Many of my patients like to come in and tell me a joke or two. Sometimes, these jokes are actually funny. Being the generous soul I am, I figured I’d take a moment and share some of these jokes with you when I get a chance.

This one was told to me last week by a sweet little old lady.

An elderly lady was cleaning her attic when she came across a rusty old lamp. Just as she started to rub the grime off of the lamp, a genie appeared. He offered to grant her three wishes.
“I wish my house was as clean and new as it was fifty years ago,” she said. Poof! Her house was beautiful, clean and brand new.
“I wish I was as beautiful and young as I was fifty years ago,” she said. Poof! There was now a beautiful young lady where a wrinkled woman had been.
“You have one wish left,” said the genie.
The woman looked around and spied her cat. “I wish that my cat was Prince Charming!”
Poof! The cat turned into a tall, handsome and well-dressed prince.
The prince looked at her, looked down at himself, and then looked back at her and sadly shook his head. “Should never have had me neutered,” he said.

Being a fan of alternate history and super-heroes, I enjoyed Planet of the Capes. It’s certainly not a “happily ever after” book, but then it never pretends to be one.

The book tells of four super-heroes from an alternate Earth who find themselves transported to our Earth. Each of the characters is clearly based on a classic comic icon, though with an interesting twist or two thrown in.

The art, initially, is black and white. The tone of the book at this point is very somber, so the simple color scheme fits it well. The middle section reverts to color. “Reverts,” because this section looks back on these characters’ “Silver Age” and all the comic-book baggage that implies. The final third of the book turns somber again and returns to black and white.

The art by Brandon McKinney is well-done and adds to the story. I particularly enjoyed his black and white sequences. Larry Young’s writing is what really grabbed my attention. In a brief encounter with an autograph seeker, the four heroes reveal more about themselves than pages of expository dialogue ever could. There is some nice foreshadowing thrown in as well in the articles showing in the fan’s scrapbook.

There are undoubtedly deeper meanings written into the characters and plot. Because that sort of interpretation is not mt forte, I’m not going to dwell on that aspect. If you want that, go read Dave or Steve and Rose…they’re good at it. I’m not a comic book scholar (well, except maybe Hawk and Dove). What I am is a comic book fan and a super-hero fan. On that level, I certainly enjoyed this book.

My only real gripe is that it was too short. I would have liked to see more of the characters. Not necessarily on our Earth, but more stories on theirs. But I think that’s the alternate history fan talking again…

It’s that time of the month again. Time to see what bizarre searches led people across this wide old internet to Polite Dissent:

The most common searches were Bwana Beast, She-Hulk, Kim Possible (and her various friends and enemies), Pica (especially ice, laundry starch and cardboard), and Dungeons and Dragons adeventures (particularly The Forgotten Temple of Tharzidun). I think I hit a nerve talking about Dave Trampier’s comic strip Wormy because that was a big hit as well. Sadly, I had only one search this month looking for Zatanna naked, and none looking for her in culottes.

rarest disease I’d stick with Kuru, the brain disease transmitted by eating other people’s brains.

obsequious spleen disorder Exactly how can a spleen be obsequious?

useful sentence for conversation in coffee shop Would you like a biscotti with that?

blog gorilla comic library You’re probably looking for Yet Another Comics Blog and his monkey cover Sundays.

empty narcotic bottles on e-bay Every month somebody is searching for this. Why?

correspondance school appliance repair This is a comic book and medical blog; Sally Struthers is not mentioned anywhere.

heimlich maneuver talespin “Baloo, help! I’m choking!”

best neurosurgeon 2004 I’m not sure the best neurosurgeon of 2004 is, but I can tell you that Thomas Elliot is the “best neurosurgeon in the world!” (And remember, the phrase “best neurosurgeon in the world” is © and ™ 2004 by Polite Dissent)

Finally, here are the searches I can’t even begin to explain:

lettuce sedation iceberg allergy

non-cartoon bacteria medium

when will you humans learn feelings

Make sure you check out Hi & Lois today (2 Nov 04), where Thirsty wants a cartoon character to vote for…well here’s his chance (and yours!)…VOTE VOODOO!!

UPDATE: If you’re having trouble viewing the comic strip, it’s most likely due to anti-viral/firewall software. Disable it (briefly! briefly!) and then retry.

I was puzzled. Someone ended up on Polite Dissent looking for a Dr. Seuss poster about malaria. A tropical disease…and a children’s book author. This seemed preposterous, yet somehow intriguing. I did a little research and it turns out that Dr. Seuss did write an educational piece about malaria for the U.S. Army during World War II.

This is Ann…she drinks blood.
Her full name is Anopheles Mosquito
and she’s dying to meet you!

The classic Dr. Seuss rhyme scheme is missing, but the whimsy of the piece and the art are unmistakably his. The information is a little dated (it is sixty years old, after all), but it’s still a fascinating read.

Courtesy of the USDA’s Diptera Site (”Information About the World’s Flies”), I bring you Ann by Dr. Seuss

Strange #2
J. Michael Straczynski and Sara Barnes, writers
Brandon Peterson, penciler

This review relies fairly heavily on the anatomy of the hand. I’ve included several anatomical drawings — click on the smaller images for a larger annotated version.

Strange #2 was much better than the first issue. The story and art were improved (though not as good as Lee and Ditko’s original), and the medical aspect was better thought out. My only major medical gripes were a couple of typos due to poor editing. There were some smaller nit-picks too, of course.

First, Brandon Peterson does a very good job with the art (from the medical perspective at least). His drawings of Stephen Strange in the ICU are nearly perfect. All the tubes and wires are accurate. My only nit-pick is why is Strange in a halo brace? A broken neck was never mentioned.

The broken leg, the fractured hip, those will keep you in a chair for a couple of months, but you should recover fully.

He should be restricted to a chair for a couple of weeks, not a couple of months. On the other hand, it could be a very complex fracture.

The right palmar carpal ligament was torn. Three fingers on your right hand were broken, with two on the left seriously dislocated. Two broken metacarpals in each hand, a communited [sic] fracture of the right index metacarpal, and - -

To begin with, it’s comminuted, not communited. (A comminuted fracture is one where the bone has been shattered into small pieces.)

The doctor is saying that Strange tore a superficial ligament on his right palm and broke two of the hand bones (or maybe three, is the comminuted metacarpal in addition to the “two broken metacarpals?”). Three fingers were broken as well. Figure 1 shows the bones, and Figure 2 shows the ligament. As a nit-pick, a doctor — especially when talking to another doctor — would say where the finger was broken (i.e. “shattered distal phalanx” and not just “broken finger.”

- - the median nerve and flexor tendons in of your right hand were both transected. Practically shredded.

There’s some poor editing here. Is it “in” or “of”? Either would make sense, but not both. The median nerve travels down the middle of the wrist (see Figure 2). There are ten flexor tendons in each hand — two for each digit. Is he saying that all ten were cut, or just a few? If all the tendons and the median nerve were severed, then the injury most likely happened at the wrist crease on the palm side. This is consistent with the fact that his palmar carpal ligament was ripped. As a nit-pick, there are also many important blood vessels there. It seems unlikely that Strange would “shred” tendons and nerves but not permanently damage the arteries.

The doctor goes on to say that Strange should be able to regain the use of 50 -60% of his hand function with therapy, and that therapy will start as soon as the stitches are out. The median nerve innervates some very important parts of the hand (see Figure 3). Small nerves that are severed can regenerate, but not one as large as the median nerve. A fifty to sixty percent recovery is overly optimistic.

The only stitches Strange would have would be non-removable sutures used to repair the cut tendons. His hand wounds themselves would not have been stitched closed. Hand wounds are not closed if more than six hours have passed since the time of injury because of the high risk of serious infection. Since nobody knows how long Strange had been lying injured in the snow, no physician would take the risk to sew his wounds closed. He should be able to begin therapy ASAP (or at least as soon as the swelling goes down).

Finally, I’ve taken a piece of classic Ditko Dr. Strange art and indicated on it where his injuries most likely were located.

Anatomical drawing are by Frank Netter and from Netter’s Atlas of Human Anatomy. The image of Dr. Strange is by Steve Ditko and from Strange Tales #137 (this black and white image is from Essential Doctor Strange Volume #1)

Tarascon is a small publisher that produces an array of pocket-sized medical reference books. My favorite is the Tarascon Pocket Pharmacopeia, a small book that contains all the information about prescription drugs any medical professional could ever need (also good for any writer who needs to know about drug names and doses). It comes in a small “shirt-pocket classic edition” and a larger “lab-coat pocket edition” (my personal favorite).

A new edition is published every year, and hidden deep within the small print of the indicia is a trivia question. If you’re one of the first 25 people to answer it correctly, you get your name in print and win a free copy of the next year’s edition. So far, I’ve gotten it right three times (but the first time I wasn’t one of the first 25). How many of these can you answer?

Notes:

1. No, I won’t post this year’s question until next year…no cheating! Plus I haven’t figured out the answer yet.
2. Each version (the shirt pocket and lab-coat pocket) has their own question. With the exception of #5, these questions are from the larger lab-coat edition.
3. I knew the correct answers to #1, #3, and #5.
4. I’ll post answers later for any question that no one’s figured out.

Questions:

1. Who, when taunted in a Doonsebury comic, responded as follows: “I think it is false and libelous, but I’m flattered by the attention.”
2. Name whose career evolved from twin to crime fighter.
3. Whose first command went down the drain because of some grain?
4. Whose musical talent was lacking because of some quacking?
5. When will Don go back to Annandale?

Ilyka Damen has the best after-election post that I’ve read. Addressed to both the left and the right — and to bloggers in particular — it really applies to all of us.

Ilyka doesn’t post as often as I’d like (hint, hint), but when she does it’s always worth reading.

Exhausted after preparing the Strange #2 medical review last night (anatomy was always my worst class), I’m just going to post some interesting link blogging today.

Thursday Blog-o-bits:

• For all you (other) eBay fanatics, here is a link to Weird Al’s eBay song [ed. note: link is long gone now], including audio and lyrics. Comic books are not referenced, but Shatner and Alf are. Courtesy of AMCGLTD.com
• The Latin Motto Page. If you ever need something to look especially impressive, just add a latin motto. This site lists several dozen mottos, including the ever popular Moritori te salutamus (”We who are about to die salute you”). Don’t laugh. I’ve used this page to fancy up various school projects and short stories over the years.
• Lorem Ipsum. This page gives a history of the use of “lorem ipsum…” as the standard dummy text of typesetters starting in the 16th century. It’s still used today as dummy texts in various background shots, illustrations, etc. Also included is a Lorem Ipsum generator:
  

  Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Maecenas sollicitudin. Vestibulum laoreet eros id felis. Donec risus purus, elementum a, pulvinar ut, sodales et, sem. Etiam purus. Pellentesque eu dolor. Ut sed sem. Aliquam sed dui ac metus rhoncus sagittis. Nullam nec turpis fringilla dolor blandit fringilla. Aliquam vehicula. Duis feugiat mollis ante. Curabitur tristique elementum nunc. Nunc sed orci. Nam id metus. Ut porttitor, mi sed ultricies aliquet, nisl mi elementum libero, in imperdiet odio turpis ac ligula. Fusce leo. Ut consequat urna ac tellus. Donec non diam. Maecenas ac leo.

• Logical Fallacies. Want to look smart when arguing? Want to put some hot-shot in their place? Well then this site is the perfect place for you. It lists the most common (OK, even uncommon) logical fallacies (including Slippery Slope, Ad Hominem , Hasty Generalization and Straw Man) and tells you how to recognize and rebut them.
• Odds of Dying. This educational site lists the odds of dying a variety of deaths, such as dying in a streetcar accident (1 in 95,031,271), drowning (1 in 690,300), dying from a dog bite (1 in 11,403,753), dying due to a bee sting (1 in 6,630,089), and legal execution (1 in 4,525,299).

Remember back to Teen Titans #25, when Robin quit the Titans and the rest of the group vowed never to wear their costumes again? Here it is three issues later, only the second storyline since taking their vow, and they’re back in costume with Robin at their side. But I’m getting ahead of myself…

Teen Titans #28, “Blindspot”, starts as Sharon, a young woman walking through the park at night, stumbles upon a horrible secret. Screaming, she runs back to her apartment. Unfortunately, in all the excitement she dropped her purse and the criminals are able to find out where she lives. Luckily, Aqualad is at her apartment looking for her roommate Donna Troy when the thugs show up. Aqualad throws them out the window and relocates Sharon to the Titan’s headquarters for safety. Sadly, the horror of what she witnessed in the park has blocked the memory from her mind. Unable to find the other Titans, Aqualad tracks down Robin at Hudson University. Robin takes him to Mr. Jupiter’s estate where the other Titans are staying. Frustrated that he can’t convince the Titans to help him, Aqualad manages to talk them into donning their costumes and talking to Sharon in an attempt to find out what she saw in the park. Lilith uses her mystical power to read Sharon’s mind and discovers that she saw grotesque aliens masquerading as humans. Aqualad wants to run out and hunt for these aliens, but the Titans remind him of their vow. Angrily, he stalks out to solve the mystery himself, but is clubbed from behind, tied to a tree and left to die. The villain is revealed to be Aquaman’s (and Aqualad’s) arch enemy Ocean Master.

In Teen Titans #29, “Captives”, Kid Flash, Wonder Girl and Speedy all show up in the nick of time — and in costume — to rescue Aqualad. They tell him that they decided “to forget about our vow, at least for the present!” Meanwhile, Hawk and Dove return to Sharon’s apartment, hoping to lure the thugs back there. Their plan works too well and Hawk is overwhelmed and knocked unconscious. Dove enlists the help of the other Titans to rescue his brother, but in the end Hawk and Dove still manage to get captured by Ocean Master and taken to his underground lair. Using their powers, the brothers manage to escape and confront Ocean Master and his alien allies. Just when Hawk and Dove are about to be defeated, the rest of the Titans bust in and the criminals and aliens are all captured. At the end of the issue, Aqualad tries to convince the Titans to give up their vow but they refuse. Sadly, he leaves them behind telling them, “I can see that you’ve learned something from this adventure! But the way I see it, you haven’t learned enough!”

The art is generally quite good. Nick Cardy does an excellent job using varying angles and perspective to keep the panels interesting. His dramatic use of shadows adds a layer of suspense to the plot. Sadly, his aliens are less than inspired. They have a distinctive Silver Age Marvel look to them and could easily have stepped from the pages of Fantastic Four.

The story, by original Hawk and Dove scribe Steve Skeates, is too full of coincidences. A young woman just happens to be walking through a park at precisely the right moment to come across aliens disguising themselves as human (and why would the aliens use a public venue to make the change when they have a secret hideout?). This same young woman just happens to be Donna Troy’s roommate. Aqualad just happens to choose the perfect minute to visit Donna. The villain just happens to be Aqualad’s arch enemy Ocean Master. More importantly, the way the Titans so easily and completely (and frequently) change their minds about their supposedly sacrosanct vow never rings true and undermines the “seriousness” of this vow (and all the stories that spring from it).

Hawk and Dove manage to get some nice action scenes in this story. Unlike previous Titans stories, their original personalities resurface and they repeatedly butt heads over their philosophical differences. Ultimately, Dove joins Hawk in attacking the aliens, figuring that violence in this instance is fine because the villains aren’t human.

This is the Hawk and Dove’s last appearance as main characters in this edition of the Teen Titans. They appear in an original back-up story in issue #31 and a reprint back-up story in issue #39. They do make some appearances when the Teen Titans is relaunched in 1977, but that is seven years down the line. The Teen Titans themselves last for two and a half more years, but the series ends at #43 in 1973.

Full Metal Alchemist starts tonight this weekend! This is an excellent anime series and definitely worth catching from the start! It’s followed by Ghost in the Shell: Stand Alone Complex, another excellent anime.

UPDATE: Well, I tried to watch it, but couldn’t find it. Instead, I was treated to Johnny Bravo. The Full Metal Alchemist site and Cartoon Network don’t agree on when it is on, and the Cartoon Network schedule doesn’t match what was actually shown. It’s unclear if it’s on the 5th or the 6th. I withdraw my recommendation until this mess can be sorted out.

UPDATED UPDATE: Managed to track down and watch both Full Metal Alchemist and Ghost in the Shell: Stand Alone Complex. They Cartoon Network and Full Metal ALchemist site were both wrong. It is on Saturday, 11PM (central time).

I spent the day with my partner and our nurse and office manager at the Peoria Women’s Lifestyle Show. To keep me sane, I dragged the poor Polite-Wife along. I also did something I rarely do: I wore a tie. Not just any tie, but a great one that shows the gameboard from Operation. If I have to wear a tie, it’s that one.

I think we did well and it looks like we interested quite a number of patients in our small-town practice. Many of the people in Pekin work in Peoria, and I don’t think that it ever occurred to them that Pekin actually has doctors and they don’t need to drive to Peoria for medical care.

We offered information on women’s health, plus handouts on pregnancy and pediatric wellness. We also offered blood pressure screenings and I offered a quick depression screen (I used a slightly modified version of the Zung screening form, an online version can be found here).

UPDATE: I forgot to mention that the booth directly behind us was for the Peoria Civic Center’s “Broadway Series.” They played the soundtrack to Mama Mia over and over and over. If I never hear another Abba song, I’ll die a happy man.

Afterwards, the Polite-Wife and I went to Kelleher’s, a nice Irish Pub on the Peoria riverfront, and had an excellent meal. I was ecstatic to discover they carried my favorite beer Paulaner. I know it’s German and not Irish, but it’s simply the best hefeweizen available. Sadly, it’s hard to find in America. (Yes, Jon, I know you can get it in Indy.)

Warning. Soapbox begins here.
There were quite a number of people at the show who, unasked, came up and gave us their views on vaccinations. Personally, I think vaccines are one of the greatest medical advances of all time. I am fully behind all rigorously tested and approved vaccines. If they’re on the “required” vaccination list, I urge my patients to get them.
I understand that there are people who do not share this belief in vaccinations. In some cases, this is due to a religious objection. I can understand that. What worries me is the growing number of parents who do not vaccinate their children because they are misled or deceived by bad information and unscientific fear mongering.
Ironically, much of this can be blamed on our own success. Most people in this country have never seen a case of polio, or even measles or mumps. Iron lungs and a wheelchair-bound President are things of the past. Deaths from measles, birth defects caused by rubella, and post-mumps sterility are unknown to today’s parents. Sadly, as vaccination rates drop, the incidence of these diseases sky-rockets. Just ask Great Britain, which has seen a dramatic rise in the number of measles cases — and deaths — because of a decline in the number of vaccinated children. Thankfully, America is not to that point…yet.

Soapbox #2.
There was a group at the show selling the “nutritional supplement” Juice Plus. I was content to leave them well enough alone until one of them spotted my physician’s name badge and walked up to me. She asked: “Are you familiar with Juice Plus?”
“Yes, I am,” I replied.
“Then certainly, Doctor,” she said loudly. “You recommend Juice Plus in order to give your patients all the important vitamins and nutrients they need.”
“I do not recommend Juice Plus at all,” I responded calmly. “It is simply an overpriced supplement offering what can be more simply and cheaply obtained by eating a healthy diet. It offers misleading and unscientific evidence as so-called proof, and is really no more than a fancy pyramid scheme.”
I don’t think she liked my answer.
Hint: Don’t puts words in mouth, you won’t like the results.
</soapbox>

In college, I was looking to expand my horizons. While I enjoyed super-hero comics, I wanted to try something different. My local shop was small and didn’t carry many independent publishers. They carried some manga, but I had looked through it occasionally and it had never held my attention (nothing of interest ever seemed to happen in Mai, the Psychic Girl and the same thing happened every month in Area 88 — in this issue they fly panes from a secret desert base and defeat other planes. They then return to base and gripe). However, there was one comic that always caught my eye with its fetching alien princess on every cover. Eventually, I succumbed to its siren lure, picked it up, and bought it. I was instantly hooked. I had discovered Outlanders.

Outlanders was a manga by Johji Manabe published by Dark Horse and Studio Proteus in the early 1990s. It tells the story of Princess Kahm, wayward heir of the galaxy spanning Santovasku Empire. She has led an armada to rediscover their legendary home planet — Earth — only to find it “infested”by humans. Enraged, they begin to attack the Earth in order to wipe out all the humans. Photographer Tetsuya finds himself in the middle of the battle and is nearly decapitated by a sword-wielding Kahm. Something about him interests her, and she takes him back to her flagship. Eventually the two of them fall in love, and with the help of some bizarre allies, travel back to Santovasku itself in an attempt to stop the destruction of Earth. This is an incredibly simplified plot summary, leaving out the Byzantine political maneuverings of both the Santovasku and Earth military, ancient magical conspiracies and crows.

The book is drawn in Manabe’s trademark bright and flowing style. Each character is unique in terms of both personality and depiction. His technology favors the biological over the mechanical (three words: giant goldfish speeders). The characterizations are complex and a gentle humor is a large part of the story. The romance of Tetsuya and Kahm is handled well and drives the comic to its logical conclusion. The script and art can be humorous or serious as the scene demands.

Like most manga from the ’90s, the book is printed in flipped left-to-right style and published in comic book size. Outlanders is 33 issues long, plus there is a zero issue, a special edition, and an epilogue. Dark Horse had put a series of six trade paperbacks reprinting the series, but I’m not sure if they are still in print.

In my opinion, this was Johji Manabe’s best work. His other comics, including Caravan Kidd and Orion are interesting and fun to read, but not as enjoyable on so many levels that Outlanders was.

Outlanders was turned into an OAV about ten years ago, but the movie is just fair because too much of the clever characterizations and epic plot is left out to squeeze the story into two hours.

There are three movies that, no matter how many times I have seen them in the past, I will sit and watch them again if I come across them while flipping through the channels. The house could catch on fire, and I would still feel obligated to watch the movie to the end. These are my top Guilty Pleasure Movies:

Smokey and the Bandit (1977). Starring Burt Reynolds, Sally Field, Jerry Reed and Jackie Gleason. For the six of you unfamiliar with the plot, Bandit (Reynolds) and his truck-driver pal Snowman (Reed) are hired to drive from Atlanta to Texarkana, pick up 400 cases of Coors beer, and bring it back to Atlanta (at this point it was illegal to sell Coors east of the Mississippi). Along the way, they pick up a runaway bride (Field) and dodge an obsessive southern sheriff (Gleason). I must have seen this movie at least a hundred times, yet I still watch it again and again. It is the quintessential Burt Reynolds film — back when he still had all his charm and most of his own hair. For my generation, this movie is what Reynolds, Fields and Gleason are known for, not their previous TV and movie work. The sequels are not worth mentioning.

Support Your Local Sheriff (1969). Starring James Garner, Jack Elam, Joan Hackett, Walter Brennan, Harry Morgan and Bruce Dern. James Garner plays a traveling gunman who is hired to be the sheriff of a small western Gold Rush town menaced by the Danby family. The movie is hilarious and full of memorable moments. James Garner underplays his role to perfection, and Walter Brennan (as Pa Danby) and Bruce Dern (as his dimwitted son Joe) are equally hilarious. Check out the “Memorable Quotes Page” from the IMDB for a good idea of the flavor of this under-rated gem. There is no sequel, but Garner, Elam and Morgan star in the vaguely related film Support Your Local Gunfighter — it’s also worth seeing, once.

The Blues Brothers (1980). Starring a whole bunch of people, most notably John Belushi and Dan Aykroyd. Based on the Saturday Night Live characters of the same name; Jake and Elwood Blues must raise enough many to save the orphanage they grew up in. Many memorable lines and scenes — everyone has their own favorite (just a hint: I won a prize at a trivia contest by knowing what SCMODS stands for). Another of the movies that defines my generation. Skip the sequel.

This week’s MedBlogs Grand Rounds is up. Grand Rounds is a weekly compilation of interesting articles of a medical natures throughout the blogosphere. I’m pleased to say that Polite Dissent is one of the featured blogs this week. Grand Rounds is hosted by GruntDoc this week, an interesting medical blog well worth reading on its own.

Manhunter #3 “Dark Shadows”
Marc Andreyko, writer
Jesus Saiz, artist

At the end of the previous issue, Kate Spencer’s son Ramsey injured himself while playing around with her crime fighting equipment. In the beginning of this issue, he’s rushed to the hospital by ambulance.

Paramedic #1: What’s his status?
Paramedic #2: Boy, age 6, suffered severe force trauma in an explosion. B.P. is 60 over 80 and falling. Possible internal bleeding and…

This is an impossible blood pressure. The top number in the blood pressure is the systolic blood pressure. This is the blood pressure when the heart is beating. It is the maximum arterial pressure. The bottom number is the diastolic blood pressure –the blood pressure when the heart is relaxed. It is the minimum arterial pressure. An average blood pressure is 120/80. For an adult, anything over 140 systolic or 90 diastolic is considered high blood pressure (though we call it hypertension because it sounds cooler). Looking at the scene from Manhunter, Ramsey’s blood pressure is 60/80. In other words, his maximum blood pressure is lower than his minimum blood pressure. The paramedics probably just switched the numbers around, but it’s an impossible blood pressure as it’s written.

Doctor: Ramsey has suffered a severe concussion.
Kate: Meaning what exactly?
Doctor: Meaning that he is experiencing some severe brain swelling. The drugs we’re giving him did not slow it down, so we had to perform brain surgery to relieve the pressure in his skull.

A concussion is also known as a mild traumatic brain injury. There are a variety of definitions for concussion, but the simplest is a post-traumatic alteration of mental status, with or without the loss of consciousness. Over the past several years, the medical field has realized that concussions are not as minor as originally thought and can have lasting effects. The most dangerous situation is when a person suffers a second concussion while still recovering from their first. This is known as Second Injury Syndrome and can be fatal.

That being said, as injured as Ramsey is, he clearly suffered something more than a mere concussion. It sounds like he most likely suffered a brain contusion (a bruise of the brain itself) in addition to a concussion. Brain swelling is common with such contusions. Despite what the doctor implies, neurosurgical intervention is commonly used as an early treatment in such brain injuries before stronger (and riskier) medications are used. The doctor probably just called Ramsey’s injury a concussion to make it easier for the parents to understand. He still shouldn’t have made “brain surgery” sound as dramatic as he did.

Doctor: I can’t say for certain, but his age is a plus. Children tend to bounce back from serious injuries more quickly than adults. These first 24 hours will be the barometer for his recovery.

The doctor is absolutely right here. Children have a tremendous recuperative ability. The first twenty-four hours after a severe injury — especially a brain injury — are very important and are a good indicator of how recovery will proceed.

I need to add that Siaz’s art was excellent, including his depiction of the ambulance, hospital and all the assorted medical paraphernalia.

As a final thought, the nurse who called the reporter is not only due to be fired for violating patient confidentiality, but is also due for a hefty federal fine and jail time for violating HIPAA. I wouldn’t be so smug and open about accepting money from that reporter if I were her.

More Information:
1. Medical Dictionary definition of systolic and diastolic.
2. My comments about Manhunter #1 (legal concerns, not medical this time).
3. More on comic book head injuries (from my post on the Justice League)
4. The full text of the Health Inurance Portability and Accountability Act of 1996 (for those of you with insomnia or lots of time to kill)

The second story in Teen Titans #31 (January/February 1971) is the last original Hawk and Dove appearance that will be printed for six years. Given the deplorable stories in their recent outings with the Titans, and the quality of this story here, it’s frankly a surprise that they were brought back at all.

As “From 1 to 20” begins, Hank is prowling the city streets and alleys with a pair of binoculars looking for a crime he can stop as Hawk. He sees a suspicious man walk up to a newsstand, but instead of robbing it, he buys a poetry magazine. Hank notices that the customer received $20 in change for a $1 magazine and figures that this is some kind of shakedown operation. He changes into Hawk and trails the man. A mugging derails him and he loses sight of the customer.

A short time later he runs into Don and describes the situation. They scope out the newsstand and see the same man come up and buy a second poetry magazine. By this time Don has figured out what’s going on, and he and Hawk capture both the customer and the newsstand owner. It turns out the newsstand was the front for a counterfeiting gang. Thus one of the gang’s thugs would come by, pay $1 for a poetry magazine and get a counterfeit $20 back in change. This was how the gang got their funny money on circulation.

Convoluted and credibility straining isn’t it? Rube Goldberg could have come up with a simpler plan.

The art by George Tuska is better than the story deserves, with nice use of non-standard panels and shadows to draw the eye. Sadly, he does give Don his worst outfit yet, with an orange tie at least as wide as his head. Now combine this with a maroon suit, blue shirt and tan belt. No wonder the girls prefered Hank.

I’ll admit that it’s nice to see some attention paid to the Hank/brawn, Don/brains dichotomy again, but not at the expense of plot. Steve Skeates, who was the one of the creators of Hawk and Dove, supplied this story. Even though he helped create the duo, he wrote some of the worst stories for them. The entire counterfeiting plot is simply asinine and hurts to think too much about. A gang spends its time counterfeiting $20 bills instead $50s or $100s? Then their idea of a clever plan to get the $20s into circulation is to have one of their muscle-bound goons buy a poetry magazine at one of their newsstands and get the counterfeit $20 in change? Surely there are easier and less conspicuous ways of carrying this off. Ouch! Now I thought too much about it and my brain hurts.

Sadly — as poor as it is — the Hawk and Dove tale is still much better than the Teen Titans main story. Unless you are a Teen Titans fetishist, I wouldn’t recommend this issue, even if you see it in the quarter box.

First, thanks to James Lucas Jones and Oni Press for providing my office waiting room with a nice stash of comics and graphic novels. We’ve already had a great deal of postive feedback, particularly on Alison Dare and Courtney Crumrin .

Thanks to Mike for finding those reprints of Psychoanalysis for me.

Finally, thanks to the International Comic Arts Association, writer J. Torres and publisher Oni Press for giving me a free copy of the Scandalous graphic novel. Set in Hollywood during the McCarthy era, it is a very entertaining mix of politics, gossip and celebrity. (I notice that Erin, a.k.a. the Comic Queen, won a copy of Scandalous too. This is at least her second time winning…I think she has an in with the people at ICAA.)

Now that my thank-you are done, I’m going to go fire up the X-box and play some Halo 2 so I can get enough practice to squash the surgeon who beat me so soundly at the original Halo. You know who you are — your days are numbered!

A special thanks to all Veterans, past and present, and to all my friends still serving in the Armed Forces.

Since it’s Veteran’s Day, I thought it would be a good time to share one of my more memorable days in the Air Force Medical Corps. While this story does not deal with battlefield medicine, it does highlight some of the differences between civilian and military medicine.

It was the first Sunday in March. I was deployed to a small air base in the Middle East with the 820th RED HORSE, a group of construction engineers. We were halfway through a six-month deployment designed to improve the local infrastructure and air fields. I was the only physician assigned to RED HORSE (though there was another doc who took care of the rest of the base). I had two excellent medics working under me, and we had been able to keep the injuries and sicknesses to a minimum despite the construction crews working round the clock, seven days a week.

It had been a quiet Sunday morning in the medical tent so far. I was finishing the medical portion of our weekly situation report and thinking about that night’s midnight meal. Sunday was the one night a week the mess hall made waffles. This far from home, good food was always welcome and the waffles they made were unbelievably good. A sudden call over the radio broke my reverie.

“Man down at the checkpoint!” the radio blared. “Trapped under a concrete-”

I grabbed my kit and was out the door before the sentence had finished. The checkpoint was about ¾ of a mile away over desert terrain and I was running full tilt. Out of the corner of my eye, I saw a pickup crossing the sand in the same direction. Our vice-commander was driving and heading the same place I was. He slowed down and I jumped in the cab and we sped off to the checkpoint.

Once we got there, the source of the call was clear. A concrete road barrier had fallen over, trapping the entire right leg of John, one of our younger troops. As we arrived, a group of soldiers had managed to lift off the heavy block. A quick exam showed that his leg looked intact though the ankle was clearly pointing in the wrong direction. About this time the ambulance pulled up and Jesse, my senior medic, hopped out. After a second quick exam, we got John splinted, strapped onto a stretcher and loaded in the back of the ambulance. Jesse and I climbed in back with him while the driver got in front and we raced off.

Read more…

The Batman was a the only new run super-hero cartoon today. “The Big Heat” featured Firefly as the villain. It was a decent episode — nothing special, but certainly watchable. Having Adam West provide the voice for the mayor of Gotham City was a nice touch. (And a hint to the writers/artists: infrared shows heat sources, not ultraviolet).

The Teen Titans, “Haunted”, was a repeat episode. Robin is having hallucinations (or is he?) that Slade is still alive. A so-so episode, only saved by the last minute reveal.

“The Greatest Story Never Told” was on Justice League Umlimited this evening. It’s a repeat, but definitely worth watching. The JLU does a good job of combining humor with story and action, as shown by this episode (the second best so far) and “This Little Piggy”, the best one so far. Lots of good lines and inside jokes in this episode. Here’s my original review.

Now, if you’ll excuse me, I’m off to watch Full Metal Alchemist and Ghost in the Shell: Stand Alone Complex

JSA #67 “The Autopsy”
Geoff Johns, writer
Dave Gibbons, penciler

Despite the title, surprisingly little of the book is actually concerned with the autopsy. Most of the book deals with the various members of the JSA coming to terms with Sue Dibny’s death. It makes a good story, but I was looking forward to some good forensic science. Oh well…

A more in-depth autopsy is shown in the pages of Identity Crisis #2.

Only four items of medical interest are mentioned in this issue:

1. “Spectral analysis of her blood vessels did not reveal much.” (This is hardly a surprise given that this is simply Grade-A technobabble. How can you analyze the spectrum of something buried deep within other tissues in the body? Even if it could possibly work, no useful information would be gained.)
2. The toxicology reports are negative.
3. Sue Dibny was not burned to death and did not die because of smoke inhalation. (Dr. Mid-Nite knows this because “her lungs are pink.” This is legitimate reasoning in regards to smoke inhalation, but is not necessarily correct in regards to burning to death. If the fire were hot enough and fast enough there would not have been enough time to breathe in soot to darken the lungs.)
4. Dr. Mid-Nite sees something under the microscope that reveals who the killer of Sue Dibny is (but, of course, that’s not divulged here.)

Due to the fact that I have a very sick patient in the hospital (a probable Hyperosmolar Hyperglycemic Nonketotic Coma), my blogging will be limited today. Basically just some site updates:

1. In a gesture of goodwill to heal the political rift in this fine nation of ours, I have taken down the Brother Voodoo banner. His site can still be reached, and he wants me to let you know not only to look for him in 2008, but that he’s available as a motivational speaker for lectures, seminars, conventions and bar mitzvahs.
2. The Blogroll has been updated, adding many long-deserving comic bloggers as well as a few medical bloggers to the list. I also added a few links concerning my preoccupation with bad and misleading statistics. Sadly, in an effort to keep the list somewhat short, the names of those blogs on hiatus have been (temporarily) removed — return to blogging, and your name shall one again grace my list (hint, hint).
3. That is all. Nothing to see here. Move along please.

UPDATE 15 November 2004: Got home at 5AM this morning after spending all night taking care of a seriously ill patient. Ultimately had to transfer her to a larger facility. Of course, it always happens on Monday because that’s the busiest day in the clinic. Right now, I’m surviving on sugar, adrenaline and caffeine. I have no idea how I was able to pull this off 2 or 3 days a week during residency.

The Polite-Wife surprised me by stopping by the Family Practice office after she got off work today. She accomplished the impossible: she found me a bag of Dem Bones (apparently another teacher at the school had an extra bag)!

Heaven! (Particularly after the day and night I’ve had!)

One of my favorite guilty pleasure mystery series is the Stephanie Plum series by Janet Evanovich.

Stephanie Plum is a chronically out of work Jersey girl who takes a job as a “bail enforcement agent” (i.e. bounty hunter) for her cousin, a bail bondsman. In the process of attempting to track down the “skips” she always manages to find herself caught up in one mystery or another.

Romantic entanglements come courtesy of Joe Morelli, a high-school flame of Stephanie’s who is now a police officer, and Ranger, another bounty hunter.

There are a number of hilarious secondary characters including Stephanie’ gun-toting Grandma Mazur, her wannabe lesbian sister, and Lulu, the portly ex-prostitute-now-part-time-secretary-part-time-bounty-hunter.

Humor and romance (well, “romantic hi-jinks” is probably a better term) are a large part of these book’s charm (Evanovich was originally a romance writer). The first five books are the best (the fourth, Four to Score, is my favorite). From the sixth book on, the mysteries become less compelling and Stephanie has hit the Cheers limit¹, but the books are still worth reading, for the comedy if nothing else.

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¹The Cheers limit is the time in a piece of romantic fiction where the protagonist either has to put up or shut up; the romance has been going on so long that to sustain any hint of believability a romantic liaison must take place. Sadly, this action usually dooms the series (c.v. The Moonlighting Effect and The Northern Exposure Problem). Another name for the Cheers limit is the Betty and Veronica point.

Since David Welsh is giving us some of his favorite mystery writers this week, I thought I’d chime in with some of my own overlooked mysteries that are worth the time to track down and read.

• The Brother Cadfael series, by Ellis Peters, is a captivating mystery series set in the England of the late 12th century*. Its main character is Brother Cadfael, a former crusader who is now a Benedictine monk. The mysteries themselves are well written and the history is fascinating. The first book is the probably the weakest, but still well above average. Brother Cadfael was turned into a BBC series, shown on PBS’s Mystery, that is supposed to be very well done.

• Malcolm Shuman has written a brief series of mysteries focusing on professional historian and archaeologist (but not in the Indiana Jones sense) Alan Graham, who finds himself involved in a variety of mysteries mostly around the Baton Rouge area. All of the books have a historical tie and topics covered include Meriwether Lewis (of Lewis and Clark), Jim Bowie, Indian burial grounds, Lee Harvey Oswald and the Mayans.

• Tonya Huff has a five-book series involving Victoria Nelson, a former police detective now P.I., her ex-partner and sometimes-lover Mike Celucci, and Henry FitzSimmons, a vampire “romance novelist” around since Tudor England. The books combine mystery with horror, and each book addresses a classic horror staple (i.e. demons, mummies, Frankenstei’ns monster, werewolves, etc.). A sixth book was recently published focusing on Henry and minor character Tony.

• G.K. Chesterton’s series of books and stories involving Father Brown, a quiet shabby priest who solves mysteries in an almost “by the way” manner remains a wonderful read well over a hundred years after they were written. Inexpensive because of that whole public domain thing. As a comic book reference, G.K. Chesterton is who Gilbert (aka Fiddler’s Green) is based on in the Sandman “Doll’s House” storyline.

Warning! Footnote involving a small history lesson:
*Historically, the Brother Cadfael books take place in the period of time when both Stephen and Matilda were fighting for the throne of England. Ultimately, Stephen wins, though to preserve peace Matilda’s son Henry is named as his heir. To put this is in a historical perspective, Henry is better known as Henry II, husband of Eleanor of Aquitane and father of Richard the Lion-Hearted and King John (or Magna Carta and Robin Hood fame), and murderer (albeit indirectly) of the Archbishop of Canterbury Thomas Becket — which leads down the line to Chaucer’s Canturbery Tales. Clear as mud?

Anybody who has spent any time hanging around doctors (or reading a lot of medical blogs) will have run across the term zebra. In medical parlance, zebra is slang for a rare and unusual condition. It can have a positive connotation (usually when referring to yourself, as in “I found this incredible zebra when I was treating this patient’s cough.”) or a negative one (which is generally reserved for other people, as in ” She wastes too much time chasing zebras.”)

The term comes from one of the “laws” medical students learn in their first year of two of medical school. Unlike Sutton’s Law¹ and Occam’s Razor², this law doesn’t even have a fancy name. It’s usually referred to as the horse law, or the zebra law or the hoof beatrule.

“If you hear hoof beats, you should look for horses, not zebras.”

This rule reminds clinicians to look for the common causes of symptoms first, not the unusual ones. Sure, a nine-year old could have a thyroid condition that’s causing his sore throat, but it’s phenomenally unlikely. The odds are that he has an infectious sore throat — probably viral, maybe bacterial. A doctor should make sure all common causes are ruled out before spending time chasing rare ones.

So now the next time you hear about a medical zebra, you’ll know what it means.

UPDATE 16 Nov 2004 9:15 PM
I was watching the new medical show “House” on Fox tonight and one of the doctors (Omar Epps, I think) mentioned zebras. You heard it here first!

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¹Sutton’s Law is based on a story about Willy Sutton, a famed bank robber from early in the twentieth century. When asked why he robbed banks, he allegedly replied, “because that’s where the money is.” Therefore when performing an exam or running tests, go where the money is. If it’s a sore throat then look in the throat and check a throat culture, don’t waste time fretting over neurological reflexes or getting a urinalysis.

²Occam’s Razor (at least the medical interpretation of Occam) tells us that if a patient presents with multiple symptoms, the most likely diagnosis is the one which explains them all (or at least most of them).

I just finished reading Avengers #503, Chaos part 4, and there were several scenes that struck me as particularly awkward and ill-conceived. This isn’t an in-depth review or discussion of the comic (see the Precocious Curmudgeon or the Comic Treadmill for some good thoughts on the issue), but a look at those five scenes that caught my eye.

• In regards to Jan and Wanda’s poolside conversation, I don’t think women really talk that way. I think it’s more how men imagine women talk, not how they really do.

• Doctor Strange: “I am a practitioner of the mystic arts and I have achieved Master level.”
  This is an awkward statement that needs some more clarification. Why didn’t he just use his normal nom de guerre of “Sorcerer Supreme” which explains the situation better?
  What exactly is a Master Level sorcerer anyway? I figure that it’s one of three things:
  1. Like any other Master’s Degree, it’s an advanced degree in magic. That would make him Stephen Strange, M.D., M. Sor. He probably wrote his thesis on “The Metatextural Analysis of the Jungian System and Sexual Dynamics: a Comparison between the Books of Eibon and the Vishanti Texts.” This concept also suggests that somewhere there’s a Doctorate Level magician who’d be able to kick his butt.
  2. Like a Master Chef or a Master Carpenter (such as Norm Abrams on the New Yankee Workshop), Master Level sorcerer is a title which must be earned. He probably had to past some GRE-style test to earn the title:
     

     When faced with the minions of the dread Dormammu, your best choice of incantations is:
     A. That is not dead / which may eternal lie / and in strange aeons / even death may die
     B. By the powers that dwell in the darkness / I summon the hosts of Hoggoth
     C. For hate’s sake, I spit my last breath at thee
     D. Wake me up before you go go / ’cause I’m not planning on going solo
     E . All your bases are belong to us

  3. Master Level sounds very reminiscent of a role-playing term, like in Dungeons & Dragons or Everquest. Remember in the old AD&D system where each level had its own title? Master Level sorcerer is probably just like a 20th level magic-user. I can imagine Dr. Strange running around shouting, “I just need five more experience points to make Master level! Has anyone seen a Mindless One I can kill?”

• Spider-Man’s comments do seem somewhat out of character (well, not out of character for the Paul Jenkin’s written Spectacular Spider-Man – some of his statements make me cringe), but I think it was more likely Spidey’s comments were taken out of context. We’ve all been in the same situation: talking to someone in a crowd when we make some stupid or inane comment just as there is a lull in conversation. Everyone turns to look at you and you do your best to take your foot out of your mouth as quickly as possible. This is what I think happened to Spider-Man.

• It seems rather condescending of Dr. Strange to dismiss Scarlet Witch as someone who was born with her powers and never earned them. Most super-heroes are born with powers, or gain them through some lucky accident. Very few earn them. Just look at the Avengers: Warbird - lucky accident, Captain America - lucky accident, Hulk -lucky accident, Firestar - born with powers, Justice - born with powers, Wasp - lucky accident (married a smart guy), Thor - born with powers, She-Hulk - lucky accident. It seems that only Hawkeye, Iron Man, and Yellow Jacket have “earned” their powers. I’m probably reading too much into this, but it just struck me as an out of character comment.

• I’m expected to believe that Captain America would hand over his mentally ill and comatose teammate to her estranged a father — a known criminal who just months before tried to destroy New York — without batting an eye? And no one else says anything, not even Nick Fury? This ending seems one of the the most unlikely parts of the entire storyline to me.

Time travel stories are one of the staples of comic books. Characters travel up and down the time stream from the distant past to the far future. Almost every character or team seems to have traveled in time: the Flash, JSA, Birds of Prey, Avengers, JLA, X-Men and even the New Warriors.

Stories set in the near future are almost always an interesting read because they show a glimpse of how a character’s life might turn out. This is the reason almost all DC’s Armageddon 2001 Annuals were good — unlike the mini-series itself, and unlike most other themed annuals. Stories set farther in the future are not always as good becuuse the writer needs to establish a frame of reference so the readers can relate to the new setting. Sometimes this is done well (almost all Legion of Super-Heroes stories); sometimes it’s not (the DC One-Million stories). Most comic book futures seem to be portrayed as dark and grim, and the heroes must work to prevent that particular future from occurring (a la Days of Future Past). Rarely have there been any particularly happy futures.

Time traveling to the past presents its own complications. That whole concept of whether changes made in the past will affect the future is always a stumbling block. The trouble with most of these time travel stories is that they don’t change the status quo. Admittedly, sometimes the entire story is set up so the heroes have to fight to maintain the status quo (the “Must Shoot Abe Lincoln” issues of Plastic Man are probably the best recent example.) Have there been any comic stories where characters have traveled into the past and actually significantly changed things in the present? Like Marty McFly did in Back to the Future — he ended up with cool parents and a new truck. Has that ever happened in comics?

Quick medical terminology pet peeve:

The suffix -itis indicates an inflammation of something. Thus tonsilitis is inflammation of the tonsils, otitis is inflammation of the ear, appendicitis is inflammation of the appendix, and so on.

The prefix hypo- means a low level of something. For example, hypothyroidism is a low level of thyroid hormone and hypoglycemia means a low blood sugar level.

So, to the writers of that otherwise fairly clever Toyota truck ad: Your sad sack of a character would be suffering from hypoadrenalism (low adrenaline), not adrenalinitis.

Today is the annual Great American Smokeout. Need I say more?

The recent issue of the Comic Buyers Guide, #1600, features the “1600 Greatest Comics of All Time.” I was considering posting about the list, but frankly that’s a lot of comics. Luckily, H at the Comic Treadmill saves me the hassle and has done an exhaustive review of the list himself. I agree with nearly everything he says, so go read it, and Dave Fiore’s comment too.

For me, the list lost all credibility when the Batman: Hush storyline was included on it. To put it mildly, I am no fan of the Hush storyline. It was a shallow piece of writing contrived to allow Jim Lee to draw a new “classic” character every month. And then they stole the Unknown Soldier for a villain. There is no way any legitimate list can contain this storyline in any “top list” (except maybe the “Top 10 Comic-book Storylines Scott Would Like to Pretend Never Existed.”)

I also disagree with the inclusion of Kevin Smith’s run on Daredevil and Green Arrow. His Daredevil story was a mish-mash of contriavances and cliches strung together as if to appear clever and groundbreaking when it was neither. What makes the inclusion of this storyline even more incredible is that there are no Frank Miller Daredevil comics on the list. Where is Born Again – the standard against which all other Daredevil stories will forever be measured?

I have never been a fan of Smith’s incarnation of Green Arrow. Green Arrow is a B-level character. A fascinating one, I’ll grant, but still a B-level hero. Smith’s re-invention of the character adds no new twists and instead brings back all of the excesses of the Silver Age. I had hoped those trick arrows were lost for good. None of the writers following Smith has written a particularly good story either. As far as I’m concerned, the Mike Grell “urban hunter” Green Arrow was the best this character has ever been.

What would I have added to the list? Hawk and Dove, of course. OK, just kidding about Hawk and Dove, but I would have expected there would have been more Steve Ditko on the list, Dr. Strange would have been nice.

Once again joining somebody else’s bandwagon, I join David and Ed in Book Week and today I promote some of my favorite historical novel series.

The Sharpe Series by Bernard Cornwell
This started out as a series of eleven books that chronicled the fate of British Army infantryman Richard Sharpe through the Napoleonic Wars ending at the battle of Waterloo. Originally a common sergeant, Sharpe saved life of Lord Wellington during a battle in India and found himself promoted to Lieutenant. The stories do an excellent job of bringing the battles to life as well as the harsh life of the British soldier. Cornwell has since gone on to write more Sharpe books set before, after and in-between the original eleven. The BBC also made a very entertaining series of Sharpe movies starring Sean Bean (Boromir in Lord of the Rings). They can sometimes be seen on Masterpiece Theater or the History Channel (and are available on VHS and DVD).

The Hornblower Series by C.S. Forester
Chronicling the adventures of British sailor Horatio Hornblower during the Spanish and Napoleonic Wars. Hornblower starts off as a lowly Midshipman and makes it all the way to Admiral by the end of the series. The best books to start with are Beat To Quarters, Ship of the Line, and Flying Colours. Technically they are the sixth, seventh, and eighth book in the series, but they are the first ones that Forester wrote. They were also turned into an excellent movie starring Gregory Peck and Virginia Mayo. The earlier books were turned into a well done series of movies on A&E starring Ioan Gruffudd as the young Hornblower (Gruffudd is to play Reed Richards in the upcoming Fantastic Four movie). Horatio Hornblower was one of the first popular heroes who broke from the idea of the dashing hero — he was shy, awkward, not particularly handsome and usually scared to death (at least in the earlier books). As a bit of trivia, Forester also wrote The African Queen, later turned into the famous Humphrey Bogart and Katherine Hepburn movie.

Even though it shares a setting with the Hornblower novels, I never enjoyed Patrick O’Brian’s Aubery/Maturin series (Master and Commander is the first book — later turned into the Russel Crowe movie), so I gave up after the fifth book. There was just no joy in reading the books; it wasn’t fun — more like a chore.

Other good historical novels include the Arundel series by Kenneth Roberts and any of James L. Nelson’s various naval series.