Polite Dissent

Episode Title: In Which Addison Has a Very Causal Get-Together

The medical ethics were better this week (except for everyone looking in other people’s medical charts), but the medicine was equally questionable. This show would really benefit from some Grey’s Anatomy style continuing storylines; this patients-of-the-week format just doesn’t sustain the interest here.

Dr. Addison Montgomery and Dr. Sam Bennett
After seeing Sam on a local morning news show, a pregnant patient named Rebecca arrives in the clinic seeking medical care. She claims that she just escaped from the hospital because they were trying to kill her and her baby. She is five months pregnant, but surprisingly skinny. In short order, it turns out that she was involuntarily committed to the hospital because she was a psychiatric patient with Munchausen’s Syndrome, and now the hospital – and her mother whois her medical guardian — wants her back in the psychiatric ward.
Addison is not convinced that Rebecca has Muchausen’s, though some lab values which suggest she has not been eating give Addison pause. In the end, the team gets the hospital to run a capsule endoscopy (”GI camera”) which reveals that Rebecca has Crohn’s Disease — a type of Inflammatory Bowel — and not a psychiatric disorder.
Five months along and she is just now feeling the baby kick? That’s not a good sign.
I’m concerned by the amount of x-rays and CT scans performed on Rebecca. There was an entire wall full. Radiation is not good for developing babies. (And if the Crohn’s was that bad, something should have shown up on the CT).
Involuntary psychiatric admission laws vary greatly between states and I’m not familiar with the laws in California. I can see an involuntary admission being granted in this case though, for fear of Rebecca harming herself and harming her baby.
I’m not sure what labs would show Rebecca hadn’t been eating when she claimed she had been. Albumin and other proteins can be low in malnutrition, but that’s in the long term, not short term. Ketones in the urine can also suggest starvation — though it can mean other things as well including diabetic ketoacidosis and an Atkins dieter.
I don’t know why the team was thinking they could get a capsule endoscopy performed in under an hour. It takes the better part of a day to run a capsule endoscopy, let alone the prep beforehand. An actual colonoscopy would be faster and give more definite answers.
There are simple blood tests to detect active autoimmune diseases. They’re not always good at pinpointing which disease in particular, but would at least let the team know that something physical is going on.
Sam uses the word “occult” way too many times in this episode.

Dr. Cooper Freedman
Cooper was dealing with Michael, a ten year-old boy who was in love with a friend. When Cooper encourages Michael to ask his friend out, the boy returns to the office bruised and bloody. It was not a girl he asked out, but another boy. Now he runs away and Cooper — of course — finds him and manages to bring him back home.
No skateboarding or contact sports if you have Mononucleosis because the spleen can become enlarged during Mono and there is a chance of rupturing it with any blunt trauma.

Dr. Violet Turner and Dr. Naomi Bennett
Violet become obsessed (well, more obsessed) when she sees her ex-husband’s (or is it ex-boyfriend’s — it’s not clear) new wife visiting Naomi. It turns out she was there to be treated for a urinary tract infection, not pregnancy as Violet feared.
Violet’s one note characterization is quickly becoming tiresome.
What kind of doctor is Naomi exactly? Who goes to see a fertility specialist for a UTI?

Dr. Pete Finch
Pete is seeing Stan, the curmudgeonly fiancée of Sylvie, an old patient of his. Stan has been having fainting spells and Sylvie is secretly concerned that the fainting spells are a subconscious sign that Stan does not want to marry her. Pete runs some “basic tests” which are all negative, but after some more probing, he determines that the Arthur has a “trigger point” that causes a “painless migraine” (a type of Atypical Migraine) which causes him to pass out when he is in certain positions.
An EKG, echocardiogram, and carotid Doppler all are good tests for this situation. Some sort of head imaging is indicated, but I would never consider an MRI a “basic test.” Maybe that’s just because I practice in small town Illinois and not a big city in California.
As for a muscle trigger point causing a painless migraine, that’s a rather cavalier diagnosis. I have seen atypical migraines that cause symptoms that look just like a stroke, but never one that causes passing out, one that shuts one and off that quickly, or one caused by a “trigger point.” I’m not saying it can’t happen; it’s just quite a stretch.

Tags: television medicine private practice munchausen’s syndrome crohn;s disease syncope

Episode Title: In Which Addison Finds the Magic

A show primarily about marriages this week. Pete and his dead wife. Violet and her ex-husband. Naomi and Sam doing more of their infighting. And Addison whining. Plus more bad ethics. I expect this from Dr. House, it’s his shtick, but not from these doctors who are supposedly better and brighter.

Dr. Cooper Freedman
Cooper is brought to see a young girl who is blue. Not depressed, as he thought initially, but the patient actually has blue skin. He asks about dyes, inks, or any topical compounds that could have dyed her skin, but there have been no exposures. There was no other chemical exposure, by history. He ultimately decides that she has methemoglobinemia (an abundance of chemically-damaged hemoglobin in the blood) and treats her, correctly, with intravenous methylene blue. He in unsure what exposure lead to her developing the condition, but she responds to the medication. Over the next day or two, her skin turns blue again, as does the skin of her three younger sisters. One of the girls has a seizure as well. Cooper and the mother search the house, but can find no source of toxicity. He eventually talks the girls into letting him spend the day playing with them and they lead him to their “castle” – a neighbor’s old shed filled with leaking bags of the fertilizer ammonium nitrate. Nitrates are a known cause of methemoglobinemia and the girls are inhaling enough of the fumes to make themselves dizzy and their skin turn blue.
Methemoglobinemia is rare. There is an inherited form of the disease, but the girls have an acquired methemoglobinemia. It is treated with oxygen and 5 minutes of intravenous Methylene Blue followed by a saline flush (a big bag of blue IV fluid shouldn’t just be left hanging like it was in the episode).
Other possible causes of methemoglobinemia include certain older antibiotics, local anesthetics, nitrates, and metoclopramide (Reglan). There are a few unusual household chemicals that may cause it. Well water with a high nitrate content has been known to cause methemoglobinemia.
Inhalation of ammonium nitrate generally causes a nasty headache, cough, and sore throat — symptoms that were missing but would have helped narrow down the type and route of exposure.
I find it hard to believe that a parent who chose to stay at home to raise her kids is not going to notice her four kids regularly disappearing from the yard like that?

Dr. Addison Montgomery and Dr. Pete Finch
Addison has a newlywed couple as her patients who complain that they cannot have sex. Any attempt causes severe pain to the wife. Addison attempts an exam, but even that is too painful for the patient to endure. She diagnosis her with vaginismus. She tries muscle relaxants first, but they do not work. Next she tries trigger point injections combines with guided imagery. That works miraculously.
Vaginismus is a real condition, and difficult to treat. It is almost always psychological in nature.
The best treatment for vaginismus is a combination on counseling, special exercises, time, and understanding. It rarely resolves overnight.
I’ve never heard of muscle relaxants being used as a treatment. I can imagine that benzodiazepines like Valium might work, but more for their psychological effects than the physical ones.
If her problem is indeed caused by overly-sensitive nerves, then trigger point injection might work. Her issues seemed much more psychological to me, though, so I suspect Pete’s therapy did the most good.
For a “world renowned” surgeon, Addison has some lousy bedside manner.

Dr. Violet Turner and Dr. Sam Bennett
Violet has a patient named Doug who is unhappy in his marriage and wants a divorce, but is scared to tell his wife. After three years of therapy, she has finally convinced him to stand up to his wife and tell her what he wants. When he does, his wife’s nose starts to bleed uncontrollably and he brings her to the clinic for evaluation and treatment. Sam is able to control the nosebleed, but the patient’s labs show that she has a moderate anemia (low blood count).
A day or so later, the wife confronts Violet and she once again begins bleeding. Not just a nosebleed this time, but hemoptysis (coughing blood). She is admitted to the hospital and diagnosed with Wegener’s Granulomatosis, a chronic disease caused by inflammation of the blood vessels. After a confrontation with the hospital chief of staff, Sam discovers that the patient has known she has Wegener’s for at least 6 months and never bothered to tell the husband. He and Violet confront both the husband and his wife with the truth, but in the end Doug chooses to stay in his unhappy marriage.
There are good treatments for Wegener’s now, but it can still be a fatal disease. Relapses occur in about 50% of patients, and about 80% suffer some variety of long-term complication (deafness or kidney disease, most commonly). Survival rates vary, depending on the study, but around 75-80% can expect to live at least another 5-10 years with treatment.
No chief of staff is going to overrule an attending physician like that. It’s bad form and it’s not her job. Plus, it will drive doctors from the hospital. Hospitals like doctors, they make them money.
The confrontation in the end may have been within the letter of privacy laws, but clearly against the intent. You don’t threaten patients into sharing information with each other. The wife should have refused to tell them anything and reminded Violet that she had been fired as her husband’s therapist, so her husband would not leave the room with her. (OK, ideally, she should have told her husband the truth in the first place, but how likely was that to happen?).

Tags: television medicine private practice methemoglobinemia nitrates vaginismus wegener’s

Episode Title: In Which Sam Receives an Unexpected Visitor

Two significant cases this week: one was medically wrong and ethically murky, and the second was medically correct (if incredibly fast) but ethically wrong. I’m not going to say much about the stripper other than the rash appeared to be a resolving case of shingles (herpes zoster) from what little was shown. As for Violet, well the bicyclist in me was pained by her destruction of such a nice bicycle.

Dr. Cooper Freedman (with assistance from Dr. Addison Montgomery and Dr. Naomi Bennet)
Cooper has a patient, 9-month Emily O’Brien who is has been sick since birth and not growing well. She also has some poorly defined neurological symptoms. He runs some tests on her, including genetic testing, and determines that she is suffering from a severe form of the rare neurological disorder Pelizeaus Merzbacher. He runs tests on her parents and discovers that they are not carriers for the mutation responsible for Pelizeaus Merzbacher, and this makes him realize that Emily cannot be their child.
Looking through the hospital records, the team is eventually discovers that while Emily was in the nursery after birth, her real father switched his sick child with another couple’s healthy baby. Much pathos ensues when this is announced.

• Pelizeaus Merzbacher is an often fatal x-linked gene. This means that it is a disease that shows up in males, not females. Females are carriers for the condition, and can very rarely show mild symptoms, but full Pelizeaus Merzbacher cases (as Emily is said to be) are always males. This is a major mistake — there is no way that Emily can have Pelizeaus Merzbacher in that they’re describing.
• Any real infertility expert would cringe at Naomi’s line: “I didn’t promise you perfection, I promised you a baby.” The first part is true enough with any pregnancy, but no fertility doctor would ever “promise” any couple a baby. Even with all of modern science, the odds of an infertile couple conceiving is roughly 50%, and drops with each subsequent attempt. Promising success is inviting angry bitter couples and lawsuits.

Dr. Sam Bennet
Sam is making a house call on Dave Walker, a patient who is a known alcoholic. Dave is recently divorced and living with his teenage son and elderly mother. Arriving at the house, Sam finds him very sick with nausea and vomiting. An ambulance is called and Dave transported to the hospital. He improves after a short amount of time and is sent home, much to Sam’s dismay, with a diagnosis of viral gastroenteritis (the “stomach flu”).
Later in the same day his teenage son shows up at the clinic with identical symptoms. A check of his blood reveals coprine (scroll down to the bottom of the page), a toxin found is certain mushrooms. Coprine, we are told, works like “Antabuse” and causes a patient who drinks alcohol after ingesting it to become violently ill. Sam is able to determine that the patient’s mother is purposefully spiking his food with coprine-containing mushrooms to get him to stop drinking. Rather than tell Dave the truth about the poisoning, Sam tells him that he is allergic to alcohol.

• It’s amazing this all happens in one day: patient becomes ill and all his lab tests including cultures — which take several days to grow — are negative. The son becomes ill and his fancy and expensive blood tests are run and manage to come back the same day.
• Antabuse (generic name disulfiram) is a drug that interferes with the breakdown of alcohol in the human body. The alcohol is only partially metabolized and becomes acetaldehyde, a noxious chemical. This accumulates in the body and causes nausea, vomiting, and severe abdominal pain. Antabuse is prescribed in certain situations to help patients with alcohol problems stop drinking. It is not widely used because, in my experience, patients still drink when taking it, and now instead of an alcoholic patient, you have a violently ill still alcoholic patient.
  • Flagyl (generic name metronidazole), an antibiotic, has a similar effect on alcohol metabolism and we advise patients not to drink when on the medication, or even for several days after.
  • Pete is right that Coprine has the same effect as Antabuse.
• Never lie to patient. Sure, it’s tempting and seems like an easy way out sometimes, but it’s never a good idea. Sooner or later, they’ll find out and there goes all their trustin you. For another thing, how would you document it? Does Sam write in the medical record what really happened, the lie he told, or both? It’s a medicolegal nightmare. If the patient drops dead of coprine toxicity and the police discover Sam knew all along he was being poisoned, yet didn’t warn him or tell the police, Sam’s days of practicing medicine are long over.

Tags: television medicine private practice pelizeaues merzbacher coprine antabuse

Keith sends his own interpretation of what the psychiatrist from Psychoanalysis #3 is saying (and it makes a great deal more sense than the nonsense he is spouting off in the comic):

Keith had a good idea and now it’s your turn to play along at home. With this blank template, let me know what the psychiatrist is really saying…

All the glamour — the heartache — the throbbing excitement — of a big-city hospital!

Fresh out of high school, small town girl Linda Carter¹ has been accepted into the prestigious nursing school Metro General². She meets her two roommates: Christine, a rich girl trying to make it without her family’s money; and Georgia, an inner-city girl trying for a fresh start. They don’t get along at first, but soon become fast friends and help each other through the tough classes of nursing school³.

They each have problems outside of school as well. Linda falls in love with one of her patients; luckily he’s young, handsome, and very rich. He wants to marry Linda, but he wants her to give up nursing first. She asks for a few days to consider his offer. Meanwhile, Christine’s father pressures her to give up nursing. She promises to think about it. Georgia returns home to find the same sense of hopelessness as ever in the slums, made worse by the searing heat of the summer. In addition, no one has heard from her older brother for weeks.

The heat causes a brown out and soon most of the city loses power. Luckily, the hospital has emergency generators so it maintains electrical power. This doesn’t sit well with some of the inner city residents who are convinced that the hospital is part of plot to steal their power. Two of them sneak into the hospital to plant a bomb on the emergency generator. Linda and her roommates catch the criminals in the act and a standoff ensues. One of the thugs turns out to be Georgia’s older brother, and he leaps on his partner when he pulls a gun on the student nurses. The hospital is saved, the girls are safe, Gloria has found her brother, and now Linda must give her boyfriend the answer to his marriage proposal…⁴

Notes:
¹Sadly, this is not the Lynda Carter of Wonder Woman fame.
²Could this be the same “Metro Hospital” where Dr. Burke and Dr. Landon work?
³There seems to be little actual nursing taught in the classes shown. There’s basic science, and some fairly advanced medicine, but no nursing. And there’s fashion: “Now we will discuss the proper assembling of the nurse’s uniform.”
⁴Her answer? Here’s a little hint: the comic is Night Nurse not Housewives at Play.

Previous episodes of Flashback Week.

Tags: comics medicine nurse night nurse

Comics publisher EC took a substantial PR hit in the 1950s thanks in large part to psychiatrist Frederic Wertham’s book Seduction of the Innocent and anti-comic book congressional hearings. They gave up publishing their crime and horror comics, and instead switched to a “New Direction,” publishing comics designed to be more informative and inspirational. This concept never met with much success, and within a few years, the “New Direction” had failed and Mad Magazine was all that was left of a once successful comic book publisher.

M.D. was one of the “New Direction” comics. According to the preface of the first issue, M.D. was written to “contain stories of people…people who are helped by their Family Doctor and his associates in the Medical Profession. It will deal frankly and honestly with the diseases and misfortunes that beset people. It will deal graphically and candidly with the treatment they receive. At times, the stories will be poignant…at times they will be sad…at times they will be grim. But at all times, they will be true to life!”

Every issue of M.D. featured several realistic medical stories, each focused on a particular disease or condition. Issue #5 was the final issue of M.D. and frankly, it shows. The art is as intricate as always — if a little sensationalistic at times (particular when focusing on the grieving mother in the forefront of the panel, her fingers thrust worriedly at her lips) — but the stories are not nearly as compelling as in earlier issues, rather humdrum actually, which is unusual for any EC comic.

“Complete Cure” is the first story and tells of Philip Stuart, who had both of his legs amputated after an automobile accident. He takes the loss of his legs hard and decides to give up on his education and job, much to the concern of his wife and family doctor. In the end, Philip is introduced to another man who lost both of his legs (on the beaches of Normandy during D-Day, which pretty much trumps every other reason), but went on to become a successful surgeon. This inspires Philip who agrees to return to college.

The second story is “Child’s Play” and concerns Jimmy, a young child. He has gone deaf due to audiosclerosis (known as otosclerosis now) and needs an operation and a hearing aid to regain his hearing. His mother refuses, fearing that the other kids will make fun of Jimmy. Eventually, her husband steps in and sends Jimmy for the surgery. It’s a success and Jimmy’s hearing is returned. His mother still won’t let him play with his friends because she is convinced that they’ll reject him. One day she returns home from shopping and finds Jimmy missing. Fearfully, she runs down the street calling out his name, only to find him in the neighborhood clubhouse happily playing with the other kids, his hearing aid an object of interest, not scorn.

The third story, “Emergency” shows what happens in a hospital when a bad storm hits, knocking out both the power and emergency generators. By working tirelessly, the doctors are able to save everyone and even manage to perform an emergency surgery by flashlight. They end the story lamenting the fact that medicine has become so dependent on technology. Bear in mind that this was written over 50 years ago, and their medical technology consisted mostly of lights, x-ray machines, and iron lungs. The doctors of this story would be devastated to learn that modern medicine’s dependence on technology has increased a thousandfold since those halcyon days of not so long ago.

The fourth and final story deals with George Gordon. He is convinced that he has appendicitis, but his family doctor suspects otherwise. He believes that George has somatization disorder, and his depression is the root cause of George’s abdominal pain. George leaves in a huff and visits another doctor and hospital, but is told the same thing. Despondent, he threatens suicide but his family doctor is able to talk him down off the ledge and get him the help he needs. Based on my experience, somatization is never quite this easy to diagnose or treat, plus George seems to have as much a diagnosis of Munchausen’s Syndrome as somatization.

Previous posts on M.D.: Issue #1, Issue #2, Issue #3, and Issue #4.
Previous episodes of Flashback Week.

Tags: comics medicine m.d. amputation technology depression

Another example of the psychic nosebleed courtesy of Nate Gray, the eponymous “X-Man.” In this scene from X-Man #18, Nate is having a psychic battle with Mr. Sinister, and losing. The script is by Terry Kavanagh with pencils by Steve Skroce. This issue marks the beginning of the Onslaught storyline, at least in this title. To drive the point home, there is a feature in the back about Jim Lee’s redesign of the Fantastic Four (which was probably the least offensive of the Heroes Reborn comics, though I surprisingly enjoyed Iron Man as well — it’s the only time that I can remember liking Whilce Portacio’s art) All previous Psychic Nosebleed Zen posts Tags: comics medicine nosebleed nate grey

This scene is just a small taste of what is occurring (mostly off screen) in the recent Drafted preview issue. Everyone in the city of Jerusalem — and later St. Louis (which strikes a little too close to home) — suddenly suffers what is described as “non-physical head trauma” with symptoms including a buzzing in their heads followed by “hemorrhaging of the ears, nose, and in some cases, the eyes.” The exact cause of the symptoms isn’t named, but highly suggested by the final panel.

All previous Psychic Nosebleed Zen posts

This episode of psychic nosebleed zen was suggested by Marc M.
Tags: comics medicine nosebleed drafted

(As comicdom’s top NASCAR fan — or NASCAR’s top comics fan — I felt it was my duty to review the recent comic NASCAR Heroes #1, the first in a new ongoing series published by Starbridge Media)

This is not the worst comic I’ve ever read — it’s not even in the bottom ten — but make no mistake: this is a bad comic. To be more succinct, this is the Herbie Fully Loaded of comics. Actually, that’s not fair to Herbie because it was more authentically NASCAR as it at least featured cameos by actual NASCAR drivers.

Dashiell James is a lowly janitor working for Diesel Industries, the top racing team in NASCAR, which just happens to field the top driver: the arrogant and rude Jack Diesel. Dash’s best friends are the pit crew for Team Flatstock, the worst team in NASCAR. They’re so bad that they’ve never even managed to qualify a single race car, let alone win a race. Instead of actual personalities, each member of the pit crew has a personality quirk, such as Ed who always says everything twice. Says everything twice. The lone female character is Astor, the owner of Team Everlast. She doesn’t seem to need a personality quirk because she has breasts.

Late at night, Jack Diesel is conducting some secret experiments in his trailer, and when he is interrupted there is a mysterious explosion. He, as well as Dash and Team Flatstock are all doused in some mysterious radiation. Being a comic book, this radiation doesn’t give everyone cancer, but instead endows everyone with super powers — powers the Flatstockteam uses to finally field a winning race car. Dash becomes the team’s mysterious masked driver and he and a similarly super powered Jack Diesel compete the tooth and nail to win the race. I’ll let you guess how the race end.

The story is so far removed from anything resembling the reality of NASCAR that I doubt any casual race fan who picked up the book will consider coming back for the second issue. I’m not talking about the super powers aspect, I’m talking about the blatant disregard for the rules and realities of the sport the comic is supposed to be about. Speaking of super powers, the super-hero aspects read like some of the worst excesses of the Silver Age, but with none of their charm. In short, this comic manages to combine NASCAR and comic books in such a way that it alienates fans of both.

On the plus side, the paper quality is nice and there aren’t many ads.

Tags: comics nascar nascar heroes

This is the final regular issue of Hawk & Dove. It’s an above average issue, and manages to tie together most of the various plot lines of the series.

After being tricked by Barter and an unnamed co-conspirator, Hawk is suspected of causing a car crash and trying to kill Senator Tom O’Neill. Hawk is now in hiding and on the run from the police. He’s also mad at being played for a fool, and wants to take it out on Senator O’Neill — or whoever is in his body now.

Dawn is looking for Hawk as well. She is visited at home by Mrs. Hall, Hank’s mother, who admits that she has long known that Hank was Hawk, and it didn’t take much to deduce that Dawn is the new Dove. She implores Dawn to find Hank and clear everything up. In the middle of the conversation, Dawn’s mother stops by the room and casually mentions that Hawk has been spotted downtown. Dawn and Mrs. Hall head off in that direction.

It turns out that Hawk has been discovered by Azure, the Aztec goddess from issue #2. She has gained increased powers as part of the War of the Gods crossover and wants to take revenge on those responsible for defeating her last time. (She also turned the three Wildebeests hunting Hawk into stone, thus quickly ending the Titans Hunt crossover). As Azure and Hawk’s battle destroys a grocery store, Dove shows up to help capture the goddess. The Washington Special Crimes Unit shows up as well, and is able to trick Azure into losing her powers, just like before.

As the battle ends, Hawk heads for Senator O’Neill’s house to confront him and Dove follows along. Hawk busts through a window and is ready to pummel the Senator when Uncle Sam walks in through the door. Hawk and Uncle Sam have a tussle while the Senator escapes out the window, now exposed as Roscoe Dillon, the Top (remember him from Hawk and Dove Annual #1? He was one of the dead villains the team fought). Dove takes off after him and defeats him relatively quickly. She returns to the house to discover that Hawk has had a change of heart and has turned himself in to the police. Dove wants to turn herself in as an accomplice, but Hawk won’t let her.

The next time we see Hank, he is in a closed session before a judge (because of the “Federal Metagene Privacy Guidelines”). The judge releases Hank into his parent’s custody until his trial. As he leaves the courtroom, Ren and Dawn are waiting for him. Ren promises to stick by Hank forever and asks him to marry her. Seeing the two of them together makes Dawn feels guilty and she calls Sal. They have a long conversation that closes out the book with Dawn admitting to him — just as he suspected — that she is Dove. A happy ending…at least until Armageddon 2001.

The first half of the book has great art, penciled by series regular Greg Guler. The second half is penciled by Curt Swan. I like his Superman art and he is clearly very proficient, but his art here is a jarring change of pace from the usual series art. His character designs (particularly Dove and Sal) don’t fit, and the inking makes his art look muddy. It also doesn’t help that his pages begin with Uncle Sam’s entrance, one of the sillier parts of the book if not the series.

Overall, this is a good issue, but clearly it was rushed a little to meet the sudden end of the series. The sales had been declining for some time and cancellation was probably inevitable, but it was the revelations of Armageddon 2001 that added the time crunch. It shows in the art, and it shows in the writing. I would have liked to see how the Kesels had planned to end the Senator O’Neill storyline if given all the time they needed (I’m hoping the original plan did not include Uncle Sam). Most of the dangling plot threads were tied up — some a little too conveniently — but a few were left dangling (and the best of my knowledge are still dangling today):

• Titans Hunt crossover – Completed.
• War of the Gods crossover – Completed.
• Donna/Kyle – Eloped.
• Ren – Asked Hank to marry her.
• Rodger – Still in the hospital.
• The Top – Still in Senator O’Neill’s body. Last scene, he was back as the Top, post-Identity Crisis. I don’t think this was ever explained.
• Barter – Still free

This is not quite the end of the series (or my recap of Hawk and Dove). There is still Hawk & Dove Annual #2 which ties into the Armageddon 2001 crossover, as well as the two issues of Armageddon 2001 themselves.

Tags: comics hawk dove barter top

In this scene from Wisdom #5 (Cornell, Garcia), psychic Maureen Raven gives her erstwhile kidnapper a little taste of her powers. (Take-home lesson for the week: Never kidnap a psychic or telepath. It never ends well and there’s usually a nosebleed involved somewhere).

All previous Psychic Nosebleed Zen posts

Tags: comics medicine nosebleed wisdom

New Avengers #28 “Revolution, part 2”
Brian Michael Bendis, writer
Leinil Yu, penciler

This is yet another example of the word homeopathic being used as a buzzword in a situation where it makes no sense.

Homeopathy was developed in the 19th century as an alternative to the conventional medical care of the time. Of course, given that 19th century medicine consisted of such wonderful concepts as bloodletting, cupping, and trepanation, it’s understandable that a less aggressive manner of treatment was developed. Since the 19th century, conventional medicine has progressed by leaps and bounds — homeopathy has stayed the same.

Homeopathy follows two “principles”: The Principle of Similarities, and the Principle of the Infintesimals. Let’s say that we had a patient with hives. The Principle of Similarities states that to treat a symptom, you need a substance that causes the same symptoms. For the purpose of our example, to treat hives, we would need to use a substance that actually caused hives. A solution would be made from this substance and then diluted down (the Principle of Infintesimals) to such an incredible extent that it is unlikely that even one molecule of the original substance would remain in the solution. This ultra-dilute solution (in reality: water) would be used to treat the hives.

Medically, Homeopathy is nonsense and bunk. Logically, it makes no sense, and multiple rigorous scientific studies have confirmed that it works no better than placebo. I’ll grant you that there are no side effects — but that’s just because the treatment is simply water. But let’s assume for a minute that Homeopathy does work — and even then Dr. Strange’s statements make no sense. Is he casting a spell that actually worsens her vital signs, but “diluting” the magic? Casting a placebo spell?

I’d suggest he become less chatty and simply cast some real magic, or at the very least use some of his medical skills to stabilize her vitals.

Tags: comics medicine homeopathy avengers dr strange brian bendis

Click on the image for the full ad.

First up, from Kamandi #12 (December 1973), is the “Big Break” we’ve been waiting for all our lives! At least that’s what the ad says, so it must be true. Personally, I suspect that Jim is a drug dealer or spammer and just made up the whole electronics school as a scam, much like those “work from home” websites (send me money and I’ll tell you how!)

Finally, from Superman’s Pal Jimmy Olsen #83 (March 1965), comes an ad for Silly Putty. Remember, if your comic book shop doesn’t carry Silly Putty, it must not be a good shop!

Tags: comics advertisement kamandi jimmy olsen electronics silly putty

Greetings everyone! I’m very happy to be back home from the hospital.

First off, I’d like to say thanks for all of the get well comments, e-mails, and thoughts. My wife and I truly appreciate them.

As for me, it looks like little permanent damage was done (except to my ego, which took a pretty solid hit). The cardiologist says that I can be back to full activity, including jogging and biking, in a month. In the meantime, I’ll just have to relax and catch up on reading, television, and a few other projects that have been stacking up.

Once again, thanks for all the kind thoughts and it’s good to be back!

The first of nine new House episodes in a row, tonight’s show featured a Iraq veteran suffering from Gulf War Syndrome, though little attention was actually paid to the controversial diagnosis. Medically, an above average episode, though it felt fairly light otherwise.

House is asked by Cuddy to see a patient who just happens to be the nephew of one of the hospital’s benefactors. Strangely, House has just had a dream about the patient, and is sure that he has seen his face somewhere before (he probably recognized him as Riley from Buffy the Vampire Slayer). John is a thirty-four year-old sergeant in the Marine Corps who recently returned from a two-year tour of duty in Iraq. John believes that he has Gulf War Syndrome and complains of chronic fatigue, intermittent rashes, joint pain, and frequent sore throats. While Chase seems predisposed to believe that it might be Gulf War Syndrome, the rest of the team suspect that he must have another diagnosis because there has never been any definitive medical proof of Gulf War Syndrome — in fact, there is medical evidence against it. House orders a blood work-up including tests for HIV, Hepatitis C, Malaria, schistosomiasis (a parasitic infection acquired from contaminated fresh water. Schistosomiasis does not occur naturally in the US, but does in Irag), and Acinetobater baumannii (a bacteria that can cause health-care related infections and has been seen with some frequency in soldiers who have served in the Middle East).

John’s physical exam is normal. He describes a frequent rash of black dots on his palms and soles, but he doesn’t have the rash currently. He also mentions a cough and sore throat, as well as chronic joint pain and tingling in his legs. Nothing shows up on exam. His routine blood work is also normal, except for his potassium which is a little low. Chase suspects John may be suffering from the after-effects of chemical warfare medication, military pre-deployment vaccinations, or toxins encountered in Iraq. He also mentions that John could be suffering from radiation poisoning from depleted uranium (depleted uranium is used in artillery and tank shells because it is extremely dense and has very good penetration). He wants to order a special urine test from England No one else agrees with his suspicions and House orders a polysomnogram (sleep study) figuring that poor sleep may be at the root of John’s problem.

The polysomnogram is normal, but John starts to complain of a foul smell. Foreman discovers that John has a nasty oral infection that is causing the odor. The team describes it as “bacterial vaginosis of the mouth.” (Bacterial vaginosis is an overgrowth of normally occurring vaginal anaerobic bacteria. It is a common cause of vaginal infections and is not usually considered to be sexually transmitted.) John is started on antibiotics for the infection (metronidazole is the most common). His HIV test is negative and there is no evidence of diabetes or other endocrine problems. Cameron suspects an autoimmune disease such as Sjogren’s Syndrome, but Foreman rules that out (but you’ll notice that he doesn’t rule out any other autoimmune diseases). Foreman suspects lymphoma, a cancer of the lymphatic system. House agrees that it is cancer, but suspects it is a parotid tumor (the parotid gland is the large salivary gland on the side of the jaw). He criticizes Chase for not sending John’s urine to England for the uranium test. Wilson performs a parotid biopsy, but the results are inconclusive. He next performs a sialogram (a test to look for blockages or obstructions in the salivary ducts), but it is normal. During the test, John suddenly becomes deaf. Wilson obtains a head CT which shows 6 tumors in the brain.

House is having problems of his own. He has been unable to urinate for three days — a side effect of the Vicodin — and has painful bladder distention. He tries some alfuzosin (brand name: Uroxatral) ( a drug that relaxes the prostatic and bladder muscles), but it doesn’t help. There is a funny scene in the clinic with a patient with diabetes insipidus (a condition where the kidneys are unable to concentrate the urine correctly, and thus the patient is urinating frequently and always thirsty).

A brain biopsy is scheduled, but just as Foreman is about to cut (or drill) into John’s skull, he realizes that the tumors aren’t showing up anymore on the scanner — they’ve disappeared. Looking over the symptoms, the team now considers the diagnoses of infection or infection plus cancer. Chase arrives with the tests from England showing that John does have evidence of depleted uranium in his urine. Since House no longer suspects cancer, he is not interested in the urine results. He tells the team to continue John on the antibiotics and monitor his symptoms. He goes home to catheterize himself and sleep. While House is gone, the Young Guns decide to go ahead and treat John for presumptive uranium poisoning, but the treatment does no good and may actually have worsened the situation. John now complains of paralysis to the abdomen (though the show confuses paralysis and lack of sensation, which are two different conditions).

When House arrives the next morning, he’s cracked the case thanks to another dream about John. He is aware that John is showing a lowered blood pressure and a lower hematocrit (signs of blood loss) and House announces that John has Hereditary Hemorrhagic Telangiectasia (also known as Osler-Weber-Rendu Syndrome). This condition can lead to AVMs (arteriovenous malformations) which cause frequent bleeding. Epistaxis (nosebleeds) are one of the earliest symptoms. House states that an AVM in the spine led to John’s neurological symptoms, and one is his lungs led to the joint pain as well as the mouth and brain infection.

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Overall, the medicine wasn’t too bad this time. Hereditary Hemorrhagic Telangiectasia is a logical diagnosis and fits most of the symptoms. However, I do have some concerns. I don’t understand how an AVM in the lung led to the blood not being “filtered” and this “dirty blood” led to joint pain and mouth and brain infections. First of all, very little filtering occurs in the lungs, (mostly gas exchange exchange) — blood is filtered in the liver, kidney, and spleen (depending on what you are filtering for). Similarly, what exactly is this “dirty blood” and how does it cause joint pain, because I’m sure my patients with long-standing arthritis would love to know. Is House saying that John’s joints are infected? All this still doesn’t explain how a vaginal pathogen managed to end up in John’s mouth, let alone survive there and cause an overwhelming infection.

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I wasn’t too keen on the whole “dreaming about the patient” concept either. For a show which prides itself on being (more or less) realistic and factual, the dreaming aspect seemed out of place.

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I give the medical mystery a B and the ultimate solution a B+. The medicine was above average, but I’m deducting for “bad blood”: C+. The soap opera/non-medical content, despite Cameron and Chase’s best efforts, only struck me as so-so and deserves another C+ .

Last week’s House review
A list of all previous House reviews
A story from medical school involving a urinary catheter

Tags: television medicine house hereditary hemorrhagic telangiectasia gulf war syndrome depleted uranium

I felt this was the weakest scene in the whole comic. First, it doesn’t sound like Reed Richards — it sounds more like bad Braniac-5 fanfic*. Second, that whole “adrenal glands” comment just struck me as awkward. It’s not necessarily wrong, just graceless.

The adrenal glands are located just above the kidneys. Among the many hormones they produce is epinephrine (better known as adrenaline), the chemical that activates the fight-or-flight response. Adrenalin is produced at the direction of the brain when the body experiences certain kinds of stress. So I guess Reed is saying the seeing Sue stresses him to such an extent that it activates his fight-or-flight response and makes it hard to communicate romantically. That’s entirely likely — from personal experience I can tell you that seeing the person involved in a bad break-up can cause those feelings.

But why mention the adrenals at all? Why not blame the locus ceruleus or the other areas of the brain responsible for activating the adrenal glands in the first place? Why not just say “it hurts to see her” and leave it at that. And while the fight-or-flight response might cause some problems, I think the bigger problem is the anger and betrayal they feel with each other and you can’t blame the adrenal glands for that. The way it’s written, it makes Reed sounds like someone trying to seem smarter than they actually are by using big words that are close, but not quite right. And that’s not Reed — he may use big words, but he uses them correctly (usually).

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*“I…will…always…love…you…Quer-” she gasped. Taking a final ragged breath of the thin air, she clutched at my arm and then was still.

“You shouldn’t have, Mary Sue,” I said feebly to her lifeless body, the rising wind tousling her long blond hair. “That death beam was meant for me.” I realized that my computer-like brain was unable to deal with the rush of emotions I felt. I cursed my unfeeling ancestors of the planet Colu and their emotionless breeding program. Gently I closed her eyes, which before had always shown the most brilliant azure blue but now had slowly faded to dull gray in the light of the setting suns. I clung to her body until it became cold and then I buried it on that barren world.

I returned to my lab and cried for a full ninety-three minutes.

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Or maybe Reed has just been listening to too much “Death Cab for Cutie” and now he’s going to run home and blog about it. Reread his captions above, but this time imagine them on some overly dramatic MySpace blog or LiveJournal.

Tags: comics medicine civil war reed richards adrenal gland braniac-5

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

Click on the image for the full PSA ad

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

Tags: comics psa world’s finest

One of the better issues of the series, and not just because it accomplishes the nearly impossible: it manages to fit the horribly out of continuity Brave and the Bold #181 logically into the main Hawk and Dove storyline. For those of you who don’t remember, that issue of The Brave and the Bold featured a middle-aged Hank and Don Hall being stripped of their powers because they didn’t fulfill their destiny and they fought with each other too much. It did have nice art by Jim Aparo, though.

Hawk & Dove #25starts just as the story from The Brave and the Bold is ending: Batman is swinging away and Hank and Don are discussing the loss of their powers. Hank returns home to his estranged wife Linda, who welcomes him with open arms…

…but then before his eyes she morphs into Ren. Not quite the same Ren we know and love, but a hippie version of her, including bell bottoms, tie-dyes, and psychedelic posters on the walls. Confused, Hank stumbles outside…

…and finds himself back on the Georgetown campus. There’s a crime in progress, but Hawk and Dove are already there. Only it’s his late brother Don, the original Dove, and a female Hawk. They capture the criminals, make snide remarks about the SCU, and then change back into their civilian identities. Hank confronts the two of them, protesting that he is supposed to be Hawk. You get the feeling this is an old argument between the brothers. Don sadly reminds Hank that while he was saving the children’s lives during the Crisis he was crippled, and subsequently stripped of his powers and a new Hawk chosen. Hank keeps protesting, “I’m Hawk,” over and over again…

…and he wakes up in bed, apparently a victim of nothing more than a bad dream. Then his wife appears, and it’s Dawn. He panics, but Dawn reminds him that they lost their powers on Druspa Tau. They returned home and subsequently married. She pushes Hank into the shower…

…and he finds himself back in the real world as Hawk, punctured by spear growing from a giant blue gem (just like on the cover). Hawk thinks back: he remembers entering the Smithsonian, changing to Hawk, and stealing the sapphire his brother needs to return to life. He remembers dodging the Smithsonian security and heading to roof to hide. He also remembers being puzzled when he didn’t immediately change back to Hank — but then he realized the gem had started glowing. The gem suddenly exploded in size, piercing him with several of its blue crystal arms.

Now that he’s awake, Hawk realizes that the gem is magic and somehow related to Order (the opposite of the Chaos that gives him his powers). It is purposefully warping his mind and memories. He is able to summon the willpower required to break the gem’s hold on him. Then he smiles because the gem has transformed into a giant blue crystal golem, and he realizes that he has something to hit.

Meanwhile, Ren is at the hospital visiting the still recuperating Rodger. She is concerned that she hasn’t been able to get in touch with Hank for a few days, and even more worried that it might have something to do with Dawn and Dove. Rodger does his best to reassure her.

Speaking of Dawn, she is on a date with Captain Arsala. They are sitting in his car, watching the sunset and eating burgers when his pager goes off. Hawk is robbing the Smithsonian and Arsala and the SCU are needed there. He offers to drop Dawn off at home on the way, but she declines and tells him she’ll get a ride home once they get to the Smithsonian.

The SCU team arrives at the museum grounds to find Hawk battling a blue crystal monster. He defeats it, and it reverts back to the sapphire he stole from the Smithsonian. Arsala orders him to surrender. Dove appears and asks Hawk what happened. He is surprised to see her, and tells her that he can’t explain, but asks for her just to trust him. He runs off, gem in hand. Arsala demands that Dove fly after him, but she refuses, saying that Hawk must have had a good reason for his actions.

The issue ends with Hawk alone in an abandoned warehouse, staring at the gem he stole, and wondering out loud if it was worth it.

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The writing was very good this issue, and the Kesels manage to weave action and soap opera together seamlessly. The opening alternate histories of Hawk and Dove are extremely well done, and each story has a distinctive voice — but then I’ve always been a sucker for alternate history stories. Each of the different versions has art by a different team, with the regular Guler/Hannah team handling the art on the main story.

It was clever of the Kesels to reconcile the Brave and the Bold story by explaining it away as one of the alternate histories shown by the gem. I’m not sure who provided the art on this section (the comic only all the artists involved, not who did each section), but they did a good job replicating the Aparo art from the original story. The second alternate history basically serves as a segue from the counter-culture late ’60s, when Hawk and Dove debuted, to their reappearance in the ‘90s. It sets up the most powerful of the alternate histories, the third one, where Hank has lost his powers. In this version of events, Hank went back to save the kids during Crisis on Infinite Earths instead of Don. Since Don didn’t die, he’s still Dove. Unfortunately, Hawk was crippled saving the children and a new Hawk appointed. Trivia buffs should note that this is the first appearance of a female Hawk, though I doubt she is anyway related to the current female Hawk as she goes by Kath and not Holly. The art is very somber The final alternate history presents Hank and Dawn as a married couple. In this reality, they lost their powers after the death of T’Charr and Terataya, but returned home from Druspa Tau to fall in love and get married. I did recognize the art on this section — it’s by Kevin Maguire, who also drew Hawk & Dove #20. I like the little touches like the wedding pictures on the wall with Hank in a blue tux.

Sadly, this is the last really good issue of Hawk & Dove. There are great moments in the remaining three issues (and one annual), but no single issue stands out.

All Previous Hawk and Dove Reviews

Tags: comics hawk dove jim aparo kevin maguire

A change of pace in tonight’s episode. There was no grand medical mystery to solve. Instead it was a character show. I’ll admit it was a well done character show, but personally, my favorite parts have always been the medical aspects of the show.

The episode begins with House in the clinic as part of his payback to Dr. Cuddy. His first three patients are all concerned about sexually transmitted diseases (STDs). House tries to bribe patients to leave, but Cuddy isn’t very pleased with that plan. In the middle of their discussion, one of the patients in the waiting room stands up, grabs his head and starts screaming. He runs around the room screaming about how much his head hurts. House trips him and then injects him with medicine to calm him down — of course it turns out he didn’t inject him with a sedative, but instead a paralytic. This paralyzes his muscles, so he can’t run or scream. Unfortunately, as Cuddy points out, it does nothing to stop the pain, and it also paralyzes his respiratory muscles so he’ll need to be intubated. House convinces Cuddy to let him admit the patient so he can work him up. Foreman suspects the patient may have an acoustic neuroma, Chase thinks the patient may be psychotic, and Cameron mentions that the patient may have a severe ear infection and mastoiditis. House tells them all to run the appropriate (and expensive) tests, then he admits that he already knows the problem: the patient has a cockroach in his ear. He just admitted the patient to the hospital so that he could get out of working in the clinic.

When Cuddy finds out, she drags House back to clinic. Eventually, she offers him $10 for each patient he can diagnose without touching, but he will have to pay her $10 for each patient he has to touch to diagnose. This leads to several amusing scenes where House has patients use tongue depressors on themselves, check their own pulse, and diagnose their own rash.

The STD test results are back and House has to deliver the news to the patients. The first two tested negative. But the third patient, a young woman named Eve, has tested positive for chlamydia. Based on her reaction to the news, House realizes that she is a victim of rape. He goes to Cuddy and requests that a different doctor be assigned to the patient because — let’s be honest — being supportive isn’t one of House’s best skills. However, Eve feels differently and states that she only wants to talk to House. The two of them talk some more, but don’t come to much of an understanding, so House sends a psychiatrist in to talk to Eve. After talking to the patient for about an hour, the psychiatrist screams for a crash cart. It seems that when she was giving Eve a benzodiazepine sedative (the same family of drugs as Valium), Eve grabbed the whole bottle and took them all.

Eve is resuscitated and admitted to the hospital. After she wakes up, Eve tells House that she won’t try to kill herself again. She tells him that she just wants to talk. She asks if anything bad has ever happened to him. He tells her a story that when he was a child, his grandmother used to be an extremely strict — if not downright abusive — disciplinarian. Eve asks him if the story is true. He avoids the question, but finally admits that it isn’t necessarily completely true.

Cuddy pulls House out of the room and informs him that not only does Eve have chlamydia, but she is also pregnant. House tells Eve the news and recommends an abortion given the circumstances of conception. She tells him that she believes abortion is murder and that she could never go through with it. What follows is a long discussion, both within the hospital and in a nearby park, concerning God, suffering, life, and death. House confesses to Eve that his story about his childhood was true, only it was his father who was the disciplinarian, not his grandmother. At this point, Eve lets down her guard enough to finally talk about what happened to her.

There was also a side plot about Cameron admitting a homeless man terminally ill with lung cancer. He feels that he has wasted his life and he wants somebody to remember him so he decides to die without pain medication (and lung cancer is a very painful way to die) so that Cameron will remember him.

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I have nothing bad to say about the medicine in tonight’s show, basically because there wasn’t much of it. The opening clinic scene was accurate: patients who are embarrassed about coming to the doctor for an STD frequently lie to the nurse about why they’re at the clinic. I also see this in patients with hemorrhoids and other problems “down there” — it’s usually a guy thing though. I’ve never had a female patient who wasn’t upfront about it.

I did have a couple of small nit-picks. First, why was House carrying around a syringe of a paralytic? If I were Cuddy that would worry me quite a bit. Second, why did Cuddy get mad at the pharmacist for not giving her a sedative quick enough? He can’t dispense it without an order and she never told him what she wanted. Third, those sedatives Eve took kicked in extremely quickly, unless the psychiatrist lied about when she took them. Finally, it didn’t look like Eve was under any sort of suicide precautions once she was admitted to the hospital.

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The interactions between the main characters were clever. Each character gave different advice to House about how he should talk with Eve, and the advice differed wildly depending on who he talked to. The best was Chase’s “Keep her sedated.”

If I have one main complaint about the story, it was the use of the clichéd “traumatized person’s magic lie detecting skill.” Eve could magically tell when House wasn’t telling the truth, and then could miraculously tell when he finally told her the truth — and this is what allowed her to trust him enough to share everything with her. Please. This cliché is bad on any show, and House is a much better liar than that.

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No grade for the medical mystery tonight since there wasn’t one. The medicine wasn’t bad, though there wasn’t much of it, and earns a B. The character interaction/soap opera was the highlight of the episode and deserves a solid A.

The previous House review
A list of all prior House reviews

Please remember that the name of this blog is “Polite Dissent” — emphasis on polite — so let’s try to keep all discussions cordial this week, particularly those concerning abortion and religion.

Tags: television medicine house rape suicide lung cancer

Click on the ad for the full-sized image

Will wonders never cease? Thanks to modern technology and revolutionary electronics, I can now make my own records — at home! And I can record them in 331/3, 45, or even 78 rpm. It is truly an age of miracles we live in. I wonder what will come next? Portable telephones? Color television? Flying cars?

Take a look at that first paragraph:

Sing, tell jokes, record secret conversations, speeches, take off your favorite shows and music, and it’s all ready to play back instantly.

“Record secret conversations” — between this and listening through walls with the stethoscope, I wonder what sort of values were taught in the ’60s. Maybe it wasn’t quite as idyllic as everyone remembers.

(Ad scanned from Doctor Tom Brent, Young Intern #1, Charlton, February1963.)

Tags: comics advertisement

Hank returns home from an evening of studying to find a mysterious woman in a wheel-chair waiting for him in his apartment. She explains that she is Barbara Gordon and she calmly informs Hank that she wants him to call Dawn because she needs to talk to both Hawk and Dove.

Once Dawn arrives, Barbara explains that she needs their help in taking down Velvet Tiger once and for all. She explains that Velvet Tiger was once one of Batgirl’s enemies, but since Batgirl has “retired,” Hawk and Dove will need to step in and apprehend Velvet Tiger. When asked how she learned their identities, Barbara plays coy at first, telling them that she got it from “an oracle.” Then she quickly explains that Oracle is a top secret government computer expert, but in the next panel she all but admits she is Oracle (”I hacked the Titan’s database”). Clearly this is before Oracle’s identity became the big secret it is now (and it is one of her first appearances outside of Suicide Squad).

Barbara tells the duo that Velvet Tiger is said to be Lani Gilbert, but she finds that hard to believe because records show that Lani is only ten years old. Barbara explains that the Tiger is trying to take out Washington D.C.’s mob bosses one by one so she can take over as top boss in the city. Barbara has been able to pinpoint who Velvet Tiger will attack next and she wants Hawk and Dove to intercept and capture her.

Across town, the Velvet Tiger and her bodyguard/lackey Sudden Death arrive at the hide out of one of the few remaining mob bosses. As the Tiger moves in for the kill, Hawk and Dove arrive. Hawk quickly subdues Sudden Death with the help of a conveniently thrown gas grenade. Dove’s battle with the Velvet Tiger is much more interesting. First, she fools the Tiger into thinking that Batgirl has returned. While Velvet Tiger is focusing on “Batgirl,” Dove tries to grab her and suddenly everything goes topsy-turvy. It turns out that Velvet Tiger has the ability to stop time and enter a special dimension that is “between the seconds.” Due to an unhappy childhood, she has spent years hiding in this dimension and the grown-up Velvet Tiger really is the ten-year-old Lani Gilbert. She now uses her powers for criminal gain and to evade capture. Since she is the only one who can survive in this dimension, her plan is to strand Dove here to slowly starve to death. Unsurprisingly, Dove is not too keen on this plan, and she deliberately strikes Lani’s already injured ribs so that the shock will cause her to bring them both back into normal time. As they suddenly appear in the hideout, Barbara shows up just in time to handcuff Lani to a pipe. She informs Lani that that while Dove may not be able to testify at a trial (because of that whole secret identity thing), Barbara will testify and make sure that the Velvet Tiger is put away for a long time.

As the issue ends, Dawn has a quiet chat with Barbara while Hank receives another message from his dead brother. This one asks him to steal a special sapphire from the Smithsonian Institute that he’ll need to bring Don back to life. Hank is unsure what action to take: he’ll do anything to bring Don back, but stealing would mean that he’d be “no better than a criminal.”

Notes:
The art by Greg Guler continues to be good. The writing by the Kesels is still good — particularly the quiet character moments — but overall the last issues of Hawk & Dove just don’t have the same zing as the earlier issues.
The Unofficial Oracle Chronology
Barbara Gordon makes a reference to the Titans Hunt storyline, the company-wide Titans crossover that was occurring at the time (and went for what, six or seven months?) This is the second reference to Titans Hunt in Hawk & Dove, but the actual crossover doesn’t occur until issue #28 and lasts for all of 2 panels before it is crushed (literally) by another company-wide crossover, War of the Gods. More about this when later.
While their children are off fighting the Velvet Tiger, Hank’s and Dawn’s parents are both attending a fancy soirée for Senator Tommy O’Neil. The parents chat for a bit and are clearly confused about who’s dating whom, but the main reason I mention this is that O’Neil will play a key role in the remaining 4 issues of the series.
I find the idea that Velvet Tiger has actually spent half her life hiding in her special between-seconds dimension and really should only be ten years old is kind of creepy, but handled well. It’s nice to see super-powers that actually have real world consequences.
All Previous Hawk and Dove Reviews

Tags: comics hawk dove batgirl oracle velvet tiger

Once you start the clinical rotations in your third and fourth year of medical school, grand rounds become a way of life. For those of you unfamiliar with the term, “grand rounds” is a weekly event where all the physicians of a particular specialty come together to hear an educational lecture. Medical students are required to attend the grand rounds of whatever specialty they’re on at the time. Some “gunners” also attend the grand rounds of the specialty they intend to go into, particularly if it a highly competitive field and they want to be “seen.” I was never one of those.

OB/Gyn grand rounds were held ins a dark little theater with comfortable seats. To an exhausted medical student, that just meant a nice place to nap. Pediatrics had the best grand rounds. They were short and sweet, just forty-five minutes, and were on useful topics. They were also held at lunch so we didn’t have to stay late or come early — plus food was provided. For a poor medical student, any meal I didn’t have to pay for or buy at the highly suspect hospital cafeteria was a definite bonus. Internal medicine also held their grand rounds at lunchtime, but we had to bring our own lunch. The topics weren’t nearly as interesting to a medical student either. Psychiatry grand rounds were Wednesday afternoon. There was an hour lecture followed by a half-hour discussion of the lecture. Since we got to go home a half-hour early on those days, we were happy. Surgery grand rounds were the worst. They were Saturday mornings at 6 AM. Even on the rare Saturdays you weren’t working, you were still expected to be there for grand rounds. Like psychiatry, the lecture was followed by a discussion of the topic. Frankly, the discussion period was much more interesting than the lecture. The head of the surgery department was set to retire at the end of the year and his replacement had not yet been named. There were two leading candidates in the department and each had their followers and detractors, and the two sides were quite vocal about their feelings. Like clockwork, the discussion after the lecture quickly degenerated into partisan bickering, and as a medical student with zero interest in surgery, I always found this much more educating and entertaining than the lecture itself.

There are two grand rounds in particular that stand out in my memory. The first was a psychiatry grand rounds. An out of state psychiatrist was brought in to speak. He had no clinical practice; instead he worked as a consultant for the FBI — primarily helping them track down sexual serial killers. This was long before Silence of the Lambs, CSI, and Law & Order: SVU, so the subject of serial killers wasn’t as common as it is now. His lecture was fairly interesting and filled with lurid and explicit crime scene photos. He finished his talk, answered a few questions, and then left. The after-lecture discussion started, and nobody talked about the lecture. Instead, they all talked about the lecturer.

“Did you see the way he was getting off showing the crime scene photos?” one staff psychiatrist asked.

“He’s clearly a reverse voyeur,” another intoned.

“He has issues with women,” the department head announced.

This went on for half an hour. I was fascinated, a little dismayed, but mostly amused to see these professionals go to such length to psychologically “dissect” another psychiatrist who had just spoken to them. For the record, there was something a little off about the speaker and I think the other psychiatrists were undoubtedly right in their analysis. I still think it was rude, though.

Then there was the surgery grand rounds where a well-known hand surgeon was brought in from Los Angeles to speak. He was talking about surgical reconstruction of hands that had been severely injured by gunshots. He was an excellent speaker and had some memorable and somewhat sickening before- and after-surgery x-rays. About halfway into the lecture, he made the point that it was difficult to get good follow-up with the injured patients because “they’re ghetto people and theyrre unreliable about making it to their follow-up appointments.”

At this point, Dr. K-, the acting head of our surgical department stood up from his seat, fixed the speaker with his steely gaze, and said, “We don’t appreciate racist talk here. Please refrain from making any more such statements.”

The speaker had that deer-caught-in-the-headlights look for a minute, and then he collected his thoughts and resumed his lecture. It went well until about five minutes later when he made another statement about “those backwards ghetto people.”

“That’s it!” Dr. K- announced as he stood up. “I told you that we do not tolerate racist comments.” He paused, took a breath and then simply said, Let’s go.” At this point, all the other surgical attendings stood and filed out of the room. Dr. K- looked over at the medical students and residents and told us we could stay or we could go at our own discretion. We all left.

Other True Tales of Medical School

How would you like to earn $70 or more each week? Well now you can with this amazing 10-week home study course! Free swag too (including a “Simplified Nurses Dictionary” — which sounds a little condescending to me)!

Click on the ad for the full-sized image

From The Young Doctors #3 (Charlton, July 1963). Technically not a public service advertisement, but it gives a nice picture of the history of nursing (or at least this one aspect of it), so it’s close enough to count.

Tags: comics medicine psa nursing advertisement

In this week’s episode of House, the mystery is good, but the medical treatment is not. There are some good character moments, but this doesn’t stop the Tritter storyline from limping to a weak ending. Spoilers follow!

Derek, a firefighter, becomes short of breath and disoriented while at the scene of a fire. He tells his partner Amy that he is feeling chills. He is brought to the hospital and admitted to House’s service. Cameron notes that he has a fluctuating temperature as well as skin grafts over half his body from bad third-degree burns suffered on the job a year ago. She also discovers that he has had several episodes of disorientation in the past few weeks. Cameron reports that Derek’s tests for hepatitis C, HIV, TB (tuberculosis), Lyme disease are all negative, as is his drug screen. The EKG is said to show an “arrhythmia” (an abnormal rhythm) but House blows it off. Foreman suggests a hypothalamic tumor, while the other doctors are suspicious of a hospital acquired infection — one he picked up when he had his skin graft surgery and which has smoldered since then. They are concerned about MRSA (methacillin-resistant Staph. aureus), a particularly nasty germ.

Because of concern about MRSA, Derek is placed in isolation. He casually reveals to Cameron that everything looks blue. Foreman mentions heavy metal poisoning as a cause of this, particularly thallium. House suspects the patient has “male menopause” (low testosterone, elevated estrogen levels) brought about by burns he has suffered to his genitals. Viagra is known to cause blue color shifts, and House believes he is taking Viagra to make up for the effects of the low testosterone. The next time we see Derek, he is out of isolation (the MRSA tests came back negative) and he is receiving hormone therapy (apparently his levels were low). He suddenly starts screaming that the hormones are causing pain, then he lashes out and starts throttling Cameron. Foreman sedates him with some Lorazepam (brand name: Ativan).

The team tests, but Derek is not allergic to the hormones and they were not contaminated. Additionally, there is no evidence of a pulmonary embolism and his EKG is normal. Foreman, true to form, suspects a neurological cause, either a frontal lobe tumor or meningitis. However, a CT scan and lumbar puncture are normal. Other possible diagnoses mentioned include polyarteritis nodosa (a rare disease caused by inflammation of the arteries) and Legionnaire’s disease. Chase also believes it is unusual that Derek’s drug screen is negative as he must be taking some pain medication to treat the severe pain from his skin grafts.

The Young Guns are paged to Derek’s bedside where they discover that he has become suddenly short of breath and tachycardic (rapid heart rate). His oxygen saturation is 85%. Chase notices ST elevation on the EKG and realizes that Derek is having a heart attack. Elevated cardiac enzymes confirm this diagnosis (a heart damaged by a heart attack will release certain proteins in a predictable pattern over several days. By testing for these proteins, you can discover if a patient has had a heart attack.) The team eventually realizes that the common denominator in all of Derek’s attacks is his partner Amy. It is only when she is around that he has problems. They can find no inciting agents she carries, but Cameron recognizes that Derek is in love with Amy. He explains that she is engaged to his brother and that he can never have a relationship with her. Cameron explains to the rest of the team that Derek is literally dying of a broken heart.

The team starts Derek on beta-blockers and nitroglycerin (common medications for heart attack patients) but they don’t help. The team considers antidepressants, but discards the idea because House believes their side effects will make things worse (which is quite a stretch). Chase suggests propylthiouracil (a drug that is inhibits the thyroid gland), but House feels it would be bad for the heart as well (not to mention a bizarre and incorrect use of the drug). At the end, the team decides to use EST (electroshock therapy) to cause a permanent memory loss so Derek won’t remember Amy or his brother.

The therapy seems to be successful, but in a casual conversation with Amy, Cameron discovers that she was never engaged to Derek’s brother. It turns out that Derek had false memories (I would have first thought of House’s favorite mantra –”patients lie” — rather than jump to the diagnosis of false memories). A brain MRI (now they get an MRI) shows decreased blood flow to one part of the brain. A close look at the blood flow in the spine shows a spinal meningioma (a tumor of the membrane that covers the spinal cord) that is pressing against the blood vessels supplying blood to the brain. When this tumor is removed, Derek will be good to go (well, except for that permanent memory loss).

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Medically, the two big problems this episode were the EKGs and the ECT.
In the beginning, House ignores an abnormal EKG. You never ignore an abnormal EKG — that’s just asking for trouble, and they would likely have made the diagnosis much sooner (but then the show would be too short). Then later in the episode, Derek had a normal EKG. If he truly had suffered multiple heart attacks, there’s no way he would have had a normal EKG.

The biggest problem was the EST. First, there’s no way EST would ever be used without a psychiatrist’s evaluation and consent, and no psychiatrist would jump straight to EST without attempting other therapies first. A thorough testing, evaluation, and history would reveal the false memories. EST is still used occasionally for depression, schizophrenia, and mania — but the patient is suffering from none of these. EST can certainly cause memory problems, and does cause temporary memory loss in most patients, but it is not a predictable effect and ECT is not used to purposefully block out memories.

For nitpicking, I will point out that the bacterial cultures came back surprisingly fast once again, and that Cameron needs to brush up on her isolation skills. She wasn’t dressed correctly for either contact isolation or drawing blood.

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On the non-medical side, I liked the scenes with House and Cuddy and House and Wilson — especially the ones with Cuddy; she showed some real teeth. I thought his interactions with Foreman and Chase were good, but wasn’t as impressed with the scenes with Cameron.

Legally, it seemed all wrong. I am certainly not a lawyer, but the show seemed to be confusing grand juries and actual trials. The judge said she was going to determine if there was enough evidence to try House, which suggests a grand jury (or something like that), but House pleaded “Not Guilty” before that. How can he plead if he hasn’t been brought to trial on charges yet?

And the resolution of the whole Tritter storyline? Let’s just say that it ended with a whimper and too much deus ex machina for my taste.

I did like that House had the last laugh after all.

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The medical mystery was good, so I give it a B+ and the ultimate solution was well-thought out and earns another B+. The actual medical treatment was bad, especially the EST aspect, and drags down the overall medical score to a D+. The character interaction/soap opera was good and earns an A-. Overall, I give the Tritter arc a C-.

The previous House review
A list of all prior House reviews

Tags: television medicine house mrsa electroshock therapy meningioma

A recent PSA comic this week: last month’s Robin #156. As the cover suggests, this issue is about suicide. No scene resembling the cover actually takes place inside the book, and frankly, the story is better for it. This is not a “heroic-rescue-the-jumper-from-midair” story. Instead, it is a well scripted story consisting of two lonely people talking and working things out.

After the end of the hostage storyline last issue, Tim Drake returns to high school and then, as Robin, visits wannabe teen-hero Dodge in the hospital. On his way home from the hospital, he spots a lone man standing at the edge of the roof of a tall building. Robin swings down to sit down next to him and talk. And that’s it. The rest of the comic is pretty much the two of them talking. It’s not hard to see that the young man is clinically depressed. Robin, for all his skills and accomplishments, has his own failings and is able to be a good listener. Robin makes some good points, particularly when he talks about how everyone’s problems are the worst, because they’re their problems. But mostly he just let’s the other guy talk. When he comes down off the edge at the end, it’s a believable scene.

Full credit to writer Adam Beechen and penciler Freddie Williams for producing a well done PSA comic, and managing to fit it in continuity.

The only problem I have with this issue has nothing to do with the script or art, but with the packaging. First, those stupid HeroScape 3-D glasses were inserted in the comic. It’s a poorly thought out ad for many reasons, but mainly because of the glasses and the fact that it makes HeroScape look dark and cluttered — everything the game is not. Then, in the center of the comic is an 8 page television Teen Titans comic/ad for Spark Top. This was particularly jarring this comic because you go from the middle of a serious conversation with a somber Robin to the overly cheerful and too-brightly colored Teen Titans Robin. Not a good place for the ad.

Tags: comics medicine psa robin suicide

I spent the latter part of last week with the Polite-wife and the in-laws in Las Vegas. Her family is great, so visiting is always something I look forward to, but it’s exhausting too, particularly at the holidays. While in Vegas, we had the chance to catch up with old friends as well as visiting my favorite comic book store, Alternate Reality.

We returned home early Christmas evening and spent the remainder of the night and the next day with my folks, celebrating our family Christmas. It was fun, there was plenty of good food, but it’s nice to be back in our house. I have the next few days off before working in the clinic New Year’s weekend, so I think I’ll relax, play some Lego Star Wars, and — maybe, just maybe — update the Comic Book Drug Reference and maybe try out some new CSS for this site.

I’ll resume regular posting Wednesday night with a look at Rabies in Jonah Hex, followed by a look at the best and worst in comic book medicine in 2006.

In the meantime so you can get your medical fix, this week’s Grand Rounds is being held over at Blogborygmi. (Grand Rounds is the weekly collection of the best medical blogging). In addition, the 2006 Medical Blog Award nominations remain open, so head over and check out the nominees so far, or nominate one or two of your favorites.

It’s that time again to look at what internet search engine queries brought people to Polite Dissent over the past two months. You’ll notice a couple of repeats on here, but that’s only because people keep asking for it. As always, my comments when appropriate (or even when inappropriate) are in green italics. (Previous seach posts can be found here, and it seems I missed September. I’ll have to correct that oversight at some point)

As Hawk & Dove neared the end of its run, there still remained several outstanding issues. Unfortunately, there were also an increasing number of issues that were painfully mediocre. This is one of those comics.

It starts out promising. Dove and Captain Arsala are on a date, just like in issue #13. She ditches him in the middle of the meal, only to reappear a few minutes later as Dawn. It’s part of her cunning plan to make Arsala think that Dove is flighty and that Dawn is a better prospect for dating. Ren and Hank are hiding in the restaurant helping Dawn with her plan.

There is a brief interlude featuring the Velvet Tiger and her new bodyguard, Sudden Death, putting the squeeze on a Chinese mob boss. The scene returns to the restaurant as Captain Arsala is leaving. He promises to call Dawn and then drops a cryptic comment about missing Teen Titans¹.

Hank, Dawn, and Ren start walking home when they stumble upon an attempt on the Velvet Tiger’s life². They change to Hawk and Dove and swoop in to help, unaware that the Tiger is actually a vicious criminal. The team sent to dispatch her is the Cyber-Brats, easily one of the lamest villain teams of the nineties³. There is Database, a young kid who has a keyboard on his forearm and a wheel instead of his left leg (here he comes: step, roll, step, roll, step, roll). He doesn’t seem to have any powers other than shouting out random technobabble. Next is Cursor who controls a 4-inch flying sphere. She can hang onto it and “fly” or use it to hit people. She doesn’t last long in the fight. Modem can materialize in and out of electronic equipment and is also down for the count quickly. Mainframe is a bruiser (or “tank” if you prefer MMO-speak) who can increase in size and power, like Giantman. He’s the only one who actually puts up a fight.

Then the fifth member of the Cyber-Brats appears: their leader, named Hakker, who can possess any one of the other ‘Brats and manifest through them as a giant computerized Grim Reaper. It turns out that he is actually the older brother of the Velvet Tiger — and he is here to “cut out her evil side.” In the end, the Cyber-Brats are captured and the Velvet Tiger escapes, but not before revelaing her evil sadistic side to Dove.

The excitement over, everyone returns home and Hank finds another message waiting for him from his deceased brother asking for his help.

All Previous Hawk and Dove Reviews

Tags: comics hawk dove velvet tiger

While our home lay blanketed in ice and powerless this weekend, the wife and I decided that it would be a good idea to travel someplace with a working heater, so we decided to see a movie. And not just any movie, but we decided to catch Casino Royale, the latest James Bond movie and the first to star Craig Daniels Daniel Craig as Bond.

It was a wise decision. Not only did we avoid hypothermia and frostbite, but Casino Royale is one of the best — if not the best — of the Bond films. Daniels played a phenomenal James Bond, and it was great to a Bond closer in spirit to the James Bond of the books than the outrageous movie bond of late. I agree with Tom that the movie was about thirty minutes too long, but the chase scene at the beginning more than makes up for it.

Cynical physician that I am, there was scene that caught my eye about two-thirds of the way through the film:

While playing a high stakes game of poker at the Casino Royale, James Bond drinks some poison that was slipped into his martini. Once he notices its effects (rapid heart rate, diaphoresis), he rushes to the bathroom where he makes an emetic of salt-water in an attempt to purge any remaining poison from his stomach. He rushes to his car where an AED (automatic external defibrillator) is waiting, along with a connection to the team at MI6 back in England. He jams a fancy needle in his arm which allows the chaps at HQ to determine that he has been poisoned with Digitalis. They have him slap defibrillator pads on his chest and then inject a medication into his neck. As the medicine takes effect, he tries to set off the defibrillator, but can’t manage it. As he collapses and his heart stops beating, Vesper arrives and sets off the AED, reviving Bond.

Digitalis is a potent cardiac medicine. Originally refined from the foxglove plant, digitalis is still used today in conditions such as heart failure and atrial fibrillation. A digitalis overdose has a surprisingly high morbidity and mortality.

It takes 6 hours for digitalis toxicity to kick in after a large dose, so it wouldn’t have taken affect until well after the poker game.

Toxic levels of digitalis can cause a wide variety of abnormal cardiac rhythms. The most common in acute toxicity is a bradyarrythmia, or an abnormally slow heart rhythm. Tachyarrythmias (abnormally fast rhythms) can also occur in acute toxicity and are a worrisome sign. Bond had a racing heart rate — though I have to admit that while he had fairly fast rate of around 135, it looked like a normal conduction pattern to me and not a dangerous rhythm.

Defibrillation is not recommended routinely for digitalis toxicity because it can cause very nasty heart rhythms (such as ventricular fibrillation) or it can cause the heart to stop beating entirely (asystole) — neither of which are good things.

I did not catch the name of the drug he injected into his jugular vein, so I I’m not going to speculate on how it would work. However, if someone more observant than me did catch the name…

You’ll note that Bond was defibrillated while in asystole. This is not a good idea, and one of the Most Common Comic Book Medical Errors (and movies too).

A final thought on the defibrillator. Many modern AEDs can set off the shock themselves once they are turned on, so there’s no need to manually trigger the shock. Additionally, nearly every model has a fault detector to make sure the circuit to the pads is working. It’s a shame MI6 spent all that money on his car and skimped on the AED.

[Don't let this medical nit-picking make you think I didn't enjoy the movie. I did. Go see it, and on the big screen too. That intial chase scene just won't be the same on a small screen.]

Tags: medicine james bond casino royaledigitalis/small>

After visiting the seriously hurt Rodger in the hospital, Hank walks home, blaming himself for Roger’s injuries. He stumbles across a drug deal and wastes no time in trying to break it up. He can’t change into Hawk because it would be out in the open and everyone would see. He fights strictly as Hank and does well at first, but then one of the drug dealers pulls a knife. Luckily, Dawn was concerned about Hank’s state of mind and had been following him. She changes into Dove and quickly takes care of the drug dealers. She then delivers a stern –- and mostly tongue-in-cheek — warning to Hank about letting those with powers handle crimes.

Watching the melee across the street is former beach bum Sudden Death (remember him from issue #5?). He wants a rematch with Hawk and figures that if Dove is around, Hawk can’t be too far behind. He strolls into the fracas, pushing Hank aside to confront Dove. Unfortunately, Sudden Death shoved Hank straight into a tree, knocking him out. Dove realizes that she’ll have to buy time for Hank to recover. She dodges Sudden Death the best she can, then pulls that hoary old comic book cliché “overload the villain.” Sudden Death explodes, ripping a great hole in the ground. He is stunned, but Dove and Hank fall down the hole into a Metro tunnel. Seeing a train barreling down upon them, Dove manages to wake up Hank just in time for him to turn into Hawk and stop the train.

Hawk jumps up to the surface and pummels Sudden Death again and again. As Sudden Death nears critical mass, he throws him at a tree in the distance. The tree explodes, but Sudden Death mysteriously disappears.

All in all, this is a fairly light comic with well done guest art from Steve Erwin. This issue is mostly a set-up issue, as the storylines and villains of the final six issues of the series are introduced. Velvet Tiger appears, first as someone who’s killing mob bosses, then as the rescuer and potential employer of Sudden Death. (For those of you who don’t remember the Velvet Tiger, she was one of Batgirl’s foes from the 1980s.) The last two panels of the issue set up a cliffhanger that really drives the remainder of the series: Hank receives a message on his new answering machine from Don, his dead brother.

All Previous Hawk and Dove Reviews

Tags: comics hawk dove velvet tiger

This is one of the best issues of the series. It focuses mostly on Dove, but it also manages to tie up several dangling plots including Ren and Hank, as well as Dawn and the mysterious Brian. It also introduces a new plot thread: “The Black Russian¹.”

While the script alone is entertaining (especially the dialogue), the best part of the issue is the art. Guest artist Kevin Maguire turns in some of his patented fantastic penciling. His use of facial expressions is so essential to the storythat I don’t think any other artist could have pulled it off so well.

As the issue begins, it’s the Christmas season and Dawn is sitting by the window, looking out at the snow. Her father is out of town on a job for S.T.A.R. Labs and her mother just got called away on a diplomatic mission. Home alone² with nothing to do until Donna’s party that evening, Dawn decides that an afternoon spent shopping would be perfect.

She heads to We R Toys to pass the time. The big draw at the store is a live performance of the Super-Powered Samurai Saurians³ (an intentionally unsubtle nod to the Teenage Mutant Ninja Turtles). In the middle of the show, robbers dressed as Santa and his helpers strike. Dawn quickly changes into Dove and has little trouble subduing the criminals. In the end it turns out that it wasn’t a robbery as much as an act of revenge. The leader of the crooks was a failed toy manufacturer who blamed We R Toys for his company’s failure. When he tries to slink away in the confusion, the Saurs capture him and the kids erupt in cheers.

The police arrive to find Dove (with help from the Saurs, or course) has already taken care of business. Captain Arsala and Dove flirt a little, but then she flies off telling him that she’s late for a party.

And late she is. Donna growls at Dawn for being late to her Christmas party but relents when she admits that Brian, the guy she’s been trying to set up Dawn with since the second issue, is also late. Surprisingly, Ren is not at the party. Hank asks Donna where she is, and she explains that Ren is a little upset over something she overheard⁴. The gang takes the opportunity to give his Hank his Christmas present: an answering machine. Kyle tells hank to go home, hook up the machine, and wait for Ren to make the next move.

Brian arrives and Dawn is shocked to discover that her blind date is Brian Arsala, captain of the Washington Special Crime Unit. As Dawn and Brian talk, Hank heads back to his appartment. Arsala asks Dawn if he was her boyfriend, but she tells him that Hank is the big brother she never had⁵. Back at his apartment, Hank plays the message on his answering machine, which is from Ren. He heads out to find her and discovers that she is conveniently is waiting outside his door. He promises Ren that he’s not in love with Dawn and they kiss and make up. And Tiny Tim wishes everyone a Merry Christmas (OK, I made that part up).

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Notes:
^1. The Black Russian is the alter ego of Roger, one of Hank’s friends from the wrestling team. He plays a key role in the next issue.
^2. Conspiracy theorists start your engines: In this issue, Dawn clearly refers to being an only child. So then where did her “sister” Holly, the new Hawk, come from?
^3. The Super-Powered Samurai Saurians (the Saurs) include Jefferson, Lincoln, Roosevelt, and an unnamed fourth Saur. Since their headquarters is at Mt Rushmore, it’s probably safe to assume that the fourth Saur is named Washington. They even have their own theme song:

When we get into the action
Villains take a tumble
‘Cause we’re Super-Powered Saurs
and we like to rumble
…
We’re the Super Powered Samurai Saurians
comin from Mt Rushmore to your neighborhood!

^4. She overheard Dawn and Hank talking about what happened on Druspa Tau, and whether they were supposed to be in love with each other.
^5. This conversation will become important later.

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All Previous Hawk and Dove Reviews
This comic is December 5th in my 2004 Comic Book Cover Advent Calendar

Tags: comics hawk dove

I’ve picked on DC enough recently for their PSA advertisements, so now it’s time to take a look at Marvel.

Here we have one of their “Verb” PSAs, in this case the one starring Wolverine. Take a look…

Click on the image above for the full ad.

A Few Thoughts:
1. I like the way it clearly says “Advertisement” at the top — because there’s no way you’d be able to tell this is an ad without that warning — because, you know, it fits so seamlessly in the narrative of The Ultimates.

2. Chopping off arms and gutting oponents with lethal force = playing football.

3. I don’t care if your bones and claws are made of the second-strongest subtance known to man, there’s no way climbing a mountain like that would be possible (especially if you weigh a ton because your bones are made of metal).

4. Diving at someone with claws extended = sliding into home plate.

5. “Wolverine’s way or your way, it makes no difference how you play”. No, it makes a big difference. For one thing, I don’t routinely eviscerate people.

6. “Verb – It’s What You Do.” While this campaign has a valuable message (“Get off your butt and go outside and get some exercise!”), the way it has been written has always annoyed me. It tries too hard to be clever. Let me remind the crafters of this slogan that loafing, sleeping, and gorging are also verbs.

Tags: comics psa wolverine

A few days ago, a patient came in complaining of abdominal pain. He was an otherwise healthy 29 year-old male who I had previously seen a few months ago for some allergies. He reported that the previous day he had a sudden episode of severe cramping lower abdominal pain while driving home from work. The pain was so bad that he had to pull over to the side of the road. After 10 minutes, the pain had decreased enough for him to finish the drive home. Once home, he climbed into bed and wrapped up in blankets because he was starting to feel chills. He turned off the light and took a fitful nap.

After about 2 hours, he woke up. The chills had passed but the pain was still present. He started to feel nauseated, so he stumbled into the bathroom. He threw up and then dry heaved for the next twenty minutes.

He stumbled back to bed and slept for the rest of the night. The next morning, he felt much better. While still present, the pain was significantly decreased. The nausea had passed, though he admits that he didn’t have much of an appetite. He decided he felt good enough to go to work, though his wife did talk him into making an appointment at our office after work.

When he came to see me in the clinic that afternoon, he looked pretty good. There was no fever and his vital signs were strong. His heart and lungs were fine. There was some generalized abdominal tenderness but no guarding or rebound. It was clear that he was looking for reassurance that everything was fine. However, there were a couple of findings on the exam that worried me. First, the abdominal pain was definitely more pronounced in the right lower quadrant. Second, there were no bowel sounds; it was absolutely quiet. That’s what really caught my attention — if you listen to the abdomen long enough with your stethoscope, you;re eventually going to hear some of the normal gurgling/tinkling sounds. Not in this case – there were no sounds at all. This is not considered a good sign.

Even though it was late in the day, I set up a stat CT scan of his abdomen and pelvis. I explained that although he looked and seemed to feel pretty good now, I was concerned about his appendix. He laughed it off, but I told him that I was serious and explained why. He explained that he couldn’t have appendicitis because his pain would be worse, not better. I reminded him that the appendix can do strange things and did he really want to take that chance? Reluctantly, he agreed to have the CT done. I told him to wait in the radiology department after the scan was complete until either somebody from our office or the radiologist discussed the results with him.

About an hour later there was a call from the radiologist: the CT scan showed acute appendicitis. However, when the radiologist went out to the waiting room to talk to the patient, he had left. We were able to track him down on his cell phone and found him in a local bar eating hot wings. He was so sure that nothing was wrong that he left to have dinner. Luckily, this didn’t delay surgery and he had an appendectomy later that evening (the third for our local surgery group that night, and the third of five from our office that week).

Tags: medicine abdominal pain appendicitis

Georgetown University, the home of Hank Hall (Hawk) and Dawn Granger (Dove), is hosting their annual Crime and Punishment Symposium. This particular year, the guests include the Vice President of the United States, Judge Irwin Hall (Hank’s father), and political gadfly columnist Jack Ryder. As part of the symposium, the Metropolis Special Crimes Unit will be displaying some advanced weapons prototypes.

Across campus, Farley Fleeter, once leader of the Madmen gang, has taken a job as a custodian at the University so he can steal drugs. While he is snooping around a biochemistry lab, there is an accident and he is exposed to an experimental virus. He thinks little of it at the time and goes on with his job and returns to his apartment. However, it turns out that the virus infects anyone he touches and links their mind with his. These people think the same thoughts he does and carry out the same actions. So when Fleeter decides to dress as the Madman and steal the experimental weapons, every person he has touched also dresses up as the Madman and tries to steal the weapons. Instead of a single Madman, there are now over a hundred Madmen (and women) converging on the weapons display.

When the Madmen swarm the gymnasium where the weapons are being displayed, Hawk and Dove leap into the fray. The Secret Service also springs into action. It seems that when the Vice President shook Fleeter’s hand earlier in the day, he caught the virus. This means that the Vice President is one of the Madmen, but the Secret Service doesn’t know which one, so they decide they have to protect every Madman. This, understandably, puts them at odds with Hawk and Dove.

Of course, Hawk and Dove aren’t the only costumed vigilantes present. Wherever Jack Ryder goes, the Creeper can’t be far behind — and before too long he pops in, adding his own brand of insanity to the mix. Whether he’s helping or hindering is up for debate.

By now Fleeter has figured out what is going on and realizes that he can direct the other Madmen. When he tries to infect the Creeper, his plan starts to fall apart. The Creeper’s personality is to strong — and too maniacal — to be overwhelmed and starts to take control of the other Madmen. Dove takes advantage of the confusion to identify Fleeter as the lead Madman and Hawk punches him out. This frees the rest of the Madmen from his control. The Vice President is rescued and everything returns to normal.

NOTES:

1. The Vice President is never officially named as Dan Quayle, but it’s clear that’s who it is supposed to be (and the comic was published in 1990 when he was in office). There are some admittedly cheap laughs at the VP’s expense (de rigueur for comedy of this era), but the Kesels manage to redeem themselves by taking it one stop farther and having him become one of the Madmen — but nobody knows which one.

2. This storyline is a cornucopia of Steve Ditko goodness. Hawk and Dove as well as the Creeper were all Ditko creations. In addition, the Madmen gang was also created by Ditko (they debuted in Charlton’s Blue Beetle #3).

3. Hawk & Dove #18 is one of my all time favorite Hawk & Dove covers. I love the way everything has been sprayprainted with a neon green “C” by the Creeper, including a pissed-looking cat and his captive mouse.

4. Punch and Jewlee (and their unnamed offspring) appear in this story as well. They are speaking at the Symposium about how they turned their life of crime around, but then they decide to steal a prototype force field vest. Unfortunately, Punch quickly learns the downside of experimental prototypes as the vest malfunctions and causes some painful burns in some delicate places.

Jewlee: Look, Love Puppet — the munchkin thinks it’s funny! I think you’re bonding!

All Previous Hawk and Dove Reviews

Tags: comics hawk dove creeper steve ditko

At last! The event every fan had been clamoring for: the return of Titans West! Personally, I never really understood the mystique of Titans West as they appeared for all of two issues in the late ’70s version of the Teen Titans and consisted of mostly B-level heroes (excepting Hawk and Dove of course, and the post-Crisis version did ramp up the power level). Nevertheless, the first Hawk & Dove Annual features their “long-awaited return.” But that’s not all the surprises this issue contains as it also features a final guest star that really puts the machina in Deus Ex Machina. Overall, this is near perfect example of what an annual should be: a larger than life adventure that just wouldn’t fit in the regular title.

The story picks up shortly after Hawk & Dove #14-17. In that adventure, Hawk and Dove had chased their arch-foe Kestrel to his home dimension of Druspa Tau — a dimension that also happened to be the residence of T’Charr and Terataya, the Lord of Chaos and the Lord of Order that gave Hawk and Dove their powers. In the final scene of that story, Hawk and Dove absorbed the essences of their respective creators. This greatly increased their powers, but it also raised the question of whether or not Hawk and Dove also absorbed the love the two Lords felt for each other.

In the days since their return to Georgetown, Hank and Dawn have been avoiding each other and pretty much everybody else. Today though, their friend Donna has a big tennis match and they’ve promised her their support. Donna’s game is against one of the rising stars of the professional circuit: Bette Kane. Does that name ring a bell? It should. Debuting in Batman 139 in 1961, Betty Kane and was the original Bat-Girl (note the hyphen). After a brief time in the sun, she appeared only rarely — the last time with Titans West. After Crisis on Infinite Earths, she was ret-conned to Bette Kane and Flamebird.

Anyway, Bette trounces Donna. After game, Dawn returns home to find a mysterious envelope on her front step made out to Don Dove Dawn. Inside she finds a picture of the Titans West team and a note telling her that she needs to go to a certain hotel room across town. It also hints that father, a S.T.A.R. Labs scientist, may be in trouble. She knocks on the door and discovers that she’s at Bette’s hotel room and that Hank is already there (but not for the reason you think — and not the reason Bette would like — he just wanted someone to talk over the whole Don/Dawn thing). Hank and Bette realize that the note must be from their old teammate Lilith and that they must be needed at S.T.A.R. Labs.

Hawk, Dove, and Flamebird travel to S.T.A.R. Labs. It turns out that the scientists there have opened a portal to some mysterious dimension. The exploration team, as well as the rescue team that went in after them, have both disappeared. Flamebird calls up her old teammates Mal Duncan (once the hero Gabriel — an expert in dimensional travel) and Karen Duncan (Bumblebee — who is a S.T.A.R. scientist in her own right). They bring Chris King with them (who has somehow absorbed the abilities of the H-dial he used to wear and now becomes a different random superhero on the hour every hour) as well as a houseguest who has overstayed his welcome, Charlie Parker (Golden Eagle).

While Mal stays behind to monitor the portal, the rest of the new Titans West team (though you’ll notice they’re actually on the East coast) travel through the portal and find themselves in a barren, rocky landscape. Chris, as Synapse the Energy Man, tracks the homing device used by the rescue team. But it’s a trap! He and then the rest of the team are ambushed and defeated by a gang of villains including the Iron Major, El Papagayo, Icicle, Clayface II, the Top, and the Electrocutioner. Dove realizes that all these villains are dead, and the dimension they are in is some sort of purgatory. The villains take Bumblebee with them as a hostage as well as the homing device. They intend to use the S.T.A.R. Labs portal to return to the land of living and resume their life of crime. They figure they can force Bumblebee to open the portal, and the rest of the Titans won’t be a threat because they’re stranded miles away without the homing device to lead them back to the portal.

Mal Duncan and Lillith are waiting for the villains at the portal. Mal manages to defeat the Iron Major and rescue Bumblebee, but the Icicle takes Lillith hostage easily (maybe a little too easily). About this time, the remaining members of Titans West arrive on the scene riding on the back of the Haunted Tank. Yes, that Haunted Tank, along with the ghost of General J.E.B. Stuart (in a scene that has to be seen to be believed). The tank smashes Clayface with its gun and the Titans easily defeat the remaining villains — but Lillith is still a hostage. Using this to their advantage, the villains escape and have Lillith lead them to the portal — which they eagerly jump into. Of course, it isn’t the real portal, but a fake portal set up by Etrigan the Demon. In fact, this whole scenario was a trap set by the Demon, and he was the one holding the scientists and rescue team captive. All the villains are returned to Hell except the Icicle, who has repented his life of crime and actually helped Lilith trap the other villains. He is allowed to move on to “the mountains”, which is presumably Heaven. Hawk realizes that his brother Don must be there as well and wants to bring him back, but the ghost of J.E.B. Stuart makes him realize that while Don’s life may have been cut short, it was a fulfilling one. Hawk, Dove, and the remaining Titans West members return to the real world, bringing the missing scientists and rescue team with them.

All Previous Hawk and Dove Reviews

Tags: comics hawk dove titans west flamebird etrigan haunted tank

Time for the bi-monthly post where take a few minutes tolook back at what internet searches brought people to Polite Dissent for July and August. Mostly rather bland searches this time, but then I’m not sure anything will top May and June’s intravenous pumpkins. As always, there were plenty of searches for She-Hulk, Hawk, Dove, Dave Trampier, Wormy, and B’wana Beast. Plenty of House questions too. Then there were the usual searches for sex pictures involving any combination of the following: the Teen Titans (Robin, Starfire, Cyborg, and Beast Boy — but no love for Raven), Kim Possible, Shego, Ron Stoppable, Danny Phantom, and/or Tanith Belbin.

Capitalization has been added to make the searches more readable, but the grammar and spelling are untouched otherwise to give the true flavor. My thoughts are added in green.

Vaguely Medical Searches

• Tiniest bacteria serratia Sounds like a title of a children’s book. [information on Serratia]
• Difference between the circumcision done by a quack doctor and medical doctor? Is this really a question you need to ask?
• Can a blow stop the heart rhythm instantly? Yes, under the right conditions, when the timing of the heart cycle is just right and a blow lands in the right place. This is known as Commotio Cordis and is thought to cause 2-3 deahts per year in Little League baseball.[more information on commotio cordis]
• Kissing fishes skin cure No idea here.
• If you don t test for it you don t have to treat it house of god The actual quote is: “If you don’t take a temperature, you can’t find a fever” and it is Law X from the back of House of God.
• mystery painful rash secreting string You’re probably thinking about Morgellons. [wikipedia entry on Morgellon's Disease]

Supposedly Comic Book Searches

• XY the last man close.
• John Byrne pregnant I doubt it
• Women in the freezer comics Another example of being close but not quite right
• Senseless comics involving the devil Are there any other kind?

Miscellaneous Seaches

• Give me at least 3 valedictorian addressed I don’t know which is more disturbing, that someone is plagiarizing valedictorian speeches, or that they can’t spell “addresses” right. Or maybe it’s just somebody who’s looking for the home addresses of smart people so he can beat them up…
• Hats Somebody searches the internet for “hats”? And found my site? (Several times too, according to the logs).
• How do you spell polite? Just like that.
• I have telescopic vision Good for you.

Adventures in Spelling (presented with few comments)

• Cot having sex on tape
• 37 weeks pregnant cervix is thinning and pressure in Virginia
• Ohno Cryten birth control I assume they meant “Ortho Cyclen” but “Ohno Cryten” evokes much better imagery.

Fan Fiction Want List (presented without comment)

• Airwolf fan fiction
• Fanfiction kim possible giving birth
• Fanfiction kim possible vomit
• Extreme Justice fan fiction

And Last but not Least, the I-Really-Don’t-Want-To-Know Seaches (also presented without comment)

• How can i sudues my sister
• Woman groin picture without obstacle

In honor of Star Trek’s 40th Anniversay this weekend, I’m reposting this “Polite Dissent Classic” — from my fourth week of blogging — that proves that Star Trek can cure depression.

True Tales of Medical School: Live Long and Prosper

My other “True Tales of Medical School”

Tags: comics television star trek depression medical school

After the infamy of the 1950s Senate hearings on the comic book industry, EC abdandoned their traditional horror and true crime stories for a new public-friendly approach. One of EC’s new comics was M.D., a comic about doctors, told in the delicate art and typographic fonts common to classic EC comics.

M.D. #4 was published in October/November 1955 and contains four short comic stories, a one page text piece, and a letters page. The cover by Johnny Craig shows physicians resuscitating a drowning victim. Note the old-style approach to artificial respiration, with the patient laying face down and the doctor’s weight on the back of the patient’s chest and abdomen. This was the standard approach until mouth-to-mouth respiration was developed.

The first story, “So That Others May Walk”, concerns polio. Thanks to immunizations, polio is thing of the past in the developed parts of the world and we’ve forgotten how devastating this disease truly is. I think a copy of this story should be provided to everyone who questions the need for vaccinations.

Danny Hoyt has contracted polio and has been placed in an iron lung. His mother Francis is concerned that the doctor is treating her son as a number, and not a real person. Dr. Wolack tells her the story of Jimmy, a young boy who contracted polio just like Danny. Jimmy had to learn to breathe on his own again and then had to learn to walk. It was slow going, but Jimmy persevered. Even though he walks with a limp, he still made it a point to play sports. He studied hard and made it through high school as the valedictorian. He went on the college and then medical school. That’s right: in that hopeful twist that occurs in many medical stories, the boy Jimmy grew up to become Dr. Wolack, the physician treating Danny. Reassured, Danny’s mother thanks him and goes to spend time with her son.

Next is a one page text piece about Dr. William Harvey, the doctor who discovered the circulation of the blood. He was ostracized and considered a heretic for his views. He was even placed on trial. Charles the First remembered Dr. Harvey though, and when a French countess was bitten by a poisonous snake, he sent for him to treat her. Click here for the full fascinating tale.

The second story, “New Outlook”, tells the story of Marian, a college student who suffers extensive facial injuries in a car accident. She is horrified by her appearance, and locks herself away from her family and boyfriend. The plastic surgeons calmly work with her, and after more than a year and multiple surgeries, she regains her beautiful countenance and says yes when her boyfriend offers her his fraternity pin.

The third story, “Point of View”, is fairly disturbing. Donald Archer wakens in the hospital after a terrible car accident (yes, another one). He demands to know what happened to his daughter and wife. The doctor tells him that his daughter is fine, but that his wife has died from her injuries. The doctor then asks for permission to transplant his wife’s corneas into a blind patient. Donald refuses and orders the doctor out of his room for even suggesting such a thing. The doctor doesn’t give up and keeps talking to Donald about the need for the corneas but Donald remains adamant and refuses to give his permission. Finally, the doctor brings in an ophthalmologist who manages to talk Donald into donating his wife’s corneas. At the end of the story, when Donald finally gets the chance to visit his daughter, he discovers that she was the blind patient. The doctors needed his wife’s corneas to repair the eye damage his daughter suffered in the accident — though you think it would have gone smoother if they told him who the blind patient was from the beginning.

“Worried Sick”, the final story, is an unusually downbeat story — in an O. Henry kind of way — for this comic. The story concerns a man with a stress induced ulcer. He is an up and coming grocer, but that’s not enough for his wife. She keeps pushing him to expand his business, and he does — time and time again — until he is the top grocer in the city. He doesn’t see any money though, because his wife keeps spending it. He sees the doctor about some stomach pain he’s been having, and the doctor informs him that his has an ulcer and puts him on a special diet. The grocer explains things to his wife, and she promises to cut her spending, but she keeps throwing expensive parties and he ends up requiring surgery for a perforated ulcer. This time, the doctor speaks to the wife himself and explains how the stress from her spending is causing her husband’s ulcer. She promises to restrain her spending. All seems well until her husband returns home from the hospital and finds his wife and thrown him a get well party – and told the caterer to bring the best food money can buy. The look on her poor husband’s face is priceless.

Like previous issues, M.D. #4 contains interesting glimpses of state of the art medicine from a half-century ago. It also contains some not-so-subtle sexism, but I’m afraid that’s standard issue for most of these classic medical comics.

Tags: comics medicine m.d. polio iron lung ulcer william harvey

This is a comic that was produced by the United States Forest Service and the Ad Council during the 1960s and early ’70s. I remember owning it when I was a preschooler. It was always one of my favorites. It tells the true story (more or less) of Smokey Bear, who went on to become Smokey The Bear and the forest fire prevention mascot of the U.S. Forest Service.

As the comic starts, a forest fire rips through Lincoln National Forest in New Mexico. Most of the forest animals flee, but many perish in the flames. One lone animal survives the fire: a badly burned bear cub stuck in a tree. The firefighters rescued him and he was bandaged up and his burns treated. The rangers called him Smokey and he became the mascot used to remind the public that “Only You Can Prevent Forest Fires.”

Smokey lived out his days at the National Zoo in Washington D.C. I remember seeing him as a youngster in the ’70s, so I’m sure he has long since passed on. I just remember that I could care less about the pandas and the other exotic animals, it was Smokey that my sister and I desperately wanted to see on our visit to the zoo.

• Thanks to the Minnesota Department Department of National Resources, you can download your very own copy of this comic. About 3/5 of the way down the page, under the “Smokey comic book audio CD” heading is a link to a pdf file of the comic (though the last four pages seem to be the same in my copy).
• In addition to this freebie comic, Smokey had Gold Key comic book series that ran for 13 issues from 1970 to 1973. Not to be outdone, Woodsy Owl (”Give a Hoot, Don’t Pollute”) had a ten issue series, also from Gold Key, from 1973-1976.
• Wikipedia tells a slightly different origin of Smokey the Bear. I’m sure theirs is correct as it is more politically expedient, but I prefer the comic book version.
• Why should you, as a comic reader, care about forest fires? From the comic book:
  Smokey tells them how he hates forest fires!
  How they destroy his animal friends…
  How they burned up timber that could have been used to make homes — perhaps a new home for you…
  How they waste wood that could have gone into furniture…
  

Tags: comics psa smokey the bear forest fires

Y: The Last Man #47 “The Tin Man”
Brian K. Vaughan, writer
Goran Sudzuka, penciler

By request, a look at Y: The Last Man #47:

Dr. Allison Mann is experiencing an incredible amount of what appears to be vaginal bleeding. In fact, she’s bleeding so much that she’s going into shock from the blood loss.

What conditions could lead to this amount of bleeding?

1. Trauma
   Like anywhere else in the body, trauma (such as lacerations or abrasions) to the female genital tract can lead to bleeding. The pelvic region has a good blood supply, so heavy bleeding is possible.
2. Uterine Fibroids
   An abnormal (but non-cancerous) growth of muscle cells within the uterus.
3. Hormonal Imbalance
   Especially elevated or unopposed estrogen. A thyroid or adrenal gland problem can cause some abnormal bleeding as well, but generally not this amount.
4. Pregnancy-related bleeding
   This can include a miscarriage or threatened miscarriage. In pregnant women, placenta previa (where the placenta is lying over the cervix) or placental abruption (where the placenta is pulling away from the uterus. This can be fatal to mother and child.) are concerns. Heavy bleeding could also be from retained tissue after birth or miscarriage, such as a retained placenta. A final pregnancy-related cause would also be postpartum hemorrhage, when the uterus does not contract down after birth and continues to bleed. Postpartum hemorrhage can be fatal — but given Dr. Mann’s recnet history, that is unlikely to be the cause here.
5. Genital Tract Inflammation
   Inflammation, most commonly caused by infections, can cause bleeding, but not at the level Dr. Mann is experiencing.
6. Bleeding Disorders
   Hemophilia (though extremely unlikely in a woman), Von Willebrand’s Disease or other blood disorders can lead to heavy bleeding. Use of anticoagulant medications such as warfarin or heparin could also cause heavy bleeding.
7. Cancer
   Cancer, particularly endometrial or uterine cancer, can cause heavy bleeding.
8. Arteriovenous Malformation
   A uterus with an abnormal blood supply could result in heavy bleeding.

Note: There are certainly many other causes of abnormal vaginal bleeding, but I am focusing on the ones most likely to cause the copious bleeding.

Dr. Mann believes the cause of the bleeding is related to miscarriage she suffered earlier, before the series began. Without knowing more about the timing involved or the miscarriage itself, it’s difficult to know for sure. But if I had to speculate: Given that she was not receiving professional prenatal care, she may not have sought professional assistance at the time of her miscarriage. Thus uterine trauma or damage could have occurred during, or due to, the miscarriage. I suppose there could also be retained tissue left over from the miscarriage, but that seems unlikely given the time that seems to have passed since the miscarriage. I think we’ll just have to wait and see what Vaughan has in mind.

Other medical evaluations of Y: The Last Man:Y: The Last Man #29 (plague or botulism?) Y: The Last Man #30 (active and passive Immunity) Y: The Last Man #45 and #46 (homeopathic surgeons?)

Tags: comics medicine y: the last man brian vaughan allison mann hemorrhage vaginal bleeding

“Dallan and Sepsis Preserve Us!”

Those of you who read the Marvel Comics series Micronauts during the ’80s no doubt recognize that sentence, while those of you with less comics knowledge but more medical background are understandably puzzled. It was a common oath muttered (or screamed) by the denizens of Homeworld whenever danger threatened.

A little background: A thousand years ago, King Dallan Rann and Queen Sepsis Rann were the rulers of Homeworld, the lead “planet” in the Microverse. They sent their only son Arcturus Rann out to the far reached of the universe on a thousand-year quest for knowledge¹. Shortly after he left, Dallan and Sepsis were killed by their son’s tutor, Baron Karza², who went on the conquer Homeworld and the rest of the Microverse and set himself up as dictator. Upon returning from his voyage and discovering what had happened in the Micorverse while he had been gone, Arcturus Rann took the name Space Glider and joined the Resistance trying to drive Karza from power. With the other core members of the Resistance (Marionette, Bug, Acroyear, Microtron and Biotron), Rann formed the Micronauts³.

Personally, I think it’s a clever bit of storytelling to have the modern denizens of the Microverse revere Dallan and Sepsis Rann as saints or demi-gods. It ties together the past and present of the Microverse (but for Space Glider, it’s got to be a bit creepy having your girlfriend pray to your dead parents).

Dallan is a good name. According to Wikipedia, in the Christian context it means “blind,” named after the blind Irish poet Saint Dallan Forgaill. It’s also an Arabic word meaning “lost” which can be used in several contexts including a loss of the true religion. It’s not an uncommon name for boys.

Sepsis, on the other hand, is an unfortunate choice for a name. Sepsis is the medical term for an overwhelming infection of the entire body, though the term is also used to refer to the body’s response to this overwhelming infection. Regardless, sepsis is frequently fatal and always represents a tough battle to survive. Not the best name for a beautiful Queen, though I doubt writer Bill Mantlo was aware of the actual meaning of Sepsis when he chose the name⁴. Still, it’s hard not to chuckle whenever I see a character praying to “Sepsis.”

---

NOTES:
¹Not the really best plan to insure the continuance of your dynasty.
²If I were undisputed ruler of the Microverse, I would have chosen something better than Baron. King, or Emporer maybe.
³Though I notice the team was now called the Microns when they appeared in Peter David’s Captain Marvel. I suspect it has to due with the rights to name Micronauts.
⁴Though Mantlo also named another beautiful female character Slug, so maybe he used the term on purpose.

Previous fond memories of the Micronauts:Micronauts #26-28 (The Micronauts and S.H.I.E.L.D. fight Karza) Micronauts #29-35 (The quest for the origin of the Microverse).

Tags: comics medicine micronauts sepsis

A real world case this time: Michael Swango’s troubles were first noticeable during medical school at Southern Illinois University. Swango’s demeanor was brusque and he had no bedside manners to speak of. He seemed to have a peculiar fascination with dying patients. He also liked to take the easy way out, and was nearly expelled after being caught cheating during his OB/GYN rotation. In the end, the school let him graduate if he repeated the course work.

Despite a poor recommendation from the dean at the SIU School of Medicine, Swango was selected for a surgical internship at Ohio State University. That’s where the trouble really started. Nurses noticed that healthy patients on the floors where he was assigned happened to die…frequently. One nurse even caught him injecting some medicine into a patient who later became ill. The nurses reported their concerns to the administration, but they were brushed aside and only a superficial investigation was carried out. Despite being cleared by this investigation, Swango was not asked back to OSU because there were concerns about his skills as a physician and surgeon.

Swango returned home to Illinois and started working as a paramedic. Within a few months, the rest of the paramedics noticed that they would get violently ill whenever Swango brought any food in, or prepared the coffee. They investigated and found arsenic and other poisons in his possession, along with a book about poisoning. He was arrested, tried, and imprisoned for these poisonings.

After being released from prison, Swango worked various medical related odd jobs for a while, but eventually managed to bluff his way into a residency program in Sioux Falls. Things went well at first, but then he tried to join the American Medical Association. Unlike the hospital, the AMA performed a background check and discovered that Swango had no medical license and had a past felony conviction. About the same time, the ABC television show 20/20 aired a segment on Swangoand his poisoning conviction. When these were reported to the Dean of the University of South Dakota, Swango was summarily dismissed.

A short time later, Swango surfaced in New York at Stony Brook Medical School where he had been admitted as a psychiatry resident. Once again, his patients started dying for no apparent reason. When the dean at South Dakota heard that Swango had moved to New York, he called the administration at Stony Brook and Swango’s full history came to light. He was fired from yet another residency position. This time, the residency director learned from past mistakes and mailed a warning about Swango to every other residency in the nation.

A year later, Swango surfaced in Africa working as a physician in a rural hospital in Zimbabwe. True to form, his patients again started dying mysteriously. This time the police stepped in and he was arrested, but he skipped town before his trial date came. He hid out elsewhere in Africa and Europe and was close to taking another job as a doctor in Saudi Arabia when he was arrested at O’Hare Airport in Chicago.

Swango was extradited to New York where he was charged and convicted of practicing medicine without a license and fraud. While in prison for those charges, police were building other cases and he ultimately pled guilty to four counts of first-degree murder and was sentenced to life in prison with no possibility of parole. This plea bargain allowed him to avoid the death penalty and extradition to Zimbabwe. All told, it is estimated that Michael Swango killed thirty to sixty patients.

• The Crime Library report on Michael Swango (like all Crime Library articles I’ve read, this one is full of hypebole and trips over its own attempts at flowerly language. Still it’s chock full of good information.)
• Timeline and Documents of the Michael Swango case from CourtTV
• CNN article on Michael Swango.
• An AMA Op-Ed about Swango.

Tags:medicine news michael swango.

Dr. Karla Sofen was a brillaint psychiatrist* whose mother had to scrimp and save and work three jobs to put food on the table. Karla decided that she wasn’t going to end up that way and had no intention of working hard to make ends meet; she wanted all the finer things of life, and she wanted them NOW. She left her private practice and took up with another evil psychiatrist, Dr. Faustus, and helped him with his crimes. At one point, she became the therapist of Lloyd Bloch, the original Moonstone. Using her evil psychiatric skills, she convinced him that the stone was turning him into a monster. He handed the stone over to her and she took it to become the villainess Moonstone.

She worked for some time with the Masters of Evil, but when the majority of Earth’s heroes disappeared, she joined with Zemo in forming the “hero team” the Thunderbolts. As a Thunderbolt, she took the name Meteorite. After the Thunderbolts were exposed, she received a pardon for her past crimes and returned to her original name of Moonstone. Currenlty, in addition to her own Moonstone, she has taken possession of the moonstone from an alternate dimension which has dramatically increased her powers. Except she’s in a coma and Zemo controls the stones now. Or at least that’s what she wants him to think.

Dr. Sofen may be evil, but you have to admire her for actually using her medical/psychiatric skills. Her med school training and residency didn’t go to waste. I’m sure her actions violate the Hippocratic Oath somewhere, but at least she’s doing it in style.

*There is some debate whether Sofen is a psychiatrist or psychologist. Most sources state the former, but quite a few name the latter (and many are wishy-washy and list both). Marvel.com lists her as a psychologist, but the Official Handbook of the Marvel Universe lists her as a psychiatrist — so that’s what I’m going with since it is, after all, official.

• The Wikipedia entry on Moonstone.
• Marvel.com entry on Moonstone.
• The Moonstone HeroClix.
• Who would win? Danny Phantom vs. Moonstone.
• The Moonstone Homepage fansite.
• Thunderbolt micro-heroes, including Moonstone and Meteorite.
• Information on the real world gem “Moonstone”.
• And of course Moonstone Comics, home of Buckaroo Banzai, Kolchak, and the Phantom.

Tags: comics medicine karla sofen moonstone thunderbolts psychiatrist .

Dr. Harleen Quinzel was a psychiatrist who managed to make it through both college and medical school relying on her personal charms and womanly wiles rather than any actual skill or ability. She applied for an internship at Arkham Asylum with the plan of turning her experiences into a best-selling tell-all book later. However, upon arriving at the Asylum, she found herself attracted to the Joker. She managed to persuade her boss into letting her conduct therapy sessions with him, but she was the one who underwent therapy. These were far from normal counseling sessions, and the Joker manipulated Harleen, tugging at her heartstrings and telling her waht she wanted to hear. After one of his escapes and post-pumelling return by Batman, she snapped, stole greasepaint and a costume and became Harley Quinn (This is according to the excellent one-shot comic Mad Love — set in the Batman Adventures continuity — by Paul Dini and Bruce Timm. The regular continuity Harley Quinn has a slightly different origin, but the key points are all the same. All images in this post are from Mad Love.)

Harley Quinn orignated on the Batman Adventures television cartoon (in episode #22, to be exact), but proved so popular she quickly appeared in the regular continuity comics as well. She even had her own 38 issue series from 2000 to 2004.

Since becoming Harley Quinn, Dr. Quinzel has rarely been shown to use her psychiatric skills and training. I recall one storyline (in Catwoman #89) where she used them in an attempt to brainwash Catwoman, but that was about it. Well, it’s not like she really paid attention in class anyway.

Remember what I said in an ealier post about psychiatrists — that they’re comic book shorthand for characters who are “off,” “creepy,” and “up to something.” As far as I’m concerned, this applies to Harley as well. She can be a fun character, but when you get right down to it, there’s something unnerving and more than a little creepy about the her.

• The Wikipedia entry on Harley Quinn.
• Harley Quinn fansites: Harley’s Haven and Harley’s Heaven.
• Gotham Girls, online WB Dini-verse cartoon starring Catwoman, Poison Ivy, and Harley Quinn.
• Funny, she doesn’t look Jewish.
• Harley Quinn in Batman: the Animated Series.
• Arleen Sorkin, the voice of Harley Quinn
• The Birds of Prey TV series, with Mia Sara as Dr. Harleen Quinzel. (Mia Sara is probably best known for her role as Sloane Peterson, Ferris Bueller’s girlfriend in the classic ’80s movie.)
• Harley Quinn Micro-Heroes (scroll to the bottom of the page) and Thrillkiller Micro-Heroes, including that version of Harley.
• The IMDB entry on Harley Quinn Smith, daughter of director and alleged comic book writer (Whatever happened to the Bullseye miniseries? Three and a half years and counting) Kevin Smith.

Tags: comics medicine harleen quinzel harley quinn joker batman psychiatrist .

It’s that time once again to see what searches have brought people across the web to Polite Dissent. Capitalization has been added to make the searches more readable, but the grammar and spelling are untouched otherwise. As usual, my snarky comments are added in green.

Comic Related Searches

• Is Superman’s girlfriend pretty? All that matters is that Superman thinks so.
• Batman parents disappointed Death and the Maidens I think we all were disappointed with that comic.
• Clark Kent’s 8 pack abs Two better than six-pack abs.
• Green Arrow Longbow rape I’m sure we all can guess what this search was in reference to. For the record, I always though she had been.
• Zatanna naked The return of a classic search term.
• Wonder Woman groin I have no idea what they were searching for here, but I hope I answered their question.
• Lana Lang underwear ditto.
• Does Carter Hawkman Hall have a doctorate? Good question.
• John Byrne Vision Scarlet Witch genitalia I blame Chris Arndt for this one.

Medically Related Searches

• Do drug testes screen for Ritalin? I’m going to assume you mean “tests” and not “testes”, but the answer is yes — I suspect someone takingRitalin would test positive for amphetamines.
• Differance between cyst and mass A mass is solid, a cyst is hollow.
• Why is clostridium perfringens likely to grow in gangrenous wounds? You have it backwards, it is the infection with Clostridium that is causing the gangrene.
• Rh negative celebrities I have no idea. I’m A-, do I count?
• Cleaning a wound bleach Please don’t. While it’s true the bleach would probably kill any nasty germs, it would also kill many of your own cells, severely impeding the healing process.
• Rash where butt hits toilet seat Probably because somebody smeared something on the toilet seat.
• Medical term when scrotal organ burst out Painful
• Will the pregnancy test aome out positive when using the IUD? If you’re pregnant it will.

Homework

• Macbeth soliloquy she should have died hereafter. OK, here you go. From Macbeth, Act V, scene v, spoken by Macbeth:

  She should have died hereafter;
  There would have been a time for such a word.
  To-morrow, and to-morrow, and to-morrow,
  Creeps in this petty pace from day to day
  To the last syllable of recorded time,
  And all our yesterdays have lighted fools
  The way to dusty death. Out, out, brief candle!
  Life’s but a walking shadow, a poor player
  That struts and frets his hour upon the stage
  And then is heard no more: it is a tale
  Told by an idiot, full of sound and fury,
  Signifying nothing.

To Each Their Own (presented without comment)

• Kim Possible and Ron Stoppable having sex
• funny sex comics with the Teen Titans and Kim Possible
• Peter Parker adult fanfiction Norman Osborne

Miscellaneous

• Comics of nose Huh?
• Intravenous pumpkins Double huh?
• Obsessive compulsive personality disorder getting married Hope for neat spouse, or failing that, a patient one.
• Homemade defibrillator These two words should not go together.

Y: The Last Man #45 “Kimono Dragons, Chapter Three”
Y: The Last Man #46 “Kimono Dragons, Conclusion”
Brian Vaughan, writer
Pia Guerra, artist

In Y: The Last Man #46, Allison Mann’s mother describes herself as a “homeopathic surgeon.” I have some problems with this. First, I’ve made it no secret that I consider homeopathy pure and utter bunk. Second, given the definition of homeopathy, how can one be a homeopathic surgeon?

Homeopathy was started in the early 19th century as an alternative to the conventional medicine of that time. Given that the conventional medicine of the early 1800s was brutal and ineffective (bloodletting, trepanation, etc.) , this is understandable. In the two hundred years since, conventional medicine has become scientifically rigorous and vastly more effective, whereas homeopathy has remained mired in its pre-Victorian view of science and its repeatedly demonstrated ineffectiveness.

Homeopathy follows two principals. The first is the Principle of Similarities, which states that treating a particular symptom necessitates using a substance that causes the same symptom. For instance, if you want to cure a fever, you’d start with a substance that can cause a fever. Next comes the Principle of Infinitesimals, which states that extremely dilute solutions of this substance are required for treatment. How dilute? Not ten times, not a thousand times, not a million times, but many, many orders of magnitude — diluted well past Avogadro’s Number* so that it is unlikely that a single molecule of the original substance remains in the mixture.

Returning to Y: the Last Man, how can a surgeon be homeopathic? Does she use anesthesia that has been diluted so much it is nothing more than pure air? Does she use an incredibly dilute solution of scalpels to cut the patient? Maybe she means that she uses homeopathic medications when medicine is required, but given that she was discussing the use of Morphine and Cloves (Eugenol) in a previous issue, this seems unlikely. The story and characterization suggests that she is a surgeon who tends to use herbal and alternative medications, but not actual homeopathy.

I suspect that Vaughan is using “homeopathic” as a synonym for alternative or non-conventional medicine. It’s an incorrect use of term, but he’s not the first comic book writer to make the same mistake. (In fact, I’ve seen the term slapped willy-nilly over all sorts of dubious alternative medical therapies regardless of whether it actually applies).

As for the abdominal surgery in Y: the Last Man #45, I really don’t have any significant problems with it. It was an emergency surgery performed in an improvised operating room, so I wouldn’t expect all the fancy lights, equipment, and surgical garb one would find in a hospital. Vaughan also cleverly starts the scene as Dr. Matsumori is suturing the incision closed, so all but the clean up is over with. This allows Guerra to escape criticism over surgical imagery (though I have faith in her as she is one of the few artists who has consistently drawn the nasal canula correctly). If I had to nitpick, the scene seems mighty clean for an emergency bowel surgery, and I’m surprised there aren’t any surgical drains being used. I’m not even going to nit-pick the lack of surgical eyewear, because while it’s always a good idea to wear eye protection, OSHA is an American agency, not a Japanese one.

Tags: comics medicine homeopathy brian vaughan pia guerra

I’m feeling a bit under the weather this weekend, so I’m going to declare this “PSA Classic Weekend” and I’ll take a look back at some of the better PSA comic posts from the past two years here at Polite Dissent. First up is Spider-Man and Power-Pack, the infamous (and non-canon) story where Peter Parker reveals he was sexually abused by an older boy. Originally posted 14 November 2005.

Spider-Man and Power-Pack was a giveaway comic produced in 1984 by Marvel, the National Committee For Prevention of Child Abuse, and the NEA. Written to educate children about sexual abuse, this comic contains two stories.

The first is a Spider-Man tale written by Jim Salicrup and penciled by Jim Mooney. Peter Parker is in his apartment darkroom developing pictures when he hears something disturbing from the next apartment. Changing into Spider-Man, he swings over and finds that Tony, the son of the couple next door, has been abused by his babysitter Judy. Spider-Man wants Tony to tell his parents what happened but Tony is too scared.

Spider-Man tells Tony the story of a young man about his same age who lived with his aunt and uncle (could it be Peter Parker?). This young bespectacled boy was a bookworm and didn’t have many friends. He was pleased when a slightly older boy named Skip befriended him. Then one day, Skip pulled out some Girlie magazines (no really, that was the name of the magazine) and told Pete that they should “touch each other like the people in that magazine.” The young boy tells his aunt and uncle what happened and in the end everything works out. Spider-Man tells Tony that just like that other young boy, he should let his parents know what happened. Tony’s parents are very supportive and tell Tony that he did the right thing. They thank Spidey, but he tells them that there’s no need for thanks as Tony has already helped him. Web-swinging back to his apartment, Spider-Man realizes that helping Tony face his abuse has allowed Spieder-Man to face a dark chapter of his own past (an incident never mentioned again in any other Spider-Man comic book ever).

The second part of the comic is a Power Pack story by Louise Simonson with pencils by June Brigman and Mary Wilshire. Jane, a young school friend of the Power children, has run away from home because her father sexually abuses her. Jane told her mother what happened, but her mother didn’t believer her. The Power Pack are able to locate the runaway Jane and they bring her back to their house. Jane tells Mrs. Power what happened. After Mrs. Power consoles her, she gives Jane a number to call to get her family some help.

• SpiderFan on the Spider-Man portion of the story.
• Scott Shaw!’s Oddball Comics entry on this comic.
• The Appendix to the Handbook of the Marvel Universe entry on Skip Westcott.

Tags: comics medicine psa spider-man power pack child abuse

It’s been a year since I took my last look at pregnancy in comics so I think it’s time to take an updated look. In the past few months alone, Selina had her baby, and unlike Jessica Jones, managed to have a pregnancy of less than a year (how long was Jessica pregnant anyway, 2 or 3 years?). As always, comments, corrections, and suggestions are appreciated. Thanks to everyone who has contributed in past years.

Heroes:
ADAM STRANGE
1. Alanna dies during childbirth.

ANIMAL MAN
1. Annie was pregnant and gave birth in the last issues of the series.

AQUAMAN
1. Dolphin and Garth (Tempest) had a son, Cerridan.
2. Mera’s pregnancy happened “off camera.
3. In the Atlantis Chronicles: Cora was raped by her cousin Dardanus and gave birth to Kordax (pregnancy not shown). Also Atlanna had a tryst with her ancestor Atlan and gave birth to Orin (Aquaman). This pregnancy was shown.

AVENGERS
1. Ms. Marvel was pregnant*
2. Scarlet Witch’s pregnancy was shown in the Scarlet Witch and the Vision mini-series, though her twins were later ret-conned out of existence. This led her to become murderously insane and then crossover-miniseries-murderously insane**. Apparently, the children have now shown up as characters in Young Avengers.
3. Jessica Jones was pregnant for what seems like years, and delivered a healthy baby.

BATMAN COMICS
1. Spoiler was pregnant and gave her child up for adoption in Robin; she later died during Wargames.
2. Francine (Man-Bat’s wife) was pregnant in the Batman titles in the 1970s and gave birth in Batman Family #17.
3. Batman and Talia had a son in the more-or-less non-canon Son of the Demon (though the pregnancy was pretty much “off screen”

CATWOMAN:
1. Selina gave birth in the first “One Year Later” issue of Catwoman. The pregnancy has not been shown (it was in that one year time gap) and the identity of the father is unclear at this point.

FALLEN ANGEL
1. Lee conceived a child with Juris. She let him think that she had miscarried after a fight with Boxer, but instead handed her son over to a nun.

FANTASTIC FOUR
1. Sue Richards had Franklin, and then lost her second pregnancy. A magical/time-stream induced third pregnancy gave the Richards a daughter, Valeria.
2. Lyja Storm was pregnant and gave birth to an egg.
3. Crystal and Pietro (Quicksilver) have a daughter Luna. Reed Richards (apparently an obstetrician in his spare time) delivered the baby.

FLASH
1. Iris was pregnant with twins at the time that the silver age Flash (Barry Allen) died.
2. Linda West lost twins due to an attack by Zoom. There was some question as to whether she would be able to become pregnant again. However, after another melee involving the timestream, Linda suddenly found herself very pregnant (from 0 – 9 months in seconds) and delivered a healthy set of twins.

HARBINGERS:
1. Kris Hathaway was pregnant and gave birth to the child who would be sent to the future to become Magnus, Robot Fighter.

INCREDIBLE HULK
1. Betty Banner was pregnant, but miscarried.

IRON MAN
1. Pepper Potts was pregnant, but miscarried.

JLA
1. Sue Dibny was pregnant when she was killedin Identity Crisis #1

JSA
1. Hawkgirl was pregnant as a teenager and gave the child up for adoption.
2. Dove was raped by Hank Hall (Hawk) and later gave birth to a child who ultimately ended up housing the soul of the new Dr. Fate, Hector Hall.
3. Power Girl was mystically impregnated by her grandfather Arion so she could give birth to the prophesied demon fighter Equinox.

INFINITY INC.
1. Hippolyta Hall was pregnant a long time, and ultimately gave birth to Daniel (who was taken from her by Morpheus to become the new Sandman).

KILLRAVEN
1. Carmilla Frost discovered she was pregnant in the Killraven graphic novel.

LOSH (1)
1. Garth Ranzz (Lightning Lad) and Irma Ranz (Saturn Girl) had twins. (Twins are the usual on Garth’s home planet of Winath; however, twins are determined maternally and Irma come from Titan. Plus are the twins fraternal or identical? Both have been shown on Winath in the series.)

LOSH (2)
1. In the “five years later” Legion, Night Girl was not only married to Cosmic Boy, but also pregnant.
2. Laurel Gand had a child by Rond Vidar.
3. The Ranzzs had a second set of twins during the five year gap.

LOSH (3)
1. Apparition (Tinya Wazzo) and Ultra Boy (Jo Nah) have married and had a child (Cub).

L.E.G.I.O.N.
1. Stealth had a child by Vril Dox.

MANHUNTER
1. Kate Spencer miscarried after a fight. She had not been aware she was pregnant.

MIRACLEMAN
1. Liz Moran gave birth in Miracleman #9.

MR. MIRACLE
1. Beautiful Dreamer was pregnant and gave birth.

NOBLE FAMILY
1. Zephyr became pregnant after a spiteful “night of passion” with her family’s greatest enemy. She delivered a healthy child, but it was stolen and she informed that her child had been stillborn.

SABRE
1. Melissa Siren was pregnant and gave birth in Sabre.

SQUADRON SUPREME:
1. Arcanna Jones was pregnant for most of the limited series, and gave birth sucessfully.

STARMAN
1. Jack fathered children with the Mist (see below) and his significant other, Sadie.

SPIDER-MAN
1. Mary Jane was pregnant but miscarried when one of Norman Osborne’s flunkies poisoned her before she gave birth (there is some debate online about whether she actually miscarried or the baby was stolen by Osborn).
2. Gwen Stacy had twins after an ill-advised tryst with Spider-Man’s greatest enemy: Norman Osborn (the Green Goblin).
3. In the Spider-Girl universe, Mary Jane’s second pregnancy was shown in detail.

TEAM TITANS
1. Donna Troy was pregnant at the beginning of this series. Her husband and child died in a car accident, and then she died in Graduation Day. She came back (again), but has yet to mention her family.
2. Mirage was pregnant at the end of the series and has since been shown with her infant daughter Julianna (Refresh my memory: was the father of Julianna the evil future Nightwing? And was it consensual?).

X-MEN
1. Madelynne Prior was pregnant with Scott Summer’s child (and gave birth to him) in the Uncanny X-Men. This child later went on through a very convoluted storyline to become Cable.
2. Wolverine left a pregnant lover behind in the Savage Land in the one-shot Wolverine: The Jungle Adventure (though it’s not 100% certain that he’s the father).
3. According to one of the tales in Classic X-Men, Colossus also fathered a child during a visit to the Savage Land (pregnancy off camera).
4. Angel Salvadore and Beak had a brood of flying beaked kids. Angel laid eggs, so I’m not sure you would necessarily call her pregnant.

Villains:
Punch & Jewlee
1. During their time inSuicide Squad, Jewlee suffered morning sickness and discovered she was pregnant. She and Punchh left the team soon thereafter and the pregnancy and delivery were “off camera.” They later showed up in Hawk & Dove toting a toddler.

Chesire
1. Gave birth to Lian, fathered by Speedy/Arsenal (Roy Harper). The pregnany was entirely off-camera, and Roy didn’t know he was a father until well after the fact.
2. She seduced Thomas Blake (Cat Man) in Villains United, allegedly for him to father a child for her.

Mist
1. Had a child by Jack (Starman). Pregnancy was entirely off camera.

Star-Sapphire
1. Raped by Predator (another of Carol Fenris’s alternate personalities) and impregnated in Green Lantern #43. Gave birth sometime during Extreme Justice.

Non-Super-Hero:
FABLES: Snow White became pregnant after a drug-induced night with Bigby. She later gave birth to a litter of wolf/human hybrids.

Y: THE LAST MAN:
1. Beth is pregnant with Yorrick’s daughter (note that this is not fiancee Beth, but another one)
2. The female astronaut conceived a child with one of her fellow astronauts and has delivered a healthy son

HELLBLAZER:
John Constantine’s birth was shown in detail, including the death of his mother and twin.

LUCIFER:
Jill Presto is mystically impregnanted by a magic deck of cards.

SWAMP THING:
Swamp thing used the body of John Constantine to father a child on Abby, unaware that John was tained with demon’s blood. Abby ultimately gave birth to Tefe. Not sure if pregnancy was “on camera” or not.

STRANGERS in PARADISE:
Francine miscarried.

ELFQUEST is chock-full of pregnancies and births. I’m not conversant enough with the series to comment.

Characters UNABLE to become Pregnant:
1. Black Canary – Sustained tortue injuries in Green Arrow: Longbow Hunters that rendered her sterile. Her recent dip in a Lazarus pit may have reversed this.

2. Firestar – Using her powers will cause her to become sterile. Hank Pym developed a costume for her that repairs the damage.

*Explanation per Matt Rossi: “Ms. Marvel was impregnated originally by Immortus’ son, who used the devices of Limbo to draw her to him, make her fall in love with him, and then implanted himself into her via some freaky Limbo technology. She then was sent back to Avengers mansion where she gave birth in an extremely short amount of time and the baby was Marcus, Immortus’ son (the one who impregnated her, remember) and then the baby, too, grew up rather remarkably quickly while time itself went ape because Marcus, concieved and born in Limbo, was a being out of time and his mere presence, not to mention the twisted nature of his self-conception into our world and the rapid time displacement, was shattering causality. Eventually Marcus agreed to go back to Limbo but pledged his love for Ms Marvel and asked her to come with him to Limbo, which she agreed to do and the Avengers let her (this was later pointed out to have been a really dumb move.) …I’ve simplified this immensely.”

**Explanation per Chris Arndt: “At first they were magically concieved from the Vision and Scarlet Witch’s love. I mean, how else could they do it? The Vision may be a synthezoid, but I bet he lacks swimmers. Heck, in Avengers West Coast, John Byrne revealed that the Vision didn’t even have external equipment, so to speak. Anyway, eventually it was revealed that the kids souls were re-allocated chunks of the major WCA villain at the time, Master Pandemonium. Mephisto stole his soul, broke it in five chunks, and Scarlet Witch accidentily made off with two of them when she started concieving babies; turns out creating life was beyond her; she still housed souls but later the housing disappeared when her thoughts were not specifically on her children. Raw deal. Her memories of the kids were erased to remove the trauma. All in all it turned out to be a good story but definitely something too dark for an all-ages comic. The worst part is that it was part of Byrne’s de-construction of the Scarlet Witch. She made up her children; she forgot her children; most readers assumed that the Vision was anatomically on-model and as Star Trek’s Data puts it “fully functional” and then Byrne revealed that the synthezoid lacked a male member (and based on dialogue the sudden absence wasn’t a noticeable change) which would essentially de-humanize the character to the greatest degree and thus make the Scarlet Witch the sickest she’s ever appeared to her fans. You can fool a legion of nerds, geeks, sci-fi fans, and whatnot into thinking she married a man if they’re given the impression that the Vision is a man but for his origins. It’’s harder to achieve the idea that she married anything but a robot, something with a life value or even a sexual value equevalent “to a toaster oven” when the robot in question has no Mr. Happy!”

Tags: comics medicine pregnancy

This is the famous scene from the Superman newspaper strip where Clark Kent is denied entry into the army because he is “blind as a bat.” It seems that he got so flustered during the physical exam that he accidentally used his x-ray vision and read the eye chart in the room next door.

A couple of thoughts:

• Superman can fight aliens and super-villains without batting an eye, but gets so preoccupied by a physical exam that he doesn’t realize he’s using his x-ray vision? If that’s the case, it’s probably a good thing he didn’t get in the army because he’s likely to send his men right into the middle of an enemy encampment he missed while accidentally using his x-ray vision.
• Eye charts are fairly standardized, so even if Clark read the wrong one he should still get the letters right. Even if the clinic wasn’t using the now standard E FP TOZ chart, I think it’s safe to assume that they would have purchased all their charts from the same company (the low bidder naturally) and they would have all been the same.
• Look at the first eye chart. Even seen one like that? JKLMNO PQRS. And then the next three lines are the entire alphabet from A – Z. Just get the first couple of letters right, and you can guess the rest of them easily. Makes it way too easy to miss someone with poor vision and have them end up in the infantry (of course, given that this is during WWII, that might be the army’s intention).
  Take home message: eye charts are specifically designed with certain letters, not just a random sampling. Notice how difficult it is to tell F from E or P, or O from C or D in the smaller lines? (The eye charts in our office only use the letters CDEFLOPT and Z)
• Make sure you check out Brian Cronin’s Comic Book Urban Legends Revealed #49 over at Comics Should Be Good. He addresses this very scene.

Tags: comics medicine x-ray vision clark kent army

A very somber (but sadly, not sober) episode this week. As usual, there are significant spoilers for this week’s episode of House ahead, so don’t come crying to me claiming nobody warned you.

A husband returns home to find his wife Kara have a seizure in the bathtub and their four-week old son Mikey drowning. By the time they reach the hospital, Mikey has resumed breathing and Kara has stopped seizing. Mikey is taken to the neonatal intensive care unit (NICU), where Chase happens to be working. Kara’s case is tackled by House, Cameron, and Foreman. Her calcium is elevated, and the initial concerns are hyperparathyroidism, cancer, and a “calcium-mediated neurotoxicity” — but apparently all those were ruled out in the ER. The next diagnoses considered include polyarteritis nodosa (a rare inflammation of blood vessels), Whipple’s disease (a rare type of bowel infection), a Strep infection, and vasoconstriction (a sudden narrowing of important arteries). The Strep test is negative, and when she is undergoing angiography, Kara suffers some sort of massive muscle contraction/seizure.

Meanwhile, Mikey’s oxygen levels suddenly drop. Chase listens to his lungs and diagnoses a collapsed lung (pneumothorax). He performs a needle thoracostomy and then acquires x-rays. He thinks the x-rays show a chemical pneumonitis (an inflammation of the lungs caused by an inhaled — or swallowed — irritant), but House disagrees and thinks the x-rays look like a bacterial pneumonia. He suggests placing Mikey on antibiotics and ECMO. Chase decides that House must be correct and starts the antibiotics and ECMO (extracorporeal membrane oxygenation — a big machine that oxygenates the blood and removes carbon dioxide).

In terms of Kara, the doctors are now considering a lithium toxicity and a myelogenous meningitis (a rare complication of leukemia where the cancer cells invade the lining of the brain). An MRI shows no brain tumor, but it does show a subarachnoid hemorrhage. It turns out that Kara has a bleeding disorder and her blood is not clotting as well as it should. Foreman’s search of Kara’s apartment turned up no lithium, but it did show a hidden bottle of vodka. When the team discovers that Kara is a former alcoholic, House suspects that she started drinking again and is now suffering from delirium tremens (a dangerous form of alcohol withdrawal). The liver damage from the alcohol would cause her bleeding problem (though they never seemed to run any liver tests). Foreman thinks it may be a conversion disorder, basically her body is having seizures to cope with the severe stress in her life. House overrules him and they place Kara in a phenobarbital coma to essentially sleep off her delirium tremens.

Kara’s feeling better when she awakens from her coma, and she is delighted to see her son (who appears fully recovered) and her husband. A short time later, House discovers her trying to suffocate Mikey. Chase resuscitates the baby and rushes him back to NICU. The team is now concerned that Kara has postpartum psychosis, especially after she admits that she hears voices telling her to kill her son. To ensure there is not some other neurological condition going on as well, they attempt to cause a seizure in her with sleep deprivation and strobe lights. Ultimately they succeed in setting off an atypical seizure that causes them to think that Kara is suffering from some sort of progressivedelirium. The possible diagnoses at this time includes Wernicke’s Encephalopathy (neurological disease caused by a severe thiamine deficiency – common in alcoholics), lithium toxicity, Whipple’s Disease, and pellagra (neurological disease caused by a severe niacin deficiency). Pellagra is the best fit, so they start her on niacin supplementation.

In the NICU, Mikey is not doing well. The lack of oxygen has severely damaged his kidneys and he has developed hyperkalemia (high potassium). Chase tries medication to bring the potassium level back to normal but it doesn’t work, and Mikey suffers a fatal arrhythmia (an abnormal heart rhythm — ventricular fibrillation in this case).

Kara is not improving despite the niacin, and complains of stomach pain shortly before vomiting blood. House has an idea but needs an intestinal biopsy. Because he suspects a disease that has a genetic component (and because Mikey has been breastfeeding and essentially eating the same food as mom), he can test the baby. A post-mortem examination of Mikey’s intestine reveals celiac disease, an autoimmune disease tied to eating food with gluten (wheat protein). This has caused malabsorption of vitamins (niacin, leading to pellagra and vitamin K, leading to a clotting disorder) as well as led to the development of a stomach cancer.

As the episode ends, both Kara and her husband are trying to come to terms with their son’s death — and having a hard time of it. Foreman is struggling to regain the skills he lost, and did I mention that Cuddy is looking for a sperm donor?

Kara’s medical care wasn’t that bad, but the pediatric medicine was sub-par. First, Chase is an adult intensivist, not a neonatologist, and the two are not interchangeable. Second, why did Mikey develop a pneumothorax? Infection (or pneumonitis) are not causes of a collapsed lung. Third, speaking of a collapsed lung, a needle thoracostomy is for treatment of a tension pneumothorax, not a spontaneous pneumothorax. The needle simply converts the tension pneumothorax into an open pneumothorax, which they neglected to treat. Fourth, I know ECMO machines look cool, but pneumonia is not an indication for using one (though bacterial sepsis can be an indication).

In terms of Kara’s treatment, isn’t it ironic that she was found to have a cancer after we were told in the beginning that the ER had categorically ruled out cancers? For Foreman, I’m glad to see he’s recovering, albeit slowly, but why is everyone convinced it was the biopsy alone that caused his problems. Meningitis takes at least a month of convalescence (which does not include going to a stressful job) before a person is anywhere near recovered. Finally, shame on House and Wilson (especially Wilson, as an oncologist he should know better). Tumor markers can be used to follow an established cancer or to check for a recurrence, but have no use in screening for tumors (except maybe the PSA — prostate specific antigen — in men, and even that’s open for debate).

The mystery was interesting and gets a B and the solution logically followed, earning a B+. However, the medicine and in particular the pediatric medicine was bad enough that I can’t give a higher grade than a C-. The soap opera component, particularly the Wilson/Cuddy “date”, had potential and deserves a B+.

• The previous House review
• A list of all prior House reviews

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Still want more great medical reading? This week’s Grand Rounds — the best medical blogging of the past week — are being hosted by Tara over at Aetiology. As usual, there’s an incredible amount of fascinating reading.

Tags: television medicine house celiac disease pellagra grand rounds

Time for another look at what strange internet searches have led people to Polite Dissent over the past two months. Here are a selection of some that cuaght my eye (as usual, my comments are in green italics).

Frequent Searches:

• Hawk and Dove
• Wormy by Dave Trampier
• Tanith Belbin
• Scottie from Mythbusters
• “We Make Holes in Teeth”

Medically-related Searches:

• Bleach accidentally injected into bloodstream How exactly does one “accidentally” inject bleach?
• Discharge plan for unconscious patient with head injury Well for starters, I wouldn’t discharge them until they woke up.
• Why does the gallbladder cause pain in the upper right hand corner under the ribcage? Because that’s where it is located: under the liver in the upper right hand quadrant of the abdomen.
• Can a woman fall pregnant if she had a pacemaker inserted and her husband has recovered from a stroke 3 years ago/ If she’s having unprotected sex, yes.
• Are b12 injections good for you? If you have a B12 deficiency. Otherwise, they’re pretty much a placebo.
• Temperature scales for normal human body kelvin Strange question, but the normal human body temerature in Kelvin is 310.
• The subtance in the fluid lining the alveoli that prevents their collapse Surfactant

Comic Book-related:

• Spider-man comic aunt may is sick That narrows it down to about one hundred and fifty different issues.
• How to draw and create my own comic book of heroes and violins This one speaks for itself, musically.
• How to shoot heat vision from your eyes I wasn’t sure if this was medical or comic related.
• Unknown soldier hush See, I’m not the only one who thought so.
• Rudolph the red nosed reindeer with tusky I’d like to see this too.

Television-related Searches:

• We’re leaving mother earth save human race Those would be from the lyrics to the opening theme from the first season of Star Blazers
• cuddy and cameron wedding fanfiction I’m confused — are Cuddy and Cameron marrying each other? Because I find that hard to believe after the way Cameron cut her down to size last episode.
• kim possible and ron stoppable pregnancy and graduation stories fan fiction I just find it interesting that the pregnancy comes before graduation.

“I Have No Idea What On God’s Green Earth They Were Looking For” Searches

• uterus polite
• caveman voodoo convents

“Scary Thoughts” Searches

• homemade defibrillator
• o negative blood groups and alien connections

It’s been a little over a year since I first hosted Grand Rounds, and I am amazed by the amount it’s grown in that time. Not only in the sheer number of submissions (nearly three times as many as last time), but in the range of subjects — not to mention the variety of the writers themselves, from physicians to nurses to EMTs to professors to research scientists to patients to economists and on and on. Grand Rounds: it’s always a pleasure! Enjoy!

School Years and Career Choices

• A Word to the Wise about Career Choices, from the MSSP Nexus Blog
• Milliner’s Dream shares her experiences of a rough day on the floors in nursing school.
• On Floundering — the title says it all, from My Life, My Pace

The Patient’s Perspective

• Pixel RN shares her experience of being a patient at an In Vitro Fertilization clinic. Not only can the staff be difficult to communicate with, but she leanrs more than she expected.
• Difficult Patient talks about “Patient Advocates” — who really aren’t advocating for the patient, but instead the hospital.
• A look at the time-honored (but not necessarily correct) use of bedrest in pregnancy, by Doulicia
• Laurie shares her experiences about finding the delicate balance between a chronic medical condition, a social life, and guilt.
• Amy from Diabetes Mine discusses her Top Five List of What Sucks About Diabetes At The Moment

The Practice of Medicine

• Kim from EmergiBlog explains the truth behind ambulance diversion
• A look at nursing morale issues from The Nurse Parctitioner’s Place
• Kevin MD mentions an “old timer” who “bemoans demise of the physical exam.”
• A remarkable experience with a local pharmacy, as related by Dr. Charles
• Dr. Bob from The Doctor is In takes a hard look at Medical Coding and Compliance Programs
• Drug seeking patients and pain, a thoughtful look by Dr. Hébert.
• A chance encounter in a fast food drive-thru leads Dr. Peg to consider a face of courage
• GruntDoc shares some hard earned advice on extubation and paralytics.
• Dr. Flea looks at the (alleged) communication between primary care physician and specialist.
• Zosyn on the Sopranos. Accurate medicine, product placement, or both? From Kidney Notes
• When a post begins “Do you have any idea how many babies are born in a toilet each year?” you know you’re in for a fascinating ride. From Tales from the Womb.
• The Babados Butterfly has thoughts on impaired physicians
• A lovely poem, courtesy of Cricoid Pressure
• Over at Unintelligent Design, Dr. Clark considers screening a newborn’s stool for drugs
• Good news for a patient at Digital Doorway
• Political Calculations provides the unintentional comedy of medical notes

Drugs and Drug Companies

• A consideration of the economics of generic proton pump inhibitors, from InsureBlog
• Barely MD takes a different look at the profits of the pharaceutical companies
• “Yet Another Lilly Study” from Health Policy & Research, looks closely at a study of Zyprexa that is supposed to show that the medication can prevent the conversion of pre-psychosis to psychosis.

Diseases and Conditions

• A new swine flu, courtesy of Tara at Aetiology (she didn’t cause it, she’s just explaining it)
• NHS Blog Doctor takes a hard look at Bird Flu…and Malaria
• An explanation of Ludwig’s Angina from Inside Surgery

Mental Health

• A nice post and video over at Treatment Online dealing with Loss and Grieving
• Dr. Deborah Serani is not sure that T-Shirts for mental disorders are a good idea
• Psychiatry versus Pop Culture at Over My Med Body!

Living with Disabilities

• A heartwrenching tale, and the thoughts that follow by Dream Mom
• TC from Donorcyle talks about her Aunt

Medical Economics

• The Health Business Blog addresses the concept of Guaranteed Issue and how it is actually a boon for entrepreneurs
• Over at Healthy Concerns, Elisa looks at another blogger’s ideas on how to “Fix the System.”
• A lone hospital financial administrator in a convention of nurses? Get the lowdown at Hospital Impact.
• The Medical Blog Network addresses consumers and RHIOs (Regional Health Information Organizations)
• The Canadian Health System and Universal Health Care — not as broken as we’ve been led to believe? From Healthy Policy

Technology

• The effects of electronic medical records on the doctor-patient relationship, from Wandering Visitor
• Why read journals at all? Clinical Cases and Images reports that JAMA is now available via podcast.
• Straight from the Doc reports on the new technology of Terahertz Imaging for breast cancer

Nutrition, Weight Loss, and Dieting

• Disease Proof warns us to beware the high fructose corn syrup
• A fascinating look at supermarket purchases as opposed to self-reporting as a source of diet information, from Fixin’ Healthcare.
• Orac discusses a celebrity nutritionist — respectfully, of course
• Dr. ibear from Doc Around the Clock has decided that It’s Time to Get Healthy
• Medic of One gives some blunt advice on losing weight

International Medical News

• Dr Ng Swee Choon reports that some top California researchers are heading to Singapore
• From Hsien-Hsien Lee, PhD comes the news about the working conditions of healthcare workers in Lesotho.
• Parallel Universes explains why Filipino doctors are choosing to work abroad…as nurses

Next week Aetiology is hosting Grand Rounds. And remember that Unintelligent Design is hosting the second edition of the Pediatric Grand Rounds and needs your submission s by Saturday!

Looking at the location of Jason Todd’s head wound — and assuming it is not just a superficial cut — it appears that Jason has sustained an injury to his frontal lobe.

The frontal lobes, as the name suggests, are at the front of the brain. They are a key part of the brain and play a part in motor function. They also influence with memory, language, and problem solving. Finally, the frontal lobes play a large role in personality, judgement, impulse control, spontaneity, and social and sexual behavior. Because of this, it should come as no surprise then that injuries to the frontal lobes can cause severe personality and behavioral changes.

Traditionally, left frontal lobe injuries have been noted to cause pseudodepression (apathy and indifference without a sense of depression). This doesn’t seem to apply to Jason (but now that I think about it, he was showing these symptoms when he was living as a homeless man in the recent Batman Annual #25). Injury to the right frontal lobe often manifests in psuedopsychopathy (lack of impulse control and restraint without the emotional components of psychopathic behavior). To some extent, this seems to apply to Jason, but I suspect he is more of a true psychopath then pseudopsychopath. (Don’t worry too much about the left/right aspect. As with many brain injury syndromes this can vary from person to person. Frankly, most patients never meet the exact criteria for either specific condition and show a mix of symptoms.)

The post-Crisis Jason Todd was always a bit wild, but not to the extent seen as the Red Hood. His more agressive and sociopathic nature has many possible explanations. Writer Judd Winick suggests it is due to a sense of betrayal and abandonment by Batman. There was also his dip in the Lazarus Pit, known to cause psychosis. Still, one cannot discount the fact that brain injury plays a role in his new behavior. There is evidence of a left frontal lobe injury, but remember he was caught in an explosion and likely suffered more brain injuries that are not visible to the naked eye.

Admittedly, Jason doesn’t seem to manifest any of the non-behavioral aspects of frontal lobe injury such as loss of fine motor skills and difficulty with language, but it seems reasonable that his poor impulse control and increase in risky behaviors may have tipped an underlying pathology over the edge.

Tags: comics medicine jason todd fontal lobe brain

Batman Annual #25 “Daedalus and Icarus — the Return of Jason Todd”
Judd Winick, writer
Shane Davis, penciler

The real reason Jason Todd is mad. A play presented in three panels:

Jason in the hospital, soon after emerging from the grave. Note the bleeding head wound.This scene is actually drawn well, I just wish they’d change the dirty bandage.	A segue: One Year Later…(sound familiar?)	They left the stitches in! For a year! No wonder he’s mad (and poorly drawn stiches at that. Stitches are supposed to hold the two sides together — those sutures look more like it would pull them apart.)

Tags: comics medicine jason todd batman batman sutures

It’s another in the series of HIV and AIDS public service ads that DC ran in their comics in the early ’90s. This particular ad features Blue Beetle (the late Blue Beetle), Booster Gold (in what must be the ugliest costume ever), and Fire (though now that I look at it, her costume is pretty ugly too). It was found in Flash #87 (February 1994).

Brazil, Fire’s home country, has been hit hard by the AIDS epidemic. It saw its first case of AIDS in 1983 and now has over 600,000 individuals living with AIDS or HIV. Brazil accounts for 57% of the AIDS cases in Latin America and the Caribbean. Despite this, or because of this, Brazil has one of the world’s most aggressive HIV treatment and prevention programs in the world.

Click on the image to the left for the full size ad.

Tags: comics medicine psa hiv aids

Looks to be a beautiful weekend with gorgeous weather. Plans include:

• Yard work, and lots of it. Mow the lawn and get the gardens ready for planting.
• Bike riding. Hopefully a nice long ride on both Saturday and Sunday.
• Pick up the in-laws at the local airport Sunday night.
• Wasting time with my new toy: an X-Box 360 (thank you, state income tax refund). Elder Scrolls IV: Oblivion here I come!

Tags: home yardwork bicycling xbox360 in-laws

Ex Machina #18 “March to War, Chapter 2″
Brian K. Vaughan, writer
Tony Harris, penciler

In the end of issue #17, Mayor Hundred’s former aide Journal is attending a peace rally when she and hundreds of other protestors are exposed to some form of chemical toxin. In issue #18, the effects of the poison and the number of casualties becomes known. Journal is one of the victims: in the hospital and not expected to survive.

The Mayor’s security detail suspects sarin, but the Department of Homeland Security suspects that the toxin is ricin.

Sarin is a liquid nerve toxin that was developed in Germany prior to World War II as a pesticide. Poisoning can occur from skin exposure, eye exposure, or breathing sarin vapor. The toxin works on the communication between nerve cells. There are many symptoms of exposure including runny nose, watery eyes, blurred vision, drooling, and nausea. Symptoms usually appear within seconds of exposure, but may take several hours. Large doses can lead to loss of consciousness, paralysis, respiratory failure, and death. There are antidotes, but they work best if given early. Other than that, the best medical treatment is supportive.

Ricin is a toxin made from the castor bean. It is one of the most potent poisons known, and less than a milligram can kill a person. It works by disrupting the protein synthesis within a cell. It is a powder that can be inhaled, swallowed, or injected. If inhaled — as in the story — victims would develop shortness of breath, cough, and nausea within a few hours of exposure. Later, they would develop pulmonary edema (fluid building up in the lungs). A dangerously low blood pressure and respiratory failure may follow, leading to death. There is no antidote to ricin, and the best treatment medically is to provide as much support as possible and hope the patient pulls through.

When the mayor visits Journal in the hospital, the doctor refers to ricin poisoning. However, if you look at the time course (seconds vs. hours) and the symptoms, you’ll see that sarin fits the scenario better.

Journal’s treatment is a little suspect as well. The doctor is right that there’s no known treatment for ricin poisoning, and even survivors face a good chance of organ damage. However, someone as sick as Journal needs more than just an (incorrectly drawn) nasal canula and a single IV. They would need intubation and mechanical ventilation. Special medications such as dopamine would be needed to raise the blood pressure. Intensive care admission would be a must.

One last thought, Police Commissioner Angiotti refers to Ricin as “Schedule I”, but I’m not entirely certain what she means by that. At first I thought she meant it was a DEA schedule I drug — but ricin is not on the DEA list at all. However, it is listed as a Schedule I Controlled Substance according to the international 1997 Chemical Weapons Convention, so I guess this is what she is referring to. A strange thing for NYC cop to know off the top of her head.

• A belated thanks to Aaron for suggesting I take a look at this issue. In addition to my concerns, he notes the excellently drawn ventilator next to Journal in the hospital — which is strange as she’s not being ventilated. He also points out what appears to appear a tire gauge in the doctor’s pocket (image coming later).

Tags: comics medicine ricin sarin ex machina

The fourth episode of House in a row that features sex as a selling point. Enough already, please!

Melinda Bardach is 16 year-old girl who is deathly allergic to penicillin, bee stings, and peanuts. Thanks to trauma from an automobile accident, she also needed a heart transplant. She lives in a specially prepared clean room, and is not allowed out except to visit the doctor. When friends come to visit, they have to scrub down and wear a mask. Melinda’s boyfriend visits her and she wants a kiss. As he leans down to kiss her, he notices hives on her skin. Within seconds, she is wheezing and having difficulty breathing. angioedema sets in. Her mother rushes in and gives her a shot of epinephrine to stop the anaphylaxis.

By the time Melinda is admitted to House’s service, she has undergone “4 days of work-ups” which were all negative. Looking around Melinda’s room at home, Cameron and Chase notice that one window is unlocked, does not have and alarm, and is conveniently near a tree. They confront her boyfriend who admits he snuck in the night before her attack and that he and Melinda had sex. They test his semen, but Melinda shows no allergies against it. House questions him more closely and discovers that he took a week’s worth of antibiotics — penicillin, he thinks– before visiting her because he didn’t want to get her sick. The team deduces that just enough penicillin molecules were in his semen to set off an allergic reaction the next day. Just as House is ready to discharge Melinda home with a diagnosis of ‘allergic reaction” she goes into pulmonary edema, with sudden onset of wheezing, crackles in the lungs, white frothy sputum, and jugular venous distention.

Tests show that Melinda has developed congestive heart failure (the heart isn’t beating strong enough and fluid is backing up into the lungs). There is question whether this is a separate event from the allergic reaction, or if the two are connected. Cameron suggests a toxin of some kind, but that is ruled out. Other thoughts include an infection, heart disease, or rejection. A CT (apparently of her entire body) was negative, as were blood tests to rule out infection (though they came back way too soon. Negative blood cultures take forty eight hours) and a heart biopsy to rule out rejection. Meanwhile, Melinda has fled from her room. Foreman finds her on a back staircase, wanting to go outside, but too scared to go. As he escorts her back down to her room, he notices a left foot drop, which he refers to as steppage gait, but that’s a neurologist for you. As she is being examined for the foot drop, he also notes muscle fasciculations in her leg and diagnoses her with an ascending paralysis (a paralysis that starts at the extremities and works its way in, rather than the other way around).

Cameron suggests tick paralysis, but this is discarded when House points out that thorough exams showed no bites or ticks. ALS and MS — the usual suspects — are mentioned, as are Guillain-Barre Syndrome, botulism, and the catch-all viral infection. A spinal tap is obtained but is shows no evidence of viral infection. EMG (electomyography) shows increasing weakness in her lower-extremities and Foreman is convinced she has Guillain-Barre (an overactive immune response that causes paralysis). She is started on plasmapheresis, which filters out the offending proteins, but shows no improvement. Clearly depressed, she once again develops trouble breathing. This time her lungs are clear and there is no evidence of any allergic reaction. She is intubated and Foreman informs her parents that the paralysis has spread to her lungs (though presumably he means her breathing muscles, and not the lungs themselves).

Foreman and House agree that the paralysis has spread too fast for Guillain-Barre. Cuddy has taken over the case and ordered a spinal MRI to look for a possible lesion there. The team discusses but quickly dismissed the possibility of a toxin from glue inhalation or pesticides. House now decides the answer must be botulism and figures that the boyfriend smuggled in some food. He pulls his usual extubate-the-patient-so-I-can-question-them-as-they-are-gasping-for-air stunt, but Melinda is adamant that her boyfriend did not bring her any food. She also mentions that he had not been taking penicillin, but instead clindamycin – an antibiotic that she is not allergic to. The team now realizes that all three conditions (the allergy, the heart failure, and the paralysis) must be related – House belatedly decides that Cameron was right all along about the diagnosis: tick paralysis. He deduces that the boyfriend must have accidentally brought the tick in with him and that the team must have missed the tick on exam. As Melinda is sliding into a fatal heart rhythm, House declares that he must find and remove the tick before anything else. As Foreman pumps her full of atropine, House searches her entire (and I mean entire) body and manages to find the tick, lodged in the most unlikely of places (and during the most ridiculous scene in quite a while).

Let’s look at the diagnosis and the three main complaints:

1. Anaphylaxis: There have been cases of anaphylaxis from tick bites, though the time course seems a little off. Anaphylaxis usually kicks in quickly, or at most four hours after an exposure, not a day later — though it is possible that the tick had been wandering around for a while before it decided to settle down and bite. I’d also like to know that if it was an allergy to the tick bite that caused her anaphylaxis, then why didn’t she continue to have the reaction while in the hospital as the tick was still attached.
2. Heart Failure: I’m assuming that the paralysis is what led to the heart failure, though some animal studies have shown that tick venom has a direct affect against heart muscle. While atropine is used as an antidote to some neurotoxins, and it can speed up the heart rate under certain conditions, I think its use as depicted here is quite a stretch. It is not indicated in the treatment of tick paralysis or the routine treatment of heart failure. Speaking of heart failure, I never saw them do anything to treat the failure, and the CT scan is not a good way to evaluate heart failure (echocardiogram with doppler is much better).
3. Ascending paralysis: Right symptoms, but the time course is wrong. The symptoms of tick paralysis are fairly slow, taking several days to progress once they appear, not just a few hours. It usually occurs in people who have ticks that have been attached for 5-7 days, and that seems to fit this case as Melinda underwent “four days” of tests before coming to see House. I will agree that House is absolutely correct in that removing the tick solves the problem.

The soap opera again centered mostly on House and Wilson being roommates. House was cruel, but Wilson got him back in the end. Foreman is becoming the strongest of the junior doctors, standing up to House on several occasions this episode. Finally, for Hawk, who thought that Cameron wasn’t getting her share of the limelight: not only was she correct about the diagnosis, she also got the best zinger of the show in her little crack about Chase’s “staying power.”

The mystery was good, so I give it a B+, but the solution was quite a stretch so earns a C-. The medicine overall gets a C because there were too many holes. The soap opera was slight, but fun, so earns a B+ as well.

• The previous House review
• A list of all prior House reviews

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Still want more top of the line medical information? This week’s Grand Rounds are being held over at UroStream.

Tags: television medicine house guillain-barre botulism tick paralysis grand rounds.

Back to the ‘Con this morning. Much shorter line to get today — and better weather as well. Once inside, the first thing we did was stop by the CBLDF booth. I re-upped my membership, and in return got a copy of All-Star Superman signed by Grant Morrison. Nice.

Next, Robin and I swung by the Comics Fairplay booth and met Heidi and Jim Meeley. Had a great talk with them, particularly with Heidi. I did get to connect with Laura as well, but more briefly than I would have liked (check out the sword she gave to Kurt Busiek).

We proceeded up to the “DC Comics Panel” featuring writers Kurt Busiek and Gail Simone and editor Bob Schreck. It was a fun hour, as all three of the speakers involved can easily be described as…umm…having a strong personality. Not much information was gleaned, but it was an entertaining time nonetheless. (To me, this was the biggest shortcoming with the ECC. It had great guests, dealers, and exhibitors — but few panels. Panels have always been one of the best things about a good con. For one thing, they give me a chence to rest my feet. More, they give me a good chance to learn more about the creator — and see their interactions with one another — than a brief chat getting a sketch or a Newsarama interview will. More panels next year!)

Went back to the Dealer’s Area and picked up a few more Kamandi and Superman’s Girl Friend Lois Lane. I also bought several Batman Family and Superman Family comics. I also managed to find several PSA comics in a 25¢ box, so expect some fun over the next few PSA Mondays.

It was a nice weekend for the Hawk & Dove fanatic as well. Saturday, Rob Liefeld was kind enough to sign his five issues of the Hawk & Dove mini-series. Say what you will about Liefeld and his recent art, his Hawk & Dove work was good and he was extremely friendly and easy to talk with. He pointed out a couple of facts about the Hawk & Dove covers that I had never knoen. Sunday, I met Karl Kesel and chatted with him about Hawk & Dove, as well as some more recent work, and geot him to sign the comics as well.

Robin and I left the ‘con about 1:00 and headed over to the Science Fiction Museum. It was interesting and had some great stuff, but I was a little underwhelmed. Robin liked it a great deal better. I suspect it is because the museum is aimed at the general public and not a specific “science fiction fan” audience. I would have liked something more in depth, but if I were a science fiction novice I would have probably found it just right. Note to Sterling: The first issue of Swamp Thing is used as one of the exhibits in the Science Fiction and Society display. Other comics were mostly limited to some of the older EC titles.

Tonight, we’re just going to relax at the hotel, play in the pool, and have a simple dinner. Tomorrow — back to St. Louis!

The Exterminators #1 “Bug Brothers, chapter one”
Simon Oliver, writer
Tony Moore, penciler

The main character Henry is providing narration, and letting the reader know how a common household pest humbled the great Roman Empire. Unfortunately Henry has most of his facts wrong.

Henry’s Narration: Cultural imperialism right up till 164 A.D. when the Empire slipped up on a banana skin. Nature’s banana skin. The army had returned from conquering Iraq and unwittingly carried home black rats. Innocent enough, but those rats carried fleas and the fleas carried the most f****d-up bacteria, Yerainia pestis…the “Black Death”…and over the next 16 years 100 million people died.

There was a plague in Rome in the years 165-180 A.D. It is known as the Antonine Plague, the Plague of Marcus Aurelius, or Galen’s Plague. As Henry suggests, it was brought back from the Middle East by the Roman armies. However modern research as well as Galen’s contemporary account suggests that the disease was smallpox or possibly measles. It was not the bubonic plague that Henry implies and thus the rats and fleas had nothing to do with it.

Speaking of the bubonic plague –the most commonly accepted source of the Black Death — it is caused by Yersinia pestis, not Yerainia. Yerainia is not even a real word.

Finally, the 100 million deaths due to the Antonine Plague is way too high. Most researchers pin the number at around 5 million, though some go as high as 25 million. It was a devastating disease, killing up to 25% of the population in some areas, but not as severe as Henry believes. (Recall that the infamous Black Death of 1347-1350 “only”” killed about 34 million).

I’m willing to lay the blame for most of these errors on Henry and his incomplete understanding of the history and medicine involved. But not the “Yerainia” — that comes down to sloppy fact checking and editing.

Tags: comics medicine plague yersinia smallpox black death

Medics: Code 3 Special was a one shot put out last month by Shanda Fantasy Arts (though you’ll find no mention of it on their website). It concerns the ambulance crew of “Shift A from Southside.” It’s your standard “wild and crazy” crew: there is the handsome heroic leader (with a spit curl, of course), who’s good at anything he does. The second in command is a beautiful and intelligent woman (and cat). The rest of the crew is comprised of the dumb blonde, the Elvis-loving assistant, the wide-eyed newcomer, and the surprisingly wise cook.

In the first story, the team attends their annual training. There are simulated rescues, obstacle courses, and classroom work. They screw up a little bit at first, but come through when it counts. In the end, the trainer passes them and sends them home early because another teacher warns him “that whole bunch is crazy.” (Though it’s never made clear why that warrants them getting sent home early. There’s no property damage and the only people injured are on the Southside A team.)

The city (Cedar Rabbits) is planning on switching to a private firm to run their ambulance service in the second story. The paramedics mount a full offensive to save their jobs: they talk to council members, lecture school children, and steal drugs from their competition (to prove the drugs are illegal, of course). With the help of a friendly city council member and some conveniently delivered memos, Southside A is able to prevail.

The final story has the most medicine in it, and honestly, all the medicine is well done. The plot is straightforward: the main hospital used by the ambulance is on diversion and they have to take their patients to another hospital. In this hospital, the nurses (all female, by the way) ignore the EMTs and provide horrible patient care. By the end of the story, the ambulance team gets their revenge (more by luck than skill though).

The stories are strictly by the book. Within the first page or two, you know how the story is going to end and there are no surprises. There’s certainly potential, but not much more.

The art is very loose and cartoony. Inking and shadow show up now and again, but not often. The background, when drawn at all, resembles what you would expect from a second-grader. The color art on the front and back cover are very well done; it’s a shame the same art wasn’t produced internally.

I grew up on Captain Carrot. I read Kevin and Kell daily. I enjoy a good anthropomorphic comic. Sadly, this isn’t one. Don’t get me wrong — it’s not a bad comic, just very mediocre. The only interesting aspect is the anthropomorphism, and if you remove that, the comics’s not even mediocre. For $4.95, I expect a great deal more.

Tags: comics medicine furries ambulance

From Haunt of Fear #26 (August 1954):

Click for the full image

The Grand Comics Database lists the artist as Jack Davis and Albert B. Feldstein as the scripter. It refers to this as a “tongue in cheek attempt to link efforts to destroy comics to Communists.”

Personally, I don’t think it is tongue in cheek. By the time this comic was on the shelves, Dr. Wertham’s infamous book Seduction of the Innocent had already been released (and excerpts published in the Ladies Home Journal) and the House Subcommittee on Juvenile Deliquency had already turned its eyes toward comics. Within just a few months, the Comics Code Authority would begin, and within a year EC was no longer publsihing comics.

Tags: comics psa seduction of the innocent frederic wertham communists ec Comics

It’s time for my bimonthly look at what search terms brought people to Polite Dissent over the past two months. Sure, it’s a lzay post — but a fun one.

Common search terms:

• Weird n Wild creatures, Scottie from Mythbusters, and D&D module X2 (Castle Amber)

Trivia (Some people are clearly entering trivia questions verbatim as search terms. This is particularly evident in the last question as it starts out with the category. Click and drag the mouse to reveal the answer.)

• What cable hit is introduced by the voice over what happens when people stop being polite and start being real? Answer: The Real World
• Drs Kildare and Gillespie could be found in which hospital? Answer: Blair General
• gen x tv before coming to WKRP johnny fever got fired for saying what word on the air? Answer:Booger

Medical Concerns:

• Humorous spiral fracture Spiral fractures are rarely funny, at least to the people who have them. I suspect you want information on a spiral fracture of the humerus.
• Strep throat involving blisters on plate of mouth Blisters on the roof of the mouth are more suggestive of a viral sore throat than a strep throat.
• How many vials of csf are take during lumbar puncture? Usually four.
• What can I do to lower my blood pressure besides medicine? The big three: Healthy diet (low sodium), weight loss, and aerobic exercise — lots of it.

Alternative Medicine:

• Blood type O personality traits I hope I don’t have to tell you that any connection between blood types and personality is nonsense. Still, it is a common concept in many Eastern cultures and shows up in manga from time to time.
• Homeopathic remedy scaphoid fractures First, homeopathy is a ridiculous concept and doesn’t work. Second, no medicine can fix a scaphoid fracture. Third, scaphoid fractures can have long-term consequences if not repaired, so I’d suggest going to see an actual medical doctor.
• Incurable autoimmune disease natural cures Anyone else see the logical error here?

• Mistletoe side effects homeopathy Homeopathic remedies are nothing more than water, so there should be no side effects.

You People Are Sick (presented without comment):

• Wonder girl chloroform
• Sarah sutton dr who nyssa bondage
• How many seasons of Full House are there on DVD
• Self-circumcision clamp

I’d be Interested to Know What They Were Thinking:

• nuns & comics
• comic books with sodium involved
• sputum fantastic 4

Miscellaneous:

• Hostess cupcakes. For some reason, it pleases me to know that my site turns up in a search for “Hostess Cupcakes.”
• Playlists for depressing songs. I suspect it depends a great deal on your taste in music. I consider Billy Joel’s Captain Jack to be one of the most depressing songs ever. And one of my friends in college felt that if you could listen to the Pink Floyd album The Final Cut all the way through and not contemplate suicide, then you were uncommonly stable (or in denial)
• Bode Miller fanfiction. You can tell it’s fiction because Bode actually wins.
• Digital Fortress is the worst book ever. I agree it’s not a good book, but there are worse books out there. I mean, I actually finished this book and there are many books so bad I couldn’t finish them (one that springs to mind as an overly praised work I could never finish is A Confederacy a Dunces.) Digital Fortress does follow the same plot Dan Brown uses in every book.
• inttel inside idiot outside What’s funny is that they spelled Intel wrong

Birds of Prey #91“Donor”
Jim Alexander, writer (“guest” writer)
Brad Walker, penciler (“guest” penciler)
Hi-Fi Designs, colorist (Why am I mentioning the colorist for once? Keep on reading.)

The prognosis is acute renal collapse.

That’s really more of a diagnosis than a prognosis. Also, “Renal Collapse” is not a commonly used term. Renal Failure is the better one.

This doesn’t sound like an acute condition. The description makes it seem like his kidneys have been failing for quite some time, which makes it chronic renal failure instead of acute renal failure. Additionally, kidney transplants are used as a treatment for chronic renal failure and not acute renal failure.

Bull’s kidneys can no longer remove the toxins that accumulate naturally.

The kidneys serve several important functions in the body. One of them is filtering chemicals and toxins out of the blood. They also help regulate the concentration of electrolytes such as potassium and sodium in the blood. When the kidneys fail, toxins build up to dangerous levels and even electrolytes can rise to lethal levels.

A needle takes his poisoned blood into the machine. Another returns the filtered blood back into his system.

When the kidneys can no longer serve as filters, dialysis is started. Blood from the body is run through a special machine that acts as an artificial kidney, filtering the blood before it is returned to the body. It’s a complicated machine that requires close attention and specially trained personnel to operate.

The artist clearly did his homework in regards to the dialysis machine and draws an very accurate depiction of one. It’s shame that the colorist had to ruin it by coloring every single piece of tubing blood red. Even the one coming from the clear IV bag. Even the oxygen tubing.

However, while I give the artist credit for drawing a good dialysis machine, he has drawn way too many IV lines. Bull has five lines running into him, including two into the same site. Dialysis requires two: one to take the blood and one to return it. Like many other comic book artists, he also can’t draw a nasal canula correctly.

I ran this scene past a colleague of mine who worked in a dialysis center before going to medical school. He agrees with my thoughts, and he also points out the dangling IV tubing in the first panel. That’s never a good idea because the IV fluids don’t have enough pressure to work against gravity.

Last thought: Take a look at Huntress on the front cover. It’s another example of the De-Nudifying Effect (as described perfectly by Dave and Tom). Unless the Huntress’s flesh really is purple on her belly.

Tags: comics medicine birds of prey dialysis schizoaffective disorder renal failure

This ad starring Meatloaf appeared on the back cover of Marvel comics in 1987 (this scan is from New Mutants #57). It’s for a good cause — the International Special Olympics — but this has to be one of the worst PSA ads ever. (Click on the image for the full ad)

• First, is it Meat Loaf or Meatloaf? He seems to prefer the latter former, but this ad goes with the one-word moniker, so I’m going to stick with that.
• Meatloaf’s tagline in this ad is “Humongous Rock Star of the Universe.” Does “Humongous” refer to his popularity or to his size? Given the fact that this is ten years past his magnum opus Bat Out of Hell, and five years before the derivative-yet-still-listenable Bat of Hell II (not to mention his role as a bouncer in Wayne’s World), I suspect it refers more to his girth than his crowd drawing ability.
• His left hand is fingering some bizarre chord on his guitar, a guitar that seems to be pointed straight out at the concert audience. And where is his right arm? All I can figure is that he’s somehow reaching back and strumming the guitar behing his back.
• Does anybody really want everything Meatloaf’s got?
• Maybe if he wasn’t onstage under bright lights in an orange duster he wouldn’t be sweating as much. Or maybe he’s just crying, it’s hard to tell.
• Apparently, there’s no crime going on in the Marvel universe that night and all the heroes decided to show up to the concert, in costume, even Thor ( “Forsooth, methinks I will enjoy the vocal stylings of this minstrel known as Loaf of Meat. By Odin’s Beard — he doth be Humongous!”)
• The art makes him look more like Tiny Tim and less like Meatloaf.

Links:

• The single “A Time for Heroes” actually sounds pretty interesting. It was sung by Meatloaf and Brian May from Queen. An instrumental version was also perfomed by Tangerine Dream.
• Lyrics for “A Time For Heroes”
• Guitar tabs for “A Time for Heroes”
• The CD-single version of A Time for Heroes is available on eBay. Going price is £14.99 (just over $26, US) — not counting shipping and handling, of course. The poster of this ad is also available on eBay.
• This Wikipedia article on meatloaf got a laugh out of me.
• Emeril’s recipe for meatloaf. And Alton Brown’s.

Tags: comics psa meatloaf

When last we left Hawk and Dove, they had returned to the restaurant after defeating Shellshock to discover that Hank’s girlfriend had been possessed by Kestrel. Teasing and taunting, Kestrel takes particular particular delight in tormenting Hawk by changing his visage between that of Kestrel and that of Ren. Kestrel slices open a dimensional doorway with his/her claws and tells Hawk and Dove that this time they’ll have to meet on his home turf: the world of Druspa Tau. The doorway closes behind Kestrel.

The only person they know who can travel dimensions is Barter, so they look him up in the phonebook. Strangely, his phone number is only six digits long, but it seems to connect. When Dawn opens her bedroom door, they find themselves in Barter’s shop. He agrees to take them to Druspa Tau but wants to strike a better bargain for the trip back. Hawk has other ideas, knocking him out and tying him up.

Entering Druspa Tau, Hawk instantly feels stronger and more powerful. Dove is having a harder time trying to integrate all the information her enhanced senses are receiving. It turns out that Druspa Tau is not only Kestrel’s home, but also the home dimension of Hawk and Dove and thus their powers are exponentially increased there.

A small world with few resources, Druspa Tau is nearing the Kali Yuga — the mythical time when Order and Chaos will fight their final battle. M’Shulla, one of the Lords of Chaos, is fomenting rebellion to advance the Kali Yuga. Kestrel is at his side, and together they convince Hawk to join them, pointing out that they are fighting the entrenched government of Druspa Tau in order to bring more freedom to its citizens.

Dove encounters Rome, one of the priests of the Order goddess Arriya. He believes that Dove is an incarnation of Arriya and he leads her to Arriya’s citadel, but they are ambushed by the Lord of Chaos Child and his companion Flaw. In a brief battle, Dove easily defeats Flaw, leaving Child helpless.

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Hawk is relaxing in M’Shulla’s castle. Since this is a world of magic, his costume can be removed; underneath is a broadly-built spiky and hirsute warrior. Sadly, he also has — this being the early ’90s — a mullet. He refuses to let Ren/Kestrel take off her costume because he doesn’t want to see what Kestrel really looks like.

M’Shulla and Hawk, with help from Kestrel, attack the city at the base of Arriya’s citadel. The priest Rome tries to stop Hawk but is quickly defeated and captured. While exploring the city, Ren comes across Barter and not realizing who he is, unties him.

Meanwhile up in the citadel, Dove is learning her role in Druspa Tau. She understands that this world has very limited resources and some order must be imposed upon its citizens or they will all die all out within a few generations. Hearing the news that the city below has fallen to M’Shulla she realizes that it will only be a matter of time before she has to confront Hawk.

This is the first half of the four-part storyline that reveals the origin of Hawk and Dove. The story is well-written with equal attention paid to both Hawk and Dove. They both make different choices of Druspa Tau, but the changes are entirely consistent with their personalities and beliefs. It’s nice to see the return of both Kestrel and Barter.

The art, as usual for Greg Guler, is good. His Hawk costume fits the underlying warrior’s persona, but is definitely a design of the early-90’s. Dove’s designs is more ephemeral and hard to describe, but I suspect that’s intentional. Guler does a particularly impressive job onM’Shulla, drawing him so that he is always shifting appearances and is rarely the same from one panel to the next, from raven to crone to serpent to demon, always changing –j ust like you’d expect a Lord of Chaos to be.

Tags: comics hawk dove kestrel .

Finishing up the Trivia Night questions with rounds seven through ten. These were some of the hardest rounds, particularly rounds eight and ten.

Read more…

In the recent Infinite Crisis/Days of Vengence Special*, the Spectre kills the Lord of Order Teratraya and the Lord of Chaos T’Charr in his bid to wipe all magic from the universe. Since Hawk and Dove receive the powers from these entities, they immediately lose their powers and their career as crime-fighters seems over (and it lasted, what, all of a year-and-a-half?).

I’m of two minds about this.

First, T’Charr and Teratraya are already dead. They died back in Hawk & Dove #17 (October 1990), so it would be hard for the Spectre to kill them now.

Second, I don’t really care. Sure, I’m one of the world’s biggest Hawk and Dove fans, but if they’re going to be around, I want them done right. Quality over quantity. The team has already had two good runs: the original Skeates/Ditko/Kane run in their own title and the Teen Titans back in the ’70s, and the Kesel and Kesel run in the ’80s and ’90s. The two attempts since then haven’t impressed me. I’d rather remember the good runs than struggle through mediocre ones.

*Hat tip to Charles W

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While not a slave to continuity, I’m definitely a fan of it. I like having a consistent past for the characters. Having this 40+ year history is one of the things that makes our hobby unique. I can understand why this would be intimidating for some readers, particularly the new ones, but it should be viewed as a challenge rather than an obstacle. I am aware that Joe Quesada among others has advocated caring less about continuity and more about telling “great stories”; I’d be more willing to agree with this if they were actually telling great stories.

This has been a long-winded introduction to why I’m not fond of the new Hawk and Dove team. I like having Dawn Granger return as Dove, but I’ve never fully accepted her (never before seen or even mentioned) sister Holly Granger as the new Hawk. It’s possible that given enough time and some good explanations, I could learn to like her. But for now, she goes against two previously well-established facts of the Hawk and Dove canon (and I’m probably the only person in the world who can use that phrase non-ironically):

1. Dawn Granger is an only child.
All the pictures on the walls in the Granger house show 3 people: Mom, Dad and a single child. Dawn herself mentions being an only child in Hawk & Dove #20, as she’s sitting bored at home wishing for some excitement. I’m sure there’s some way this can be explained away: Daddy’s little secret or an evil twin, but those explanations only make it seemed horrible clichéd.

2. Hank and Dawn are the last Hawk and Dove
The death of T’Charr and Teratraya in Hawk & Dove #17 means that they can no longer bestow the powers on anyone else. This was one of the main themes of the latter half of the Hawk & Dove series. The two of them would be the last Hawk and Dove, ever. In the scene below from Hawk & Dove #18, Hank reflects on this fact with Dawn ( “Unity” refers to T’Charr and Teratraya as a combined entity).

scene from Hawk & Dove #20

scene from Hawk & Dove #18

I know I’m behind in my reviews and recaps of the Hawk & Dove series, but I’ll catch up posting this weekend, at least through their adventure with the Titans and the death of T’Charr and Teratraya.

Remember: Continuity doesn’t have to be bad; some of us like it. And Quality over Quantity.

Tags: comics hawk dove infinite crisis .

This medical review of House contains lots of words (probably too many) and several spoilers, so don’t say I didn’t warn you…

Fletcher Stone, a famous journalist, is at an office function when he falls and hits his head on a desk. There is some confusion whether he tripped or fell. He was knocked unconscious briefly, and when he came to he was unable to speak normally. He had developed aphasia and he only spoke in random words. He could understand what was being said, but was unable to talk intelligibly. When he was later examined in the hospital, he was also noted to have agraphia, the inability to write. Both aphasia and agraphia are signs that something very bad is going on in the brain.

Stone had apparently been the stereotypical “wild journalist” for most of his life. He had volunteered for risky assignments, drank copious amounts of alcohol, and indulged in frequent recreational drug use. He gave up all his vices when he got married a few years before the episode occurs.

House is away in Baltimore and Cuddy wants to transfer Fletch to another hospital. Foreman convinces her to let the rest of the team handle the case, though they keep in touch with House by phone for most of the episode. They initially suspect that Fletch may have had a stroke, suffered a seizure, or may be having a medication reaction. A carotid Doppler was normal as was an EEG. Fletch suddenly develops a coughing spell and has trouble getting oxygen. He is emergently intubated and placed on a ventilator. A chest x-ray shows pulmonary edema (fluid build-up in the lungs). He is given a diuretic (a “water pill”), which apparently worked very well because he is never shown intubated or having breathing problems again.

Meanwhile, his drug screen has come back positive for amphetamines. His editor confesses that Fletch had found difficulty sleeping in his new married life, so he started taking sleeping pills. Those made him too tired during the day, so he started taking amphetamines. Of course his wife knows nothing about this.

Fletch starts running a fever of 101. The team is now concerned about infection (encephalitis or meningitis) or an autoimmune disease. The treatment for these two conditions is very different, and treating both would be counterproductive, so they have to choose one treatment and go with it. House suggests treating the suspected infection with antibiotics and antivirals. He also insists the team obtain an MRI. The MRI shows brain swelling; it also shows scarring in the brain — as if from an old injury — but not in the areas of the brain that would cause aphasia.

Feeling they’ve reached a dead end, the team falls back on an old House standard: breaking and entering. Foreman and Chase search Fletch’s office and home. They find the sleeping pills and amphetamines, as well as a bottle of Topamax (officially a seizure medication, though it has many unofficial uses). At the hospital, Fletch starts complaining of a metallic taste and Cameron realizes that he is going into kidney failure (a metallic taste in the mouth is a symptom of kidney failure).

A lumbar puncture is performed. This can be a dangerous procedure on a patient with elevated intracranial pressure or brain swelling. When the puncture is performed, a sudden drop in intracranial pressure can occur. In patients with swelling, this can be enough to smash the brainstem against the spinal column, causing death. Luckily, Fletch’s test is performed safely and shows some non-specific signs of infection.

Belatedly, the team realizes that Fletch is hiding some of his past from his wife. They lure her out of the room and are able to discover that Fletch has bipolar disorder, which is why he had been taking the Topamax (one of its unofficial uses is as a mood stabilizer). To “cure” his bipolar disease before getting married, he had crossed the border into Mexico or the Caribbean and had an experimental brain surgery designed to cure bipolar. It didn’t work, but it did cause the scarring that the MRI revealed. Also, while he was “south of the border” he contracted malaria, and that is the underlying disease that had been causing all his problems. Fletch is soon cured of malaria, but sadly, his wife had left him because he kept too many secrets from her.

The writers played very loose with the diagnosis of aphasia. The symptoms shown by Fletch (sentences seemingly composed of random words – yet retaining understandable syntax) are not common in any type of aphasia, particularly the “expressive aphasia” Cameron mentioned. In addition, the idea that one can “decode” aphasia is simply ludicrous.

The final solution of malaria was a bit of a letdown as well. Malaria can certainly cause kidney failure and pulmonary edema, but it’s very rare and only in very severe cases. I’m not certain how the malaria caused the aphasia — a stroke maybe? — as that part was conveniently left unexplained. I find it hard to believe that malaria severe enough to cause renal, pulmonary and neurological disease would not have been easier to diagnose; there are many more common early symptoms including the classical cyclical fever (a high fever recurring like clockwork every 24-36 hours). According to the timeline of the episode, Fletch would have to have had malaria for several years without knowing it — something unheard of. While a mechanically tested blood sample would not show malaria specifically, it would show other abnormalities that could be picked up on. Finally, intravenous quinidine is not routinely available in the United States and must be shipped directly from the CDC so the hospital would not just have some on hand.

The soap opera aspect consisted of House and Stacey flying to Baltimore to defend House’s Medicare billing. A snowstorm leaves them stranded in Baltimore and in a single hotel room. There is some mutual smooching going on, but then the case intervenes. Things are left up in the air between House and Stacey, but with a definite “this is never going to work” undertone. I’m not sure why they had to fly to Baltimore (except to get them together and out of the hospital). The billing inquiry could have been handled over the phone or by mail.

I give this episode a B+ for the mystery, bot only a C- for the solution. The medical content also earns a below-average C- (mostly for the “decode the aphasia” scenes). The soap opera earns a B.

• Previous House reviews

Tags: television medicine house aphasia malaria.

This is the first of two recently acquired New Teen Titans drug awareness public service comics drom the 1980s. This particular comic starts out with a letter from then-First Lady Nancy Reagan telling kids to fight the battle against drug abuse. There is a strong martial theme running through the letter as if she expects the Draft to start any moment. No mention of astrology, though.

After a start like that, things can only get better, right? Think again…

The Teen Titans, teamed up with generic teen hero “The Protector,” stop a group of drug dealers at an amusement park (and destroy most of the park in the process). Then the Feds show up and take over.

Feds: Titans, Protector,thanks. We’ll take over now.
Protector: It’s the Federal Task Force!

Now when I say the Teen Titans, I’m referring to the classic Wolfman and Perez New Teen Titans from the early ’80s. Well, most of them, anyway. Robin is conspicuously absent. Everyone’s favorite ex-druggie super hero, Speedy, is also conveniently missing.

The Protector asks Wally West (a.k.a. Kid Flash) to keep an eye on his cousin Ted who just moved to Wally’s home town of Blue Valley, Nebraska. It seems that Ted once had a bad drug habit and the Protector is concerned he might fall prey to temptation again.

Everything is going great for Ted at first. He meets a nice girl and is doing well in school. Then Coral, a conniving cast off from Jem and the Holograms, talks him into trying drugs again. After that, it’s too late — he’s hooked! Ted starts doing harder and harder drugs. He breaks up with his girlfriend and begins skipping school.

Ted quickly runs out of money and the dealer won’t give him any more drugs. He and his buddy end up snorting some spilled cocaine off of a bathroom floor. When that doesn’t prove effective, the two of them attempt to rob a local convenience store. Unfortunately, they picked the wrong store and the shopkeeper pulls out a gun and wings Ted’s friend. Ted runs away and is found sobbing on the ground by his ex-girlfriend Amy, who takes him to the hospital to get help.

Meanwhile, the Titans (and the Protector) bust the dealer and the local drug ring. They all visit Ted and his friend in the hospital who both promise never to do drugs again.

The book ends with several pages of activities for readers regarding peer pressure, communication skills, and taking responsibility. This last part is actually very clever and well done.

The story is by Marv Wolfman, who created the New Teen Titans. Sadly, none of his normally keen storytelling skills or inventiveness are evident in this heavy handed story. There is page after page of by-the-book recitation of “drugs are bad for you” facts. In terms of the art, Ross Andru draws the action scenes well, but his talking heads approach to the didactic parts makes the dull sections even duller.

This comic was brought to you by DC Comics, the President’s Drug Awareness Campaign, and NSDA (the National Soft Drink Association).

Tags: comics medicine psa teen titans

1. Nothing short of surgery is going to increase the size of any God-given organ (or organs) you have. No creams, no pills, and no patches.
2. Nobody ever died of baldness.
3. All medications have side-effects. This includes over the counter medications and prescription drugs, as well as herbal medications. If someone tells you that their medication doesn’t have side effects, then they are either lying or selling you water (see #5 below)
4. If you’ve been sick for several days, it’s going to take you at least a couple more days to get completley better. If you get better immediately, it’s unlikely to be the medicine you just started taking.
5. Homeopathy doesn’t work any better than a placebo or water, and it’s a lot more expensive.
6. There is no such thing as “Generic Viagra,” “Herbal Viagra,” or “Viagra Patches.” There is just prescription-only brand-name Viagra. And really, where exactly would you put those patches?
7. Losing weight comes down to simple math. If the calories you burn during the day are more than the amount of calories you eat, you’ll lose weight. If they’re more, you’ll gain. That’s it — there’s no magic involved. All weight loss comes down to a combination of diet and exercise. No over-the-counter pill, liquid, tape or patch will help…unless you use the patch to seal your mouth shut.
8. Real drugs aren’t spelled with punctuation.
9. Kevin Trudeau is a con man. All he wants is your money. He doesn’t give a damn about your health.

A complicated episode of House, but an interesting one. This medical review contains a bunch of spoilers, so don’t say I didn’t warn you…

As the story begins, we discover that House and Chase are facing a hospital disciplinary hearing over the care of one of their patients. This episode takes place mostly in overlapping (and sometimes contradictory) flashbacks. While this is a good storytelling device, it makes for an awkward discussion of the medicine so I’m going to approach the case chronologically.

Kayla, a young mother, is experiencing severe abdominal pain as well as joint pain in her legs. A clinical exam reveals uveitis, a type of eye inflammation. The team considers a variety of diagnoses including gonoccocal arthritis, rheumatoid arthritis, and Takayasu Arteritis. They finally settle on a diagnosis of Behçet’s Disease after finding some genital ulcers on a pelvic exam. Behçet’s Disease is very rare chronic inflammatory disease. Symptoms include mouth and genital sores, uveitis, arthritis and skin rashes. Abdominal pain can also be a symptom. Chase starts Kayla on some medication to calm down the Behçet’s, some antacids for the stomach pain, and performs a skin test to confirm the Behçet’s known as a pathergy test.

When Kayla comes back to the clinic two days later to have her pathergy test read, she complains to Chase that she is still having abdominal pain. Her test is positive, so he refers her to a rheumatologist. He also prescribes some stronger antacids and sends her on her way. He does not perform an exam or ask any more questions about her abdominal pain.

Two hours later Kayla is brought to the Emergency Room after vomiting a tremendous amount of blood. Chase performs an endoscopic exam and notices a stomach ulcer. He cauterizes it to stop the bleeding, but a second stomach ulcer has perforated, spilling the stomach contents into the abdominal cavity. This is very dangerous and Kayla develops peritonitis and then a severe bacterial infection known as sepsis. This leads to kidney damage and liver damage. A blood clot forms in the liver, leading to even more liver damage. Kayla’s best hope of survival is a liver transplant. Despite the fact that she’s too sick for a transplant, House browbeats Cuddy into placing her at the top of the transplant list.

Unfortunately, Kayla has type AB- blood, the rarest blood type, so it will be unlikely that a liver will be found in time. Her brother offers to give Kayla part of his liver, a type of “live organ donation.” He has lab tests to prove that his liver is in good condition and will match her genetically. House blackmails one of the transplant surgeons into performing the operation, and both brother and sister do well.

At a follow-up visit 2 months later, Chase notes that Kayla has a low-grade fever, unusual for someone on immune suppressant medication. He orders some blood cultures and other lab tests, as well as a chest x-ray. One of the blood cultures grows Strep. This usually means that it was a skin contaminant (If it had been a real infection, Strep would have grown in more than one sample. Strep commonly grows on the skin, and a single positive culture suggests that her skin was not cleaned off well enough before the sample was drawn). Her liver enzymes are elevated, signifying liver damage. Chase chooses to believe that Kayla has a Strep infection, but Foreman believes Kayla’s body is rejecting the liver. Her brother comes in and demands to know what is going on with his sister. House looks him over and deduces that he has Hepatitis C and that he faked his liver tests to so that his sister could have the transplant. He transmitted Hepatitis C to his sister and because of her immune suppressant medication, she deveoped a severe infection. In addition, his liver was cancerous (from the chronic Hepatitis C) and he gave this cancer to his sister hidden inside the liver transplant. At this point, there’s not much that can be done for Kayla. She has Hepatitis C rampaging through her body, and because of the liver cancer, she isn’t eligible for a second transplant. Her brother wants her to get a “black market liver transplant” in Mexico, but Chase advises against it. Kayla returns home to her children and dies a week later.

There is no doubt that Chase should have performed a better exam. Abdominal pain is never something to be taken lightly and people can die from gastrointestinal bleeding in a remarkably short amount of time. Both he and House know he screwed up. The question of the episode is why did he screw up. At one point, Chase confides to Kayla’s brother that he killed her by missing her ulcer and blamed it on being hung over. Unsurprisingly, her brother files a malpractice suit against Chase. In reality, Chase was not hung over, but instead had just been informed that his father had died. This threw him for a loop, and he wasn’t really paying attention to what Kayla said. He tried to call her back a few hours later, but by then it was too late and her ulcer had burst.

Chase is reprimanded by the committee and suspended for a week. In addition, the committee is distressed by House’s actions and places him under another physician’s direct supervision for the next month. Cuddy chooses Foreman to be that supervisor.

The medicine was fairly straightforward this episode and almost error free. Chase should have been more concerned about the abdominal pain, and taken a better history to find out what medication Kayla was taken, but his mistakes were the basis of the episode. I’m surprised that the team would accept her brother’s lab values without confirming them, and that goes double for the surgeon (blackmailed or not). I will make my usual complaint that the team is performing tests themselves that are best left to specialists (such as endoscopy). I also wonder why Foreman, a neurologist, was consulted for someone having abdominal pain and arthritis.

The soap opera was more restrained this week, focusing mainly on House and Stacy trying to salvage their professional relationship. I expect more fireworks in the next episode when Foreman is in charge.

This episode earns a B for the mystery, another B+ for the solution, and a B+ for the medicine overall (it was competent, just not as exciting medically as usual). The soap opera earns yet another B.

UPDATE:
My boss just reminded me of a scene I forgot to mention, when Chase performs a pelvic exam on Kayla. First, he performs an unchaperoned exam — that’s a lawsuit waiting to happen. Then, while his hands are still gloved and contaminated from the exam, he flips through her medical records. You use gloves for a reason…

• Previous House reviews

This medical review of House contains a whole bunch of spoilers, so don’t say I didn’t warn you…

House finds himself accosted outside his home by Kalvin, a young man with AIDS who wants House to figure out why he is having increasing shortness of breath and fever. House tells Kalvin that he simply has one of the common infections that occur in AIDS patients and to leave him alone. When Kalvin refuses to leave, House gives him a gentle shove. The patient falls, hitting his chest against a nearby car and going into anaphylactic shock — a sudden and life-threatening allergic reaction.

Kalvin is admitted to the hospital, but House is still sure that he must have an opportunistic infection such as herpes simplex, pneumocystis, or tuberculosis. Kalvin’s tests are all negative and his T-cell count is over 200. T-cells are the infection-fighting cells that are the targeted by HIV; a high T-cell count makes it unlikely that Kalvin has an opportunistic infection.

Kalvin’s drug screen is positive for methamphetamine and ecstasy, and when Cameron confronts him about this, he develops a sudden hemoptysis — a bloody cough — and some of his blood ends up in Cameron’s eye and mouth. Realizing she has been exposed to HIV, Cameron talks to the hospital infection control officer who starts her on some anti-viral drugs. She must wait six weeks before being tested because the AIDS test looks for antibodies against HIV, not HIV itself, and these antibodies take several weeks to show up.

Cameron wonders if Kalvin’s symptoms may have been caused by contaminated drugs so she and Chase search his apartment. They don’t find any drugs, but they do discover some old photographic equipment and speculate that Kalvin may be suffering from beryllium poisoning, since that was a chemical used in old flash bulbs. A subsequent lung biopsy is negative for beryllium damage.

Kalvin becomes suddenly short of breath and his distended neck veins suggest cardiac tamponade. Tamponade occurs when the pericardium, the sack that surrounds the heart, fills with so much fluid that the heart cannot expand properly. The treatment is to drain the fluid through a long needle inserted through the chest wall into the pericardium. Most tamponades are caused by blood, but when a clear liquid is withdrawn instead of blood the team suspects Kalvin must have a cancer of the heart. A CT scan confirms a tumor mass in the heart and some smaller ones in the lung. Non-Hodgkin’s Lymphoma is the diagnosis and surgery is scheduled.

Meanwhile, Kalvin’s father has come from Montana. He and Kalvin don’t get along because they both blame Kalvin for his mother’s death. When House notices the father profusely sweating, he deduces that Kalvin does not have lymphoma, but instead a parasitic infection known as echinococcus. Kalvin and his father both caught this disease years ago while hunting foxes in Montana, and it had laid dormant until recently. In Kalvin, it masqueraded as heart and lung cancer, while in his father it masqueraded as cirrhosis — a liver disease most commonly caused by heavy drinking. It was the fever that gave it away, because cirrhosis does not cause fever. When these parasitic cysts would break open, such as when Kalvin fell against the car, the body would develop an immediate allergic reaction against the parasites causing anaphylactic shock. Two quick surgeries later and Kalvin and his father are healing, both physically and mentally.

The medicine was reasonable. House’s behaviors, such as purposefully inducing anaphylactic shock in the father, were unethical and quite likely illegal, but the science behind them was sound. I do wonder what sort of radiologist could mistake a hollow cyst for a solid tumor on a CT scan, or confuse cirrhosis with a cyst.

The highlight of the show was the soap opera. Using the notes he stole last week from Stacy’s therapist, House begins to worm his way back into her life. He tries to show her that he can do all the things her incapacitated husband can’t — such as cleaning the dishes and catching the rat terrorizing her apartment. He also continues his subtle and not-so subtle jibes at her husband, like leaving the toilet seat up so that he’d know Stacy had had a male visitor. By the end of the episode Stacy realizes that House had read her file and kicks him out of her office, and possibly her life entirely.

Meanwhile, Cameron is not coping particularly well with her HIV exposure. She puts on a brave front, but is clearly scared. She samples some of Kalvin’s drugs and seduces Chase while she’s high. A very dumb move on her part, but a monumentally stupid one on his. Not only does Chase sleep with an intoxicated co-worker, but one who may be HIV positive as well. Only time (and a few more episodes) will tell.

This episode earns a C+ for the mystery, a B+ for the solution, and another B+ for the medicine overall. The soap opera, especially the Cameron and Chase subplot, earns a solid A.

• Previous House reviews

My usual music listening software had been MusicMatch Jukebox. It’s an excellent mp3 player, it has a wide variety of good online radio stations, and it has a good selection of downloadable content. Howeve,r I’ve noticed that it’s been eating more and more CPU cycles recently, to the point where I am unable to multi-task (and I live for multi-tasking). It’s not just some quirk with my home computer, I’ve noticed the same problem on my work computer. Because of this, I’ve been looking around for some alternate music software.

I’ve never liked Microsoft’s Media Player (I don’t trust it), so I’ve avoided using that. I tried iTunes, and while I appreciate its mp3 playing, I’m not as impressed by its online music stations. XM Radio seems to have the best online radio. I have an XM radio at home, so I can use its online content for free. In particular I’ve enjoyed station #44 “Fred” — which is described as “classic alternative rock”. Basically, it’s the alterntive rock I listened to during high school and college.

It’s been great listening to all that music again. In addition to the usual suspects (the Cure, Oingo Boingo, Depeche Mode, REM) , there have been the occasional bands that I enjoyed that I had loved but totally forgotten about: the Jesus and Mary Chain, Book of Love, and Bauhaus.

I think I’m scaring the nurses though.

Spider-Man and Power-Pack was a giveaway comic produced in 1984 by Marvel, the National Committee For Prevention of Child Abuse, and the NEA. Written to educate children about sexual abuse, this comic contains two stories.

The first is a Spider-Man tale written by Jim Salicrup and penciled by Jim Mooney. Peter Parker is in his apartment darkroom developing pictures when he hears something disturbing from the next apartment. Changing into Spider-Man, he swings over and finds that Tony, the son of the couple next door, has been abused by his babysitter Judy. Spider-Man wants Tony to tell his parents what happened but Tony is too scared.

Spider-Man tells Tony the story of a young man about his same age who lived with his aunt and uncle (could it be Peter Parker?). This young bespectacled boy was a bookworm and didn’t have many friends. He was pleased when a slightly older boy named Skip befriended him. Then one day, Skip pulled out some Girlie magazines (no really, that was the name of the magazine) and told Pete that they should “touch each other like the people in that magazine.” The young boy tells his aunt and uncle what happened and in the end everything works out. Spider-Man tells Tony that just like that other young boy, he should let his parents know what happened. Tony’s parents are very supportive and tell Tony that he did the right thing. They thank Spidey, but he tells them that there’s no need for thanks as Tony has already helped him. Web-swinging back to his apartment, Spider-Man realizes that helping Tony face his abuse has allowed Spieder-Man to face a dark chapter of his own past (an incident never mentioned again in any other Spider-Man comic book ever).

The second part of the comic is a Power Pack story by Louise Simonson with pencils by June Brigman and Mary Wilshire. Jane, a young school friend of the Power children, has run away from home because her father sexually abuses her. Jane told her mother what happened, but her mother didn’t believer her. The Power Pack are able to locate the runaway Jane and they bring her back to their house. Jane tells Mrs. Power what happened. After Mrs. Power consoles her, she gives Jane a number to call to get her family some help.

• SpiderFan on the Spider-Man portion of the story.
• Scott Shaw!’s Oddball Comics entry on this comic.
• The Appendix to the Handbook of the Marvel Universe entry on Skip Westcott.

As usual, there are House spoilers below, so I’d suggest you watch the episode before you read (unless you’re one of those people who read the last page of a mystery first).

An interesting and enjoyable episode of House with a good medical mystery.

Cornell, a young black man, is at a party celebrating his graduation from Princeton when he begins to convulse from intermittent and excruciating shock-like pains. Initial work ups are negative except for a low white blood count, and an MRI rules out multiple sclerosis. House thinks the patient might have Type II Neurofibromatosis, but the genetic tests are normal.

Cornell looses control of his bowels. This is a worrisome symptom because it indicates that the central portion of the spinal cord has been compromised. The gang decides that he has transverse myelitis, but they don’t know what caused it. House suspects that it is pesticide exposure, so he starts pralidoxime, an antidote for pesticide poisoning . The medication seems to work at first, but then Cornell starts running a fever of 106°F and his symptoms recur. He develops a perforated bowel from the raging infection and requires immediate surgery.

One of Cornell’s friends from college, who we already knew had a weird rash, starts vomiting blood and is brought to the hospital. House is finally able to put the full story together and realizes that the patients have been exposed to radiation. Cornell’s father runs a scrap yard and gave his son a scrap metal weight as a key chain to remember “where he came from.” Unfortunately, this keychain was radioactive. The father and friend have mild cases of radiation poisoning but Cornell has a much more serious case. The radiation has killed off his white blood cells, leaving him open for infections. It also caused a spinal cord tumor (a cavernous angioma) which explains his neurological symptoms. The surgeons are able to remove the tumor, but as the episode ends it seems unlikely that Cornell will survive his infection.

The medicine was fairly sound in this episode. I have a few nit-picks, but no major complaints. Time course is a concern. It is unlikely that an exposure to a pesticide over spring break would have caused symptoms to appear months later at graduation. Radiation poisoning, especially exposure to long-term low-dose radiation, can take months for symptoms to surface — so the time course there was reasonable. It does seem that the tumor developed awfully fast though. Finally, if Cornell had a white count as low as the story suggests, he should have been in isolation shortly after admission, and his father should have been wearing a mask and gloves (and probably a gown) when he went in to see him at the end.

On the non-medical, soap opera side, the action picks up. House has borrowed $5000 from Wilson to buy a new motorcycle. Of course, it turns out that House didn’t need to borrow that much money — he was just testing Wilson to see how much he’d lend him by asking for increasing amounts over the course of a year. Surprising no one (except maybe House), this annoyed Wilson. Also, House’s parents are in town for a brief layover at the airport and want to go to dinner with him. He is trying to avoid them, but doesn’t want to lie to them. He concocts various schemes to get out of dinner, but ultimately sits down to share a meal with them at the hospital cafeteria. The interactions between House and his father (a bushier-eyebrowed than usual R. Lee Emery) drive home the underlying theme of this episode: fathers and sons, when do they lie to each other, and when do they tell the truth?

I give this episode an A for the mystery with a B+ for the final solution. The medicine overall earns a B and the soap opera also deserves a solid B.

• Previous House reviews

I got home from working out later than I had planned, so the House review will be up in the morning (first thoughts: good drama, not-so-good medicine).

The summer of 1959 was a heady time in Gotham City. Citizens were flocking to the Gotham Theater to see Charlton Heston in Ben Hur and Bobby Darin was rocking the town with Mack the Knife. And in a small periodical known as Detective Comics #267, the hero known as Bat-Mite made his debut.

Originally from a rural farm town in a small backwater dimension, Bat-Mite had always expressed an interest in Earthly super-heroes. When his parents died in a tragic yeti accident, he packed his meager belongings in a suitcase and headed out for the big city: Gotham.

Bat-Mite’s Brother: He always had his head in the clouds, talking about them super-heroes and skyscrapers. He was never any damn good at growing pumpkins, that’s for sure.

His first appearance was a smash success, and Bat-Mite appeared in Detective and Batman and World’s Finest again and again. He hung out and partied with all the big names: Batman, Superman, Batwoman, Robin and even Bat-Girl.

Mr. Mxyzptlk: That Bat-Mite sure knew how to have a good time. I would meet up with him after work and he always had at least 2 or 3 women draped all over him. He also had a fondness for those fruity foo-foo drinks. I think it was the paper umbrellas, really. He could always make me laugh though.

It seemed that the good times would never end. But end they did.

New management took over DC and decided that the comics needed a new direction. The Golden Age was over. The ship had sailed; the jig was up; the soup had scorched. Batman comics would no longer be humorous and extra-dimensional imps were no longer needed. Batman had his new look and only serious comics would be published in Gotham. Bat-Mite found himself out on the street. His money? Wasted on pink ladies, cheap women, and racehorses.

Ex-Girlfriend: I kept telling him he needed to save his money. Stop betting on those damn horses. Buy a better car. And shave. Would shaving at least once a week kill him? And clean up that apartment — jeez, what a pigsty. And then he accused me of being nag, can you believe it?

The late 60’s and early 70’s were tough on Bat-Mite. He kept auditioning for roles at DC, Marvel, Charlton, Atlas, Quality and even Archie — but nobody wanted a washed-up has-been imp. A few editors took pity on him and managed to squeeze Bat-Mite into a story here and there — but paying gigs were few and far between. His Broadway debut as Woodstock in You’re A Good Man Charlie Brown was lambasted by the critics and he was fired after opening night. He soon found himself reduced to performing dinner theater in Lansing.

One night, Bat-Mite had an epiphany after a particularly rousing chorus of “You Gotta Have Heart” as performed by the Southern Michigan Men’s Dinner Theater Glee Club. He realized that if ever wanted to work in a respectable medium — such as comic books — again he would have to clean up his act and get his life together. He joined Alcoholic Anonymous, Gamblers Anonymous and other unnamed organizations and gave up the booze and gambling. He felt better and was able to lose some weight, but he remained unhappy and unemployed. Even with his new outlook he still couldn’t find any good work. He was offered a recurring role on Little House on the Prairie, but even a washed-up cartoon had his pride. Finally, he packed his mask and cape and headed back to the family farm.

Brother: It was good to have him back, and he sure seemed happy — even met and married a local girl — but he still didn’t know the first thing about pumpkins.

Things seemed to be finally settling down for Bat-Mite. His dreams of stardom were over and he was resigned to life as a farmer and husband. Or was he?

In 1977, Hollywood called. Batman and Robin had been given a new Filmation cartoon show and the producers wanted Bat-Mite to be involved. He was ecstatic.

Ex-Wife: He came into the kitchen, stunned, and I asked him what was wrong. He told me to “Pack my bags ’cause we were going to Hollywood!” I had never seen him so happy, even on our wedding day — he was ecstatic. Of course, as we were heading out to California he casually mentioned that the producers wanted a skinny Bat-Mite, so he started popping diet pills. A few with breakfast, some with lunch, a few more with dinner and a handful with every snack. He was eating them like candy.

The New Adventures of Batman was a hit and Bat-Mite was a star again. He didn’t handle the fame well and soon reverted to his old habits. He bought an expensive car and developed a taste for Fuzzy Navels and fast women.

Ex-Wife: I kept telling him that he needed to slow down or he’d kill himself, but he never listened. After I caught him in bed with Betty and Wilma, I’d had enough and I walked out. I told him, “Just you wait. I’ll get my own show.” He just laughed and chugged down a bottle of Grenadine.

The series ended abruptly and Bat-Mite found himself once more out of a job. The cartoon continued to be shown in syndication, but Bat-Mite found his contract was “work-for-hire” and he wasn’t owed any money. In a booze and diet-pill fueled rage, he stormed the offices of DC comics in 1979 and demanded his own comic. He was quickly escorted off the premises and thrown in a back alley dumpster.

A decade of living on the edge followed. Bat-Mite refused to return to the family farm and admit defeat. He was drinking again, peach schnapps, up to a pint a day. He was still hooked on diet pills and had taken to snorting Benadryl in an effort to calm down. He bounced from relationship to relationship, often getting married and divorced the same day.

Ex-Wife #2: It was horrible! Bat-Mite had this two-dollar-a-day Benadryl habit. I was so embarrassed. After one particularly bad argument at a Grateful Dead concert he threw a bong at me. I was so conflicted: I wanted to leave, but I didn’t want to miss the Dead. So I ended up getting a ride home with Shaggy — now he was a quality cartoon character. Too bad he never got over that thing with Velma.

The slope was getting steeper and steeper and Bat-Mite was sliding down like butter on Teflon. Would he ever recover?

After narrowing avoiding a car accident after accepting a ride with Leif Garrett, Bat-Mite took stock of his life. He quit drinking and cut back on the cigarettes. He weaned himself off of diet pills and Benadryl. He swallowed his pride and filmed a few Burger King commercials and a guest shot on Manimal. That gave him enough money to rent a small apartment and hire a personal trainer. He shed pounds, and more importantly, gained confidence. He swallowed his pride and looked up his old partner, Mr. Mxyzptlk.

Mr. Mxyzptlk:I hadn’t seen Bat-Mite for years, and the last time I had seen him it wasn’t pretty. He was high on Schnapps and antihistamines and kept accusing me of selling out. That’s why I was so surprised when he showed up again on my doorstep clean and sober. He apologized for the past and asked if there was any chance I could get him a job.

Mr. Mxyzptlk pulled a few strings and soon DC comics published the critically acclaimed Batman: Mitefall. Bat-Mite was back in print, and on expensive paper, too.

Sadly, the years of hard living had taken their toll. Just two weeks after Mitefall was released, Bat-Mite was found comatose in his Gotham City apartment. The years of booze and pills had been too much for his liver and he never regained consciousness. He was buried in Gotham Heights Cemetary with a simple headstone that reads: Bat-Mite — Cartoon Imp, Visionary, and Hero to Short People Everywhere.

“Obviously” Batman, you’ve never read The Iliad either — the Trojan Horse is never mentioned in it. The horse is mentioned briefly in Homer’s other great epic The Odyssey, and at greater length in Virgil’s The Aeneid.

Image taken from Batman: Legends of the Dark Knight #121 with script by Larry Hama and pencils by Rick Burchett.

October’s Redirected Male column over at Sequential Tart is by yours truly.

This week’s House? Spoilers and discussion below…

This was probably my least favorite episodes of House. The medicine was suspect, the pathos cloying, and the soap opera missing. And enough with the false dilemmas already!

Andie is a 9 year-old with alveolar rhabdomyosacrcoma, a terminal cancer. She experiences a hallucination at home and is brought to the hospital for evaluation. She is run through an entire battery of tests, some very invasive, and all are normal. Well, except for her oxygen saturation (the amount of oxygen in her blood) which House notices is slightly low. This convinces him that Andie has a tumor in either her heart or lungs. More tests are done which are again normal, and finally she goes to surgery where a tumor is found in her heart. The tumor is discovered to be benign (not cancerous), so that cannot explain her hallucination. Chase notices that Andie has suffered a a retinal bleed, so House deduces that she has a clot in her brain. House decides that the only way to find this clot is to chill her body to 21° Celsius (about 70° Fahrenheit) , stop her heart, remove two liters of blood, add the 2 liters of blood back while performing an MRI to find the clot, and then restart the heart.

The medicine was extremely questionable. If Andie has a tumor in her heart large enough to lower her oxygenation and damage her mitral valve, then it definitely would be seen on an echocardiogram, CT or MRI; it wouldn’t show up for the first time during surgery. That whole stop-the-heart scene? While it’s not my area of expertise, it seemed mighty fishy to me. Also, why would you use a metal bracket and bolt on a patient who’s going though an MRI — a magnetic instrument? Frankly, when the episode started off with House taking ten times the maximum dose of Benadryl, I knew we were trouble.

The writers were trying way too hard for emotion. It was one of those “Tonight, on a very special episode” nights. The dying girl begs Chase for a kiss. House has a chat with the dying girl, who doesn’t want to die and leave her mother alone. Sniff, sniff, where’s my Kleenex?

What happened to all good the soap opera? This is the second episode of House without any significant interplay between the characters.

This episode gets a middling C for the mystery, a lousy D- for the medicine and a needs-to-be-better C- for the soap opera (or lack thereof).

(Sorry for the lack of links tonight, but there really wasn’t much linkable medicine in this episode. Next week…)

• Previous House reviews

Anon, it be that day that be loved above all others: Talk Like A Pirate Day!
Being the good buccaneer that I am, I stole last year’s post, and I be re-posting it (with some additions though matey).

• Talk Like A Pirate Day Official Website
• Download the official Talk Like A Pirate Day Theme mp3 — only 99 ¢ — and it’s from Tom Smith, so you know it’s good! (And for those of you a little low in swag, here are the lyrics)
• Git yer own pirate name, ya’ land lubbers! Pirate Name Generator
• Methinks the Truth be Out There: Pirate and Privateer Legends!
• Some comic-book pirates (and pirate comic books) off the top of me head (to be updated as I think of more):
  • Crossbones
  • The Psycho Pirate
  • Occulus from Fantastic Four
  • And in the Fantastic Four’s first encounter with Dr. Doom (FF #5), The Thing ended up becoming Blackbeard.
  • Pirate Club
  • The evil pirates from My Monkey’s Name is Jennifer
  • The Starjammers
  • The hilarious Scurvy Dogs (”The cow says moo…”)
  • Barbarossa and the Lost Corsairs
  • El Cazador
  • Street Angel #2
  • Long John Silver and the Pirates (Charlton comic from the 1950s)
  • Belit (and Conan, for a time) from the Conan comics (older Marvel volumes)
  • The Black Pirate appeared in some of the 1940s issues of Action Comics
  • There was the pirate comic-within-a-comic in Watchmen (Tales of Black Freighter)
  • Buccaneers from the 1950s
  • The similarly named Buccaneer, also from the 1950s
  • The Golden Medallion, a pirate comic book put out by LEGO
  • The Pirates of Dark Water A kids comic put out by Marvel based on the Hanna-Barbera cartoon.
  • Terry and the Pirates. Sure it was a comic strip, but it’s been reprinted in comic book form several times
  • Then of course there’s Colonia (pointed out to me last year by Laura, the “Scourge of the Seattle Seas”)
  • Pirate Corp$
  • Even Mickey Mouse is getting in on the act: Air Pirates Funnies
  • Metrokitty (the “Feline Felon”) reminded me that there was a pirate as a suporting character in the Starman series (and in one of the Talking with David issues).
  • Speaking of Disney, we can’t forget air pirate Don Carnage from Talespin
  • Pirates appeares in at least one Spirit story
  • EC’s Piracy
  • Indiana Jones and the Sargasso Pirates
  • Some pirates appeared (briefly, before being slaughtered) in Grendel: War Child #4

In Hawk & Dove #5, both of our heroes take a day off. Dawn is at home, sick in bed, having caught the flu from her pre-dawn plunge in the Potomac River in Hawk & Dove #3. Hank, on the other hand, has gone to the beach for a day of fun in the sun with Ren.

Sniffling and sneezing in bed, Dawn is being cared for by her father. He gently scolds her for sneaking out that night. After he leaves, Dawn is astonished to see Don Hall, the original Dove. He sits down on the bed next to her and the two of them talk. She apologizes for killing him. He brushes her apology aside, telling her that it was a brick wall that killed him, not her. He tells her that she makes a much better Dove than he ever did — she stands up to Hank, does more with the same powers, and she looks much better in the costume. He then disappears and Dawn in left to wonder whether he was ever really there.

Meanwhile, Hank and Ren are enjoying a day at the beach when an over-muscled beach bum starts hitting on Ren. He shoves Hank aside and literally picks up Ren. Enraged, Hank changes to Hawk and punches back. Unfortunately for him, this is no ordinary beach bum. Instead, this is a metagene-enhanced beach bum who goes by the name Sudden Death. Oh yeah, and he explodes when struck. He and Hawk have a grand battle, with Hawk initially taking more damage than he’s giving. Then he seizes upon the idea to “overload” Sudden Death so he hits him until he’s ready to explode and then keeps punching him and punching him before ditching him in the water where he harmlessly explodes. One more punch and Sudden Death is unconscious and ready for the SCU to arrest while Hank and Ren walk off into the sunser. “Look, Ren,” Hank explains. “Sometimes the right thing to do is the wrong thing to do — you know what I mean? gives you an edge. Makes you unpredictable. An’ I’m better at doing the wrong thing than almost anybody!” A little foreshadowing maybe?

This is one of my favorite issues of the series. Hawk’s explosive fight stands in stark contrast with Dawn’s thoughtful discussion with Don. The overall plot of the series is advanced in that we get the first hint of what Hawk looks like under his costume. The past is also addressed: Dawn’s talk with Don brings closure to his role as Dove and his approval further legitimizes the new Hawk and Dove team.

The art by Chris Wozniak (with inking assist from Karl Kesel) is impressive. Wozniak has very clean and expressive lines and they do a good job with both the quiet scenes and the action-filled ones. Whatever happened to him? He did this issue of Hawk & Dove and a few early “cross-time” issue of Excalibur, but then what? I always liked his style.

I don’t do a great deal of link-blogging, but as I was sitting around donating blood yesterday, I decided it would be a good time to look once again upon the wonderful world of comic books and …well…blood. Here’s a selection of fun reads, from blood being responsible for super powers, to blood in comic book ink (and the inevitable demonic possession that follows), to Superman and “alternative medicine,” and finally a look at what our government talks about in offical meetings.

• I know I’ve posted this one before, but it’s too good to pass up. Is Superman’s blood responsible for every super-hero ever? This author thinks so.
• In a similar vein, here’s an article looking at Clark “Hugo” Kent and Superboy and Supergirl. It tries to tie together Siegel and Shuster Superman, Wylie’s Gladiator and much of the Silver Age superbooks.
• From Snopes, is the blood of the band KISS really mixed in with the ink in their first comic book? (No mention of the late Mark Gruenwald and the Squadron Supreme TPB at Snopes, though here it is mentioned in the sidebar of an HBO article on Six Feet Under). According to the conspiracy-minded Jack Chick wannabe Last Trumpet Newsletter, these comics are occult and pure evil!
  

  This nation has developed an insatiable appetite for the occult. One example is the popular demand for a special edition comic book printed with ink that was mixed with the cremated ashes of the author, Mark Gruenwald. The Canton Company made the special ink for the printing of “Squadron Supreme.” (12) This is reminiscent of the 1978 comic book published by Marvel Comics printed with ink mixed with a vial of blood from each member of the rock band, KISS. (13) The name KISS is an acronym for “Kings In Satanic Service.” These comics are read by millions of young people, and the special ink mixed with the ashes of cremation or the blood of the living, devil possessed people attracts evil spirits and gives them the right to stay in the homes of those who buy the books.

• Here’s an article from a homeopath claiming to have cured Superman’s “allergy” to kryptonite. (Makes sense: Superman is an imaginary character and the benefits of homeopathy are all purely imaginary)
• A transcript from a Health and Human Services meeting on “Blood Safety and Availability” where they discuss the poor transfusion techniques at Metropolis Hospital.
  

  Well, as part of my due diligence, I pursued to see what other hospitals in the United States were doing as well. And I came across this photograph in the newspapers which showed Superman receiving a blood transfusion. One of my colleagues, upon seeing this, said, “Well, there’s your answer. Superman doesn’t get leuko-reduced blood. There’s no filter in the line.”

  I was chagrined. So I actually called the Metropolis blood center, spoke to the director, my good friend, Jarriel [ph], and I asked him about this, and he said not to worry, pre-storage leukoreduction.

  [Laughter.]

  DR. SNYDER: So that clearly explains why there is no filter. But ever mindful of the FDA guidance, 606.122, paragraph B, to use a filter in the administration equipment, if you look closely, there are 270 micron filters right over there.

  Lest you think, however, that I am biased by my friendship, let me point this out, that this photograph also shows Lois Lane donating double the usual amount of blood and her saying that she’d gladly give it all. She doesn’t want to go on living. So I bring to the FDA’s attention that the Metropolis blood bank may have some conflicts as far as the validity of the donor screening and also their SOP for blood donations.

Update (14 Sep 05 0830): Broken links fixed.

During my second year of medical school I decided to make more an effort to be social. To that end, I had decided to attend the annual medical school Halloween party. It was held at the VFW in one of the smaller St. Louis suburbs (Each of our parties seemed to be held at a different VFW. Allegedly we made such a mess that we were never allowed back at the previous ones).

I had thrown together a costume at the last minute and dressed as Willie Nelson. I bought a cheap red wig and braided it into long ponytails. I dusted it with some gray and white paint to add some age. I trimmed the ends of the braids to get enough hair to make a matching beard which I attached with spirit gum. With some cardboard and aluminum foil I made a huge belt buckle. With my cowboy boots, a horrid plaid shirt and a baseball cap that I had scrawled “Farm Aid” on, my costume was complete.

The VFW was hopping. A DJ was playing some decent dance music and there was an open bar. Everywhere you looked there were medical students in cheap costumes and a slightly maniacal look in there eyes.

I was standing in the fairly long line for the bar and had just made it to the front of the line. A girl dressed as a hippy came up and asked if I could grab her a beer. Being the gentleman that I am, I grabbed one for both of us. I handed her the beer and we spent the next hour or so talking. Her name was Lisa and she was a nurse at the university hospital. She and her nursing friends made it a point of attending most of the medical school parties.

As her friends dragged her off to another party, I realized that I should have gotten her number. I asked the bartender for a pen and some paper and he found an ancient pencil I could use. I ran out the door of the VFW after her to get her number and bumped into her coming back in to give me her number. Phone numbers were exchanged and things were looking good.

A few days later, some friends of mine decided to attend The Nightmare Before Christmas. They asked if I wanted to go. I agreed and thought that this seemed to be the perfect excuse to ask Lisa out. I called her up and she agreed, saying that she had heard it was a good movie. She gave me her address and I told her I’d pick her up in couple of hours.

I showered, shaved and got dressed. I didn’t want to be too dressy or too informal so I decided on the medical students informal uniform: dockers and a button down shirt. I put on my one nice pair of shoes and went outside to clean the car. I pulled up to the dumpster next to the apartment building so I could quickly clean it out. When I’m busy at work or school, junk tends to accumulate in my car (lecture notes, mail, magazines, medical journals, etc.), and I needed to empty it out so I could make a good impression. I opened the passenger side door of my old Tercel and started throwing out the accumulation a handful at a time.

Then I heard a very distinctive “ching” sound and realized that I had just thrown my car keys in the dumpster. Damn! Luckily the container was mostly empty, but I still had to jump in after them, wade across the dumpster and sift through about a foot of trash until I found them.

I ran up to my apartment to quickly change clothes and wash up. I was already running late, so I just grabbed the nearest pair of shoes and ran back to my car. I only had the one pair of good shoes, so I ended up in a slightly beat up pair of athletic shoes. I headed across town to the (much nicer than mine) apartment complex where she lived. Driving up and down the streets, I simply could not find her apartment. After about ten minutes of looking, I talked to a passerby and discovered that she lived not in apartment 1430, but in apartment 1430 ½, around the back of the main building.

I knocked on the door of the building.

“Come on in!” she yelled. “I’m almost ready.”

I opened the door and her dog, a giant Samoyed, made a lunge at me. I dodged and spun, but he kept coming after me.

“Prince! Stop that!” She shouted at the dog, but the giggle she added at the end didn’t suggest any real discipline. By now, he had stopped chasing me and seemed to have decided that I looked like a fire hydrant. He closed in, sniffed, and then raised his hind leg.

“I’ll wait for you outside.” I hurriedly said as I slipped out the door and away from Prince. Lisa came outside a minute later, nicely dressed in skirt and blouse. She smiled at me, but I swear I saw the smile falter a little bit when she got a look at my shoes.

We hopped in my little Toyota and headed to the theater. We made it just as the movie was starting but luckily my friends had saved us some good seats.

Five minutes after the movie started, her cell phone rang. She grabbed it and started a whispered conversation with one of her nurse pals. After receiving some dirty glares from the people around us in the theater, she headed to the back of the theater to finish her conversation. In a few minutes, she plopped back down in her seat. Just then, her phone rang again and once more she retreats to the back of the theater. This process of phone call migration continued for the rest of the movie.

After the movie, my friends were heading over to Cyrano’s where they served this absolutely sinful creampuff with ice cream and fudge sauce dessert that was famous across town. I asked Lisa if she wanted to go, knowing that nobody said no to a dessert at Cyrano’s, but she declined. She added in an aggrieved tone that she needed to go back home and feed her dog.

I drove her home and parked in front of her building. I got out of the car and walked over to the passenger side of the car to let her out. She hadn’t waited for me, however, and was already striding to her door. “‘Night,” she called out as she walked in her apartment and (I assume) securely locked her door.

I think it’s safe to say that that remains my worst date ever. I’ve never been entirely certain what went wrong. I have a few guesses. First, I suspect that she found me more attractive dressed as Willie Nelson. Second, I have a strong suspicion that she preferred more affluence in her dates, apparently forgetting that the vast majority of medical students (including me) live below the poverty line. Plus, I think the shoes may have done me in.

Epilogue: Two years later as I was starting my final year of medical school, I stopped by the “Welcome New Students” reception thrown by the school at a local bar. I grabbed a Bud Light and met up with one of my friends. We saw another friend of ours and headed over to talk to him. He was chatting with this bevy of cute girls and he introduced us to them. The last one, of course, was Lisa. She fixed me with a chilly stare and, with the icicles dripping from her words, said, “We’ve met.” I could only laugh.

One of the most thought-provoking recent comic storylines was in the overlooked Marvel Knights 4 #19 and #20.

In this story, Gorgon’s daughter Alecto and her Alpha Primitive boyfriend Reyno flee from the sanctuary city of Attilan and arrive at the doorstep of the Baxter Building seeking asylum. The teens claim that they are being persecuted by her father and the rest of the Inhumans who will not allow the couple to stay together. Reed and rest of the guys are studying ocean life at the bottom of the sea, so Sue, Franklin and H.E.R.B.I.E. are the only ones home. Sue immediately takes the refugees in and swears she’ll protect them. Meanwhile, Gorgon has tracked his errant daughter to New York and the obligatory fight scene results.

The rest of the FF return just in time to rescue Franklin and Sue. After briefly looking over the situation — and without discussing his decision with Sue — Reed calls the rest of the royal Inhumans and hands the children back over to them. In the end, Sue reassures Franklin that the teens will find a happy ending, though she knows that won’t be the case.

At first, I was stunned by Reed’s actions. Handing back abused children to the abusers? What was he thinking?

But were Alecto and Reyno actually abused? Not liking your daughter’s boyfriend and trying to keep her away from him is a story as old as time and it’s not generally considered “abuse”