 2007 Comic Book Cover Advent Calendar (so far) in traditional calendar format.
One year ago, the cover was Archie’s Christmas Stocking #3.
Two years ago, the cover was Batman: The Long Halloween #3.
Three years ago, the cover was The Goon #3
Previous Comic Book Cover Advent Calendars: 2006 2005 2004
David Carter always has another good comic book advent calendar over at Yet Another Comics Blog

Tags: comics advent calendar christmas geeksville

A DC comics super-hero Christmas cover! For the second day in a row! And just 4 days until Christmas! Anyway, here is Batman Family #4 which, in addition to stars Robin and Batgirl, features such luminaries as Fatman and the Phantom General. At least it’s got the Elongated Man in it, too.

Batman Family #4 (DC, 1976)
4 Days until Christmas!
click on image for larger view

The entire 2007 Comic Book Cover Advent Calendar (so far) in traditional calendar format.
One year ago, the cover was Fantastic Four #4 (creepy variant cover).
Two years ago, the cover was Jingle Belle #4.
Three years ago, the cover was Street Fighter #4 (also a variant cover)
Previous Comic Book Cover Advent Calendars: 2006 2005 2004
David Carter always has another good comic book advent calendar over at Yet Another Comics Blog

Tags: comics advent calendar christmas batman robin batgirl elongated man

Another common theme on Christmas covers is the characters/ornaments concept. A good example of this is on today’s comic, The Strangers #19. That nineteen also means there are only nineteen days remaining until Christmas.

(Other good examples of the ornaments CHristmas cover include The Sensational Spider-Man #24, Batman and the Outsiders #19, and Nick Fury Agent of S.H.I.E.L.D. #15

The Strangers #19 (Malibu Comics, December 1994)
19 Days until Christmas!
click on image for larger view

The 2007 Comic Book Cover Advent Calendar (so far).
One year ago, the cover was Captain Marvel #19.
Two years ago, the cover was Comic Cavalcade #19.
Three years ago, the cover was Batman and the Outsiders #19
Previous Comic Book Cover Advent Calendars: 2006 2005 2004
David Carter always has another good comic book advent calendar over at Yet Another Comics Blog

Tags: comics advent calendar christmas the strangers ornaments

Back in 1994, one of DC Comic’s house ads reimagined their upcoming releases as television shows and presented them in a TV Guide style format. The best part was that they supplied casting information for the characters using popular actors and actresses of the day including Grant Show (Cosmic Boy), Jason Patric (Blue Beetle), Madeline Stowe (Nightshade), Christian Slater (Guy Gardner), and others. Looking through the listing, the only show that I absolutely have to see would be Green Lantern #50 just to see Paul Williams as Ganthet (though John Goodman as Killowog is tempting as well).

Click on the Legion of Super-Heroes listing for the full schedule, or click here

Found in Supergirl (1994 mini-series) #3.

Tags: comics televison dc supergirl

There are so many incredible pages of the Atom running through Batman’s brain in The Brave and the Bold #115 that it’s hard for me to pick just a few panels to highlight. But somehow, I did.

Courtesy of Bob Haney and Jim Aparo, here’s the Atom running around inside the brain of a brain-dead Batman, stimulating various parts of his brain, and using him like a puppet to track down and apprehend the crooks who killed him.

Tags: comics medicine brain batman atom bob haney jim aparo

With all the characters with shrinking powers in comic books, it was only a matter of time before they started shrinking small enough to enter someone’s brain. Most of the time, the miniaturized character enters the brain to cause damage, but sometimes it is done to heal. While most common in the comics, this concept can also be seen in movies (Fantastic Voyage) and television (The Simpsons in their spoof of Fantastic Voyage, Futurama, Astroboy).

Once the shrunken character enters the brain, there are four basic “Styles of Attack”:

1. Crude and Deadly
This style occurs when a miniaturized character blunders haphazardly through the brain itself, doing as much damage as possible along the way. This is best exemplified by Jean Loring’s murder of Sue Dibney during Identity Crisis.
A more recent example had Micromax take out a leader of the Jihad in a similar manner in Marvel Comics Presents #1 (see the image below — that’s Micromax climbing out the ear; I’m not sure what that line is in the background – heart monitor? brain waves? biothythms?). Symptoms he caused included headache and seizure as well as the ubiquitous nose and ear bleeding (and death).

2. Surgical Precision
This style is most often utilized in a curative manner rather than as a weapon. The best example is actually a movie, not a comic book. In Fantastic Voyage, five adventurers and their submarine are shrunken so that they can remove a clot in a Soviet defector’s brain. A good comic book example would be Micronauts #30, where Acroyear, Bug, and Marionette are miniaturized and enter Commander Rann’s brain to cure his coma. They battle and defeat Nightmare and are able to physically unlock hidden areas of the commander’s brain.
Conceivably, precise strikes by a tiny character could also be used to damage specific parts of an enemy’s brain…but I can’t recall any good examples of this.

3. Vague but Effective
This is the most common style. A menacing villain looms up behind the heroes, ready to strike. Suddenly, they collapse in a heap and the Atom/Shrinking Violet/other-tiny-character jumps out of their ear. It’s never explained exactly what they did inside the villain’s brain (Squeezed the blood supply? Caused a seizure? Kicked something important?) — but it sure knocks them out quickly.

4. Haney-style
In the destined-to-be-classic Brave and the Bold #115 (written by Bob Haney, art by Jim Aparo), Batman is electrocuted and rendered brain dead but the Atom is able to enter his brain through the ear and control Batman like a puppet. Sure, it makes no sense anatomically, but then, Haney written titles always followed their own unique science. The Atom also manages somehow to kick-start Batman’s brain again after capturing his murderer and saving the day.

Other Comic Book Diagnoses:
Frozen Solid
Brains! Brains!
Hypertrichosis
Xenografting
De-Aging

Tags: comics medicine brain identity crisis micromax fantastic voyage micronauts atom batman baob haney

It’s prime ragweed and hay fever season here in the Mid-West. My most common reason for patient visits this week has been allergies.

Allergies are no fun for anyone, but there’s definitely certain characters for whom allergies would be even worse. Here’s the list I came up with:

Tigra
Doctor: “I’m sorry Ms. Grant, but you’re allergic to cats.”

Thor
“Forsooth! Mine sneeze hath leveled that house!”

M.O.D.O.K.
Just imagine all the snot that would come from that giant nose. Come to think of it, I’m actually surprised that no one has written a story where M.O.D.O.K has allergies (or would that be M.O.D.O.S.* or M.O.D.O.R.N.I.E.S.**?).

Dr. Doom
Just try sneezing inside a metal face mask. Would also apply to Iron Man, Crimson Dynamo, War Machine, etc. etc.

All-star Batman
“I’m the godd – ACHOO!! I’m the go – ACHOO!! I’m the – ACHOO!! Eh, forget it.”

Superman
Itchy, watery eyes interfere with x-ray vision. If you want to rob a bank in Metropolis, do it during allergy season.

Madrox
Every time he sneezes, a double is formed.

Wolverine
Hard to track by scent when you’re all stuffed up.

The Human Bomb
Pretty self explanatory.

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*Mental Organism Destined Only for Sneezing
**Mental Organism Destined Only for Runny Nose, Itchy Eyes, and Sneezing

Just in time for Labor Day, here is Superboy: Job Counselor. It’s actually a pretty good PSA, suggesting that people find a career involving what they enjoy. College is mentioned, as are various trades. No sexism either — you’ll notice there’s only one woman shown, but she’s the only character actually going to college.

I do wonder why Superboy is cruising the employment agencies, though.

Click on the image to the right for the full ad.

This PSA comes from the August/September 1950 issues of various DC comics including Action Comics #147, Batman #60, and World’s Finest #47. As always, the PSA was written by Jack Schiff. Art is by frequent PSA collaborator Win Mortimer.

Tags: comics psa superboy jack schiff win mortimer

Detective Comics #835
John Rozum, writer
Tom Mandrake, artist

Jim C. asks about Detective Comics #835, and was kind enough to provide scans of the scenes in question:

The Scarecrow has escaped incarceration, but not before causing tremendous fear in the other inmates, particularly the ones who were picking on him:

Guard: In attempting to block out Crane’s words, he pushed his fingers all the way through his ear drums into his brain…which is only moderately less horrifying than his friend gagging down his own intestines.

While the ear canal does eventually reach the inside of the skull, it’s not a straight shot. It’s a convoluted passage that passes through the middle ear and inner ear and eventually narrows so that only the VIIth and VIIIth cranial nerves (and a small blood vessel) can fit through.

You can’t just ram your fingers deep in your ears and expect to hit brain (thankfully, or we’d see a lot of kids with Q-tip induced brain injuries). Assuming your fingers are long enough, you’d rupture the ear drum (pain, dizziness, loss of hearing) and disrupt the bones of the middle ear that you learned about in elementary school. With extra-long and narrow fingers, you might be able to reach far enough to disrupt the semicircular canals and cochlea of the inner ear (severe vertigo, balance problems, and hearing loss). Even then, there are lots of turns and a little thing called the skull in the way of reaching the brain.

The inmate who tried to hang himself with his intestines, but then resorted to just choking himself on them, presents other logistical problems. How’s he going to open up his abdomen to reach his intestines using just his bare hands? If he is able to get into his abdominal cavity, remember that the intestines aren’t just hanging loosely — they’re attached to their nerves, blood vessels, and various support tissues. It would take a great deal of work and brute strength to pull out and free up enough intestines to choke oneself, let alone hang oneself. I simply don’t think that a person would have the strength left to swallow anything (especially intestines) after having eviscerated themselves. And did I mention it would be excruciatingly painful and very messy?

Of course, bear in mind that these comments apply to ordinary people. If one were super strong — and insane enough — then one could theoretically push their way into their skull and brain through the ears, or rip out their own intestines and choke themselves (but remember these inmates are explicitly described as gen-pop, and not possessing super powers).

Tags: comics medicine batman scarecrow fear ears brain intestine

Another great DC comics PSA, this one comes from various August 1958 titles, including Adventure Comics #251, Batman #117, Superman’s Pal, Jimmy Olsen #30, Wonder Woman #100, and of course, Sugar and Spike #17. I think it’s safe to say that this PSA is just dripping with subtext… Click on the image to the right for the full ad. As with most DC PSAs, this one was written by Jack Schiff. Pencils were provided by Lou Cameron. Tags: comics psa subtext jack schiff lou cameron

Detective Comics #833, 834 “Trust”
Paul Dini, writer
Don Kramer, penciler

By request of David, a look at the drowning scene in this recent storyline from Detective Comics.

The pathophysiology of drowning is actually fairly complex, but here’s a quick look at the basics: intake of fluid into the lungs disrupts the air/lung interface, preventing the diffusion of oxygen (in) and carbon dioxide (out). This leads to hypoxemia (low oxygen levels) and respiratory acidosis. These in turn lead to other significant problems including asphyxiation, cardiac arrest, and brain damage which in turn lead to death.

In an attempt to stave off drowning, an individual can hold their breath, but eventually the urge to breathe will overcome their resolve and they’ll end up taking a breath of water — or whatever medium they happen to be in at the time.

The exact anatomical mechanism behind breath holding is not clear. The glottis snaps shut, sealing off the airways. There is also thought to be involvement of some of the respiratory muscles, including the diaphragm, preventing breathing.

In the story, Zatanna has been shot in the neck1 — apparently disrupting her trachea/vocal cords so she can’t speak — making casting spells difficult2. She is then dumped tank of water which is subsequently locked shut. After some repartee with the villain and an escape from a classic electrical trap, Batman frees Zatanna from the trap. He finds she has managed to heal herself of her neck injury, but has fallen unconscious in the tank.

Because of Zatanna’s injury, it’s unlikely her glottis can close tightly enough to keep water out of her lungs even when she holds her breath. The average adult drowning victim has just 4 ml of water in their lungs — Zatanna will have much more than that. This means she’ll have an extremely difficult time taking a breath and will likely drown even if she manages to escape the water. The water leaking into her lungs should not affect her ability to hold her breath; it will only affect her when she has to take a breath.

How long can Zatanna hold her breath? The world record for humans³ is a little over 9 minutes (9 minutes and 8 seconds, to be precise). Of course, that is someone who has been specially trained and has had time to prepare beforehand. By contrast, Zatanna has been caught by surprise, shot, and dumped in a tank of water — that definitely puts her at a disadvantage. Still, I think she would be able to hold her breath for at least 30- 60 seconds, maybe even longer, which should be enough time to write “EM LEAH” on the ceiling of the tank⁴. It looks like it takes Batman another minute or two to rescue her. She’s unconscious and hypoxemic, but not dead. If Batman can restore her breathing in time, she should not suffer any permanent problems.

To me, that’s the real issue: can Batman restore her breathing in time? Medically, Zatanna is going need hospital evaluation after her near-drowning because of the amount of water she inhaled. Some Bat-CPR and a watchful eye at Wayne Manor probably isn’t going to be sufficient. She needs 100% oxygen and will most likely require intubation and admission to the intensive care unit. I don’t think she’ll be ready for round two for at best a few days, probably longer.

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Notes:
1. That’s an incredibly skilled shot to take off the cuff like that. I can believe Deadshot could pull it off, but the Joker?
2. Has an actual vocal component always been required by Zatanna to cast her spells? She can’t just mouth the words?
3. And remember that Zatanna is only half human.
4. The tank is full of sloshing water, yet her letters written in blood don’t get washed away? I find this more unbelievable than Zatanna being able to hold her breath as long as she did.

Robin #164 “Making the Band”
Adam Beecher, writer
Freddie E. Williams II, penciler

Robin (Tim Drake) wants to join the high school tennis team, but Batman is opposed.

Batman: To join an sports team, you’ll have to take a physical.
Robin: It’s not like I won’t pass.
Batman: It’s not that. You’ve had broken bones, Tim. Lots of them. All of that will show up. Excuses won’t cover them. It’ll raise too many red flags.

Batman is right that most states require a Preparticipation Physical Exam prior to joining a school sports team, but other than that, his reasoning is strained. The preparticipation physical is good head-to-toe physical exam, but nothing excessive. Unless something turns up on the exam, doctors do not order labs*, x-rays and other studies. If Robin’s broken bones were set correctly and healed normally, there’s no way they’d show up on exam.

There has been some talk about expanding the sports physical to include a closer look at the heart (including an EKG or echocardiogram), but there is not much good evidence in support of this. At no point have general screening x-rays (the only thing that would show Robin’s old fractures) ever been considered as part of the physical. The cost/benefit ratio would be horrible, and we let’s not forget that x-rays involve radiation exposure and — though it’s only a small amount — they should be avoided unless truly necessary.

(Plus — Tim would have needed a physical to start high school, or when transferring to his new school. By Batman’s logic, any broken bones should have showed up then as well)

As I said, it’s a nit-pick, but since it’s that time of year where I’m performing dozens of preparticipation physicals per week, it seemed timely.

*In Illinois, it’s “suggested” that we screen for diabetes in children with a body mass index above the 85th percentile. On one hand, given the recognition that obesity is becoming a childhood disease, this makes sense. But on the other hand, the research doesn’t support this. I could only find one small study supporting screening for diabetes, and that was in a selected population more prone to diabetes. I don’t want my patients to be diabetic, but nor do I want unnecessary blood tests performed on them.

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Switching topics to Batman Confidential #6. This line towards the end of the book caught my eye.

Batman has just confronted Lex Luthor in his lair and defeated all his military-style robots:

Batman: You underestimated yourself. I used your own virus against you — with a few minor adjustments. You programmed my machines to kill. I programmed yours to kill themselves.

Since Batman’s talking about WayneTech products as “my machines”, hasn’t he just admitted to Luthor that he is Bruce Wayne?

…because, really, what can you add to it?

Whatever happened to pipe-smoking characters? Back in the Golden and Silver Ages, they were a dime a dozen.

Smoking a pipe had several connotations. In the Golden Age, it was used to lend an air of sophistication to a character, for instance an itinerant archaeologist (Carter Hall) or a playboy dilettante (Bruce Wayne). Check out this classic ad posted by Sleestak as well for the pipe smoking/sophistication connection.

During the Silver Age, it was used to represent a scientist who was brilliant — yet unorthodox – such as Reed Richards, Will Magnus, or Leonard Samson.

Then there was the classic use of pipe smoking to represent a fatherly figure (for a quick example, check out Dan’s supervisor in the most recent Dr. Dan Dazzler story).

Nowadays, I think Will Magnus still smokes a pipe (maybe) and that’s about it. When did the depiction of pipe smokers in comics die out? Did it mirror the decline of pipe smoking in society at large, or did it fall prey to comic book anti-smoking zealotry? While I am opposed to smoking (both from a medical and a scent-oriented point of view), I see nothing wrong having the occasional character who smokes. Despite all appearances to the contrary, I can tell fact from fiction and a cigar chomping Nick Fury is not going to convince me to smoke (or join the Army, for that matter — why don’t people complain about the soldiers in comics making kids want to join the military?). Personally, I miss having characters who would pull their pipe out their pocket and light it, all the while lecturing about the Negative Zone, responsometers, or the sublimation of the psyche.

Tags: comics pipes carter hall bruce wayne reed richards will magnus leonard samson

What’s wrong with this picture?

An easy one this time (not that any of them are really too 0challenging, except maybe the surgical ones). If you absolutely need a hint, you could probably find one here. (And I’m not counting intentional grammar errors.)

This scene is taken from one of the last pages of Batman: Seduction of the Gun, script by John Ostrander with art by Vince Giarrano.

Previous picture quizzes

Tags: comics batman picture quiz

In 1990, the adult son of one of the Warner Brothers executives who worked with DC Comics was senselessly murdered. In response, DC published Batman: Seduction of the Gun, a comic with a strong anti-gun tone, and with the added bonus of the proceeds going to a charitable educational foundation.

In Gotham City, a drug-for-guns deal is going down. The police and Batman bust up the deal, but the main criminals — members of the NZN gang — escape. To capture the gang, Batman masquerades as a gun dealer while Robin enrolls in an inner-city high to protect the dealer’s daughter from gang reprisal. The Batman aspect of the story is a fairly typical Batman adventure with subterfuge, fights, and narrow escapes from death. The Robin part I found a little over the top, with Robin attending a school where over 95% of the students are armed, and gun fights in the hallways between classes are daily experiences. Admittedly, I didn’t attend an inner city high school, but this strikes me as more than a little unbelievable. Both stories converge in the end, but things don’t work out as well as Batman — and Robin — had hoped.

Overall, it’s a well done story and a PSA comic that actually appears to be in continuity. For the most part, it doesn’t hit the reader over the head with its message, though there is a page or two of talking heads looking directly at the reader and lecturing. We also learn way too much about the wounds that killed Thomas and Martha Wayne (“The bullet…struck the left lung and then the heart through the right ventricle, ruptured the superior vena cava and the aorta. The bullets struck back left ribs and flattened out, breaking the ribs…I remember a lot of blood. The hearts continued pumping for a bit.”). The story by John Ostrander contains the intense action-filled plot with a touch of pathos he seems to favor (and it works for him, his scripts hit a lot more than they miss). The Vince Giarrano art is a satisfying cross between Graham Nolan and Neal Adams. There are places where the art is particularly explicit and disturbing — bullet wounds, for instance — but I suspect that was the intended effect.

Online, I’ve seen this comic described as “pro-gun-control”, but I don’t think that’s really the case. I can certainly see where people might get that impression, particularly as the proceeds from the book went to an educational gun-control foundation, but in the last panels of the comic, Bruce Wayne tells Tim Drake that gun control is not the best option (“No law passed can change the human heart or open up a mind that is closed. We must give up the guns in our hearts and minds first.”). The story certainly takes a strong stand against the proliferation of handguns, but gun control is not specifically mentioned. To me, the comic seems more anti-guns-in-school, anti-gang, and anti-Saturday-Night-special than explicitly anti-gun or pro-gun-control, though I may be splitting hairs.

Tags: comics psa batman john ostrander

In our post-MMR world, it’s unlikely you’ll ever hear a Gotham City thug say this again:

Yet another reason to be thankful for vaccinations.

Scene from Detective Comics #47 (January 1941). A vaccine against the measles first became available in 1963.
Script by Bill Finger with art by Bob Kane, Jerry Robinson, and George Roussos. Sure is a lot of yellow isn’t there?

Tags: comics batman measles vaccination

It’s Memorial Day here in the United States, a holiday which has come to have two meanings. Traditionally and most important, it is a day set aside in memory of everyone who has died in service to our nation. Realistically, it also marks the more or less “official” start of summer, with most schools out and pools open. In the spirit of this second meaning of Memorial Day, I present this DC comics PSA from 1954 (with repeat appearance in 1959): Tips on Summer Fun. The characters are from the Peter Porkchops comic, which ran for 62 issues starting in 1949.

Click on the image to the right for the full ad.

The writer of this PSA was Jack Schiff with art by Rube Grossman. It can be found in a variety of DC comics from August 1954 and August 1959, including Batman #85, Batman #125, Detective Comics #210, Detective Comics #270, Wonder Woman #68, and Wonder Woman #108.

Tags: comics psa summer peter porkchops wolfie

JSA Classified #24 “Nightfall, part 2”
J.T. Krul, writer
Alex Sanchez, penciler

In the previous issue, Dr. Mid-Nite fought the self-professed vampire Mircea and lost. As this issue begins, Mid-Nite retreats to his sanctum and considers the situation. He is positive that Mircea is not a real vampire. Instead, he is certain that there is a scientific explanation for Mircea’s appearance and abilities. He considers conditions such as Congenital Insensitivity to Pain (a genetic disease where the patient cannot feel pain, heat or cold. It was feature in a recent episode of House)and Familial Dysautonomia (an inherited condition marked by poor development of the autonomic nervous system as well as some sensory nerves), and severe anemia. Ultimately, he decides that the diagnosis that fits best is Xeroderma Pigmentosa

Xeroderma Pigmentosa (XP) is an inherited condition¹ where the skin is extremely sensitive to light. A person with XP suffers from many skin problems including a thin dry skin that ages prematurely. Their eyes are extremely sensitive to light and easily become bloodshot and irritated. An individual with XP lacks the normal mechanisms that repair DNA damage caused by UV radiation. Because of this, they develop frequent skin cancers.

Dr. Mid-Nite realizes that not only does Mircea suffer from XP, but he has been taking high doses of Steroid A39 to control the disease. It is the steroid that has been giving him the increased strength, as well as the pallid skin and eyes associated with vampires. Armed with this knowledge, Mid-Nite once again confronts Mircea and is able to use his own strength against him. While Mircea is down, Mid-Nite injects him with Rocuronium³, a paralyzing agent, and has him hauled off to an insane asylum.

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Notes:
¹Xeroderma Pigmentosa has an autosomal recessive inheritance pattern.

²This answers a question I had from the Dr. Mid-Nite mini-series. That story mentioned a condition called “Xenoderma Pigmentosa.” I was never certain if that was a typo for Xeroderma Pigmentosa, or if the writer (Matt Wagner) was inventing a new disease. Apparently it was a typo.

³Rocuronium is a good paralytic agent. It would paralyze Mircea’s skeletal muscles rendering him helpless. Unfortunately, there is a good chance it will also paralyze his diaphragm — an important breathing muscle — and he will suffocate if he doesn’t receive mechanical ventilation until the drug wears off (and its half-life is between 1 and 2 hours).

Tags: comics medicine dr mid-nite vampire xeroderma pigmentosa rocuronium

Another Monday and that means another PSA — and this week’s ad once again contains words of wisdom from our teenage pal Buzzy. Not only that, but it features the return of Buzzy’s macrocephalic friend Wolfie.

Click on the image to the right for the full ad.

This PSA appeared in a handful of DC comics from September 1954 including Adventure Comics #204, Batman #86, Detective Comics #211, Superboy #35, World’s Finest #72 and the debut issue of Superman’s Pal, Jimmy Olsen. Like most Buzzy PSAs, the script was by Jack Schiff with Win Mortimer on the art.

Tags: comics psa buzzy jack schiff win mortimer

Another DC public service ad from the 1950s. This one features two spoiled brats brothers and their poor put upon stay-at-home mother.

Click on the image for the full PSA ad

This PSA is from World’s Finest #100 (March 1959) and appeared in several other comics published the same month, including Batman #122 and House of Secrets #18. The script is by Jack Schiff, art by Bernard Bailey, and letters by Ira Schnapp. As with most of these DC PSAs from the 50s and 60s, the ad was underwritten by the National Social Welfare Assembly.

Tags: comics psa world’s finest