Pulpy Goodness

It’s always nice to find new reprint collections of old pulp stories. I’m a big fan of these stories — sure, many of the characters are rather two-dimensional and the plots paper-thin — but there are enough diamonds in the rough to make it worth the time and effort. In the past year or two, a number of my favorites have managed to work their way back into print:

El Borak, by Robert E. Howard
The White Wolf — a.k.a. El Borak — is my second favorite Howard character (with Solomon Kane being number one). El Borak has swashbuckling adventures in the early part of the twentieth century: think Lawrence of Arabia with a liberal dash of sword and sorcery. His stories have been out of print for decades, but will be available Tuesday in a nice new edition.

Jirel of Joiry and Northwest Smith, by C. L. Moore
Moore was one of the first female adventure pulp writers — she wrote as “C. L.” instead of Catherine to disguise her gender. Most of her stories were published in Weird Tales and have a slight Lovecraftian feel to them.
Jirel of JoiryJirel is the ruler of a small medieval kingdom and her lands always seem to be under threat from natural, and supernatural, enemies. Her stories tend towards the darker aspect of fantasy.
Northwest SmithNorthwest Smith is a smuggler and anti-hero in the distant future. His stories have a darker edge to them as well.
The Science Fiction Book Club has inexpensive hardbound collections of Jirel and Northwest Smith. Paizo, under their Planet Stories imprint, also offers a Jirel as well as a Northwest Smith collection. (Paizo also offers several collections of Moore’s husband and fellow writer, Henry Kuttner. Sadly, I haven’t seen any recent reissues of stories by Lewis Padgett, which was the name Moore and Kuttner used when they collaborated together on a story).

Speaking of Paizo, they also are offering what look to be great collections of the Eric John Stark series by Leigh Brackett.

Fringe — Episode 14 (Season 2): “Jacksonville”

Big questions were answered, the science wasn’t that bad, but it still struck me as a surprisingly lifeless outing for the “Winter Finale” of Fringe.

Fringe #214

The Plot: At an office building in Manhattan, the workers grouse about a series of small earthquakes the city has been experiencing. Suddenly, there is a larger tremor and one of the workers finds himself caught in the quake. He blacks out for a second and when he comes to, he is pinned by the rubble — and has four arms and four legs.

The Fringe team is called in to examine the office building. So far, no survivors have been found, but many dead bodies. The bodies aren’t normal, however, but each seems to be two separate people fused together. Walter hypothesizes that a “Quantum Tectonic Event” has caused a rip in space that caused the quake and fusion. A survivor is found upstairs: the worker from the opening scene. Walter converses with him while he is slowly dying and learns that the worker is from the alternate universe. Walter has a new theory: an office building from that universe has suddenly merged with the same office building from ours, killing all the inhabitants. Agent Dunham suspects this to be a deliberate act on the part of Newton (the leader of the team from the alternate universe that is trying to destroy ours).

Back at the lab, Walter realizes what has happened — and what will happen. Twenty-five years ago, he and William Bell sent a car to the alternate universe and a short time later, a car of equivalent mass from that universe appeared in ours, merged into a statue. Walter tells the team that a building from our universe will disappear within 35 hours. His only idea how to stop it is to use some of the abilities Dunham gained from Cortexiphan. He drags her and Peter to Jacksonville, where the original Cortexiphan experiments were carried out. He repeats the experiment on Dunham, but it has no effect this time. Belatedly he realizes that her abilities depends on fear, and Dunham no longer experiences fear, but channels it all into anger. Defeated, the three of them return to New York.

While they’ve been in Florida, small earthquakes have started in New York City, signaling that the calamity is impending. The scientists at Massive Dynamic are trying to find a pattern to the quakes, but Walter tells them there is no pattern to find. Instead, he suggests locating the building in New York City of identical mass to the one that appeared from the other universe. They are able to narrow the list down to 147 building, but the thirty-five hours is up. Concern over her failure and the likely loss of life scares Dunham, kick starting her spot-the-things-from-the-other-universe power. She is able to spot a building that weirdly glimmers, a sign that it is the one that is going to disappear. The team is able to identify the building and the authorities evacuate it just in time — with a massive inrush of air the entire building — basement, foundation, and all — disappears.

As the episode ends, Olivia and Peter are heading out for drinks, but when she looks at him, she realizes that he is glimmering too. Walter begs her not to tell Peter the truth.

Fringe #214

1. Spellchecker
Manhattan was spelled wrong in the opening scene.

2. Island of Misfit Toys
If the building in Florida has been sealed for 25 years, why did it have toys from the Ice Age movies (’02, ‘06, and ‘09)?

3. Where’s Johnny? He Was Here Just a Minute Ago!
So did a child of identical mass to Peter get transported to the alternate universe when Walter brought Alterna-Peter here?

4. Glimmer Glimmer Glumpkin
If Olivia’s powers detect items from the other universe (that’s what Walter was testing in the classroom after all), why did the building from this universe glimmer?

5. Tick Tock
Why 35 hours? I’m guessing that’s how long it took for the car to appear.

6. Mass Effect
How are they going to be able to find the mass of the alternate universe building when it is merged with ours. Are they assuming it was identical to the one in our universe, just like their Nixon coins and double-decker cars are identical to ours?

7. There’s No Babble Like Good Babble
Quantum tectonic event. That is some grad-A prime of technobabble. It sounds impressive, but notice how none of the words really work together (or at least the two most important: tectonic and quantum. They’re pretty much contradictory — “quantum” suggest atomic or sub-atomic, while “tectonic” is very macro in its implications.)

Fringe #214

I so wanted to like this episode with the Peter reveal (that we all knew anyway), but I couldn’t — it was dull. It wasn’t horrible, but an episode this big should be more fulfilling. The Fringe Doomsday Clock stays put.

Fringe Doomsday Clock

FringeThis week’s Fringe cipher was: REVEAL.
FringeA list of all previous Fringe reviews is available here.
FringeKarl has much more to say.

Apothecarius Argentum, Volume 4: A Medical Annotation

cover, Apothecarius Argentum Volume 4Volume Four of Apothecarius Argentum moves the action from Beazol to the neighboring kingdom of Navara, a poor and starving country with a widespread wasting disease brought on by overuse of a toxic pesticide. Princess Primula and her companions, including friend/love-interest/Royal apothecary Argent and his rival, Lorca, third Prince of Navara.

The storyline revolves primarily around royal intrigue, including a sequestered king, a kidnapped heir, and stirrings of rebellion.

There is not as much medicine in this volume as previous ones, which makes sense as Argent does not play as large a role in this storyline. Several medical errors crop up in this volume, which is unusual, because author Tomomi Yamashita, a pharmacist by training, is usually very careful about his medical references.

There’s probably a spoiler or two in the annotations, so consider yourself warned.

Volume 4

Belladonna
The young prince has been suffering from seizures and was given belladonna to treat them.

BelladonnaBelladonna is a plant that has a long history of use in traditional medicine and continues to be used, to some extent, in modern medicine as well. The plant is very potent and must be used sparingly because of the high potential of adverse events, especially death. This is especially true for children (especially sickly malnourished ones like the prince). Let me put it this way: the more common name for belladonna is Deadly Nightshade.

Historically, while belladonna has been used to treat a variety of different ailments, it has not been used to treat seizures. The only mention I’ve even seen of the use of belladonna for seizures comes from homeopathy, which is not traditional medicine — or really any sort of medicine at all (despite what its practitioners would like you to think); homeopathy can best be described as a delusion combining sympathetic magic, wishful thinking, and an early-19th century understanding of science.

Belladonna contains several potent chemicals, most notably atropine, scopolamine, and hyoscyamine — all drugs that are used today. Belladonna extract itself is still used in a few modern medicines, Donnatal (a stomach medication) is probably the best known.

Dandelion
The prince has been given an overdose of belladonna, and Argent gives him dandelion extract to correct it.

Argent is correct that belladonna is excreted almost entirely through the kidney, so increasing kidney function should get rid of the medicine faster. Diuretics (drugs that increase urine output) are one way of doing this. Dandelion has long been used as a diuretic. While I have seen no recent studies or reports that confirm its benefits in this regard, I’m willing to give the plant the benefit of the doubt because the effects of a diuretic are hard to miss (if you pee a lot, it’s a diuretic).

Activated Charcoal
Activated charcoal is used again to treat the chronic wasting disease that is common in Navara. I covered this in depth in the Volume 3 annotations.

Cochineal
cochinealThe cochineal is a tiny insect (Dactylopius coccus) that grows on cacti in Central and South America. When the females of the species are collected, dried, and crushed they produce the brilliant red dye carmine which is used for coloring fabrics, cosmetics, and food.

It takes 70,000 insects, all collected by hand, to make a pound of dye, which is worth about $36 in today’s market.

Prince Lorca mentions several times that the insects grow on citrus, but they don’t — they can only live on certain species of cactus. I wonder if this might be a translation error, either in the translation of the manga, or from the author’s original sources. (There is a similar insect known as “Polish Cochineal,” and while it doesn’t grow on cacti, it doesn’t grow on citrus either.)

Marijuana
The story mentions a link between marijuana use and psychiatric disease. There haves been several studies that have looked at this very subject, but the results have been unclear. Can marijuana use lead to psychiatric illness, or do people with pre-existing psychiatric disease tend to use marijuana more? Studies have suggested both results, so just leave this one as “undecided.”

Is it possible to die from a marijuana overdose? Again, sources vary, but almost all seem to agree that it would take an incredibly high level of exposure to be fatal, and many experts suggest that it would be physically impossible to achieve this high a dose. (On the other hand, with incense burning in a sealed room with heavy curtains, I suspect the king suffocated to death when the incense used up all the oxygen).

Fringe — Episode 13 (Season 2): “The Bishop Revival”

Does Godwin’s Law apply to television shows? Actually, though the science was questionable, I thought the storyline was sufficiently creepy to be a good episode overall.

Fringe #213

The Plot: At a wedding, the groom’s grandmother notices someone standing in the back who alarms her. As she moves to confront him, she starts gasping for breath, turns an ashen gray, and then collapses, dead. Soon, other members of her family start dying as well – fourteen total – and the Fringe team is called in. After examining the corpses, Walter and Peter declare that everyone has died of asphyxia (suffocation). Agent Dunham notices a tattoo on the grandmother’s arm that indicates she was a concentration camp survivor. Poking around the church, they find the groom, still alive, but gasping for air. He dies at their feet, bringing the death toll to fifteen.

At the lab, Walter starts his autopsy of one of the victims and notices that the blood is a deep blue (Prussian blue, perhaps?), indicating some form of toxin exposure. The team also realizes that everyone who died was a blood relative and a direct descendant of the grandmother. Re-examining the church, Peter finds a candle that is different from the others and brings it to Walter. A quick run through the lab equipment shows that the candle contains some sort of cyanide compound. Walter suspects the deaths at the wedding were an experiment by the murderer to see if his toxin would work, and predicts that he will strike again soon. Sure enough, in a similar episode, nine people die in a coffee shop. The connection this time is that they all have brown eyes.

Back at the lab, Walter has isolated the toxin and shows how it can be set up to target different proteins, depending on who the murderer wants to kill. He points out a carbon chain on the toxin that he claims in the creator’s “signature.” When Peter remarks that it looks like a seahorse, Walter realizes that the poison was created by his own father who had been a scientist in Berlin until fleeing in 1943 (his nickname was “seahorse”). He has kept his father’s formulas in some old German books, Peter sold them ten years ago when Walter was in the asylum. It all turns out to be a red herring though, as they are not connected to the mysterious murderer.

Meanwhile, Walter has managed to get a partial DNA profile of the killer from skin cells left on a fingerprint. He claims that it’s a bad sample though, because the telomeres are severely damaged, suggesting that the person must be at least one hundred years old. The FBI is able to track down the chemicals used in the making of the toxin, and get the killer’s address. They search the house (poorly), but find nothing, as their target is at that very moment escaping from his lab in the basement. Eventually, Agent Dunham finds the basement lab, but the killer has set a trap for them, with some of the toxin specifically targeted to Walter. Luckily, Dunham and Peter get Walter to medical care in time, and he survives. A clue (found by Dunham even) tells the team that the killer has his sights set on a World Tolerance conference going on in Boston. Peter, Dunham, and the FBI head over to the conference to look for the killer. Walter stays behind, mixing up something in the lab, and then he heads over to the conference himself. Peters spots the poison and he and Dunham are able to confiscate it before it can be activated – but they are interrupted by a horrible coughing sound and rush over to find the killer, disguised as a waiter, gasping for breath and dying. Walter has turned the tables on him and made a version of the poison specifically tuned to his DNA. As the episode ends, Peter and Walter are still puzzled how the murderer got his hands on Walter’s father’s research, not realizing that the killer was a Nazi scientist himself, somehow still alive sixty years later.

Fringe #213

1. Stay on Target
According to Walter, the toxin binds to a particular protein, and this protein can be altered depending on who the target. Unfortunately, the Nazi scientist’s poor understanding of molecular biology has doomed more people than he realizes. For instance, there is no protein specific to brown eyes. Brown eyes simply have more melanin than other eye colors — but the other eye colors still contain melanin. Everyone in that coffee shop, including the Nazi, should have died. Similarly, there is no special protein in dark skin that sets them apart — people with darker skin simply have more melanin than lighter skinned people. Trying to kill off the darker skinned people would have killed everyone — well, except the albinos. Good job, Nazi scientist. Now the albinos rule the world.
Fringe 213Suddenly, in a virtual deus ex machina, the toxin can be programmed with a specific DNA — even though Walter made it point, repeatedly, to mention that it was created before DNA was understood.
Fringe 213Even if the poison could target DNA, how are you going to get that big of a molecule into the nucleus of the cell, let alone through the cell membrane?

2. Those Who Do Not Know History…
Walter is off on his history: the discovery of DNA predated the Nazis, not the other way around. DNA was discovered in the middle of the 19th century, well before the Third Reich. By the 1920s, there was strong evidence that DNA was involved in inheritance, with the first definitive experiment performed in 1943. Walter is probably thinking of Watson and Crick’s famous work on the structure of DNA, which was published in 1953.

3. Sure Hope He Never Testifies in Court
The signs Walter mentions — petechiae, bulging eyes — are seen in asphyxia caused by strangulation (they are related to increased venous pressure in the head from the compression of the blood vessels in the neck), not by asphyxia due to toxin inhalation.
Fringe 213Can the vitreous humor, a gel-like liquid, really swell?

4. How Dare You Kill People With My Dad’s Poison!
Walter was upset that the murderer was “perverting” his father’s work, but let’s not forget that his father’s work was a nasty chemical warfare agent.

5. It Is Impolite To Inquire As To A Telomere’s Age
Telomeres are special DNA sequences on the ends of chromosomes that keep it from breaking down or fraying. There has been some good research suggesting a link between aging and the break down of telomeres. Still, it’s a dubious stretch to tell someone’s age from looking at their telomeres.

6. Nasty Poison
Hydrogen cyanide can kill remarkably fast, depending on its concentration.

6. Comes With A Certificate of Authenticity
That seahorse “signature” is so incredibly bulky and large that it would interfere with the biological activity of the toxin. Plus, it’s bad planning because it provides an easy target to identify and develop an antibody against.

7. Two Puffs Four Times A Day
A nit-pick here, but the groom sure has poor inhaler technique (but then, so do many of my patients — and a quick Google search reveals that much of the internet has a similarly poor understanding.) The inhaler should be held an inch or two in front of the mouth, not actually in the mouth.

Fringe #212

The science was quite questionable this week, but I thought the story did a good job keeping the suspense going — and the Nazi scientist was truly creepy — so it’s a wash and the Doomsday Clock stays at 11:58.

Fringe Doomsday Clock

FringeThis week’s Fringe cipher was: FATHER.
FringeA list of all previous Fringe reviews is available here.
FringeKarl has much more to say. And he’s still talking about it a week later.

Tuesday PSA: The Atom — Servant of Man

The Atom: Servant of Man.  Click for the full PageAnother 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:
radio isotopes!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?
radio isotopes!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?)
radio isotopes!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 PSAsMore PSAs

Fringe — Episode 12 (Season 2): “What Lies Below”

The plot of this episode of Fringe was, at best, so-so. They could have at least played up the “trapped in a building with a possible killer” angle. The science — and it’s generous calling it that — was painfully bad.

Fringe #212

The Plot: In a large office building in Boston, a man walks into the office of a petroleum corporation, then drops dead, with his last breath spraying a fine mist of blood on all around him. Given the strange nature of the man’s death, the Fringe team is called in. Peter and Olivia arrive first and are interviewing bystanders. Walter, Broyles, and Astrid are on their way into the building, when one of the people exposed to the dead man’s blood comes walking toward the door, as fast as he can. Walter quickly shuts the door before the man can escape, and the man dies, spraying blood against the closed door. Fearful of an unknown contagious disease, the CDC is called in and the building quarantined — with Peter and Dunham still inside.

Some blood samples are obtained, and Walter takes them back to his lab. In the office building, the receptionist falls ill. Doing a little detective work, the team determines that the first dead man was a corporate spy from Dubai who was selling information on the peteroleum company’s competitors. The ill receptionist becomes frantic and violent. She scuffles with Peter, then jumps through a window, plummeting to the street below, dead. Unfortunately, Peter has been exposed to infected blood and now may be infected himself.

Inspecting the car of the corporate spy, the FBI and Center for Disease Control (CDC) find a core sample from 10 miles down that he was trying to sell. They also find the mysterious virus behind the outbreak contained within the core sample. Walter speculates it is 75,000 years old and was responsible for killing most of the mammals on Earth during the Ice Age (as opposed to the ice and cold). From this virus, Walter is able to concoct a test to determine who is infected and who isn’t. Walter believes that the virus has human-level intelligence and is purposefully acting to infect as many people as possible. He and Astrid enter the office building and test the staff. Most are not infected. Peter is showing signs of infection, but through sleight of hand, makes sure he has a negative test. The people who tested clean are escorted out of the building — except Peter. The guard at the door (a competent FBI agent at Fringe?) notices he has a nosebleed and keeps him in quarantine. In the end, eleven infected individuals remain in the building. Walter and Astrid also elect to stay.

Walter deduces that sulfur is a cure for the virus and relays the information to Dunham. Meanwhile, the CDC has called in the US Army to “take care of” the people remaining in the building. Dunham and Broyles ask for more time to synthesize Walter’s cure. Broyles suggests pumping the building full of Fentanyl gas (a strong narcotic) to knock everyone out and buy time. Dunham volunteers to enter the building and turn the HVAC back on. She scuffles with an infected Peter but succeeds in her mission. All the infected people are knocked out, Walter’s cure is made, and everyone (well, except for those already dead) survives.

Fringe #212

It’s been a number of years since I’ve worked in a biochemistry or infectious disease lab, and I found the “science” in this episode totally appalling. I’m sure any actual infectious disease researcher or biochemist who watched the show had their television explode from the rays of frustration and hate their brains emitted. I’ll highlight a handful of items, but there are many more mistakes and plot holes that I didn’t have time to mention because I actually do have to get some sleep tonight.

1. I Give Him Credit For Trying
I applaud the bike messenger for attempting CPR (even if it was the 5 compression/1 breath technique that is not recommended anymore), but give it some time before you declare the guy dead. Ten compressions doesn’t cut it. At least continue the CPR until the EMTs arrive.

2. You Know What They Say About “Assume”
Walter believes the virus is transmitted by bodily fluids. How does he arrive at this conclusion? Certainly blood transmission seems probable, but how does he know about other bodily fluids? Is he surreptitiously testing saliva and semen?
Fringe 212He claims the virus is not airborne, or more people would be sick. How is he so sure about the incubation time? Maybe more people could be sick than he knows, they’re just not showing it yet. Sure, the bike messenger fell ill fast, but how do you know he was not exposed before (maybe the Dutch guy wasn’t patient zero), or maybe the messenger had a weakened immune system and succumbed faster than normal. Walter is making way too many assumptions.

3. Do You Even Know What You’re Testing For
There are way too many problems with Walter’s test.
Fringe 212Why the cheek swab? That’s used for DNA samples. Is he saying the virus can be found in the DNA of cheek cells?
Fringe 212Most viral tests look for antibodies against the virus — they’re a lot easier to develop. Of course, it usually takes several weeks for these antibodies to appear. There are some tests that look for the actual virus, but I don’t care how much of a genius Walter is, he couldn’t have cobbled one together so fast, or made enough of it to test the entire office building.
Fringe 212Most importantly, there was no prior testing to determine the false negative/false positive rate of Walter’s test. No test is 100% right all the time. They are risking everybody’s life on an unknown test.
Fringe 212Then Peter’s test was negative but he clearly was infected. We the viewers know he faked the test swab, but the characters don’t know that. Their first thought would have been: “Peter’s test was negative, but he has the disease. How many of these other people we let outside also had false negative tests?” And then they would have hustled them all back inside and left them there.

4. If Only My Labs In College Were This Easy
The scene in Walter’s lab was laughable.
Fringe 212No protective gear.
Fringe 212Isolating a virus in a test-tube using a centrifuge (and using it poorly) would never work. It’s not even close to being right.

5. Down In The Hole
Admittedly, I’m not a geologist, but how does 10 miles down equal 75,000 years. I would think it would be a lot more (years) than that.
Fringe 212The virus lived 75,000 years without a host — that’s impressive. Plus this virus can apparently be visualized without an electron microscope.

6. It’s A Gas
Fentanyl gas has been used at least once before to subdue a building full of people. In this case, it was a hostage situation in Russia with Chechnyan separatists. The Fentanyl didn’t work as well as expected and actually killed 117 hostages. In situations like that, it’s hard to control the inhaled dose — and Fentanyl can kill at the wrong dose. Plus, a fair number of people are allergic — fatally allergic — to narcotics.

7. Dire-Swine Flu?
Neuraminidase inhibitors are used to treat influenza viruses and … that’s about it. So this is a flu virus now

8. Eli Lilly Is Spinning In His Grave
In vivo does not equal in vitro. In other words, what works great in a test tube often doesn’t turn out to work so well in an actual living organism. If creating a new drug were as easy as Walter makes it out to be, we’d be neck deep in fancy new medications and the pharmaceutical companies wouldn’t be laying off people left and right.

9. Not So Smart, Is It?
If the virus really wanted to infect as many people as possible, why not infect the airplane instead of an office building? Those people would be in an airport and then other planes, not trapped in a building.

8. Nice Try, But…
The US Army is not authorized to act on US soil. National Guard, maybe.

9. Georgia On My Mind
I’m not sure of the actual powers of the CDC in a situation like this, but this seemed unrealistic to me. Their response was incredibly fast and a lot like a sledgehammer. I’m not saying the CDC isn’t fast — they are easily the best in the world at what they do — but they’re not that fast. And they actually do research, rather than just shoot people. Wait, was that a knock at the door?

Fringe #212

I thought last week’s science was bad, but this was even worse. I have no choice but to move the Fringe Doomsday Clock forward two minutes to 11:58.

Fringe Doomsday Clock

FringeThis week’s Fringe cipher was: WINDOW.
FringeA list of all previous Fringe reviews is available here.
FringeKarl has much more to say.

Fringe — Episode 11 (Season 2): “Johari Window”

Not the best episode of Fringe. The storyline was pretty cliche (the sheriff involved, really?) and the science was wrong, wrong, wrong.

Fringe #211

The Plot: A state trooper picks up a young boy running away from home. A few minutes later, he looks over at his passenger and discovers that the boy has suddenly become horribly deformed. The trooper arrives at the station and he and two coworkers photograph the child and enter him into their database. They all mention that they’ve heard rumors of deformities such as this, but never actually seen one. Suddenly, a car pulls up and three adults, all as deformed as the child, enter the station and kill all the troopers, reclaiming the boy.

The Fringe team is called in because of the picture of the deformed boy. Looking through other files at the station, the team finds thirty years worth of similar reports, though no actual evidence, all centered on the nearby town of Edina. Deciding that it’s their next logical stop, the team heads over to Edina where they meet the local sheriff. He tells them he’s also heard stories of deformed people nearby, but never seen one. He also identified the sound the team has heard since entering the town as the “Edina Hum” – which he blames on turbines at a nearby military base. Strangely, the hum causes Walter to start singing nonsense words to Bizet’s Carmen.

As the team heads out of town back to their hotel, they are run off the road by a pick up truck. Dunham was knocked out by the crash but Peter stayed conscious. Walter is blissfully asleep in the back seat. The pickup that ran them off the road comes back and a deformed men gets out and starts shooting at the wrecked car. Peter gets off a couple of shots, and actually thinks he hits the shooter, before he gets back in his truck and drives away. Other federal agents arrive and inform the team that they’ve found an abandoned truck that matches their description. Peter spots a blood trail leading into the woods, and they find a dead man –- but he’s not deformed at all. The corpse is sent to Walter’s lab for autopsy.

Agent Broyles tells the team that the nearby Army base was once home to classified experiments known as “Project Elephant” back in the ‘70s. Meanwhile, in Walter’s lab, when the body bag is opened, the corpse has become deformed once again. Walter continues to sing Carmen and Astrid realizes that the song is really a mnemonic for “Harkness,” which Walter recognizes as the name of the campus’s law library. Furthermore, he remembers that he did work on “Project Elephant” –- which dealt with camouflage — and hid some papers in the library, which he and Astrid successfully recover.

Peter and Dunham are going through the county and federal records on the town of Edina and realize that several key files are missing. The census date shows the town population has only changed by deaths and a few births — no one has moved in or out of town in the past thirty years. The town sheriff calls to tell Dunham that he has located the owner of the truck and wants Peter and Dunham to join him at the subject’s house. They agree, unaware that the sheriff is setting a trap for them.

Walter tells Astrid that the people of Edina are all hopelessly deformed because they lived too close to the military experiment. However, in order to help the people of Edina, one of the scientists built a giant transmitter that sends out powerful EM waves which fool the eyes into thinking what they see looks normal. Thus, as long as the residents stay within Edina and range of the transmitters, their deformities are hidden. When they leave town, their deformities can be seen again. Walter and Astrid find the transmitter and shut it off, proving his theory, as all the deformities are suddenly clear. Across town, the sheriff is not particularly good at his ambush and loses a few men, but he ultimately gets the drop on Peter and Dunham. Luckily, one of the town’s residents – sick of all the death of innocents – steps up and shoots the sheriff, saving the team. In the end, the transmitter is left on for the residents and it is decided that no one outside of the Fringe team and the residents will learn the truth about Edina.

Fringe #211

1. The Eyes Have It
The eye does not act as a transmitter, sending through whatever the eye sees to the brain as if it were a fiber-optic cable. Instead, the receptors in the retina at the back of the eye are triggered by certain specific wavelengths of light, and when they’re triggered, a nerve impulse is sent to the visual areas of the brain. No extraneous information is transmitted. If a wavelength is not visible, it’s not visible, end of story.
fringeSo the EM wave is a low enough frequency to be heard as a deep hum, but still manages to affect the eye?

2. Are You Still Rose or Am I Hitting on Susan?
For the sake of argument, let’s say that the EM camouflage does work. How would it remain constant from person, to person, time to time? I see Rose as beautiful brunette instead of a Troma look alike. Does the person next to me see the same Rose as I do? If I leave town and then come back, does she still look the same to me?

3. A Window To the Soul (Kinda)
A Johari window is a cognitive tool that compares how we see ourselves with how others see us. It looks into four areas of personality: Arena (known to others and known to self), Façade (known to self but unknown to others), Blind Spot (known to others but not known to self), and “Unknown.”

4. God, that hand! The window! The window!
This is another episode this season (the third, I think) that had some definite Lovecraftian overtones, in this case “The Shadow Over Innsmouth”, about an isolated town with a deformed populace and a hidden secret.

5. Not What I Expect To See In a Corpse
Frankly, I’d expect histolysis (tissue decay) to be present in any corpse, not just shapechangers.

6. A Generation Unexplained
A germline mutation would be inheritable, but it wouldn’t have a tremendous (really any visible) effect on those originally exposed to the mutagen. So Teddy would be visibly deformed, but if Walter is right, Rose shouldn’t be.

Fringe #211

Painfully bad science this week, the Fringe Doomsday Clock advance to 11: 56 (ironically, the real Doomsday Clock was moved back a minute this week)

Fringe Doomdsday Clock

FringeThis week’s Fringe cipher was: MUTATE.
FringeA list of all previous Fringe reviews is available here.
FringeKarl has much more to say.

Fringe — Episode 10 (Season 2): “Grey Matters”

I liked the plot of this week’s episode of Fringe — at least for the first two thirds (until Walter was captured, when it started going downhill) — but the “science” and “medicine” was ridiculous.

Fringe #210

The Plot: Mysterious men break into a mental health facility and perform some sort of brain operation on one of the patients. They remove some sort of foreign tissue from his brain, but are disturbed before they can finish the operation, so the patient is left with part of his brain exposed. Strangely, the patient has also been completely cured of his schizophrenia.

The Fringe team is called in and it is clear that Walter is uncomfortable with being back in a mental health institution. The security tapes manage to capture the face of the intruders’ leader, and Olivia recognizes him instantly. It was one of the frozen heads that was stolen earlier in the season and belongs to a man named “Newton.”

Looking through the patient’s medical records, Walter finds reference to a mysterious psychiatrist by the name of “Paris.” Astrid can find no records of the mysterious doctor, but with Walter’s help, is able to track down some prescriptions he wrote. They find two other institutionalized patients with prescriptions from Dr. Paris. Visiting these patients, they find that they have also been recently miraculously cured of various psychiatric diseases and show evidence of recent brain surgery. Walter recognizes that one of the drugs they’ve been given is used to prevent tissue rejection in organ transplant patients. He then realizes that the patient’s brains had been used to store the tissue from someone else’s brain.

The team is informed that Walter’s old mental health records show that Dr. Paris visited him six times while he was in the asylum — visits which Walter does not remember. Peter check’s Walter’s scalp and, sure enough, there’s an old surgical scar. An MRI of Walter’s brain is obtained and it shows three missing sections of brain — missing sections that perfectly match the pieces implanted in the other patients. Someone has removed part of Walter’s hippocampus (important in memory storage) and placed it in other people’s brains. And now someone has taken these pieces back.

Meanwhile, Walter has been captured by the Newton and his cohorts. They hook him up through some sort of contraption to the missing pieces of his brain. Once the connection is made, Walter seems suddenly awake for the first time since the show began. Newton is able to get Walter to tell him how to make a door to the other universe. He then injects Walter with some sort of drug before high-tailing it just before Dunham and the rest of the team arrive. While Peter helps Walter, Olivia chases after the bad guys. She manages to shoot the driver of their van (who bleeds silver — one of the shapeshifters), and then the second man (regular blood). Newton is captured — but only for a moment — because he tells Dunham that Walter has been given a neurotoxin, and he’ll only tell her how to administer the antidote after he is allowed to escape. Dunham acquiesces and Walter survives, but she is chided by Newton for her “weakness.”

In a final flashback, we see that the mysterious Dr Paris was actually William Bell and Walter’s brain surgery was done — apparently with Walter’s consent — to remove the knowledge of how to open the cross-dimensional door from his brain and store it someplace “safe.”

Fringe #209

1. Lost ‘em Again
That tracking chip didn’t last long, did it?

2. “Iä! Iä! Cthulhu Fhtagn!”
There were a couple of H.P. Lovecraft references this week (purposefully?)
fringeDr. West (as in Herbert West, Reanimator)
fringeDunwich Mental Health Facility (as in The Dunwich Horror)

3. Department of Redundancy Department
“Global destruction of biblical proportions.” That’s ridiculously redundant — global destruction, by definition, is of biblical proportions.

4. The AMA Does Not Do What You Seem To Think It Does
A common mistake, but an irritating one. The American Medical Association is really nothing more than a professional organization for doctors, like a union or lobbying group. It has no official sanction. It is not in charge of medical licensing, and keeps no “official list of doctors.” Depending on which source you use, only 15-30% of the physicians in this country are members of the AMA, so someone not being on their roster is no proof that they’re not a doctor or don’t exist. [I've blogged about this several times before, most recently here, in relation to the Beast and Dr. Mid-Nite.]

5. But I Asked For Infinite Refills
You cannot write an “indefinite prescription.” One-year, maximum.

6. I Reject Your Rejection
The four drugs listed on the patient records (Sirolimus, Muromonab CD3, Basiliximab, Azathioprine) are used to prevent rejection in organ transplant patients.
fringeYou would think that in their years in the asylum, at least one doctor or nurse would realize the drugs make no sense.

7. Bad Radiology
Those spots on the patients’ brain MRIs were way too big to be thought of as artifacts. The brain tissue was large enough that it would show up on multiple MRI slices (images).
fringeNo radiologist ever noticed the three holes in Walter’s brain before?

8. Respiratory Depression and Death
Tolerance or no, 50MG of Valium is one helluva dose. That’s two-and-one-half times the maximum daily dose of Valium.
fringeDr. West is either extremely trusting or extremely naïve to give that much Valium to Walter just on his say so, especially when it’s clear that Walter is not all there.

9. It’s Not a Two-Dimensional Jigsaw Puzzle
The brain is three-dimensional. The tissue cut out was three-dimension. It was inserted into people’s brains (crammed in, basically, because there was no “slot” to put it in), but somehow manages to show up on a two-dimensional MRI as a perfect fit, like a jigsaw puzzle piece. There was no way they could fit the extra piece in the brain so precisely at just the right point and at just the right angle for this to be true. [A similar problem occurred in the infamous autopsy scene in Identity Crisis #6, where Dr. Mid-Nite managed to find just the right slice to find perfect footprints in the brain.]

Fringe #210

Good plot but goofy science cancel each other out. The Doomsday Clock stays at 11:55

Fringe Doomdsday Clock

FringeThis week’s Fringe cipher was: PORTAL.
FringeA list of all previous Fringe reviews is available here.
FringeKarl has much more to say.

Fringe — Episode 9 (Season 2): “Snakehead”

This week’s episode of Fringe was fairly creepy, and the science wasn’t all that bad

Fringe #209

The Plot: A boat from Hong Kong has run aground in the harbor and dozens of illegal Chinese immigrants have washed up on the shore, dead. It turns out it wasn’t the water or cold that killed them, but giant tentacled parasite worms lodged in their gastrointestinal tracts. The Fringe team is called in. One of the immigrants, Mai Lin, managed to survive. She tells the team that all her fellow immigrants were given a strange capsule to treat sea-sickness, but since she was raised in a fishing village and never got sea sick, she didn’t take it. The team suspects these capsules contained the larvae for the giant worms. She tearfully tells the team that her husband and daughter are on the next boat arriving in few days.

The immigrant smugglers are tied to a local Triad gang best known for smuggling and selling illegal drugs. The team initially surmises that the worms secrete some form of opiate, and this is why they’re being smuggled. After being bitten himself, Walter realizes that the worms produce a powerful immune boosting agent. Walter does some research and discovers that the worms are genetically modified Ancylostoma duodenale (hookworm), an intestinal parasite used in traditional Chinese medicine. The genetically modified versions make an immune boosting agent that is stored in their lymph glands.

Some financial documents tie a local woman to the one of the Triad’s front. She tells Agent Dunham that she has no knowledge of any illegal activity and only invested the money where her financial adviser suggested. Peter notices that her house has a surprising number of air filters and hermetically-sealed windows. Once the team learns about the immune-boosting aspect of the worm, they realize this woman knows more than she is telling. This time, Peter approaches her son who tells him that he has a rare immune deficiency. He receives a special monthly treatment of worm-powder delivered surgically, directly into his spleen.

Walter, with some reluctant help from Astrid, heads off to Chinatown to find a herbalist that sells Ancylostoma that is genetically similar to the giant worm. He finds several shops that sell the worms, and inadvertently discloses to one of the shop owners — the wrong one, of course — that he has a giant worm back at the lab. The Triad follow Astrid back to the lab, beat her up, and steal the parasite.

The ship carrying Mai Lin’s family is found and boarded, but it is too late — all the immigrants have already been carted off. Luckily, Peter is spying on the shop in Chinatown where they have been taken. He calls Agent Dunham then decides to do some investigating of his own. He breaks in to the shop and is in the process of freeing one of the immigrants when he is captured. The Triad and their crooked doctor are force feeding Peter one of the larva when the FBI team arrives, just in the nick of time. The villains are shot or captured, Peter is saved, the immigrants are taken to the hospital where they are treated, and everything ends happily.

(Oh, and Walter implanted a tracking chip in his neck.)

Fringe #209

Overall, the science — what little there was of it — was passable this episode, so I just have a few nit-picks an observations:

1. As the Worm Turns
Nematodes such as Ancylostoma are too primitive an organism to have a lymphatic system. They don’t even have a circulatory system.
fringeAdmittedly, these are “genetically engineered” hookworms, and for a worm to grow as large as those shown, thanks to the square-cube law and other similar concepts, they would have to have some sort of circulatory system.
fringeIn the actual worms, the many-tentacled end is the tail, not the head.

2. Glad I Don’t Have to Take Them Out
Matt’s staples should have been removed long ago. He was 3 ½ weeks out from his surgery. By this far out, the incision is healed with 80-90% strength. Leaving in staples or stitches that long serves no purpose, is going to lead to train-track scarring, possible stitch abscesses, and skin-growth around the staples.
fringeOpen abdominal surgery is to be avoided whenever possible, especially in immune compromised individuals. Why not just inject the powder into the spleen?
fringeCredit-Where-Credit-Is-Due Dept: That is where an incision for splenic surgery would be made.

3. High is Not Always Better
A high white blood count is a sign of infection (or leukemia, not the sign of a healthy immune system).

4. Ahhh, Just Right
I was starting to have concerns with Walter’s mention of “boosting the immune system” — a common alternative medicine/quackery claim. In reality, the human immune system is finely tuned: too little leaves you open for infection; too much and you get allergy problems and autoimmune disease. If all the alternative “medicine” boosted the immune system like it was claimed, we’d have an epidemic of autoimmune problems in this country. I’ll give the episode credit for having the medication be used by immune-compromised patients — a proper use.

5. What Does the FBI Teach These People?
Walter’s about as good an investigator as Olivia — that is, very bad. The logic of his whole “find a matching worm” plan had more holes than Swiss cheese (though this is Walter we’re talking about). For instance, who’s to say the various different herbalist shops didn’t all use the same importer of worms — which they probably did — so the worms from the various shops would be identical.
fringeAnd Peter’s not any better. Why would he think breaking into a shop owned by the Triad — known for their brutality — would be a good idea at all?

5. Lions and Tigers and Bears, Oh My!
The song Walter was singing was “The Menagerie“, which was also mentioned in the first season (episode 16, Unleashed).

Fringe #208

While there was some errors of scientific-concerned, most of them were minor and could be hand-waved area. Thus, for the second week in a row, there is a one-minute improvement on the Doomsday Clock.

Fringe Doomdsday Clock

FringeThis week’s Fringe cipher was: HIDDEN.
FringeA list of all previous Fringe reviews is available here.
FringeKarl has much more to say.

Tuesday PSA: Worldwide Adventures in Science!

Worldwide Adventures in Science! Click for the full page.Time for another look at science, 1950s style, courtesy of this public service ad from 1957.

This PSA refers to the International Geophysical Year, taking place from July 1, 1957 until December 21, 1958, which was an international effort to focus on the Earth Sciences (and also includes the study of various space phenomena). Overall, at least according to Wikipedia, it was a very succesful program.

Click on the image for the full ad

This PSA was found Adventure Comics #237, and can be found in other DC comics from June 1957. The ad was never repeated, undoubtedly because the International Geophysical Year would be long over before it could appear in print again (plus the fact that the ad was wrong about the US having the first satellite in space.) This PSA was written by Jack Schiff with art by Ruben Moreira.

More PSAsMore PSAs

Tuesday PSA: Buzzy Says “Get a Box-Seat To Nature’s Wonders!”

BuzzySince today is the 150th anniversary of Charles Darwin publishing his most famous work, On the Origin of Species, I thought that natural science would be the perfect subject for tonight’s public service ad.

Unsurprisingly, DC comics published no evolution themed PSAs in the ’50s and ’60s. I did manage to find some interesting science PSAs (or more correctly, SCIENCE! PSAs), speculating about the future from a 1950s perspective, but they didn’t really fit the theme I had in mind.

I also came across this Buzzy nature PSA, and I think it’ll do just fine.

birds!As a bonus, the PSA features birds. Sure, they’re no Galapagos finches, but it’s a start.

Click on the image for the full ad

This PSA was found Action Comics #182, and can be found in other DC comics from July 1953. This ad was written by Jack Schiff, with art by Win Mortimer.

More PSAsMore PSAs

The Last Days of Animal Man: A Medical Review

The Last Days of Animal Man
Gerry Conway, writer
Chris Batista, penciller

I just finished reading The Last Days of Animal Man, and I’ve got a couple of problems with it, particularly the last issue.

scene from The Last Days of Animal Man #6scene from The Last Days of Animal Man #6

1.
Animal Man defeats the villains by using his powers to infect them with Yersinia pestis, the Bubonic Plague. At first read, this is extremely clever — in a Merlin versus Madame Mim sort of way. But the more you think about it, the less sense it actually makes.

Animal Man’s powers allow him to gain the abilities of any animals he is near. He can gain the strength of a gorilla, the flight of a bird, the swimming ability of a fish, and so on. In this case, it appears he used his powers to gain the virulence of the bacteria.

Animal Man doesn’t become the animal in question; he just gains some of their abilities. So if he had won by incapacitating his opponents with a nasty bacterial toxin, that would make a certain amount of sense. But instead he actually infected them with the bacteria. How did he manage this? His powers don’t work this way. You need the actual bacteria to cause an infection, let alone one which is “overwhelming their immune systems.” Animal Man wasn’t infected himself, and he didn’t come into contact with the bacteria, so how did he infect the villains? He seems to have achieved abiogenesis – creating life (in this case the bacteria) from nothing.

2.
The biggest problem is basic biology. It goes back to something I first learned in seventh-grade science. Everyone read what Superman says, and then repeat after me: bacteria are not animals.

They belong to a separate kingdom entirely.

Fringe — Episode 8 (Season 2): “August”

A fairly light episode of Fringe, but an enjoyable one

Fringe #208

The Plot:The Observer is patiently standing in front of a museum in Boston, taking notes, and spying on brunettes. After a few minutes, he finds the one he wants, grabs her, throws her in the back of a stolen car and drives off. Arriving at an out of town motel, he gags her and ties her to a chair, and then leaves.

With the Observer involved, the Fringe team is called in. The kidnap victim is identified as Christine Hollis, and seems to be an entirely normal young woman. They review the surveillance camera footage and realize that this is a different Observer than the one they first met. It turns out that the Observer accidentally left his notebook behind, so it’s turned over to the team; however, they are unable to decipher the code/language in the book. Astrid identifies over 1200 different symbols, without any repeats. Looking online, she discovers that one of the researchers at Massive Dynamics is also interested in the code. He has not been able to solve it either, but he has documented evidence of Observers at important historical events including the Boston Massacre, the beheading of Marie Antoinette, and the shooting of Archduke Ferdinand. Peter finds a drop of what appears to be blood in the Observer’s journal. Walter notes its orange cast and wonders if the Observer might not have hemophilia.

Shame on Fox, Fringe, and FordAt a restaurant across town, a group of three Observers are meeting to discuss the actions of the rogue Observer, whom they call “August”. They mention a plane flight and imply that Christine is supposed to be dead, so they send an assassin after her.

August returns to the hotel room, unties Christine, and shows her the television news, which reports that the flight she had booked to Rome crashed en route with no survivors.

The labs tests come back and the drop in the journal wasn’t blood, but hot pepper sauce — and sauce from a particular hot pepper: the King Cobra Chili. Astrid is able to find the address of the individual who imported some last year, so Olivia and Peter head over to check it out. As luck would have it, the Observers’ assassin is there at the same time. There are some fisticuffs and Peter sustains a small wound, but the assassin escapes.

August meets with the other Observers. They tell him that Christine must be killed to set things right. This is not what he wants to hear. He manages to set up a meeting with Walter, asking for his help. All Walter can tell him is that he must somehow make Christine important to the Observers, so they won’t kill her.

August returns to the hotel room and unties Christine. He tells her that she must do exactly as he says. A short time later, the assassin appears at the hotel and in the ensuing battle, August is shot and critically wounded. Olivia and Peter arrive, and August gives his gun to Peter. Together, Peter and Olivia are able to kill the assassin. They find Christine and return her home.

The first Observer picks up August and drives him away from the hotel. As August lies dying in the back, he tells the other Observer that he had developed “feelings” for Christine, even loved her — and that is why he saved her. The first Observer tells August that she is safe now because she is responsible for the death of an Observer, and that makes her important.

Fringe #208

Overall, the science — what little there was of it — was passable this episode, so I just have a few nit-picks an observations:

1. Hot, Hot, Hot
The King Cobra Chile is the hottest chile known to man, scoring 850,000 to 1,000,000 Scoville units. It is also known as the “ghost chile”, which should be familiar to you if you watch Man v. Food.

2. 15% Tip
Why would it be a surprise that the tip about August was called in from the same hotel? Would it really be a shock that one of the other guests, or an employee, saw him and phoned it in?

3. Color of Love
This is the first I’ve ever heard of hemophiliacs having orange blood, and I don’t buy it. Hemophilia affects the clotting of the blood, not the hemoglobin (which is what gives blood its red color), so why would the blood be a different color?

4. You Go That Way, I’ll Go This Way
I would not want to be Olivia’s insurance agent, and I hate for her to be my backup. Tonight she: 1) was easily distracted by the assassin, 2) nearly shot Peter, and 3) only avoided being shot by the assassin due to dumb luck and Peter.

Fringe #208

A much better episode this week. The show does much better when they stick with the Pattern. There is a one-minute improvement on the Doomsday Clock.

Fringe Doomdsday Clock

FringeThis week’s Fringe cipher was: BLIGHT.
FringeA list of all previous Fringe reviews is available here.
FringeKarl has much more to say.

Fringe — Episode 6 (Season 2): “Earthling”

Could have been a contender, but was KO’d by bad science and too many clichés

Fringe #206

The Plot: A married man in Boston mysteriously turns to ash while waiting to spring an anniversary surprise on his wife. The Fringe team is called in to investigate. Broyles tells Dunham that he’s seen this before — there were five similar deaths several years ago at a hospital in Washington DC. He tells her he was contacted by an “Eastern European” man who provided a strange formula to him and indicated it was the solution to the deaths. Unfortunately, none of the FBI’s scientists could decipher the formula several more deaths occurred before they suddenly stopped — until now.

Dunham digs a little deeper and finds that the victim had recently been visiting his sick mother at a hospital. The Fringe team stakes out the hospital, trying to find a link between this hospital and the one four years ago in DC. They find a critical care nurse named Tomas Koslov who has worked at both institutions. Meanwhile, another ash-death has occurred on the in the hospital. A review of the hospital’s surveillance tapes show a strange being made entirely of shadow moving down the hall right before the death was discovered.

The team locates and searches Koslov’s apartment but discover he has abandoned it. They are able to find a fingerprint. When they run the fingerprint they find that their suspect is man by the name of Timur Vasaleiv who is wanted by both the CIA and the Russians because he stole something important from Russia. Broyles is told that the CIA will be taking over the case, but he decides to keep his team on it anyway. A contact at the Senate sends him Timur’s file. It turns out that his brother Aleks was a cosmonaut who returned comatose from a space mission, and it is his brother that Timur has stolen from a special Russian quarantine facility. He has been keeping him in various American hospitals while posing as an ICU nurse.

Walter has been working on the formula and realizes that it represents an organism that seems to feed on radiation. The hospital patients died because they all had been undergoing radiation treatment, and the husband died because he had been on a recent cross country flight (where he had been exposed to higher than normal levels of background radiation).

Timur returns to the hospital and takes his comatose brother out of the ICU and to a hotel. The shadow tries to emerge, but using a series of car batteries, Timur shocks his brother enough that the shadow retreats. He also knocks his brother into asystole (flatline), but after a few moments, a normal heartbeat returns.

Confident that Walter can crack the formula, Agent Broyles reaches out to Timur and offers his help. Timur is trying to decide whether to take Broyles assistance when he slowly turns to ash — the shadow is loose. The FBI arrives to find the comatose cosmonaut and the dead Timur. Peter thinks Walter can shock Aleks to make the shadow return, but Walter cannot read the equipment as it is all in Russian. When they hear a young girl scream from another motel room, Broyles takes unhesitating action and shoots Aleks in the head, killing him. The girl tells her mother that there was a shadow man in the room, but he disappeared. Later, when the CIA approaches Broyles to warn him off their case, they tell him that despite being shot in the head, Aleks returned to life, and they apparently sent him back into space.

Fringe #204

1. Glow In the Dark
There is a major misunderstanding of radiation here. While the victims had all been recently exposed to radiation, but they were not radioactive themselves. There was no “high levels” of radiation for the shadow to detect, let alone feed off of.

2. Feed Me, Seymour
What had the shadow been feeding off of for the past four years, after DC but before the husband died?

3. I See You
There is no way a patient is going to sit for four years in a hospital ICU like Aleks apparently did.
fringeICU beds are incredibly expensive. The hospital billing department would have been on the phone to his insurance company as soon as he was admitted. No insurance? While they wouldn’t have kicked him out (unless he was medically stable and had a place to go), they would have been looking at the records very closely.
fringeIf someone is in a permanent coma, they would be transferred to a rehabilitation hospital or a nursing home as soon as they were medically stable. They wouldn’t keep them in a regular hospital ICU indefinitely.
fringeHow did he get him admitted to each new ICU? ICU transfers are very irregular unless one is going from a less-equipped hospital to a better-equipped one, and that doesn’t seem to be the case here.

4. Eleven Herbs and Spices
In my brief look at the formula, there seemed to be a number of carbon atoms with more than 4 bonds. I admit that Ionly had two years of Organic Chemistry, but that seems quite unlikely to me.

5. Blackjack
Your Osama Tezuka link for the day: the little girl was watching Kimba, the White Lion.

Fringe #205

The plot line had potential, but was dragged down by too much bad science, reliance of clichés, and deep piles of nonsense they didn’t even try to explain away. The clock moves closer to midnight.

Fringe Doomdsday Clock

FringeThis week’s Fringe cipher was: DEJAVU.
FringeA list of all previous Fringe reviews is available here.

UPDATE: And I should mention that I’m already dreading next week’s show, just based on the preview, where they mention the completely debunked “most people only use 10% of their brain” myth as if it were fact.

Fringe – Episode 5 (Season 2): “Dream Logic”

The science, while a little sketchy, wasn’t half-bad in this episode of Fringe. Despite this, I found the story itself rather lackluster.

Fringe #205

The Plot:In Seattle, Greg, a businessman, walks through his office, late for a meeting with his boss. As he moves through the office, he notices that everyone he sees has the heads of demons rather than their proper heads. When he enters the conference room, he sees that his boss is also a demon, so he bludgeons him to death with his briefcase. The co-workers who wrestle Greg to the ground notice that his eyes are cloudy and twitching.

The Fringe team is called to Seattle to evaluate the case. They interview Greg at the hospital and he tells them what he saw in the office. Suddenly, he begins thrashing wildly in bed, his hair turns completely white, and he collapses, dead. Walter assists that local medical examiner with the autopsy and determines that Greg died of “acute exhaustion.” He arranges for the body to be sent to his lab at Harvard for a more complete, Walter style, autopsy.

Talking with Greg’s wife, Dunham and Peter learn that he had a history of sleep walking, but it hadn’t been a problem for several months since visiting some specialists.

A second incident has occurred: a woman driving a mini-van told her husband she saw a monster and drove her car into an innocent cyclist. She died at the scene and was found to have the same white hair Greg did.

The ThalamusBack in his lab, Walter finds a microchip implanted in Greg’s midbrain. A quick look at the body of the second victim shows an incision on the neck suggesting she had the same operation. Broyles takes the microchip to Nina Sharp at Massive Dynamics who identifies it as a chip designed to work on the thalamus to promote sleep. She identifies its creator as a Dr. Nayak, also in Seattle.

Dunham and Peter pay Dr. Nayak a visit. He identifies both victims as patients of his who are taking part in a clinical study on the brain chip. He takes Dunham and Peter to his office only to finf there has been a break-in. Nayak’s office has been trashed and the computers containing all the patient data are missing.

Walter and Peter hypothesize that someone is using the chips as a rudimentary form of mind control. Meanwhile, in a dark room, we see shadowy someone access the clinic’s computers and select a patient — a waitress at a local Greek restaurant. Soon she begins hallucinating before attacking the chef and then collapsing, dead. Nayak identifies her as one of his patients as well.

Back on the east coast, Walter has been experimenting with the chip and discovers that it siphons the patient’s dreams away so that they never dream. The chips can also be used to place the patient in a dreaming state while awake. Finally, he discovers that whoever is on the receiving end of the chip gets an incredible high from the stolen dreams. Olivia realizes that they are looking for someone addicted to the dreams. A brief amount of detective works reveal that Dr. Nayak himself is the perpetrator. He has a dream-addicted dark side that is causing all the problems. They track him to his home just as he is using his machine to activate the chip in an airline pilot’s head. Dunham destroys the computer, saving the pilot (and his crew and passengers), but killing Dr. Nayak in the process.

Fringe #204

Overall this week, I felt the science was not entirely implausible, a step up from the usual. So most of what follows are probably best regarded as “nit-picks”

1. Wherein I Make Some Concessions
I agree that exhaustion/stress can cause high cortisone levels and dehydration. For the sake of the story, I will also accept that it can cause sudden loss of hair pigment (a la Jean Valjean) and thyroid disorders. However, I am at a loss to explain how it can cause the sudden appearance of large patches of thickened flaking skin. Sure, dehydration and low thyroid can cause skin problems, but it is the entire skin, not just large discrete patches.

2. We Solve the Problem by Breaking the Space-Time Continuum
Let me get this straight: the brain chip is used to correct non-REM sleep disorders. It does this by siphoning off dreams. Now, dreams generally occur in REM sleep, which comes after non-REM sleep. So the chips fix the sleep by removing something that hasn’t even occurred yet.

3. Department of Redundancy Department
“Blood CBC” is hopelessly redundant. CBC stands for complete blood count, so a blood CBC is a blood complete blood count.
fringeA CBC looks at the blood cells (white, red, platelets). It doesn’t look at hormones like thyroxine and cortisol, that’s a different test entirely.

4. OMG, n00b
Yes hackers steal passwords. They also mount DDOS attacks, but these are two separate things. Claiming the lack of DDOS attack means that a hacker couldn’t be involved means the FBI (or the Fringe writers) need much better forensic computer experts. (And what would a DDOS attack against a single clinic server accomplish, anyway?)

5. It’s Not Brain Surgery — Wait, Maybe It Is
The thalamus is located deep in the center of the brain. Any surgery to reach it, let alone implant a chip in it, is going to be a major undertaking — a hole in the skull needs to made after all — and wouldn’t be performed as an outpatient clinic procedure.
fringeThe thalamus is part of the diencephalon, making it forebrain, not midbrain.
fringeAnd good luck getting the clinical trial approved by the IRB.

6. Your Suspicions Are Suspicious
Hearing that one of his employees was suspected, one would think that Dr. Nayak would have volunteered the information about his assistant being missing earlier in the day, rather than waiting until the end of it (or was that the effect of Hyde-Nayak?).

7. A Shot In The Dark
Peter, Dunham and the other FBI agent can’t find an on/off switch or a plug or a circuit breaker between the three of them? So the next logical step is shooting the server?

Fringe #205

It’s the reverse of last week. This time, I found the science acceptable, but the story tepid — so they cancel out and the clock stays at 11:55

Fringe Doomdsday Clock

FringeA list of all previous Fringe reviews is available here.

Quick Takes: Amazing Spider-Man #600 and Invincible Iron Man #14

Amazing Spider-Man #600

scene from Amazing Spider-Man #600

When evaluating the pupillary response in a patient, have them take off their sunglasses first.

quick takes

Invincible Iron Man #14

scene from The Invincible Iron Man #14

We already know that Norman Osborn is no good at anatomy, but it turns out he is clueless at computer science as well. Here, when he is trying to convince the Russians to allow him in their county to look for fugitives Tony Stark and Pepper Potts, he refers to “picobytes of…data.

There is no such thing as picobyte — it is impossible. A byte is made up of 8 bits*, and a bit is as small as you can subdivide a byte. A “picobyte” then, would refer to one trillionth (10-12) of a byte, which is orders of magnitude smaller than a byte can be divided.

I assume Osborn meant to say “petabyte” (a quadrillion bytes) — or maybe he meant Pikabyte, the loneliest of the Pokemon.

*There have been computer systems in which a byte is more or less than 8 bits, but 8 bits is standard now, and it was never more than 36 bits-per-byte.

Fringe – Episode 3 (Season 2): “Fracture”

I found this the best episode of the season, so far, and one of the better ones overall. There were certainly scientific mistakes, but it was nice to see some of the “police procedural” scenes well done, fo once

Fringe #203

The Plot:Officer Gillespie, a policeman in Philadelphia receives a mysterious phone call from the “Colonel” and is told to head to a nearby subway station and stop a man in a black trenchcoat with a black briefcase. When the officer spots the suspect and tries to grab the suitcase, he suddenly begins to crystalize. Gillespie screams in pain, then explodes, killing all around him

The Fringe Team is called in to evaluate the Philadelphia explosion because no evidence of any explosive material can be found. Poking around, Walter finds some crystallized parts of Office Gillespie, and realizes that it was the officer that exploded. He takes the bodies back to the lab for autopsy. As he pieces the crystallized officer back together, he finds needle marks between the toes — Gillespie had been injecting himself with some unknown medication.

UHF the Movie, with Weird AlMeanwhile, Peter takes the subway station surveillance tapes to one of his contacts, because the tapes all were strangely full of static. Peter’s friend is able to remove a little of the static but not much, so what led up to the explosion of Gillespie remains unclear. His friend speculates radio wave interference caused the static. Later, Peter and Dunham are talking to the officer’s widow when Dunham stumbles across a hidden case consisting of a syringe and a strange injectable medicine.

Across the country, Captain Burgess, once a military officer, now a suburban housewife, is seen injecting herself with the same medication. Later that day, the Colonel appears and tells her she is needed on a mission to Washington D.C. He provides her with airline tickets and hotel reservations.

Dunham and Peter discover that the Gillespie was part of an experimental medical program while he was stationed in Iraq. They travel to Iraq and track down one of the doctors who worked on the program, which was developed to produce an antidote to the chemical agent cyanogen chloride. The experiments weren’t very successful — only four out of 200 patients survived. Plus there was another unfortunate side effect: the serum turned the users into human bombs if they were exposed to a certain radio frequency.

Back in the United States, Broyles in charge of taskforce put together to capture Captain Burgess and the Colonel. They track her to a Metro station in Washington. Peter spots the Colonel and a brawl begins. Dunham is able to shut down the radio signal the Colonel had been sending just in time to stop Burgess before she exploded.

Back in FBI custody, the Colonel tells Broyles that he was trying to stop the “others” — who were planning a war and passing intelligence by a network of couriers. In the end, we see a courier hand a briefcase to the Observer, who opens it to reveal surveillance photos of Walter.

Fringe #203

1. A Quick Summation
The idea of a person being turned into an explosive device is clever, but I just don’t see how it would work. Where would the energy of an explosion that powerful come from — even if the person were injecting a strange medication and turning to crystal? I just don’t think there are that many high-energy bonds to break in a human (particularly since the explosion left behind identifiable pieces). Admittedly, this is all “back of the envelope” math so I could be wrong, but color me suspicious.

2. Deus Ex EMP
Does an “EMP disabling device disable” EMPs, or is does it utilize EMPs to disable devices?
fringeIf the former, wouldn’t the EMP disabling device itself be disabled by an EMP?
fringeIf the latter, how did it know which device to disable or when to activate? It can’t be “always on”.
fringeRegardless, if the device scrambles all radio waves, you wouldn’t be able to listen to the radio or talk on your cell phone inside the station.

3. Moses Supposed his Toeses are Roses
The webspace between the toes is used by addicts to inject drugs because the track marks are harder to find. It is commonly used by medical personnel who are addicted.
Captain Burgess’s injection was horrible as she has apparently never heard of sterile technique. There are nasty germs on the soles of the feet, why invite them into the body?

4. Just Like Detective Comics
Cyanogen chloride is a nasty chemical weapon. It acts as both an irritant (to the skin, mucous membranes, and respiratory tract) and a cyanide agent. Like most cyanide agents, it is quick acting (less than 10 minutes, usually). Treatment involves skin decontamination and use of cyanide antidotes.
fringeWith treatment, the chemical is cleared from the body quickly, there would be no need for continuing injections. And even if the soldiers were lied to about the serum, their own NBC training should have raised questions.

5. Video Killed the Radio Star
316 megahertz is technically UHF, not VHF, and falls in the band controlled by the government.

Fringe #19

While there was questionable science this week, the episode score points by actually showing some detective work (though mostly by Peter, Dunham — as usual — stumbled into clues) and having an enjoyably suspenseful chase at the end. The Doomsday Clock gains a minute, and goes back to five ’til midnight.

Fringe Doomdsday Clock

The Zombie Vaccination

Last week, I discussed a vaccination that prevented you from becoming a zombie. Tonight’s subject is the opposite: a vaccination that turn you into a zombie (actually, it turns you into a mindless super-strong drone, but close enough). This comes from the Pyroman story “The Saboteurs of Steel” in America’s Best Comics #4 (1943).

vaccination

Evil gangster Ornitz sneaks into a nearby Army base and slips his mind control serum into the paratyphoid vaccine. The next day, the soldiers are vaccinated…

scene from America's Best Comics #4scene from America's Best Comics #4scene from America's Best Comics #4

…and they all become the invulnerable super-strong mindless slaves of Ornitz who uses them to take over the Army base.

scene from America's Best Comics #4scene from America's Best Comics #4scene from America's Best Comics #4

Can Pyroman stop Ornitz and his army of Army men? Of course he can, this is his story after all. To understand how he does it, it helps to understand the story as a whole:

Dr. Clark, a scientist friend of Pyroman, discovers some bacteria still alive in an ancient sample of ore. These are no ordinary bacteria, but a species of Leptothrix, that utilize iron for food. For no discernible reason, Clark decides to make a serum of these bacteria. Later that night, a local gangster breaks into Clark’s house and steals the serum. Returning to his hideout, the gangster decides to inject the serum into Ornitz, one of his men, to see what happens (because there’s nothing better to do with a mysterious fluid in a test tube than inject it into somebody. At least he’s smart enough not to experiment on himself). Once injected with the serum, Ornitz becomes super strong and invulnerable. He uses his newfound abilities to take over the gang. Not satisfied, Ornitz wants his own army. He decides that if he takes some of his blood and injects it into other people, they will gain his super-strength and invulnerability, but will be enslaved to his will (I don’t know why he thinks this — or why it works — just chalk it up to comic book science). This is where he gets the serum he uses at the Army Base.

Our hero Pyroman’s swoops in to stop Ornitz , but his powers have no effect on him. If anything, Pyroman’s electrical attacks make Ortiz stronger. Desperate, Pyroman shoves Ortiz back into an old shed, where he stumbles and falls upon a jagged (and conveniently placed) length of steel, which kills him. Once Ornitz is dead, the soldier all return to normal.

“Wait!” you say. “Ortiz is invulnerable. How can steel penetrate his body?” It turns out that it was not just any length of steel he fell upon, but a rusty piece of steel, and it just so happens that (in this comic, at least), rust kills the bacteria that gave Ortiz his power. So you see: rust defeats the iron bacteria (which I’m sure seemed clever to the writers at the time).

vaccination

A couple of medical notes to end the post:

vaccinationParatyphoid fever is similar to the more famous typhoid fever, though it is usually milder. It is caused by a bacteria from the Salmonella family, which is found in contaminated water. It is rare in the United States, Canada, and Europe but fairly common in developing nations. There is a vaccine available, but it not used very often as it is only partially effective.

vaccinationAs the vaccination is labeled “serum,” I suspect the soldiers are getting an immune globulin injection to ward off paratyphoid, and not actual paratyphoid vaccine. In immune globulin injections, the patient receive an injection of antibodies against the disease. These antibodies will circulate for several months, protecting the patient, before eventually breaking down. The patient does not gain any permanent immunity from the injection. This is known as passive immunity, as opposed to active immunity, which occurs when patients are exposed to the germ in question and develop their own antibodies. Active immunity can occur by natural exposure, or by vaccination. All the vaccines routinely given in the United States induce active immunity.

Quick Takes: Dark Elektra #1 and Batman: Widening Gyre #1

Dark Elektra #1

scene from 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.

quackery!

Batman: Widening Gyre #1
scene from 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.

Aquaman Versus “Virus X”

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.

scene from Adventure Comics #200scene from Adventure Comics #200

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.

scene from Adventure Comics #200

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.

scene from Adventure Comics #200

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.

scene from Adventure Comics #200scene from Adventure Comics #200

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.

Aquaman

AquamanThis 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.

AquamanI 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).

AquamanApparently 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).

AquamanI 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?

The Commie Serum

It starts, as good stories often do, with the hero visiting an unassuming hospital:

scene from Young Men #26scene from Young Men #26
scene from Young Men #26

While touring a research hospital, Dr. Standish surreptitiously injects Captain America with the Commie Serum (sure, he calls it the Virus of Evil, but we know what it really is: the Commie Serum). Within mere moments, Captain America is suddenly agreeing with communist propaganda and even spouting off some himself. Bucky is horrified, but Cap plays him no mind, and agrees to perform missions at the behest of his new Soviet friends, including destroying a U.S. ammunition dump. Delighted with how well the drug is working, the doctor has Captain America row out to meet a Soviet submarine laying in wait off the coast. It is here that Cap is to meet the head Soviet spy and be taken to the Soviet Union.

Once on the deck of the submarine, Captain America shows his true colors. He decks the Soviet leader and then he and Bucky sabotage the submarine so that they can’t escape. It turns out that Captain America was never affected by the Commie Serum at all, but just played along so that he could capture the head Soviet spy:

scene from Young Men #26

There are two parts of this story that straddle that fine line between genius and insanity:

1. The deus ex machina explanation for Cap’s resistance to the drug is priceless: the scientists who created Captain America knew that he’d be facing a drug like this, so they designed immunity to it into the Super Soldier Serum. Genius! That same concept can be used to make Cap immune to anything: Radiation? Protected by immunity designed into the Super Soldier Serum. The vacuum of space? Protected by immunity designed into the Super Soldier Serum. The cloying sounds of Kenny G? Protected by immunity designed into the Super Soldier Serum. Current Captain America writer Ed Brubaker could have used it himself to resurrect Cap by claiming that the scientists behind Captain America knew he’d be facing bullets someday, so they made him immune to them.

2. How about the manner by which Captain America discovered that Dr. Standish was actually a Soviet spy? When the good doctor stepped behind the x-ray machine (the fluoroscope) to demonstrate how it worked, Cap noticed a Soviet medal in his stomach. Brilliant — at least until you stop to think about it. One of the Soviet’s top spies, instead of leaving his medal back in Russia with all his other belongings, decided it along with him to America. To hide it, he then swallowed it. Soviet medals are not small, they’re about the size of a fifty-cent piece or dollar coin — and that’s not counting the ribbon that’s usually attached. And these medals are, well, metal…and frequently pointy. Not only why would he swallow it (and did he hope to get it back?), but how did he swallow it?

Scenes from “Captain America Turn Traitor” in Young Men #26. The GCD lists John Romita as the penciler and Stan Lee as the probable writer

The Hangman #1: A Medical Review

The Hangman #1
J. Michael Straczynski, writer
Tom Derenick, penciler

scene from The Hangman #1

A hypothermic patient is brought to the Emergency Room after being caught in a cruise ship explosion. He was in the water for two hours and described as a “near-drowning.” Dr. Dickering (apparently the only doctor in the entire hospital) goes to the ER to evaluate the patient.

The biggest problem in this scene is the doctor’s use of the EEG to look for neurological damage.

The EEG, or electroencephalogram, is a device that records electrical waves generated on the scalp by different parts of the brain. It is cumbersome to set up — lots of little scalp electrodes — and takes quite a while to run — and that alone should be enough to tell you it would be useless in an emergency situation.

In my practice, I’ve used EEGs to help differentiate epilepsy, as part of a sleep study, and to determine brain death. It has other uses, which Wikipedia covers well, but you’ll notice that none of them would fit in an acute or emergent setting.

Certainly, an EEG can be used to find areas of the brain with poor blood flow or abnormal electrical activity, but that doesn’t cover all the causes of brain injury, and there are better, faster tests available.

Now, even if the EEG could be used to find brain damage in this situation, it still wouldn’t be a good choice for a neurological evaluation. For example, this patient could have a spinal injury from the explosion — which is a neurological injury — but it wouldn’t show up at all on the EEG because it only looks at the brain.

Finally, let’s remember that this patient has severe hypothermia — a much lower than normal body temperature. This has a significant effect on his nerves and the electrical activity of his brain, so his EEG would be abnormal no matter what.

The best way to perform a neurological exam on a patient like this is the old-fashioned way: by hand.

Other thoughts:
the hangmanIntubation is a good choice given that this patient is a hypothermic near-drowning victim and has a high change of developing breathing problems, if he hasn’t already.

the hangmanAn actually core body temperature would be important to know rather than the vague answer of “close to critical.”

the hangmanStarting to warm up the patient en route is laudable, providing the medics are monitoring his heart, as arrhythmias are common in this situation.

the hangmanDr. Dickering sure spends a great deal of time futzing around instead of actually intubating the patient — which is not necessarily a bad thing since the patient is awake and talking — but it does make you wonder why he wanted the intubation RIGHT NOW!

the hangmanThe rest of the scene is little better (I only posted the most egregious panel). The “med-speak” is awkward and lacks the flow one sees in trained professionals. For ER talk done right, compare this scene to the ER scene in Blue Beetle #31. Hint for the aspiring writer: Get a doctor, ER nurse, or paramedic to help with the med-speak, it makes a all the difference in the world.

the hangmanHere’s a good online case study of a near drowning patient. It’s a pediatric patient, so there are some differences, but it will give you a good feel for how such a situation is handled.

Can You Make the Diagnosis? (and a little Delirium Tremens)

Time for another Comic Book Medicine Case Study. There’s a fair amount of discussion after the case study — not about the actual diagnosis — but about what the patient thinks it is.

Case Study #10: The patient is a male in his late thirties. Though generally healthy, he leads a sedentary lifestyle and has a high stress job. His face had a ruddy complexion and he admits to being a “social drinker.”

While out to dinner alone one night, he experiences the sudden onset of a severe weakness of the left arm. None of his other limbs are affected. There is no history of prior injury, and he denies any numbness, tingling, or pain in the involved extremity.

The correct diagnosis for this patient is:
A. A stroke
B. Caught up in a science experiment gone wrong
C. Multiple Sclerosis.
D. Victim of a magic spell.
E. Tetrodotoxin poisoning (i.e fugu, or puffer fish)

Click here for the ANSWER

Read more…

Las Vegas

In Las Vegas the next few days for a couple of conferences. First, the Science-Based Medicine Conference, then a couple of days at The Amaz!ing Meeting.

Then, we’ll squeeze a few days of vacation before heading back home.

Fringe #1 – #3: A Medical Review

In addition to watching the television show Fringe, I also read the Fringe comic published by WildStorm. The comic takes place years before the show, and features two stories per issue — one a continuing story featuring scientists Walter Bishop and William Bell, and a second stand alone story. This post is about the continuing “Bishop and Bell” storyline, the third chapter in particular.

fringe

When we meet William Bell in the first issue of Fringe, it is 1970 and he is a twenty year old college student at Harvard. He meets up with Dr. Walter Bishop and becomes his lab assistant.

The next issue takes place at some undetermined point later. Dr Bishop and William Bell are still working in a lab at Harvard. There is reference to experiments the duo performed “last year.” William Bell is also referred to as “Dr. Bell” which suggests he has had time to complete not only his undergraduate degree, but also his doctorate. Depending on how much credit you want to give him for being a genius, that would make it 4 to 8 years later, so the story takes place sometime between 1974 and 1978.

Why is this important? Because the timing seemed off to me — and it turns out I was right:

scene from Fringe #3

Neurontin is the brand name of Gabapentin, a drug originally developed to prevent seizures. Gabapentin wasn’t discovered until 1973 and was an experimental drug for years after that, so it’s unlikely that the doctors would be able to get there hands on any. Even if their mysterious “Soap Company” benefactors somehow managed to obtain a supply of the medication, it wasn’t known as Neurontin until 1983.

I’ll also point out that injecting serotonin into the body is not a good idea. It doesn’t cross over from the blood to the brain well (which one assumes is where they want it), and it acts as a potent vasoconstrictor (causes the blood vessels to clamp closed) in the bloodstream. High levels of serotonin in the blood have been linked with fatal lung and heart conditions.

Injecting LSD into the body — probably not the best idea either, but for different reasons (mainly due it being a potent hallucinogen). Speaking of LSD, it’s the chemical structure the worker holding the clipboard is looking at in the second story in issue #3.

Beast, Dr. Mid-Nite, and the American Medical Association

scene from Young X-Men #11
scene from Young X-Men #11 (Guggenheim, Sandoval)

Does Henry have anything to worry about? Can he be kicked out of the American Medical Association for breaking doctor/patient confidentiality?

Yes, and no.

1. You can be expelled from the AMA for breaking its ethical rules, and these rules include patient confidentiality.
2. On the other hand, Henry can’t be kicked out of the AMA because he can’t be a member: he’s not a physician. Sure, he practices medicine for the X-Men, and he has at least one Ph.D., but he has never earned a medical degree, and thus he cannot be a part of the AMA.

There are scattered mention around the web of Henry McCoy and a medical degree, but all the mentions I found were on non-cannoncanon fansites. According to the official Marvel site, Henry has one Ph.D., and in the previous issue of Young X-Men, when reassuring Soorya about his medical abilities, Henry mentions having six Ph.Ds but never once mentions an M.D.

the AMA

While I’m talking about the AMA, there seems to be a misunderstanding among writers (both comic book and television) about what exactly the American Medical Association does.

It is a physician and public health advocacy organization whose mission is to “promote the art and science of medicine and the betterment of public health.” It has a charitable wing and it has a powerful political wing. The AMA publishes a number of medical journals, the best known is the eponymous JAMA (the Journal of the American Medical Association).

scene from Dr. Mid-Nite
scene from Dr. Mid-Nite #1 (Wagner, Snyder)

The AMA does not issue medical licenses or revoke them; that is the duty of the medical boards of each individual state. From the AMA website: “the AMA is not in a position to take action against a physician’s license to practice medicine.”

Despite what most people seem to believe, membership in the American Medical Association is not mandatory — in fact, less than a third of physicians are members of the AMA (15-30% depending on whose data you accept).

Action Comics #871: A Medical Review

cover, Action Comics #871Action Comics #871 “New Krypton, part 2: Beyond Doomsday”
Geoff Johns, writer
Pete Woods, penciler

Geoff Johns is usually one of the better writers at incorporating science — or at least decent pseudo-science — into his stories. But in this scene from a recent Action Comics I have to call his bluff:

Superman: You know of Doomsday, Zor?

Zor-El: We know of him.

He was scientifically created on ancient Krypton through the the violent and vile process of Forced-Evolution.
A child was sent into the wild, killed and then cloned from the remains and the process was repeated…
…until that child had evolved to withstand the harsh environment and bloodthirsty creatures of our primordial world.

Here are three good reasons that this “forced-evolution” is utter nonsense and could not have worked:

1. Evolution requires change, particularly change at the genetic level. In the process Zor is describing, there is no change. Cloned individuals have identical genetic codes. Since each generation is a clone of the previous generation, their genetics are identical and the scientists are essentially sending the same kid out again and again and again. This is not evolution; it’s stagnation.

2. Zor seems to imply that the child abandoned in wilderness develops some new skills or abilities to help him survive and this is what leads to evolution. The child may certainly have acquired what he needed to survive the wilds (but not, apparently, survive the scientists), but it’s all a moot point: acquired abilities cannot be inherited.

3. Finally, species evolve, not individuals.

If the Kryptonian’s grasp of geology is as good as their understanding of biology, it’s no wonder nobody but Jor-El noticed the planet was going to explode.

Fringe – Episode 18: “Midnight”

They almost made it for a complete episode without screwing up the science…almost.

Fringe #17

The Plot: Strange murders have been occurring in Boston, murders where the victim has their spinal column ripped open and have been drained of spinal fluid. Agent Dunham and her team are called in after the second murder. While examining the body, Walter finds traces of Treponema pallidum, the bacteria that causes syphilis — only it’s a variety of syphilis that has been extinct for decades. They trace the syphilis to the CDC who note that they recently sent a sample of that very syphilis to Lubov Pharmaceuticals. The CDC also mentions that the same research lab ordered RND-390, a component of the rapid skin growth bioweapon seen previously.

Olivia and her team raid the lab — only it’s not a real lab, just a split-level house in a residential area. They arrest a wheelchair-bound scientist named Boone and bring him in for questioning. He admits to working for the ZTF and having developed the rapid skin growth weapon, as well as playing a role in whatever is terrorizing the city now. He tells Dunham that he will help her, only they need to rescue his wife who was kidnapped by the ZTF to ensure he keeps working for them. Eventually, Boone admits that his wife is not a hostage, but has been dosed with a contagion that has turned her into the killer stalking the city. If Dunham and her team can capture his wife, he will concoct an antidote and then tell Dunham everything he knows about the ZTF.

Dunham, Peter, and Charlie capture the wife and brings her back to the lab where Walter and Boone have concocted an antidote. The cure is a success, unfortunately Boone died of a stroke while making it. He leaves a videotape for Dunham naming names. He doesn’t know much, but reveals to her that the money man behind ZTF is William Bell.

Fringe #18

1. Free Samples
The CDC is a little free with their germ samples, aren’t they? Particularly the bioweapon ones.
fringeAnd they know the lab is in a residential area, but don’t seem to think twice about it.

2. It Goes to Eleven
How does giving cerebral spinal fluid to his wife going to cause Boone to become paralyzed? If that’s the case, then everyone who ever had a spinal tap would be in a wheelchair.

3. FBwhat?
Astrid gets the “Only Agent Actually Investigating” Award for her finding-the-club-stamp moment.

4. Billy Squire
Taking too much spinal fluid is not going to cause a stroke; if anything, it’s going to cause a herniation (the brainstem is pushed downward over sharp bony prominences and damaged — and not in a good way). At the least, it’ll give him a nasty spinal headache.
fringeBecause it’s not a stroke, the medication tPA (tissue plasminogen activator, a “clot busting” drug) is not going to do any good. And even if it were a stroke, tPA is not necessarily a good idea. If it is a stroke caused by a clot, then tPA is indicated, but if it is a stroke caused by bleeding in the brain, then tPA will make it worse. There are very specific rules about giving tPA to minimize the risk of bad outcomes.
fringeRegardless, you don’t stab someone in the neck with a syringe of the medication.

5. K.I.S.S.
Why inject the antidote into the spinal column at the cervical spine (neck level)? It’s a tough shot, and runs a risk of injuring the cord. Since the CSF circulates throughout the spinal column as a whole, injecting the medication at the lumbar level will have the same effect, only be easier and less risky.

Fringe #18

Everything was going for this episode, and I was going to move the clock back again, but then they started talking about stroke and tPA and lost all benefits. The clock stays in place this week.

Fringe Doomdsday Clock

Fringe – Episode 17: “Bad Dreams”

A surprisingly enjoyable episode this week. The science mumbo-jumbo was kept to a minimum and storyline kept moving quickly along.

Fringe #17

The Plot: A mother is pushing her daughter in a stroller through Grand Central Station singing a song about a circus elephant. As they wait by the tracks for the next subway, Olivia suddenly appears and pushes the mother in front of the oncoming train, killing her. Olivia suddenly wakes from her sleep with a start, realizing she had dreamed the whole thing — until she sees the report of the suicide on the morning news.

Olivia and her team go to New York to investigate the death, but the evidence — including a surveillance tape — point to suicide. Her husband, however, pleads to Olivia that his wife would not have committed suicide. Walter suggests that possibly Olivia somehow compelled the woman to jump.

Olivia decides not to go back to sleep. She takes caffeine pills and drinks cup of coffee after cup of coffee. She finds herself in a restaurant full of happy couples. Suddenly, one of the wives starts accusing her husband of philandering and stabs him repeatedly with a steak knife. Olivia is beside her, helping her drive the knife in. Again, Olivia wakes up with a start — she has dreamed of another death. Investigating at the restaurant where the stabbing took place, the owner tells her a blond man with a scar was sitting in the booth she had dreamed herself sitting in. Reviewing the tape of the New York suicide, a blond man with a scar was there as well.

A search of governmental databases reveals that the man in question is named Nick Lane and was once a resident of St Jude’s Mental Hospital, until he came into a sudden inheritance and checked himself out. He also seems to have been familiar with the mysterious ZTF manifesto. The staff psychiatrist describes him as “hyper-emotive” — someone whose mood influences those about him. Looking through the patient’s chart, Olivia discovers that he was treated with the experimental drug Cortexiphan — the same drug she was once treated with. Walter reveals that during the Cortexiphan experiments, children were paired to reduce their anxiety. He suggests that Olivia must have been paired with Nick and a mental bond developed that allows her to dream what he is seeing. Thanks to the Cortexiphan and his unstable mental state, Nick is broadcasting his emotions to those around him. When he felt suicidal, the mother picked up his emotions and committed suicide. When he felt abandoned, the wife picked up his feelings and stabbed her husband.

Walter places Olivia under hypnosis in an attempt to locate Nick. They are able to find Nick’s apartment, but not before he has lured a stripper there and caused her to commit suicide. By the time the team reaches his apartment, Nick is already gone. Exploring his place, they find an entire wall dedicated to the Pattern. About this time, news reaches them that Nick has been spotted. He has gone to the roof of a tall building nearby and is prepared to jump to his death. He’s not alone though, his emotions are spilling so much that there are about twenty other people on the roof with him, also ready to jump. Walter tells Olivia that because she was also treated with Cortexiphan, she will be immune to Nick’s powers. She climbs to the roof and confronts him. He remembers her from the experiment, but she doesn’t remember him. He hands her a gun and asks her to kill him. She shoots him in the knees instead — he collapses and it releases his hold on the others. He tells her regretfully that someday soon, she’ll wish she had killed him. As the episode ends, Walter is watching an old videotape of the Cortexiphan experiments — a tape featuring a very young Olivia.

Fringe #17

Not too much science to dish on in tonight’s episode, so I’m just going to go stream of consciousness here.

1. Circus Circus
According to Wikipedia, Nellie the Elephant is a perfect song to sing in order to time CPR correctly.

2. The Count
For something that was supposedly not detecting any radiation, the Geiger counter was certainly clicking a fair amount.

3. Showtime
Walter wants to see Pippin, a musical about Charlemagne’s deformed son, Pippin the Hunchback. The song he is quoting is Corner of the Sky.

Strangely enough, the song Corner of the Sky is on the playlist I’ve been playing on my computer for the past month or so. Should I be worried? Have I become part of the Pattern? (If so, I better be getting paid for this, Abrams).

4. Stripper or Not
Continuity error: When the stripper is first shown looking in the mirror in Nick’s apartment, she is topless. When the scene flashes back to her, she’s suddenly wearing a bra (what can I say, I’m a guy — I notice these things.)

5. Torre! Torre! Torre!
Just for the record: Walter mentions Nick was using the Torre attack when playing chess. Who was he playing?

6. Clues?
Thanks to some recent articles on the clues in Fringe, I’m looking for them everywhere now. I saw the light pattern in the windows in Walter’s hotel, but now I’m wondering about the 7 of clubs shown prominently on Nick’s table.

7. Continuity
Nice to see the some of the threads begin to tie together — particularly the Cortexiphan and the ZTF manifesto (both from Episode 14)

8. The Wall
I would have loved to have time to study the Pattern wall in Nick’s apartment.

Fringe #17

An enoyable episode this week, that restores some of my faith in the show. The Doomsday clock goes back to 11:56

Fringe Doomdsday Clock

Fringe – Episode 16: “Unleashed”

This episode seemed to have potential — strange creature from lab released by animal rights activists that proceeds to terrorize the countryside. But then the bad science and awkward storyline kicked in.

Fringe #15

The Plot: A group of animal activists break into a research lab and frees all the animals from their cages. They also release a particularly nasty creature hidden in the back of the lab. The monster shows its gratitude by promptly killing one of the activists and a scientist who tried to stop them. It then hunts down and kills the other activists as they are fleeing in an SUV.

scene from Fringe episode 16Agent Dunham and her team are called in the next morning when the wrecked car and shredded bodies are found. One of the dead bodies is moved back to the lab where Walter performs and autopsy and finds a stinger of some sort buried in the body. He also finds hundreds of larval worms in the body, apparently implanted by the creature. Unfortunately, by this time Charlie has encountered the monster and been attacked. He survived, but has become implanted with the larvae as well.

Walter has deduced that the monster is a transgenic animal — composed of the genes and attributes of multiple species. He is worried that it may be based on his work because he experimented with transgenics years before. For once, the “science” turns out to be unrelated to his research.

Walter theorizes that the only way to kill the larvae inside of Charlie is to transfuse him with some of the monster’s blood so that the larvae will get confused and stop feeding on him. The team traps the monster in the sewers and kills it, but they collect enough blood to transfuse Charlie and save his life.

Fringe #16

1. Worry Wart
After all the other episodes where the plot was based on Walter’s research, why is he suddenly worried about the morality of it. Plenty of people have died because of his work already this season.

2. Blue Genes
Transgenic animals have been used in research for years. They are animals that express genes from other sources, or express specially modified genes. Walter seemed to be talking about transgenics taken to a whole new level — plus he was confusing it with xenografting (transplanting parts from different animals) with his talk about rejection.

fringe“Accelerated Darwinism”
A nonsense phrase and a particularly stupid one at that. The theory of evolution applies to natural selection, and the selection here was man-made, pretty much the opposite of natural..

3. Keep the Needle Away From Me
Astrid is told to draw 25cc of blood from Charlie and she sticks the needle in the belly? She might get some peritoneal fluid, but the big blood vessels are deep in the abdomen. Why not just draw blood from the arm like a normal person?

4. Lucky Shot
Where was the incendiary part of the incendiary 50 caliber rounds? And wouldn’t incendiary rounds have made it that much more difficult to get blood from it.

5. Ultra-Special
That was impressive resolution on that out of date ultrasound machine. Even more impressive was how the picture stayed perfectly still despite Walter waving the wand all over Charlie’s chest. (That last sentence should get some interesting Google searches)

6. The Belly of the Beast
So the idea was that by giving Charlie some of Mama Monster’s blood, the baby monsters would get confused (in that “can’t tell self versus non-self” way), and thus miraculously die off (cause of death? Confusion.) So how did the proteins on Mama’s blood cells get into Charlie’s peritoneal fluid so fast, if at all? Why not just inject an anti-parasitic into the peritoneal fluid, thus bypassing most of the side effects Charlie would suffer.

7. Random Thoughts
fringeApparently the monster has either blue curaçao or Windex for blood.
fringeJohnathan Swift?
fringeClearly Walter missed Aliens when he was in the asylum or he would have known to look up.

Fringe #15

Another week of bad science, and characters acting, well, out of character. The Fringe Doomsday Clock gains another minute and stands at 11:57 (meaning that all the gains from the good episodes before the break have been lost).

Fringe Doomdsday Clock

Fringe – Episode 15: “Inner Child”

There were two interlocking stories on tonight’s episode of Fringe. One of which contained a serial killer, and one of which contained Fringe science (if by “fringe” you mean “in no way connected to the actual laws of science”).

Fringe #15

The Plot:A demolition crew is ready to implode an old building when one of them gets a strange feeling and runs back inside. He and his co-workers find a hidden basement that appears to have been sealed off for years, and in it, huddled in the corner, they find a naked, pale, bald ten year-old child.

Meanwhile, the serial killer known as “The Artist” has reappeared after a three year absence and sent a taunting note to the FBI.

Olivia and her team interview the strange child (hereafter called “Lex Jr”) in the hospital. He is having some shortness of breath and the doctor wants to put him on supplemental oxygen. Walter stops her and lets her know that Lex Jr is from a low oxygen environment and needs less oxygen, not more. Sure enough, Walter’s right and Lex Jr starts to breathe better. He seems to form an emotional bond with Olivia. He grabs her pen and writes a name upside down — and it turns out to be the name of the serial killer’s latest victim.

Olivia visits Lex Jr again, hoping for more clues about the killer. This time, he writes an address down for her. She goes to the address, but can’t find anything. It isn’t Lex’s fault though, it was Olivia’s: the murderer’s van was parked at that address and she missed it. While in the hospital, she meets a social worker who remarks that Lex Jr will likely be leaving the hospital soon.

Walter thinks he can provide a way for Lex Jr to talk. Olivia brings him to the lab where Walter hooks him up to the neural stimulator (remember that from episode five?). About this time, the social worker appears in the lab, only he’s not a social worker — he’s a CIA agent and wants the boy. He agrees to give Olivia and team one day to find the killer before he returns for Lex. With Lex’s help, and an assist by Peter, Olivia manages to track down and capture, if not kill outright, the Aritist. In the end, Olivia finds she can’t hand Lex over to the CIA and has the friendly doctor from the hospital set him up in a good foster home instead.

Fringe #12

1. When is More Less?
The “Lex lived in a low-oxygen environment” concept bugged me. For one thing, if the hidden basement was that oxygen poor, the demolition crew would not have been able to breathe down there.
And later, when Walter tells the doctor to put Lex on 5% oxygen, what was the other 95%? Hospitals don’t keep tanks of less than 100% oxygen sitting around. If a little oxygen is needed, the flow setting is low. If more is needed, a higher flow (and fancier masks) are used. Remember, room air has 21% oxygen and if the team wants to go less than that, they’d need an air-tight room and would somehow have to remove the oxygen from it. You can’t just use a near-empty oxygen tank because all you’ll get from that are a few minutes of extra oxygen and then back to room air.

2. If a Bone Shatters, and No One is Around ti Hear It, Does It Still Hurt?
If he lived his entire life in the dark, he would not just be low in Vitamin D, he’d have rickets, a bone disease caused by long term Vitamin D deficiency.

Not quite the same machine used in the episode, but close3. Oxygen or Cautery
The machine they made a show of turning on before placing Lex on his “low oxygen” nasal canula had nothing at all to do with oxygen or air flow. It was the control panel for a electrocautery machine — which uses an electrical current to cut through tissue and/or cauterize wounds. It is a common piece of surgical equipment. You’ll notice the buttons were labeled monopolar, bipolar, and coagulate.

4. The Future’s So Bright, I Gotta Wear Shades
For someone with an extreme sensitivity to light, he was sure kept in a brightly lit room. How about some sunglasses at least.

5. Call the Amazing Randi
Let me get this straight: Lex can not only read the mind of the serial killer — oh sorry “empathize” with him — but he can miraculously express it in English, a language he cannot speak and isn’t even sure which way is up when he writes it (but he fixes that one fast). I could almost accept it if he drew a vague picture of what the killer was seeing, but for him to give a specific name or address when it’s likely the killer wasn’t even aware of them…

6. When Being Cheap Costs
The meat packing company sold used bloody drop cloths? And they didn’t find this strange? And The Artist didn’t have the common sense to spend a few bucks extra to buy clean ones?

7. Code
Ars Technica has a couple of nice articles (especially the second one) on “The Fringe Code.”

Fringe #15


Because of the nonsensical psychic powers, the complete misunderstanding of basic science, and pretending an electrocautery machine is an oxygen machine, I have no choice but to resume the Fringe Doomsday Clock countdown, and the hands move up a minute to 11:56.

Fringe Doomdsday Clock

More Savage Science

As the Sunlight Rising storyline begins, Doc Savage decides to use his science (Science!) skills to resurrect his dead wife. Here, two of his companions discuss the plans.

scene from Doc Savage #11

Unfortunately for Doc, he’s basing his resurrection plans on an untruth. It’s a myth that the hair and fingernails grow after you die. While they may appear to grow, what is really happening that the skin next to them is dehydrating and shrinking, giving the illusion of growth.

Doc proceeds with his planned resurrection, but his equipment is stolen by the villains who use it to resurrect his more-or-less archenemy, John Sunlight.

scene from Doc Savage #11

scene from Doc Savage #11 by Mike Barr and Rod Whigham

The Mad Science of Doc Savage

Recently, I’ve been reading through DC’s Doc Savage comic book series from the late ’80s. It features the titular hero brought forward into modern times and having his usual world-spanning adventures. As to be expected from a character who got his start in the pulp magazines of the ’30s and ’40s, the stories are chock full of improbable — if not downright impossible — science (or should that be Science!). Since I’m a fan of the old pulps, I’m willing to accept these in the spirit of the times.

Sometimes, though, I run across a scene where the science is just a little too mad…

scene from Doc Savage #12scene from Doc Savage #12scene from Doc Savage #12scene from Doc Savage #12

So…the “magnetic ray” exerts a force on the iron in the blood (I can buy that), but this somehow causes the pulse to race, the blood pressure to skyrocket, and then the heart to explode. I’d be interested to know how the hemoglobin in the red blood cells has that powerful an affect on the heart, since normally it exerts exactly zero influence on it. I can’t even conceive of a mechanism how this would work. A racing heart could certainly raise the blood pressure, but other severe problems would occur (severe sudden heart failure, a fatal arrhythmia, a stroke, or a heart attack) long before the heart exploded. This is another example of trying to explain things too much — they should have just left it at “magnetic ray.”

Of course, I do appreciate the fact that I get to add another entry to my “Things Which Cause Nose Bleeds in Comic Books” list.

scene from Doc Savage #12 by Mike Barr and Rod Whigham

Fringe – Episode 12: “The No-Brainer”

Another week, another episode of Fringe with painfully bad medicine — only this time with bad computer science as well!

Fringe #12

The Plot: A teen age boy is on the computer when he open an anonymously sent program. Strange images begin flickering on the computer screen and he stares, transfixed. His parent find him later, dead, his brain liquefied and oozing from his ears and nose.

Agent Dunham and her team arrive on the scene. They interview parents and friends, but can find nothing incriminating. The grab his computer and take it back to the lab. Astrid tries to look at the hard drive — after all, she has a minor in “computer science” — but announces that she cannot because its platters are fused.

A second body is found, just like the first. This time, it’s a car salesman across town. The computer hard drive shows the same damage, but this time Astrid is able to determine that he had downloaded a shortly before he died. Peter takes both computer hard drives to one of his friends who is not able to track down the sender of the file, but is able to discover that it has been sent to a new location — Agent Dunham’s home. Dunham and Peter rush to her apartment and find her young niece transfixed by the screen. They are able to bring her out of the trance and she appears fine. Dunham does notice that the webcam light is on, suggesting that someone has been watching her.

Another victim is found, this time a day trader in Evanston, Illinois. The killer has gotten sloppy and there is enough information for even Agent Dunham to discover a pattern to the killings. This victim was the new husband of the mother of Luke Dempsey. Luke was the first victim’s best friend. Dunham discovers that Luke’s father is something of an incredible computer genius. She suspects he is the one behind the murders. She brings Luke in, but he won’t tell her where his father is. She lets him go, and follows him to his father’s hideout. She confronts the killer, but in the end he takes his own life.

Fringe #12

1. Brain Fondue
Dr. Bishop: A complex combination of visual and subsonic aural stimuli, ingeniously designed to amplify the electrical impulses of the brain, trapping it in an endless loop.
That sure sounds like Dr. Bishop is describing a seizure, or actually a type of potentially fatal seizure known as “status epilepticus“.
fringePeople can die from status epilepticus, but their brain doesn’t liquefy.
fringeSpeaking of that, how exactly did this seizure-like activity cause the brain to liquefy? Was it supposed to raise the temperature so much the brain melted? That’s really too stupid for words.
fringeAnd even if the brain did liquefy, why would it leak out the nose and ears? The brain is essentially in a tightly sealed container; it won’t leak out unless the container is broken (a skull fracture, for instance).
fringeFlashing lights can certainly cause seizures in certain people; it’s called a photosensitive seizure and was the reason that one episode of Pokemon was never shown on television in the U.S. But it doesn’t cause seizures in people who aren’t already susceptible.

2. The Brown Note
fringeMy speakers can barely play real sounds, let alone “subsonic aural stimuli.”

3. Damn Viruses
Astrid: A computer virus that infects people.
I thought this idea was ridiculous when I first ran across it several years ago in the Cable/Deadpool comic book. Plus, I don’t think this was an actual computer virus. It was malware, certainly, but it didn’t have the self propagating characterstic of true computer viruses.
fringeYet another reason not to click on spam pop-ups.

4. The American Medical Association
There is no such thing as the “AMA Database.” The AMA is essentially a lobbying organization, it has little to do with the actual practice of medicine.

5. It Didn’t Even Start Well
That is an absolutely horrible episode title.

6. All Your Base Are Belong To Us
I know just enough about computers to realize that most of the “computer science” on this week’s episode was on par with the medicine. I leave it up to all you computer experts to do the critiquing here.

Fringe #12

I’m afraid Fringe is rapidly reaching the point where it has gotten so ridiculous that it’s not worth an hour of my time to watch, let alone write about afterward. To this end, I have created the Fringe Doomsday Clock, patterned after the famous nuclear doomsday clock.

When the clock reaches midnight, my patience will be up and I will stop watching Fringe. After the last two episodes, the clock has been moved ahead to 11:57.

Fringe Doomdsday Clock

Fringe – Episode 11: “Bound”

This episode of Fringe introduced a new antagonist as well as new protagonist/hostage, and also features some spectacularly bad medical science

Fringe #10

The Plot: Agent Dunham had been kidnapped at the end of the previous episode. As this episode begins, she is strapped down to a gurney by her captors and ends up on the receiving end of a spinal tap. We manage to catch a glimpse of one of her abductors: Agent Loeb (from episode 7). Dunham manages to escape, and in the process steals some suspicious looking test tubes.

Dunham calls in reinforcements, but the FBI agents who show up subdue and tranquilize her. It turns out that there is an internal affairs investigation into the FBI “Fringe” office, and it is being headed up by an investigator who bears a grudge against Agent Dunham. Tranquilizing her was his way of letting her know who is boss.

Meanwhile, a world-famous immunologist is lecturing at Boston College when he suddenly starts choking and collapses. A giant slug-like beastie emerges from his mouth and escapes into the auditorium. Agent Dunham and her team are called in to investigate. She determines that the late immunologist was asked to head a secret CDC task force concerning epidemics. Another local doctor has also been asked to serve on the committee, and he is brought in to protective custody by Dunham. It’s all for naught though, as Agent Loeb kills him by dosing his water with giant slug eggs.

About the same time, Walter discovers that it is not actually a giant slug, but a gargantuan cold virus. The samples Dunham stole from her captors are some of the (for lack of a better term) slug eggs.

Dr. Bishop: It’s viral — nasopharyngitis — albeit a gargantuan specimen

Thanks to his poor shoe-related hygiene, Agent Dunham has now realized that Loeb is a turncoat. She heads to his house to see if she can find anything incriminating, and she does find some suspicious documents, but she also finds his wife. A catfight breaks out that ends with Olivia shooting and killing Loeb’s wife. Meanwhile Charlie asks Peter’s help in setting up a tap on Loeb’s phone. They finish just in time to hear Loeb tell his wife to kill Agent Dunham. Peter calls Dunham to warn her and that’s what sets off the catfight.

In the end, Agent Loeb is captured and when informed his wife has been killed, admits that he murdered the two scientists. When asked about abducting Dunham, he replies that he wasn’t trying to kidnap her, but instead to save her.

Fringe #10

There wasn’t all that much science in this one, but what there was hemorrhoid-inducing bad.

1. No Virus I Ever Met
A gargantuan cold virus? Nonsense. It is physically impossible for viruses to grow that large. There are many reasons for this; for starters, here’s the square cube law.
fringeFurthermore, they kept confusing a virus and a cell, which are two entirely different things. A virus is much smaller than a cell — it just consists of some nucleic acid (DNA or RNA) and a handful of proteins. Because it is not a cell, comparing it to giant cells means nothing.
fringeNasopharyngitis is not the name of a virus, it is the name of a condition: a runny nose and a sore throat, i.e. a cold. Cold viruses are typically rhinoviruses or adenoviruses.
fringeHow could it have grown so big so fast?
fringeThere are certain parasites that protect themselves in hard-walled cysts that breakdown when exposed to stomach acid, allowing the parasite to become active — so that part is not too far fetched.
fringeDecongestants treat the symptoms of the cold (or more accurately the symptoms caused by the body’s reaction to the cold virus). They wouldn’t have any effect on the virus itself.

2. Cover Up the Slide’s Title Next Time
Simian Hemorrhagic Fever is a real disease, but it (like most hemorrhagic fevers) is a viral disease. The slide Walter was looking at was clearly labeled leptospira, a bacteria that causes (wait for it) leptospirosis. The “intricate web” he was talking about was just a bunch of the leptospira bacteria. Look at the picture on Wikipidia, it’s pretty much identical.

Worst Comic Book Medicine of 2008

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

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

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

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

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

Dishonorable Mentions:
Dishonorable MentionHulk’s retina scan.
Dishonorable MentionThe continuing mistaken belief that the speed of thought is faster than the speed of light.
Dishonorable MentionPeter 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”:
Worst Comic Book Medicine of 2007The Worst Comic Book Medicine of 2007
Worst Comic Book Medicine of 2006The Worst Comic Book Medicine of 2006
Worst Comic Book Medicine of 2005The Worst Comic Book Medicine of 2005
Worst Comic Book Medicine of 2004The Worst Comic Book Medicine of 2004

Your Weekend Moment of Psychic Nosebleed Zen: Backlash

scene from Backlash #2

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

nosebleed zenAll previous Psychic Nosebleed Zen posts

Chromosomes, Super-Powers, and Warren Ellis

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

Warning! Science content: Humans have 23 pairs of chromosomes, for a total of 46 chromosomes. We are considered diploid – meaning that we have 2 copies of each chromosome.

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

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

scene from DV8 #8

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

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

ULTIMATE HUMAN #1

scene from Ulitmate Human #1

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

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

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

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

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

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

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

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

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

questionsHow do you get that third set of chromosomes into every cell in the body? Or does it only have to be in certain cells — in which case the Beast got lucky with his tissue sample.
questionsBeast mentions that the mutant gene sits on the 23rd chromosome. Interestingly enough, the 23rd chromosome is the sex-chromosome…so the x-gene must be on the X-chromosome, but is it also on the Y? Are female mutants more powerful?

Your Weekend Moment of Psychic Nosebleed Zen: Scrubs

scene from DV8 #23

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

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

Thanks to Alan S. for bringing this to my attention.

nosebleed zenAll previous Psychic Nosebleed Zen posts

Science Fiction Pioneer … of the Great Moon Hoax

Science Fiction Pioneer! Click for the full page.This somewhat misleadingly titled article is actually about Richard Adams Locke and his role in the Great Moon Hoax of 1835.

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

Click on the image for the full article

For more information, check out:
moon hoaxThe Museum of Hoaxes: The Great Moon Hoax
moon hoaxHistory Buff: The Great Moon Hoax of 1835
moon hoaxWikipedia: The Great Moon Hoax

Fringe – Episode 10: “Safe”

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

Fringe #10

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

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

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

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

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

Fringe #10

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

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

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

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

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

Top Five Literary Swordswomen

To qualify for this list you need to be female sword-slinger whose adventures have appeared primarily as short stories, novellas, and novels. In addition, I’m looking for characters with staying power: there are a number of good female characters who have appeared in a single story, but I want to focus on those who have appeared in a number of books or stories.

1. Del from Jennifer Roberson’s Sword-Dancer series.
2. Morgaine from C.J. Cherryh’s Morgaine Cycle. Maybe a little more science-fantasy then straight fantasy, but she still swings a mean sword.
3. Jirel of Joiry, C.L. Moore’s classic pulp character.

My top three are pretty much written in stone. They may not be everyone’s top three, but they better be in everyone’s list of five. If not, well, you’re wrong and you should come back after you’ve thought things over and admitted your mistake.

Numbers four and five are certainly open for debate, though.

4. Laurana from the Dragonlance Chronicles.
5. Paksenarrion from the Deeds of Paksenarrion novels by Elizabeth Moon. If you ever wondered what a classic AD&D paladin would be like in action, this is the character for you.

Honorary mentions:
Jame (P.C. Hodgell), Kerowyn (Mercedes Lackey), and I’m sure there’s a swordwoman somewhere among Bradley’s Darkover novels.

Fringe – Episode 9: “The Dreamscape”

A clever initial premise spoiled by Dunham’s botching of the investigation. The medicine/science was hit or miss.

Fringe

The Story: Mark Young has just finished delivering a successful presentation at Massive Dynamic and is relaxing in the conference room. He sees a butterfly, but when he tries to get a closer look, it cuts him with its razor-sharp wings. He smashes it, but another appears, and another, and then an entire swarm, all slicing his skin with their wings. Trying to escape from the swarm, Young runs wildly and breaks through the window of the conference room, plunging to his death on the street far below.

Agent Dunham and her team are called in to exam the body. Dr. Bishop notes compound fractures and internal bleeding – consistent with the fall — but also many deep cuts, with many of them under Young’s clothes, so broken glass couldn’t have caused them. Bishop has Young’s body shipped back to his lab for an autopsy, and that’s when he notices that the cuts all seemed to be made from the inside out.

Bufo alvariusAgent Dunham receives a mysterious e-mail from the late Agent Scott, her former partner and lover. It directs her to a basement room in an abandoned building filled with boxes of toads. Bishop recognizes the toads Bufo alvarius, which are known for secreting a hallucinogen. He identifies a concentrated form of this toxin in Young’s body and deduces that he essentially died of fright (well, that and a thirty-story fall) and the cuts were all psychophysiological (i.e. psychosomatic — caused by his own mind).

Dunham decides she needs to access Agent Scott’s memories since he seems to have had a connection to Young. She goes back into the sensory deprivation tank from the first episode and discovers a memory of Scott meeting with Young and two other people. It seems that Young was selling secrets from Massive Dynamic. Young goes off with one man while Scott stabs the other. Agent Dunham is now determined to track down this remaining fourth man. Using some not-so-subtle clues from Young’s date book, she discovers he is George Morales, an infamous smuggler. The team goes on one of their SWAT-lite raids and successfully apprehends Morales. He offers tell Dunham everything he knows in return for protection from Massive Dynamic. He claims that they are behind “The Pattern” and are using it as a cover for their illegal activities. Dunham goes to confront Nina at Massive Dynamic, but while she is there, Morales dies mysteriously, his throat cutting itself open — apparently he was given the same drug as Young and imagined Agent Scott cutting his throat.

Fringe

1. Psychosomaticism
Assuming that I accepted a psychosomatic cause for Young’s cuts (and I don’t — there’s simply no process by which it could work), why would the cuts be from the inside out? It makes no sense. If he were mentally replicating the wounds he was imagining, they would be external, not the other way around.

2. Toad Lickers
The toad Bufo alvarius is found in the southwestern United States. It secretes two hallucinogenic drugs, bufotenin and 5-MeO-DMT, that are effective if inhaled, injected, or ingested. Bufotenin is the more potent of the two. Reports from users indicate it is not a particularly pleasant drug. In terms of fear, high doses have been known to cause extreme anxiety and a sense of impending death. Of course, the higher doses also tend to turn the face of the user a dusky purple color from vascular congestion.

3. Why?
Unrelated, except that the ad was shown during the show. Why in the world are they remaking The Day the Earth Stood Still, one of the true classics of science fiction cinema — and with Keanu Reeves, no less?

4. Micromanaging
All the strange equipment and requisitions for Bishop’s lab, and the only thing her supervisors ever questions is an aquarium and food for toads? What about the cow? The grand piano?

5. Can’t Find Her Way Out of a Paper Bag
I’m losing more respect for Dunham’s supposed keen investigative skills every episode. The clues and answers are all spoon-fed to her. And then, when she finally is on the verge of learning something truly important, she abandons her source and runs over and accuses Massive Dynamic before actually getting the evidence. So not only is the source killed before actually divulging the important information, but she telegraphed everything to Massive Dynamic. Great job, Olivia.

Blood, Microscopes, and Spider-Man

Seventh grade science class was the first time I got to play with microscopes. They were your old beat-up standard issue school microscopes with three lenses (but you could never use the highest power one because it was an oil immersion lens and what school could afford the oil?). We used the microscopes to view a variety of microscopic creatures such as volvox and paramecium. That was all fine and dandy, but I wanted something more — I wanted to see blood. Luckily, I had just had two teeth pulled (thank you, orthodontist), and figured I could get some blood from one of the sockets. Our teacher said I could give it a try, so I took a drop of blood, placed it on a microscope slide, put a cover slip on, slid it under a microscope, took a look — and I saw nothing. No cells, no platelets, nothing. I learned the hard way that looking at blood under a microscope simply isn’t that easy.

The slide needs to be specially prepared first. A blood smear is the easiest way to do this. A smear spreads out the blood in a very thin — nearly two-dimensional layer — so that each individual cell can be seen. Without the smear, there is just a thick pool of blood cells stacked on top of one another that’s all but impossible to interpret.

Once the blood smear is dry, it can be viewed under the microscope. This will give the basic idea of what’s going on, and most cells can be seen, but for a better view — the one we’re used to seeing in movies and television shows — the blood smear needs to be stained. This allows the various blood cells to stand out. Unfortunately, it’s also a labor intensive and time consuming process.

Why do I bring this up? Because of scenes like this, that routinely pop up in comics*:

scene from Ultimate Spider-Man #125

If only it were that easy. I would’ve been a very happy seventh grader.

usm
*And it’s not just comic books, it shows up in television shows and B-movies all the time as well. This issue of Ultimate Spider-Man (#125, Bendis and Immonen) was just the most recent example I ran across.

Fringe – Episode 8: “The Equation”

A surprisingly watchable episode of Fringe, probably the best yet. There were enough strange coincidences and evil psychiatrists to (almost) make me forget the whole nonsense of “The Pattern.”

Fringe

The Story: Ben Stockton, a ten year old musical prodigy, is kidnapped by a mysterious woman after his father is put in a trance by red and green flashing lights. After Agent Dunham picks up the case, Broyles tells her that there have been four previous kidnappings, all experts in one field or another, all by the same mysterious woman, and all four of the victims ended up insane. Dr. Bishop recalls hearing of the red and green lights before, and eventually remembers that it was from another inmate at the asylum where he used to reside. It seems there was a fifth kidnapping that even the FBI was unaware of, and the victim ended up admitted to an asylum for the criminally insane. Walter recalls that the patient was fixated with an equation he couldn’t solve. Peter realizes that when that equation is expressed in musical notation, it is the same mysterious composition Ben had recently become obsessed with.

Agent Dunham figures the best approach is to interview the patient, but the director of the asylum won’t let the patient be interviewed by anyone except Walter Bishop. Reluctantly, Walter agrees to return to the asylum to conduct the interview, but while there he is sedated and held by the guards and director, who then informs Agent Dunham and Peter Bishop that he is retaining custody of Walter for his own safety. The next day, Dunham is able to procure a court order to release Walter, but it is clear the asylum director is up to something. Walter was unable to get much from the other patient except for some mumblings about a red castle. This is enough for Dunham to locate the villain’s lair and rescue Ben, but the mysterious woman is able to escape (though she ultimately meets her demise at the hands of a turncoat accomplice).

Fringe

1. Nothing To See Here
The hypnotism scenes are pure science fiction, but I have no significant medical or scientific complaints other than that. A first for the show.
fringeDoes the red/green flashing cause a hypnogagic trance, or make the patient susceptible to suggestion? The show suggested both.
fringeAgent Dunham should have stormed the castle with a team of red/green color blind agents. That would have caught Ostler unprepared.

2. Music
Walter Bishop transcribed the equation into “9 bars” of music, but it sure seemed like Peter played for longer than that.

3. Psychiatrists
This episode is another good example of Scott’s Third Law of Comic Book Physicians — when a character is introduced as “psychiatrist”, it is shorthand for “they are up to no good.”

Fringe – Episode 7: “In Which We Meet Mr. Jones”

An international thriller, with little thrills, along with bad science, atrocious medicine, and plot holes you could drive a truck through. It must be another episode of Fringe!

Fringe

The Plot:An FBI agent recently back from a mission to Germany falls suddenly ill and is found to have a large parasite of some sort wrapped around his heart. Dr. Bishop gets a tissue sample from scene from Fringe episode 7the parasite, and its DNA sequence suggests it is tied to an organization known as ZFT. This leads Agent Dunham to Germany to quiz a prisoner by the name of David Jones about the parasite. Jones will cooperate, but only if he can talk with his compatriot Joseph Smith back in the U.S. Unfortunately, Mr. Smith was just shot and killed in an FBI raid. This doesn’t deter Dr. Bishop, who hooks the recently deceased Mr. Smith up to one of his machines so that Peter can act as an intermediary and read his brain (with a little help from high voltages of electricity). The plan works and they are able to convince Mr. Jones that he is in contact with Mr. Smith, and he gives the cure for the parasite. Loeb is saved, but surprising no one, except the supposedly very smart characters on the show, seems to be involved in “The Pattern” himself.

Fringe

1. The Heart of the Matter
The emergency department doctors defibrillate Mr. Loeb when he is in asystole. Asystole is the medical term for flatline, and as we all know, you don’t shock a flatline.
fringeLater, when Loeb is in ventricular fibrillation, one shock is tried (along with a dose of epinephrine a few minutes before). When that doesn’t work, the doctor decides to crack Loeb’s chest open and perform open heart massage. That procedure, though dramatic — and it did reveal the parasite — is rarely called for, and certainly not this early in the resuscitation (and not for ventricular fibrillation). The doctor took his own sweet time opening the chest too; it would have been nice if someone had done some chest compressions in the meantime.

2. There’s an Intestinal Parasite in His Chest?
It’s a huge jump from a simple parasite like Giardia to a giant-centipede-looking-plant-like parasite wrapped around the heart, but I guess that’s just Dr. Bishop’s way of thinking.

3. Relax, part 1
When the parasite starts squeezing harder, Peter injects Loeb with some cyclobenzaprine. Cyclobenzaprine is better known as Flexeril and is a skeletal muscle relaxant used for muscle spasms such as whiplash injuries. It doesn’t have an effect on the heart, so I’m assuming Peter was giving it to Loeb assuming it would be absorbed by the parasite and cause it to relax its grip on the heart. That’s quite a jump in logic: that a moderately strong (at best) mammalian muscle relaxant would affect a giant-centipede-looking-plant-like parasite.

4. Relax, Part 2
If I were Peter, I would definitely want a sedative. He recovered remarkably quickly, though.

5. Needle in the Heart
Sticking a syringe full of adrenalin blindly into the heart is a very bad idea because of the risk of injuring a cardiac artery, but I guess that’s just Dr. Bishop’s way of thinking. Or maybe he watched Pulp Fiction too many times at the asylum.

6. The Treatment
Mebendazole — known in the U.S. as Vermox — is an antiparasitic used to treat a variety of worm infestations. A hydrolase is an enzyme catalyst involved in the hydrolysis of a chemical bond. A thermophilic hydrolase is one that is active at high temperatures (such as those found in hot springs). Which seems to have no bearing on this case.

Fringe – Episode 6: “The Cure”

I thought the flow of the action was better on this episode of Fringe, but the medicine and science (and science-fiction clichés) were laughable.

Fringe

The Plot: At night, an unmarked van pulls into a deserted street and people in some sort of containment suits drop off a confused woman named Emily. The woman wanders into a nearby diner and a friendly waiter and cop strike up a conversation with her. She is partially amnestic and claims she was given red and blue medications. Suddenly, everyone in the diner starts screaming in pain and they start bleeding out of their eyes. The young woman tries to escape, but her head explodes.

Agent Dunham and her team are called in to the diner. They discover that Emily had a rare autoimmune disease Bellini’s Lymphocemia and she had been missing for 2 weeks. The FBI also gets information that Claire, another young woman with Bellini’s Lymphocemia, has also gone missing. The team is able to discover that both Emily and Claire were receiving experimental treatment for their disease with capsules of Strontium-90, a radioactive isotope. Walter realized that in Emily, for some reason, all the capsules detonated at once, releasing an incredible microwave beam and essentially cooking everyone in the diner alive.

Agent Dunham discovers that Intrepus, an unethical pharmaceutical company (cliché plot device #37) is involved. Peter Bishop is able to discover the location of their secret lab. The FBI goes in guns blazing with a heavily armed SWAT team (except Agent Dunham, who apparently thinks it’s casual day at the raid) and rescues Clair, just in time, and did I mention that Walter was able to synthesize an antidote?

Fringe

1. Autoimmune Insanity
Bellini Lymphocemia is a fictitious autoimmune disease. First off, lymphocemia is not even a real word, or a medical term, for that matter. It is said to be incurable — but then the vast majority (if not all) autoimmune diseases are — but for some reason, Bellini’s goes into remission with radiation treatment.
acdcStrontium-90 does have various medical uses, including the treatment of some cancers (though it can cause cancers as well).

2. Needs Protection
When doing the autopsy, Walter should be wearing some form of containment suit. As far as he knows at that point, there are high levels of radiation as well as the possibility of an infectious disease.

3. Radiation versus Microwaves
Why would a radioactive isotope release high levels of microwaves? They are at opposite end of the electromagnetic spectrum. And conversely, why would a microwave exposure leave residual radiation?

4. Smells Like Cloves
Methyleugenol is not blue, it’s pale yellow. It is one of the main chemicals involved in the hyacinth scent, but it’s found in many other plants as well. It always smelled like a milder sweeter clove-scent to me.

5. My Eyes Have Seen the Glory
How does exposing people to high levels of microwaves (or high levels of radiation) cause them to bleed out of their eyes? I would expect burns, or if the all the water in their body suddenly boiled, I would expect ruptured eyes or other organs, not just bleeding
None of this explains why Emily’s head exploded though.

6. Self-Contradicting Statement of the Week
Subcutaneous injection marks: she was being given medicine intravenously.”
Emphasis mine. Subcutaneous and intravenous are two different ways of giving medication.

Black Jack, Volume 1 — Medical Annotations (part one)

cover, Black Jack, Volume 1Black Jack is a famous manga character written by Osamu Tezuka. He is a supremely skilled surgeon, though an unlicensed one. Often he is the only surgeon skilled enough — or even willing to — perform a particular lifesaving operation. He will operate on the rich and the poor alike, and lives by his own code of ethics.

Tezuka was a medical school graduate and did his best to add medical accuracy to his stories, though he never let that stand in the way of a good plot — you’ll notice that many of the stories contain implausible fantasy or science-fiction elements. The stories were published over a ten-year period, from 1973-1983, so it’s also important to remember that they were written 20-30 years ago and medicine has come a long way in that period of time. There is sometimes a difference in the approach to certain patients and conditions between Western and Eastern medicine, and that occasionally shows up in the stories as well.

Vertical has recently started releasing a very nice collection of Black Jack stories. These volumes present the stories chronologically as they occur in Black Jack’s life. (This is different than the order in which the stories were originally published). My copy of Black Jack: Volume 1 is the limited edition hardbound and the pages references below match that edition. Hopefully, the pages numbers are the same in the softcover edition as well.

In my annotations below, I’ve added the year the story was first published. Consider this a strong Spoiler Warning as well. Click “Read More” to read the rest of the post.

Spoiler Warning!

Read more…

Fringe – Episode 5: “Power Hungry”

A step backwards for Fringe this week with bad science and a cliched storyline familiar to anyone who reads comics (plot #124: character has electrical powers and unwittingly fries nearby electrical equipment).

Fringe

scene from Fringe episode #5The Plot: Joseph Meegar has been the unwitting victim of an experiment by an evil scientist that has turned him into an electrical generator. It’s not a power he can control — electronic equipment breaks when he his near, especially when he is upset. When he accidentally causes an elevator accident that kills 8 people, then mangles his boss, and then kills his mother, he decides to go on the run. Unfortunately, the evil scientist has caught up with him and kidnaps him. Luckily, Dr. Bishop is on the case and trains some carrier pigeons to track Joseph’s unique electromagnetic signature so that Olivia and the rest of the team can rescue him and arrest the evil scientist.

Fringe

Electrical power and electricity are not areas I know a tremendous deal about, but even I could tell the science was fishy.

1. I Have the Power
That’s a rather selective power Joseph has. It fries the clock on his bed stand, but not the digital thermometer next to it? It fries his scanner and electronic pad at work, yet his Walkman continues to work?
acdcIs Joe generating DC or AC? It would affect how his power would kill people and affect his mother’s pacemaker.

2. Tape It
I’m a child of the ’80s, and the original Walkman generation, and I can confidently tell you that a magnetic field does not permanently alter a cassette tape. The neat thing is you can record over things.

On to more biology and physics concerns:

3. What is the Source?
What is the biological source of his electricity? Generating enough electricity to levitate (let alone start parked cars and trucks) takes an incredibly amount of juice that needs to come from somewhere. And unless the efficiency is near perfect, he’s going to be generating a lot of heat as well.

4. A Weighty Problem
How can sensors determine the weight of the people aboard an elevator when it’’s in free fall?
levitatingJoe may have been “electrodynamically levitating”, but if so, he was just levitiating in relation to the frame of the elevator, not the outside world (or he would have hit his head against the ceiling). So even if he were levitating, he still would have borne the brunt of the crash.

5. Stop Motion
I liked the way the Astrid and the GPS said the birds had stopped, yet they were clearly still flying.
levitatingAre those poor birds going to be flying in circles for the rest of their life, or did Dr. Bishop reset their beaks?
levitatingI’ll grant you that Tesla coils look impressive, but I wouldn’t think they’re particularly good at imparting magnetic charges.

6. Matters of the Heart
Assuming the heart hadn’t already started to break down and decompose (with that “thermoelectric trauma” — a term that doesn’t show up in any medical literature search), how would a “residual electrical charge” cause it to beat normally when removed from the body? The heart’s electrical system doesn’t work like that; it requires specifically directed electrical stimulation, not an unexplained uniform “charge.”

Eleventh Hour – Episode One “Resurrection”

Dr Hood and RachelEleventh Hour is yet another science/action/mystery show. This one is about the overly brilliant Dr. Jason Hood, biophysicist and “Special Science Advisor” to the FBI, along with Rachel, the attractive yet hard-as-nails FBI agent who accompanies him. Cloning is the subject of the first episode, as Jacob and Rachel hunt the mysterious Gepetto, a scientist who is trying to clone humans using innocent women as surrogate mothers.

The science is definitely better than Fringe, though the characters aren’t as interesting. The plot was compelling, despite a few plot holes (such as…how stupid is the surrogate mother not to realize something isn’t kosher? Or does she really think it is normal to have an obstetrical examination in an abandoned warehouse?)

If you missed it Thursday night, you can still catch it on the CBS website for the show.

1. Cloning
As Science not Fiction points out in their review, the science is reasonable, and the explanation of cloning given is fairly straight-forward and easy to understand. It’s easily the best depiction of cloning in a television show that I can recall.
Eleventh HourFor the record, the worst I can remember are the clone storylines in The Flash (Episode 18: Twin Streaks) and the live action The Amazing Spider-Man from the ’70s (Episode 5: Night of the Clones).
Eleventh HourWhy are the police running a DNA lab in a tent in the forest? It’s a delicate procedure and that’s just asking for contamination. (”The DNA appears to be half human and half oak. So let’s get the team out there looking for an Ent!”)

2. Placenta Previa
When the placenta covers the internal os (the opening between the uterus and birth canal), it is known as placenta previa. The condition is graded by how much of the os is covered. In Grade III placenta previa (mentioned on the show) — which is also known as partial placenta previa — the os is partially covered by the placenta. As you can imagine, this makes it a challenge to give birth vaginally. C-sections are the recommended delivery method in this situation*.

The classic symptom of placenta previa is painless vaginal bleeding during pregnancy, which is not what was shown on the show. Painful vaginal bleeding is more indicative of a placental abruption (when the placenta pulls away from the wall of the uterus), a much more dangerous condition**.

3. CPR
While I applaud the show for resisting the temptation to defibrillate a flatline, that has to be one of the worst examples of Hollywood CPR ever.

Television and movie CPR is almost always done incorrectly, with bent elbows instead of straight arms — but there’s a good reason for this because you don’t want to injure the actor portraying the victim. This scene was worse than that, with nearly everything done wrong, such as — in addition to the bent elbows — improperly placed hands, a patient who was up too high for good CPR, and too rapid a pace. In the end, to show he was really trying hard, Dr. Hood increased the speed of his compressions even more — but this is the worst thing he could have done. You have to give the heart time to fill with blood between compressions; faster compression means the heart doesn’t have time to fill, and the resulting CPR is worse, not better***.

CPR scene from Eleventh Hour

Notes:
*Bear in mind that a placenta previa is fairly common in early pregnancy, and will usually shift away from the os as the uterus grows during pregnancy. So, delivery-wise, placenta previa is only a concern when it occurs late in pregnancy.

**Admittedly, placenta previa can sometimes stimulate premature contractions, which can be quite painful, but that doesn’t seem to be what was shown here.

***Though they saved the patient in this situation, it would not have worked like this in real life. She had flatlined because she had hemorrhaged and lost a tremendous amount of blood. Until that blood loss is corrected, it’s going to be impossible to get her heart restarted (especially with bad CPR).
Eleventh HourSpeaking of blood, why would there still be blood in a closed-down clinic?

Fringe – Episode 4: “The Arrival”

A strongly mediocre episode of Fringe. At least the science and medicine wasn’t too bad this time around.

And Peter’s whining is really starting to get on my nerves.

Fringe

The Plot: An explosion at a construction site occurs in Manhattan. The public is told that it was a gas main explosion, but that’s only part of the story. A 2 foot long metal egg-shaped cylinder was found in the rubble and it had apparently tunneled up to the surface from underground at high speeds and hit a gas main, causing the explosion.

Dunham and her team are called in. The object is moved to a warehouse command center, but Walter has it moved to his lab at Harvard. This turns out to be a good thing, because a thug wielding a futuristic weapon attacks the warehouse looking for the egg. Back at his lab, Walter wonders if the egg might be related to Project Thor, a plan he once worked on that featured an underground torpedo. When he and Peter hear about the warehouse attack, Walter decides to hide the egg. He sends Peter off on an errand, then sedates Astrid. He grabs the egg and flees.

Walter is eventually found hours later and tells Agent Dunham that he hid the egg, but doesn’t remember well. Meanwhile, the thug is still trying to find the egg. He abducts one of Dunham’s contacts and uses a through-the-nose mind reading machine on him. Later, he abducts Peter Bishop, uses the same machine on him, and discovers the location of the egg’s hiding place — even though Peter isn’t aware that he knows it. Dunham tracks Peter and the thug to the graveyard where the egg was hidden and guns down the thug during a chase. The egg burrows into the ground and disappears. Peter confronts a strange bald man who seems to be linked to the Pattern and has been observing events for years. He ends up on the losing side of this fight as well.

Fringe

Not much to comment on science- and medicine-wise (except for the obviously ridiculous mind reading and “learning by osmosis” ideas). The rest is just nit-picks:

1. The Arrival
Sadly not related to the Charlie Sheen B-movie sci-fi flick The Arrival.
ron silverWhich incidentally stars Ron Silver — who I have been reliably informed is actually a deadly assassin working for NASA. I expect this fact to show up in Fringe sooner or later.

2. Project Thor
Was the egg part of Project Thor or not?

3. Iridium
Iridium is a logical choice for a torpedo that travels through the earth as it is one of the most heat resistant metals known.
progeriaSolid Iridium is a yellowish-platinum color though, not indigo.
progeriaAstrid should have seen what was coming. Iridium is the second densest element, how was a tiny syringe going to penetrate it?

4. Mind Reading, take two
Enough with the mind-reading already — although the thug’s model appears to be an upgrade as it conveniently converts thoughts into sounds (though only mono). And uses an oscilloscope.

5. Osmosis Jones
Learning through osmosis and proximity? Nonesense. If that actually worked I would have aced every test in college and med school, and though it pains me to reveal this, I did not.
progeriaReminds me a little too much of the discredited Hundredth Monkey Phenomenon.

6. The Observer
A bald guy who observes. Where have I seen that before?

The Watcher, the orginal bald observer

House — Episode 3 (Season 5): “Adverse Events”

A fairly ho hum episode of House, with far too many red herrings and not enough real medicine.

Spoiler Alert!!

Brandon is, at best, a mildly successful artist. At the beginning of the episode, he is painting a portrait of a woman, but when the woman and her husband take a look at the finished product, they are shocked because the subject in the painting is horribly distorted. Even stranger is the fact that Brandon cannot tell that anything is wrong; the portrait looks completely normal to him.

Brandon is admitted to the hospital for evaluation of his acute onset visual agnosia. The initial differential diagnosis include stroke, brain tumor, drugs, or environmental toxins. An initial MRI was negative, but House wants an MRI with contrast. He also sends Taub and Kutner to search Brandon’s apartment for toxins. The search turns up nothing suspicious and the MRI is negative.

Toxins and drugs remain on the differential diagnosis, but a cavernous angioma of the brain (large, abnormally dilated blood vessels in the brain) has been added as well. When Brandon shows little emotion when told he requires a risky surgical biopsy, House deduces that he is hiding something. It turns out that he has had to make ends meet by enrolling in clinical trials of new drugs. He is currently a participant in three separate drug trials. House assures him that his symptoms were due to the experimental drugs, and since they should be out of his system by now, he’ll be discharged in the morning.

As usual, being discharged from Princeton Plainsboro is a sign of problems to come, and Brandon has a sudden seizure. By now, the team has discovered what drugs Brandon was being given: an anticoagulant, an autoimmune drug, and a statin (a cholesterol medication). They suspect the interaction of all three drugs is causing his symptoms and House elects to give him dialysis to clean all the drugs out of his system. It seems to work at first, but then Brandon develops massive swelling of the tissues of the head and neck occluding his airway. Foreman performs an emergency tracheotomy and Brandon is started on steroids. The differential now includes a thrombosis, Chagas disease (both of which would block the venous drainage, causing swelling), infection, or cytokine storm, with the team favoring the latter. House and the team are unsure whether the cytokine storm is a withdrawal symptom from the experimental drugs, or a new symptom entirely. To solve the puzzle, House elects to put Brandon back on all three drugs, and then wean them off slower this time.

Once again, withdrawing the drugs seems to work at first, but then it becomes obvious that Brandon’s libido has been put in overdrive. A punch to the nose from Dr. Thirteen solves that problem, at least temporarily, but it is a new symptom to consider. Kluver-Bucy Syndrome (a condition caused by damage to both temporal lobes of the brain) is suspected, and an MR Angiogram is obtained to get a closer look at the blood vessels. It shows some narrowing of the vessels of the Circle of Willis (the main arteries supplying the brain). That should not be enough to cause symptoms, but Taub suspects there may an underlying cardiac arrhythmia that worsens them. An EP study (electrophysiology study — it looks for abnormal conduction in the heart) is ordered, and is decidedly positive. During the test, Brandon goes into ventricular tachycardia and needs to be defibrillated. At this point, House notices that Brandon’s hair is turning red around the temples.

Kluver-Bucy is abandoned and Waardenburg Syndrome is suggested, but when Kutner notices a prolonged QT on the EKG (a potentially dangerous heart rhythm), the suspicion shifts to Romano-Ward Syndrome (a common inherited form of Long QT Syndrome). A cardiac sympathectomy (a surgery that reduces the effect of the sympathetic nervous system on the heart) is ordered. When Brandon once again develops visual agnosia, Taub begins suspects the symptoms may be due to lingering toxins, and seeks out Brandon’s old paintings. The paintings show the same distortion every other month — the same time he was on all three experimental medications together. It turns out that in a previous research project, Brandon had been on an experimental antacid which allowed the formation of a bezoar in his stomach. This bezoar trapped many of the experimental pills and has slowly been releasing them, causing Brandon’s symptoms even though he has not been taking any new medications (which means the team had it right halfway through, it was the combination of the experimental drugs, and the last half of the episode was spent chasing one red herring after another. After all, who can argue against the symptoms of “experimental drug reaction”?) The bezoar is removed surgically and Brandon should be good as new.

headline

Major complaints are in red, minor in blue, nit-picking in green:

big mistakeRomano-Ward is NOT caused by five separate gene mutations. It is caused by a mutation in any ONE of five (actually six) particular genes.

mistakeThat’s a weird type of agnosia Brandon is experiencing, if it’s agnosia at all. He seems to recognize people and things (at least initially), but can’t paint them – which makes it more of an expressive aphasia than an agnosia. Later on in the show, it shifts entirely and he now can’t recognize people he should, which is a type of agnosia.

mistakeNone of the neurological syndromes or conditions the team mentioned fit the pattern, but again, why have a logical pattern when it can all be explained away with “experimental drug reactions.”

mistakeThe standard treatment for prolonged QT interval (including Romano-Ward) are beta-blockers or an ICD, treatments that Brandon can’t have, with no good explanation given as to why.
nitpickA sympathectomy is a legitimate treatment for prolonged QT syndrome if the beta-blockers and ICD fail

mistakeWhy is Taub, a plastic surgeon, running an EP study? It requires not just a cardiologist, but a specially trained cardiologist.
nitpickBut he’s better than Kutner. Shocking v-tach at 60 and then 120? Wrong.

nit-pickMost phytobezoars can be non-surgically removed (91% by a recent study).

nit-pickWith swelling of the mouth and pharynx, a standard intubation is difficult, so a tracheotomy makes more sense this week. The procedure was surprisingly smooth for a patient that swollen (no landmarks) and for a doctor who doesn’t do them regularly.

nit-pickOnce again, no eye protection during surgery.

House - 5- 1

The medical mystery was moderately interesting, though annoyingly inconsistent, so earns a B-. The bezoar was clever, but the final solution relied too much on mysterious experimental drugs and their interactions rather than actual potentially-interesting medicine, so only earns a C-. Most of the medicine was flawed, and the rest “experimental”, but it was still better than last week so earns a D+. The soap opera was better. The Taub part was good, House’s names for the experimental medications were fun, but I didn-t buy any of the Cuddy/PI/House interactions. I give the soap opera a C+.

previous House reviewsLast week’s House review
previous House reviewsA list of all prior House reviews

Fringe – Episode 3: “The Ghost Network”

This episode of Fringe, at least from the science and medicine point of view, was an improvement over the first two. Sure, it was still rubbish, but the cringe factor was less.

Fringe

The Plot: A man boards a bus in Washington D.C. and makes eye contact with another passenger. When she puts the backpack she was carrying down on the ground, the man dons a gas mask and opens a capsule of mysterious gas. In the resulting confusion, he grabs the backpack and escapes the bus. After he leaves, the gas on the bus becomes a solid gel, completely filling the bus, suffocating and trapping everyone inside. Called to the scene, Dr. Bishop identifies the gel as a aerosolized silicon base that polymerized with the nitrogen in the air, and is able to recreate it in the lab.

scene from Fringe, Episode 3Meanwhile, a mild mannered office worker named Roy McComb has been having Pattern-related visions for the better part of the past year. Dr. Bishop suspects that Roy is psychic. He ties it all in to an old project of his, the Ghost Network, which uses wavelengths “lying outside the range those already discovered” to transmit secret information. It turns out that Roy was one of Bishop’s experimental subjects twenty years before when he was trying to use “iridium-based organometallic compounds” to create a living receiver for the Ghost Network. Somehow, in the intervening years, those metallic compounds have multiplied and collected in Roy’s visual cortex (the part of the brain that translates visual input). Thus, when someone uses the Ghost Network, it gives him visions. Bishop wants to move the metallic compounds from the visual cortex to the auditory cortex so Roy can hear what is being said on the Network rather than see it in visions. Agent Dunham uses the information obtained through Roy’s abilities to capture (or at least attempt to capture) the people responsible for the bus attack. In the scuffle, she is able to recover the strange object they were after.

Fringe

1. The Jell-O Bus
Is that small an amount of silicon gas really going to fill the entire bus up with gel? No, not even if it combines with nitrogen. Sure, nitrogen makes up 75% of the air on the bus, but those molecules are spread out because it’s in gaseous form. If they did condense into solid form, the nitrogen molecules would take up dramatically less space because solids are much more condensed than gases. Even if you throw in the amount of silicon gas in that canister, there still wouldn’t be enough mass to fill the entire bus with gel.

2. Dr. Bishop, Pharmacist
Dr. Bishop takes his own homemade concoction of dextromethorphan, Klonopin, and fluoxetine.
progeriaDextromethrophan is synthetic narcotic used as an over the counter cough suppressant (it is the “DM” in Robitussin DM), and can be hallucinogenic at high doses.
progeriaKlonopin (clonazepam) is an anti-anxiety agent and sedative. IT is a benzodiazepine, the same class as Valium.
progeriaFluoxetine is the generic name for Prozac, an anti-depressant/anti-anxiety medication.
progeriaNone of these are psychotics (or even anti-psychotics) as Peter suggests.

3. Ghosts or Visions
For the sake of argument, let’s say the iridium compounds in Roy’s brain did react to the Ghost Network. That still doesn’t explain why his brain would interpret the signals as exact visions or the exact words. It would more likely result in random auditory or visual hallucinations, or possibly a seizure.

4. Magnets
Wouldn’t the MRI, an extremely powerful magnet, already have shifted the metallic elements out of Roy’s visual cortex.? If Dr. Bishop’s little homemade magnetic machine can, then certainly the much stronger MRI would have.

5. Cleanliness is next to Godliness
If a mad scientist ever drills in my brain, I would hope that — unlike Dr Bishop — he (or she) would at least use sterile technique.

Comic Book Transfusion: Alfred and the Joker

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).

scene from The Brave and the Bold #141batmanscene from The Brave and the Bold #141scene from The Brave and the Bold #141

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 transfusionsOther Comic Book Transfusions

Fringe – Episode 2: “The Same Old Story”

What will probably become my standard Fringe disclaimer: I am perfectly willing to accept “fiction” as part of my science fiction, but I do have a problem when the science [sic] violates many of the basic tenets of biology, chemistry, and physics without any explanation — not even any good technobabble. And Spoiler Warning.

I found the first episode more enjoyable — this one struck me as overly clichéd with the cold case serial killer and the all too common science fiction plots (the rapid aging, the quick pregnancy, the victim’s last vision).

Fringe #2

The Plot: A woman is dropped off at a hospital, clearly in an advanced state of pregnancy, yet she claims she’s not pregnant. From what the viewer has seen, she apparently proceeded through nine months of pregnancy is a matter of minutes. She dies during labor and an emergency c-section is performed to save the child. The child lives for only a matter of hours, rapidly aging, and dies a withered old man.

Agent Dunham is able to tie this case into one of her older cold cases, a serial killer who removed the pituitary glands of his female victims. It also seems to tie into some of Dr. Bishop previous research, where he was trying to develop a perfect soldier — someone who aged from birth to 21 years in just three actual years. He casually mentions that stopping the accelerated aging was the problem. Bishop hypothesizes that the killer is one of these experiments, and uses the pituitary glands of his victims to stave off his rapid aging. Another victim is found, and Dr Bishop is able to use a fancy machine from Massive Dynamics to recreate some of the last visions she saw. Using these clues, Dunham and Peter Bishop are able to stop the serial killer — who dies of old age before Dunham’s eyes — and rescue his final victim

Fringe #2

Given that Fringe is science fiction, (and thus far, not particularly original science fiction) I am willing to accept that — due to genetic manipulation — the killer rapidly ages. For the sake of argument, I will also accept that quaffing a handful of pituitary glands (of comely young women of questionable morals) every couple of years will stop this rapid aging.

But even accepting those, several items caught my eye:

1. The Pregnancy, Birth, and Child
Pregnancy is a joint relationship between mother and fetus — just because the fetal aspect has accelerated growth doesn’t mean the maternal aspect will be able to keep up. A miscarriage would seem to be the most likely outcome.
progeriaWhat type of c-section was that? Emergency c-sections are performed vertically along the abdomen as it’s the fastest way and scarring (and uterine rupture in subsequent pregnancies) is not an issue.
progeriaThere has to be some conservation of mass. Where did the child get all the protein and other building blocks necessary to grow that fast? He would have to have been eating a tremendous amount from the minute he was born.
progeriaFunny how his entire body seemed to age — except the umbilical cord.

2. Neuromuscular blockade
Neuromuscular blocking agents paralyze skeletal muscles. Higher doses may paralyze the diaphragm and lead to respiratory paralysis and side effects are known to occur. These drugs have no effect on cranial nerves and would not in any way “freeze” the victim’s optic nerve. This woman has been dead for hours; there’s no electrical activity in those nerves left to speak of.
progeriaApparently her eyes have no extraocular muscles.
nmbWhy the bridge? It wasn’t the last thing she saw — that would be the killer and his “father” — nor was it the last thing she saw when she was injected with the medication — that would be the killer.

3. Defibrillation
You don’t shock a flatline. It doesn’t work, and may make things worse.
defibrillationIn a situation like this: 1) stop the anesthetic — it’s short acting, that’s why it has to continually run during the procedure. 2) provide CPR until the drug wears off.

Fringe

Promotional poster for FringeI’ve had several people ask me what I thought of FOX’s new show Fringe.
FringeI liked it. It was an enjoyable action procedure with some potentially interesting characters. The science was questionable — fringe at best, pseudoscience at worst — but that’s pretty much as advertised.
PaceyI’ll certainly keep watching for few more weeks, at least long enough to see if they give Pacey Peter Bishop any actual personality.

Fringe

The Plot:FBI Agent Olivia Dunham is part of a team evaluating a fatal outbreak of an unknown disease aboard a plane bound for Logan International Airport. While following up a seemingly minor lead, Dunham and her partner/lover Agent Scott manage to stumble upon the prime suspect and his secret lab. They give chase, but the suspect triggers an explosion that knocks Dunham unconscious and exposes her partner to mysterious chemicals which affect him in a similar way to the mysterious plane contagion. Doctors are at a loss and Agent Scott is placed in a medically induced coma.

Searching the internet for answers, Dunham discovers the work of a Dr. Walter Bishop, a schizotypal genius scientist who has been confined to an insane asylum for the past 17 years. She tricks his equally genius (but much more sociable) son Peter into helping her get Dr Bishop released from the asylum and working to find a cure for Agent Scott. Through a combination of legwork, questionable science, and chutzpah the team succeeds and is able to cure Agent Scott — but even more questions are uncovered.

Fringe

Thoughts, good and bad, about the science/medicine:

1. The Contagion
The writers are quite vague — intentionally, I’m sure — about the nature of the “contagion” aboard the plane. It is strongly suggested that it is an infectious agent. If so, that was an incredibly fast spread of the disease. From one person infected to an entire planeload in just a handful of minutes. So the agent not only has to infect and affect a person in mere minutes, but is able to get far enough along in it’s life cycle to allow that person to become virulently contagious in the same period of time. That’s unnaturally — and I’d wager impossibly — fast.
LeprosyLater, it’s suggested by Dr Bishop that it may be a “leprotic contagion.” (i.e. leprosy based). I guess (shrug). Leprosy really looks nothing like that, is a very slow infection, and is not particularly contagious.

2. The Cow
Why use a cow as a test subject? Peter Bishop says, “genetically, humans and cows are only separated by a couple lines of DNA.” That’s certainly true, but following that logic, why not choose something with even an closer DNA match to humans, like primates (monkeys and apes)? In fact, cows are rarely used for medical testing. Monkeys are used frequently, but so are mice and rats, which have an immune system and pharmacokinetics surprisingly similar to humans.
The CowNot to mention you’ll need more than one test subject.

3. Synaptic Transfer
The whole concept of Synaptic Transfer is just plain silly. Brains do have an electrical field, but different parts of the brain have different electrical patterns – that’s why an EEG has more than one lead. Synchronizing the overall electrical pattern of two brains will not allow them to communicate or share thoughts. Medically, I’d be worried that the person who was having their brain waves “adjusted” to match the other person’s would suffer as seizure, as that’s what unwanted electrical activity in the brain tends to cause.

4. Drugs
Doctor Bishop wants to give Ketamine, Neurontin, and LSD to Dunham before placing her in the sensory deprivation tank. His choice of drugs makes a fair amount of sense.
KetamineKetamine is a dissociative anesthetic — it makes a user feel as if they are outside their own body. It is used primarily as a veterinary anesthetic, but is also infamous as a date rape drug.
NeurontinNeurontin (gabapentin) is a drug that was originally developed as a medication to prevent seizures in epileptics. It has also proven to be useful for treating neuropathic (nerve) pain and chronic pain. Of note, it is a relatively recent drug and had not yet received FDA approval when Dr Bishop last conducted his experiments — though it had been known for some years before that.
LSDLSD (Lysergic acid diethylamide) is a fairly well-known and infamous psychedelic hallucinogen.

5. Stored Blood
Color me skeptical that FBI agents keep blood stored in case they are wounded in the line of duty. Stored blood has a limited shelf life, so they’d have to keep donating more every few months. They would also need to donate multiple units of blood because serious injuries take more than just a single unit.

6. Technobabble
“The active toxin was a magnesium based ethylene glycol…with an organophosphate trig-”
“Calcium gluconate in a thiamine base”

Fringe is on FOX on Tuesdays, after House. The pilot episode is being shown again this Sunday night, or it can be viewed online at FOX’s Fringe site.

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Detective Comics #848: A Medical Review

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.

Spoiler Warning!  Spoiler Warning!

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.

They've Stolen Catwoman's Heart

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.

scene from Detective Comics #848

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.

  • Keeping the chest cavity open is an infection waiting to happen. Selina may be missing her heart, but her lungs and other important structures are still there. She needs to have the chest cavity closed tight with some sort of sterile bandage and needs to be on high dose antibiotics.
  • The blood/fluid should be flowing in and out through various arterial and venous cannulas, not the chest cavity itself.
  • There are multiple units of blood hanging, but she has no IVs to deliver them. If she’s on a heart-ling machine, the blood should be going into the machine, not her. In fact, at least one of the blood units isn’t connected to anything.
  • As noted above, she has no IVs, so how is she being kept sedated?
  • Why is there so much air mixed in with the blood? It should be a closed system – all fluid; no air. As it’s depicted, they’re just asking for a huge air embolism.
  • A little sterility and universal precautions would be a good idea Batman. You just got done fighting and rolling around on a cave floor — you’re covered with guano and who knows what else. Just watch Selina survive the heart-napping just to die of a bat-related infection.

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.

Another Look at Lois’s Injuries (Superman Beyond #1)

scene from Superman Beyond #1Superman Beyond #1
Grant Morrison, writer
Doug Mahnke, penciler

This comic issues a clarification, of sorts, from Clark’s previous statement:

Final Crisis #3: My heat vision’s the only thing keeping her heart beating.

Superman Beyond #1: My infrared massage is all that’s keeping her heat alive after the shrapnel was removed.

I’m not sure the clarification actually makes things any clearer. How does one massage the heart with heat vision? (I have this vision of Lois in a towel, the lights down low, Barry White on the stereo, and Clark whispering, “Let me massage that for you Lois, with my heat vision…”) Is Clark suggesting he’s been using his heat vision on Lois ever since surgery? And can infrared light even penetrate to the heart without damaging the tissues above it?

I suspect that Grant Morrison is referring in his own oblique way to photobiomodulation, the use of specific light wavelengths to help the body with healing, but at this point it’s an emerging science and has no known cardiac uses. Plus, as I mentioned above, the heart is well inside the chest cavity, how can the infrared affect it without cooking everything else around it?

Hearts damaged by shrapnel seem to be a surprising frequent comic book injury — my recommendation for Clark would be to consult Tony Stark.

heart

scene from Superman Beyond #1

If Lois has a tracheostomy, why does she need a face mask?

Important Announcement

Brother VoodooAn important announcement from the Brother Voodoo campaign headquarters:

“While I am flattered by the offer from Senator Obama to be his running mate, I cannot in good conscience accept the position. I feel that the best way for me to help this country that I love is to give it the leadership it needs: the leadership of President Brother Voodoo.”

Brother Voodoo for President in 2008

 

The sadly unsuccessful Brother Voodoo for President 2004 campaign

Psychoanalysis #4 (EC, 1955)

Flashback Week 2008

After gaining infamy for its lurid horror comics, EC Comics tried to rehabilitate its image by releasing its “New Direction” of wholesome comics. These included titles such as Valor, Aces High, and Impact as well as the medical comics M.D. and Psychoanalysis. As the name suggests, in Psychoanalysis the reader follows an unnamed pipe-smoking psychiatrist as he attempts to analyze and cure his patients.

PsychocnalysisPrevious “analysis” of Psychoanalysis issues one, two, and three

For his first appointment, the psychiatrist sees Freddy Carter. Freddy is a fifteen year old who was initially brought for counseling after being caught stealing. The doctor deduced that the theft, along with Freddy’s asthma and poor grades, are really just desperate cries for attention. His parents are constantly sparring with each other — figuratively at least — with Freddy as the battleground.

cover, Psychoanalysis #4The subject of this particular session is Freddy’s recent report card. Freddy is failing math and science — the classes important to his father — but doing well in English and history — classes important to his mother. In retaliation, Freddy’s father has grounded him and cut off his allowance. In addition, he has stopped giving any money to his wife other than for groceries, and he fired the maid. After talking with Freddy for several minutes, the doctor goes out to talk to Freddy’s parents who are upset that Freddy isn’t cured yet. The doctor points out that as long as the two of them are fighting, Freddy will never be cured because they each desire a different outcome. The doctor convinces the two of them that they each need psychiatric counseling for the good of their marriage and for Freddy’s sake. They both agree, and the doctor trades a single paying patient for two.

The last portion of the comic shows two sessions with Mark Stone, an unhappy screen writer. Mark has many difficulties, including problems with women, resentment towards his own success, and longstanding issues with his parents. This time, he is angry the psychiatrist because feels that he has become overly dependent on him. The doctor is able to get Mark to calm down, and then has him describe a recent dream. After hearing the dream, the doctor tells Mark that he is not mad at him, the psychiatrist, per se, but instead angry at authority figures in general — which goes back to his anger towards his father. The doctor is also able to deduce that Mark has a deep-seated fear of being abandoned, which brings out his feelings towards his mother. This has come to the surface because of the doctor’s upcoming vacation.

At a later session, Mark has once again started to experience the severe panic attacks and anxiety symptoms that brought him to the doctor in the first place. They started just a few days after Mark and the psychiatrist agreed that Mark had made remarkable progress and could cut back on his sessions. It doesn’t take a genius — or a board certified psychiatrist — to realize that this is nothing more than a subconscious reaction on Mark’s part. He is uncomfortable with the idea of cutting back on the counseling, so he recreates the symptoms that necessitated the visits in the first place. The psychiatrist is able to get Mark to realize the root of the problem, and once again Mark agrees that he doesn’t need many more sessions. This is probably a good thing as this was the final issue of Psychoanalysis.

Flashback WeeksPrevious Flashback Weeks

Batman #677: A Medical Review

cover, Batman #677Batman #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:

“If your gargoyle henchman did his work correctly, M’sieur Le Bossu, the Librium on the blade will make Batman more susceptible to the induction trigger phase I planted all those years ago.”

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?

LibriumIs it the benzodiazepine he is most familiar with? Or maybe the only one he is familiar with?
Librium was developed in the late 1950s, coincidentally (I’m sure) the same time Batman #113 (featuring “Batman: The Superman of Planet-X“) was published – a story which seems to be playing a large role in the Batman R.I.P. storyline (for instance, it introduced the planet Zurr-En-Arrh and the Bat-Radia). Diazepam (Valium), the second benzodiazepine, didn’t emerge until 1963.
LibriumDoes the long half-life of Librium offer some advantage to his plan?
LibriumOr I may be reading too much into a throwaway line — it certainly wouldn’t be the first time — but Librium seems such a odd choice, and to refer to it by brand name, that it caught my eye.

Otorrhagia

Otorrhagia — bleeding from the ear canal — seems to be a recurrent theme in recent comics. It’s been showing up for at least twenty years, but it seems to have become more common lately.

Otorrhagia is not a very common symptom; I see maybe one or two cases a year (and most of those are self-inflicted Q-tip-related trauma). There are a variety of causes, including (in no particular order): basal skull fracture, trauma to the ear canal, tumors of the auditory canal, certain aneurysms, infections of the ear canal, and ruptured ear drums (especially from barotrauma – i.e. pressure).

For a little historical color, check out the entry on Otorrhagia from The Practice of Medicine (6th ed.), a medical guide published in 1869.

Comic books add several more causes of otorrhagia:
1. Psychic attack
Not as common as the psychic nosebleed, which it usually accompanies. Here is a classic example of the psychic ear bleed, from the X-Men graphic novel God Loves Man Kills.

2. Sonic bombardment
Another common cause of comic book otorrhagia.
This example is from Cyborg #2

scene from God Loves, Man Kills scene from DC Special - Cyborg #2

3. Extreme Vertigo.
Poor Invincible, not only does he have so dizzy he can’t think straight, but his ears are bleeding. It turns out the vertigo is caused by an implant in his ear, so that could be the cause of the bleeding (but if that’s the case then the surgeon who put it in should lose his license for sloppiness). Neither can explain the nosebleed he gets a few panels later though.

4. Possession/Reincarnation by a New God.
I’m not sure what the proper term is in this case, but whatever it is, Turpin’s ear is bleeding pretty heavily (from Final Crisis #2).

scene from Invincible #50 scene from Final Crisis #2
Even though it’s not from a comic book, I would be remiss not to mention what must be the most infamous cause of otorrhagia in all of science fiction/comics/fantasy: the Ceti eel from Star Trek II: The Wrath of Khan. That little beastie probably caused more kid’s nightmares than any other science fiction monster. Damn you Khan!

Sometimes, the “Science” Makes My Head Hurt

scene from Ultimate Origins #1
Scene from Ultimate Origins #1. Script by Brian Michael Bendis, art by Butch Guice

The scientist in this scene — and Bendis, by extension — have just enough knowledge of biology to get almost everything painfully wrong. Let me just hit the highlights — feel free to chime in with your own thoughts (the full scene can be found here).

1. Genomes and genes are two different things; they are not interchangeable terms. A genome is a set of an organism’s genetic material. A gene is a sequence of DNA that codes for a particular protein or product.

Nit pick #1: A human genome is made up of 23 chromosomes*. That slide has way more than 23 chromosomes.
Nit Pick #2: What is going on with the “mutant” slide? It’s has triple the number of chromosomes, and they’re all changed in shape. That would take more than just a single mutated gene (unless the mutant gene codes for an abnormal chromosome structural protein). Are mutants polyploid (extra sets of chromosomes)? Because the Ultimate Hulk is, at least according to Warren Ellis’s Ultimate Human.

2. Genealogy is a different field of study.
3. There is no official “pure strain” human genome used as a standard — each person is a little different genetically from every other person** — who’s to say who is “normal” and who is a “mutant”?
4. He seems to be suggesting the there is a single mutant gene that has variable expression (this last point isn’t about an error in the scene, just an interesting observation).

*Humans have 23 pairs of chromosomes, for 46 total. A genome is one set of chromosomes, or 23.
**Except maybe identical twins.

Technobabble Theater: More Than You Wanted to Know About “Mother of Champions”

scene from Nightwing #145In Nightwing, the Mother of Champions (a Chinese super-hero who gives birth to “litters” of super-powered children every few days) has been kidnapped by Talia Al Ghul so that she can raise her own super-powered army. To make the process even more efficient, one of Talia’s (mad) scientists explains the the plan.

Warning: When a dense block of text is necessary to explain a scientific concept, that’s a sure sign you’re dealing with technobabble.

technobabbleChemicals that induce labor? We have them now: Pitocin (oxytocin) — it’s commonly used by obstetricians for induction of labor. It induces labor by stimulating contractions, which brings me around to the point that you can’t have labor without having contractions.

technobabbleHow can a chemical “mimic” contractions? And even if it could, what good would it do? The muscular contractions of the uterus are what propels the baby along and through the birth canal. If you mimicked contractions there would be no real pushing (just “mimicking”), and thus no delivery. I’m pretty sure that this would actually slow the process down.

technobabbleOf course, we’re talking about a woman who gives birth to dozens of children every few days, which means that any legitimate obstetrics and medicine is out the window. I really think that this is one of those concepts that was better left unexplained.

Scene from Nightwing #145 (script by Tomasi, pencils by Morales)

Batman: The Lazy Drug

scene from Detective Comics #42The 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?)

scene from Detective Comics #42scene from Detective Comics #42scene from Detective Comics #42

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…

Strange Drugs of the Silver Age: Jimmy Olsen’s Beard Tonic

Another subtext laden post, just from a different point of view this time.

Cub Reporter Jimmy Olsen is denied entrance to the Bearded Band — a mysterious club only open to men with beards — because he lacks a beard (well, he tried to sneak in with a fake beard, but it was quickly exposed). As he slinks away, a strange bearded man accosts him and offers him a bottle of special beard tonic. Jimmy chugs the strange brew1 and starts growing a thick beard almost immediately2.

Scene from Superman's Pal, Jimmy Olsen #23

Jimmy attends the next Beard Band meeting and discovers that he’s been tricked. The beard tonic is real — but it is far too strong. His beard will keep growing, five or six feet per day, unless he receives the antidote. And the club members will only provide the antidote if Jimmy makes several public appearances across town, proudly displaying his new beard3.

Jimmy tries his best to uphold his end of the bargain, but he keeps getting his beard cut off through no fault of his own4 — simply bad luck. Angry, the club members destroy the antidote so that Jimmy will always be bearded. Then they proceed with “Operation Whiskers” — their plan to brew a huge amount of the beard tonic and pour it in Metropolis’s water supply. Thanks to more bad luck from Jimmy, their plan backfires and the beard tonic ends up turning into the very antidote they had earlier destroyed. Unaware of this, they all take a swig of the concoction and everyone — including Jimmy — suddenly loses their beards5. Superman appears and destroys the equipment so the members of the club can never brew their tonic again6. No more beards for the Beard Band (or Jimmy Olsen).

Notes:
Scene from Superman's Pal, Jimmy Olsen #231. Did Jimmy ever meet a potion, tonic, or medicine he didn’t sample?
2. It’s impressive the way the tonic only affects facial hair, and not scalp hair or other body hair. Of course, that’s probably a good thing or Jimmy would have ended up looking like Cousin Itt.
3. The Beard Band are under the impression that these public appearances will increase the popularity of beards. Why? He’s just a bowtie-wearing cub reporter at one of several newspapers in town. Why would men of distinction follow his example? If anything, I think it would make men who already had beards want to shave them off.
4. For the record, his beard is sliced off with a sickle, burned off while cooking lunch, shot off during a robbery, and cut off and used as a means of escape from quicksand — which is apparently common around Metropolis.
5. It’s not really an “antidote” if it caused everyone to lose their beards; more of a facial depilatory.
6. Or at least until they buy more equipment.

Crimson Virus

Source: Superman’s Pal, Jimmy Olsen #23, “Jimmy Olsen, The Bearded Boy,” by Otto Binder and Curt Swan. It’s actually quite a fun story, one of the better Jimmy Olsen/mad science tales.

Monday PSA: Let Science Serve You!

Let Science Serve You! Click for the full page.

A different look for today’s PSA: it’s not your standard story-with-a-moral, but instead a quick, almost cartoony, look at scientific discoveries and the technologies that result from it. It also ends on a medical note, and I’m all for that, so remember: “Take advantage of the latest in science — get a regular physical exam and immunization against polio, tetanus, and other diseases.”

Of course, the “regular physical exam” hasn’t really changed in the past twenty or thirty years, so it’s hardly cutting edge science, but I guess it’s the thought that counts.

Click on the image above for the full ad.

Despite the change in style, the Grand Comic Database still cerdits Jack Schiff, DC’s prolific PSA writer, with the script. The art is thought to be by either Morris Waldinger or Tommy Nicolosi. This PSA appeared in the February 1962 issues of DC comics.

More PSAs

More Animal Serums: The Adaptive Ultimate

cover, The Best of Stanley G. WeinbaumWith all the recent discussion of animal-based serums, I would be remiss if I didn’t mention one of the greatest stories ever about such a concoction: Stanley Weinbaum’s The Adaptive Ultimate.

It’s not a comic book story, but instead a classic pulp science fiction short story from 1935. The setup is simple: a scientist creates a serum from drosophila (the fruit fly), knowing it is one of the most adaptive animals in the world. He and his partner inject the serum into a dying woman, figuring it is her last chance of survival. The patient not only survives, but she thrives in ways the scientists could have never predicted. The rest of the story deals with what happens with a woman who has the ability to literally adapt to anything.

Stanley Weinbaum, sadly, is a mostly forgotten science fiction writer from the 1930s. He died young, only 18 months after publishing his first story, so didn’t have the chance to produce many stories. He may have only written a handful of stories, but they’re all well worth reading. From the medical science point of view, Parasite Planet and Redemption Cairn are the most interesting. The planet Venus is the setting of Parasite Planet — Weinbaum’s Venus is a jungle world so virulent that any living flesh exposed to the air for more than a second or two develops a score of deadly infections. At the other end of the spectrum, Redemption Cairn takes place on Europa, a world where there is no microscopic lifeforms, so there is no risk of infection at all.

Other favorite stories of mine include Mad Moon, Shifting Seas, and A Martian Odyssey, probably his best known story.

The Adaptive UltimateThe Adaptive Ultimate is available from Project Guttenberg (the Australian site anyway — I suspect it may not quite be public domain in the U.S. yet). Take a few minutes and read it, if you never have.

The Best of Stanley G. WeinbaumI also strongly recommend you pick The Best of Stanley Weinbaum, a 1974 collection of his works, including all the stories I mentioned above, available fairly inexpensively on Amazon and eBay.

Your Weekend Moment of Psychic Nosebleed Zen: Kyle XY

Continuing a look at psychic nosebleed in other media besides comic books. Today’s example comes from the science fiction television show Kyle XY.

Kyle XY is an original series on the ABC Family network featuring a pair of genetically altered teenagers: the eponymous Kyle, and his female counterpart Jessi. They both seem to be developing a wide variety of powers, both mental and physical in nature. However, whenever they push their powers, they end up suffering a nice little nosebleed.

scene from Kyle XY
Jessi
scene from Kyle XY
Kyle

The first scene takes place after Jessi uses her telekinetic powers to cheat at pool, and the second takes place after Kyle uses his powers to heal another character of cancer. Both scene come from Episode 19, Season 2: “The First Cut is the Deepest.”

nosebleed zenAll previous Psychic Nosebleed Zen posts

Tony Stark’s Heart – The Last Word

(I meant to post this a while back, but it somehow got lost in the ether. It’s a follow-up to January’s posts on Tony Stark’s heart.)

So what’s the status of Tony’s heart now? Good question.
In Iron Man #30 (1998 series), Tony suffers (yet another) heart attack while fighting a sentient version of his armor. Instead of kicking him while he was down, the armor rips out its own heart and implants it into Tony’s chest (that’s what the second panel shows, though the action is far from clear).

Scene from Iron Man (v. 3) #30Scene from Iron Man (v. 3) #30

The fact that Tony now has a purely mechanical heart was confirmed in the following issue:

Scene from Iron Man (v. 3) #31

This was the status quo as Iron Man, Volume 3 continued for 58 more issues. As Iron Man, Volume 4 — the one initially written by Warren Ellis — begins, the story changes. In this version, the shrapnel never actually penetrated or injured the heart, but would have if the magnetic fields of the Iron Man armor hadn’t kept it trapped 2 cm from the heart. Tony then goes on to say that medical science was finally able to remove the shrapnel. So in current continuity, until his recent takeover by Ultron, Tony never had an injured heart.

Scene from Iron Man (v. 4) #1

One last scene, which may or may not be relevant, occurs in Iron Man #5. After being injected with Extremis to save his life after a severe beating, fellow scientist Maya mentions his damaged internal organs. “Grew new ones,” is Stark’s reply.

Scene from Iron Man (v. 4) #5Scene from Iron Man (v. 4) #5

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Grand Rounds (Volume 4, #26) – The Roundup

Grand Rounds

Welcome to Grand Rounds, the weekly roundup of the best medical blogging on the web. This week I present to you a score of posts and articles to entertain you, catch your attention, and get you thinking. Enjoy!
Anecdotes
Grand RoundsAn emergency room encounter between an inexperienced physician and a patient with chronic pain. (link: Dr. Val and the Voice of Reason)
Grand RoundsA couple of brief stories from an emergency room chaplain. (link: Rickety Contrivances of Doing Good)
Grand RoundsWhat can only be described as poor resuscitation technique (link: other things amanzi)
Grand RoundsThe title of the post sums it up nicely: The Nurse as Ogre. (link: Digital Doorway)
Politics
Grand RoundsA look at NIH funding (link: Highlight Health)
Grand RoundsA law to limit teen scents (not “teen sense”, as that would be an oxymoron) (link: Health Business Blog)
Grand RoundsThe failure of the single payer plan in the United States. (link: Insureblog)
Grand RoundsThe ethics of newborn screening and the collection of genetic material from newborns. (link: Junkfood Science)
Insurance
Grand RoundsComparing car insurance to health insurance. (link: Diabetes Mine)
Grand RoundsThe average retired couple should have $225,000 socked away to cover health care costs. (link: In Sickness and In Health)
Grand RoundsThoughts on health care reform at the state and federal levels. (link:HealthBlawg)
Fitness
Grand RoundsAbdominal muscles, a common cause of back pain with walking and running. (link: The Fitness Fixer)
Grand RoundsCan physical exercise help brain function, particularly over the long haul? (link: Sharp Brains)
Practice
Grand RoundsThe Health Concerns of Prostitutes (link: Healthline Connects)
Grand RoundsPain management in remote locations and other difficult situations. (link: Medicine for the Outdoors)
Grand RoundsWhich diet programs keep the weight off in the long term? (link: On The Wards)
Grand RoundsMaking thing’s easier for doctors and patients: Healthline’s new drug search tool. (link: Tech Medicine)
Grand RoundsChanges in CPR and minimally interrupted cardiac resuscitation (MICR) (link: Not Totally Rad)
Writing
Grand RoundsHow writing about chronic illness helps. (link: A Chronic Dose)
Grand RoundsA new book club about — and for — doctors who write. (link: Canadian Medicine)
cover, Cowboy Western Comics #31
cover, Western Adventure Comics #1
cover, Jonah Hex #67

She Blinded Me with Science!

Science! From the Brave and the Bold #55

A quick science lesson from DC Comics, courtesy of The Brave and the Bold #55, which threw in a surprising number of good science informational pages (to be distinguished from its comic scripts which were full of Haney-esque technobabble).

Fourth-Dimensional Surgery

There’s something charming about seeing “futuristic” 30th century medicine as imagined by writers in the 1960s. Here’s a good example from Adventure Comics #303: 4th Dimensional Surgery.

scene from Adventure Comics #303scene from Adventure Comics #303

The doctor takes the “healing capsule” and, using special equipment (which pretty much looks like a pair of needle nose pliers wired up to a 9-volt battery), becomes immaterial by entering the 4th Dimension. Once the capsule is immaterial, it is inserted into the body near the injury and within just a few days, the patient is entirely healed.

The doctor in me wonders:
questionsDoesn’t having such a large foreign body cause an immune reaction? Or cause any pain of its own?
questionsIs the capsule taken out or does it stay there forever (or does it break down over time?)
questionsHow do you know the capsules in the right place and not bisecting an important nerve or artery?
questionsLightning Lad and Sun Boy both have pretty mild injuries — probably just sprains. Wouldn’t a few days’ rest work just as well?
questionsWhat if you accidentally implant a fourth dimensional Junior Mint?

On the other hand, the writers did show some medical prescience. While modern medicine has yet to master the fourth dimension, there are times surgeons implant our own versions of “healing capsules.” Antibiotic infused beads can be surgically implanted to treat deep tissue or bone infections, such as diabetic foot infections. Radioactive beads can be implanted to assist in the treatment of certain cancers. I’m still hoping for a pair of those fancy needle-nose pliers.

(Anybody remember the Made-for-TV movie White Dwarf on Fox about 12 years ago? It was a fascinating and surreal sci-fi/medical movie, and it’s a shame nothing ever came of it. It featured a similar trick: special gloves that made the surgeon’s hands immaterial so he could reach inside the patient. Of course, it still shares a big problem with the 4th dimensional pliers — you can’t see what you’re doing and where you’re going. Ask any surgeon — operating blind is never a good idea).

Adventure #303 (DC Comics, 1962). Script by Jerry Siegel, pencils by John Forte.

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Comic Book Diagnosis: No Exchanges

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.)

With friends like Henry Pym, who needs enemies?Red jackets are SO back in this year

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.

Di-Namo Fluid, available now at your local retailer!  Ask for it by name!
Sure, they don't die, but they don't clean up after themselves eitherClearly Steve hasn't read any Marvel comics for the past two years

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.

That just doesn't look comfortableNotice how the blood has increased and the black fluid decreased since the first panelFiddle me this, Batman

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!Frozen Solid
Brains! Brains!Brains! Brains!
HypertrichosisHypertrichosis
XenograftingXenografting
De-AgingDe-Aging
Can't Get You Out of My MindCan’t Get You Out of My Mind

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Monday PSA: Reach for the Stars

Reach for the Stars! Click for the full page.

With the U.S. Navy scheduled to shoot down an errant satellite later this week, I thought this would be a good time for a space-related PSA. This Captain America/Young Astronaut Council ad is from the back pages of Captain American #307, an otherwise forgettable issue featuring Nomad and Madcap.

The Young Astronaut Council was formed in 1984 to get children interested in space and science. According to their article on Wikipedia, they are “the largest youth aerospace organization in the world” (though I’m not sure that’s a title with a lot of competition). As far as I can know, the Young Astronaut Council is still in operation today, though you couldn’t tell it from their website, which I seem to be unable to access.

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

For another relevant PSA, check out this one from Airboy #22 (May 1987) which takes an unkind look at the SDI program (”Strategic Defense Initiative” — i.e. the “Star Wars” program — a plan to shoot incoming enemy ballistic missiles out of the sky).

More PSAs

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Silver Age Flash

While sitting in the ER waiting room and exam room last night, I managed to read through the entire Showcase Presents The Flash. (This is not an indictment of the ER — it’s flu season and there is a nasty flu bug going around town so the ER was packed. My injury was relatively minor and I knew there’d be a wait. Scott’s First Rule of the ER: Bring the thickest book you can find — quickly — to read while you wait).

Silver Age Flash stories are always a great read, but there were more than a few stories inside that sent my medical and scientific senses a-twitching:

Flash

You do realize the mirror reflections are also light, right?The Flash being able to run that fast is a post for another day

First, Flash #105 (by John Broome and Carmine Infantino).

I’m sorry Mirror Master, but the speed of thought is not faster than the Flash. “Thought” is a biochemical process and as such is subject to the laws of science. Nerve conduction along and between neurons is not faster than the speed of light, in fact according to this neuroscience page (mainly about transmission of pain and touch sensations, but the same principles apply), nerve conduction tops out at a few hundred miles per hour, much slower than the speed of light (roughly 186,000 miles per second hour). Flash, on the other hand, can run faster than the speed of light — much faster than any nerve or thought.

Now if you want to get all philosophical in your definition of “thought” and claim that it is not subject to the laws of science, remember that thought must be put into action, and muscles do obey the laws of science.

Flash

cover, Flash 115Next, let’s take a look at Flash #115, particularly the story “The Day the Flash Weighed 1,000 Pounds” (again by John Broome and Carmine Infantino):

Barry Allen, who is 6′1″ according the statistics I could find, weighs 195 pounds. This gives him a Body Mass Index (BMI) of 25.7 (which on a side note, technically makes him overweight, and other than this issue of the Flash, Barry has never been drawn as anything but skinny).

Now how about this 1,000 pound Flash? He has a BMI of 131.9. Remember that anything over 30 is considered obese and over 40 morbidly obese. Personally, I’ve never seen anyone this heavy. Superhero or not, I don’t think he’d be able to move with that much weight on his frame. (According to a quick Google search, the world’s heaviest man weights 1234 pounds and is barely able to move).

How did the Flash lose all this weight by the end of the story? He climbed into a commercial-sized potato dehydrator and sweated out all that extra weight. Seriously. File this under “do not try this at home” (it’s dangerous and anyway, it wouldn’t work).

Flash

Finally, here’s some technobabble from Captain Cold:

I don't light refraction works that way

New Ideas in Neuroscience: The Kryptonian Brain Cell Transplant

In my previous discussion of brains and comic books, I neglected to mention a key concept: The Kryptonian Brain Cell Transplant.

It all starts when Linda Danver’s boyfriend David jumps into a swimming pool to save another swimmer, but strikes his head on some underwater debris, suffers brain damage, and falls in a coma.

so much for patient confidentiality

Supergirl, of course, realizes that just because “no power on earth” can save David doesn’t mean that no one can. She rushes off to the Fortress of Solitude to talk with the scientists from the bottled city of Kandor, certain that Kryptonian science can save her boyfriend (along the way, she rationalizes that she and Superman only turn to the Kandorians in the direst of emergencies1). Eminent Kandorian scientist Professor Ron-Kar tells her that only a Brain-Cell Transplant can save David.

Never mind all the other brain damaged patients this could help, I just want to save my guy

The Professor arranges for Supergirl to obtain the Kandorian surgical equipment necessary to perform the transplant (made of Quasi-energy, so that only Superman or Supergirl can use them2). Supergirl first uses the tools on herself to obtain “thousands of super-brain cells”, and then transfers them into David (you’ll also note that the Professor falls victim to the 10% Myth here).

Head On - apply directly to forehead.  Head On - apply directly to foreheadlooks like she's tossing a salad

The operation is a success and David survives! Unfortunately, he’s not quite what he appears. Instead of being an ordinary graduate student, he is instead a criminal gang leader masquerading as a graduate student for cover. He’s dating Linda not because he cares for her, but because he thinks she’ll make a good alibi for him (poor Linda/Supergirl, she never could find a good date). He discovers that the brain cell transplant has not only saved his life, but also granted him superpowers just like Supergirl. He puts on a lead mask3, calls himself the Super Scavenger, and robs a bank. Supergirl quickly catches up to him.

surprisingly, the bags of money did not have big dollar signs printed on them

They battle, but David’s super powers are only temporary (much like Superman’s blood transfusions), and Supergirl is able to capture him and turn him over to police. But there goes her date for the weekend…

This medical case study comes from the the physicians at the Vandyre Clinic, Kandorian Professor Ron-Kar, and Supergirl #4 (by Bates, Saaf, and Colletta)


Notes:
1. This is a little ironic coming from Supergirl who seems to call on Kandor for help every other issue. She has an awful lot of dire emergencies — most of which seem to revolve around boys.
2. Which doesn’t explain why the Kandorians have them or how they use them since they don’t have super powers.
3. He wears the mas so Supergirl won’t be able to figure out who he is. While she may be unable to see through the mask, she is able recognize David’s watch. Today’s take home lesson for would be super-villains: avoid over-accessorizing.

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Surreal Sci-Fi Covers from the Sixties and Seventies

One of my favorite science-fiction authors has always been the late Clifford D. Simak who wrote a number of great stories and novels from the late thirties until his death in 1988. I have a pretty good collection of his books, often several editions of the same novel, but the ones published during the sixties and seventies are my favorite. First, they have that “old book smell” that I just associate with good science fiction, mostly thanks to spending a large portion of my teen years perusing used book stores. Second, they all have eye-catchingly surreal covers that just fascinate me. The covers have nothing to do with the actual novels inside, but they are so wonderfully bizarre, they trap the eye and I end up more interested in the book than I would be with standard scene-style covers.

Here are three of his books from that era: Time is the Simplest Thing, Destiny Doll, and my favorite, The Goblin Reservation

cover, Time is the Simplest Thing
Time is the Simplest Thing
Crest Books, 1964
cover, Destiny Doll
Destiny Doll
Berkley, November 1975
cover, The Goblin Reservation
The Goblin Reservation
Berkley, March 1969
All books by Clifford D. Simak, all covers by Richard M. Powers

House – Episode 12 (Season 4): “Don’t Ever Change” (likely the Season Finale)

Quite likely the final episode of House in this strike-shortened season. Overall, it was a good episode even if it was another exploring the House-versus-religion theme. While the medical mystery was just moderately interesting (at least initially), the solution was clever, and the medicine mostly correct. Good soap opera too.

Spoiler Alert!!

Roz is a Hasidic Jew, recently converted, and even more recently married. At her wedding ceremony, she loses control of her bladder, and a large stain of bloody urine appears. She collapses and falls, breaking her leg. She is admitted to House’s team for the evaluation of her condition. Dr. Thirteen reports that Roz’s urine culture was negative (meaning no urinary tract infection) and there is no history of trauma or sexually transmitted diseases. A CT scan was negative for cancer and kidney stones. She reports that Roz’s sodium was low, however, and suggests that Roz may have endometriosis of the bladder. Taub counters that the low sodium may be related to Roz fasting before the wedding, while House posits that Roz may have been exposed to a toxin, carboxylic acid in particular. House agrees to let Thirteen start Roz on treatment for the possible endometriosis (with AIs, i.e. Aromatase Inhibitors) and get a cystoscopy . Meanwhile, he sends Taub and Foreman to search Roz’s apartment where they find no carboxylic acid, but discover that prior to her conversion, she had been a heavy metal record producer. She admits to a history of heroin use, but not for some time. A hair sample is obtained, but the tests are negative. Additionally, the treatment for endometriosis has been unsuccessful and the cystoscopy clean.

Taub suggests Roz may have cryoglubulinemia (abnormal proteins in the blood that thicken with cold temperatures), but House feels she has porphyria (problems in the synthesis of hemoglobin), and her sudden conversion to Judaism suggests the mental problems commonly seen in certain types of porphyria. Roz’s husband considers this an insult, and requests a new doctor. Cuddy agrees with the cryoglobulinemia diagnosis and wants to start her on Indomethacin (a potent non-steroidal anti-inflammatory drug, the same class as Motrin). Meanwhile, Roz has become hypoxic with her oxygen saturation dropping to 85%. This argues against both cryoglobulinemia and porphyria. She is kept on oxygen and her saturation improves. Foreman mentions Wegener’s Granulomatosis, but House now believes it to be Lupus with a hidden heart problem. He orders a stress test. Roz makes it through the test well and has no evidence of heart problems. After the test, she develops sudden leg pain and the team believes that she might have a blood clot. An MRI is obtained, which shows no clot, and an fMRI (functional MRI, which works by detecting increases in blood flow within the brain, and these are believed to represent area of brain activity) is ordered as well, ostensibly to look for subtle signs of a stroke. The fMRI shows activity in her limbic system (one of the emotion centers of the brain) when Foreman is placing an IV (a painful situation) which House believes shows that Roz has masochistic tendencies, but Thirteen discovers she was praying during the IV placement, so that might explain the limbic activity.

As Roz stands up after the test, her blood pressure and heart rate come crashing down. When she sits or lies down, she is fine — she only has a problem when standing (orthostatic hypotension — low blood pressure when standing). She is started on fludrocortisone and ephedrine (two drugs that can be used to treat extreme cases of orthostasis). The differential now includes pheochromocytoma (a tumor that releases high levels of adrenalin and similar compounds), systemic sclerosis (better known as scleroderma, an autoimmune disease), and a heart arrhythmia. An EP study (”electrophysiology study”, which looks for abnormal rhythms in the heart) is ordered, but the results are normal. The suspicion now turns to an autonomic nerve disorder such as Riley Day Syndrome. A thermoregulatory sweat test is ordered, but instead of becoming overheated, Roz becomes hypothermic (an abnormally low temperature) and has a seizure.

Infection is now considered as a possible diagnosis, as is Addison’s Disease (a condition where the adrenal glands do not make enough steroid hormones). Roz is started on Cortisol to test for Addison’s and she starts to feel better (cortisol is a steroid hormone). As Thirteen examine her though, she notices a swollen abdomen and Roz reports that she is starting to feel dizzy. Thirteen quickly realizes that Roz has internal bleeding. Chase (apparently the only surgeon in the hospital this season) wants to perform an exploratory surgery to locate the source of bleeding, but Roz decides to delay the surgery until after she has had a chance to celebrate Shabbat with her new husband, even though it might cost her her life. The differential diagnosis now includes DIC (disseminated intravascular coagulation), hydatid cyst (a tapeworm cyst), volvulus of the small intestine (a twisting of an intestinal loop), polycythemia vera (too many red blood cells in the blood), thrombocytopenia (low platelet count) and even Parkinson’s Disease. During the brainstorming session with the team, House has a sudden revelation and realizes that Roz has a nephroptosis, also known as a floating kidney. Instead of being firmly secured to the underlying tissue, her right kidney is hanging loosely, just supported by a few blood vessels. This explains the blood in the urine, the internal bleeding, and the orthostatic hypotension. The strain this is putting on the right adrenal gland (located on top of the kidney) likely explains most of her other symptoms. The floating kidney was not noticed on the scans because they were all performed with her laying down and it only shows up when she is standing up. Surgery should be able to fix her problem and stop the bleeding.


I really don’t have too many medical complaints this episode, other than my usual litany of untrained people doing potentially dangerous tests and results comic back to quickly. Now, you’ll notice I didn’t say I had no complaints, just not as many as usual:

House, Episode 12Roz didn’t just have a slight bit of blood in her urine, that was gross hematuria. In my mind, that should have necessitated a full bladder and kidney work-up from the very beginning that should have caught the nephroptosis.

House, Episode 12Was it just me, or did they seem to keep forgetting about her broken leg? It never seemed to be splinted or cast. She did get to do the arm stress test, instead of the treadmill one, but that seemed to be the only acknowledgment of the broken leg.

House, Episode 12I’m not clear on what caused her shortness of breath (that improved overnight) or her sudden leg pain (other than, you know, that fracture thing). Maybe blood loss and anemia led to her shortness of breath, but that much anemia should have been easily noticed on her labs.

House, Episode 12They sure like to jump to the big guns early, don’t they? Aromatase Inhibitors. Fludrocortisone. Ephedrine. I’m not saying these drugs don’t have their places, just not first thing.

House, Episode 12From what I read, there is some debate in the medical community over how significant a “floating kidney” actually is. All of Roz’s autonomic symptoms (hypotension, low sodium, low temperature, etc) are quite a stretch, especially when you remember that she was lying down when many of them happened.


The medical mystery was moderately interesting, frankly not something that would I would expect to pique House’s curiositu — I give it a weak B. The medicine was better than it has been recently, though still not without mistakes or unexplained symptoms — another B. I thought the solution was clever and elegant, though the severity of her autonomic symptoms were straining credibility. Still, I give the solution an A-. The soap opera was good and almost — almost – had me liking Amber. It was nice to see Cuddy back to her normal acerbic self, especially when she was talking to Wilson. I also give this aspect an A-.

All in all, not a bad quasi-Season Finale. Not a grand slam, but at least a solid triple.

previous House reviewsThe previous House review
previous House reviewsA list of all prior House reviews

Challenge scores can be found at the post immediately beneath this one (or click here).
I’ve also posted information about next season’s Challenge, for all who are interested…

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Torchwood – Se