I Can’t Explain This One Away…

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

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

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

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

Fourth-Dimensional Surgery

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

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

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

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

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

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

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

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Monday PSA: Lost — A Free Education!

Lost - A Free Education! Click for the full page.Fed up with always being overshadowed by fellow DC comics hipster Buzzy, Binky finally makes an appearance in a PSA — though he’s basically a passive observer, with Tim and nameless-grocery-delivery-boy getting the attention.

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

This is at least the second PSA with a “stay in school” theme (the other was “Not Wanted: High School Dropouts“). I guess DC Comics and the National Social Welfare Assembly felt that this was a major problem among comic book readers in the ’50s and ’60s.

This particular PSA is from The Brave and the Bold #20, though it can be found in other DC comics from November 1958. It’s actually the second go around of this PSA, which first appeared in some October 1951 comics. It was printed yet a third time, in October 1966 comics. 15 years off a single PSA — that’s not too shabby. As usual, the script is by Bob Schiff (of course), with Win Mortimer on pencils and inks.

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New Amsterdam

New AmsterdamSo far it’s an interesting show about an immortal New York detective and I’d say it has definitely has the potential to be a good show

I did have a couple of medical nitpicks, though. The first one I’ve mentioned multiple times.

AmsterdamYou don’t shock asystole (a flatline) — not only does it not work, but it’s actually counterproductive. Giving epinephrine or atropine is fine. CPR is good. Transvenous pacing is better. Defibrillation — not a good idea.

AmsterdamIf Amsterdam has such a rare blood type that everyone who has it died out, why are they testing for it?

AmsterdamFinally, on a non-medical note, in the last flashback it was rather disconcerting to see the New York area tribes of Native Americans living in tipis — which were used by the tribes of the Great Plains, not the northeast.

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Azrael — Animal Genes versus Human Genes

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

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

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

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

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

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

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

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

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

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Picture Quiz: Superman/Batman

Once a scene from Superman/Batman #35, now just grist for Scott's Picture Quiz

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

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

Hint #1: I count one error in the art, two in the script, and error #4 could be blamed on either.
Hint #2: Check out the anatomy of the hindbrain.
My Answers:
1. No horizontal slice of the brain will show both the lateral ventricles and the eyes; they’re on different levels, and
2. neither of them (nor Batman’s finger) are anywhere near the Medulla Oblongota,
3. which is part of the hindbrain, not the forebrain.
4. and all this means Batman was wrong about Superman’s drawing being any good.

More picture quizzesPrevious picture quizzes

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She Blinded Me with Science!

Science! From the Brave and the Bold #55

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

Too Many Hulks

Which two are the same?
from The Marvel Heroes Activity Book

Which Hulk is different?

(There’s been Green Hulk, Grey Hulk, Blue Hulk, and now red Hulk. I guess this is Albino Hulk. What really catches my eye is that all the Hulks seem to have a fabric hole in their left leg, below the level of their shorts — or maybe they just have glowing kneecaps).

Quick Picture Post

scene from Blue Beetle #1
Blue Beetle #1 (1986, by Wein and Cullins)

A hint for the colorist: don’t color IVs red automatically. Giving blood, especially in the field, is very rare. Most commonly a saline solution is used, so the tubing and IV solution should be clear.
As for this specific situation, dehydration is common in fire victims, so IV fluid rehydration is very important. However, short of major trauma, blood wouldn’t be given (and even if it were, it would be at the hospital, not at the fire site).

(Yes, I am picking on a 20 year old comic, but this is still a very common error in today’s comics. I just grabbed Blue Beetle #1 because it was close at hand).


scene from Azrael #7
Azrael #7 (1995, by O’Neil and Kitson)

Just a little something extra for all you Azrael fans, building off of my previous post. Yep, that’s a little fetal Azrael in a jar full of ape amniotic fluid. I think that this certainly qualifies as one of the more disturbing concepts in post-Code comics.

Monday PSA: Superboy Says “Don’t Give Fire a Place to Start”

Superboy Says 'Don't Give Fire a Place to Start! Click for the full page.Despite being a small town, Smallville seems to have a surprising number of big city amenities. For instance, this PSA features the Smallville Teen-Age Club, which unfortunately catches fire. Luckily, Superboy is there to put out the fire — as well as lecture the teen-agers about fires.

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

Being cynical, if were one of the teens, I’d be a little suspicious of Superboy. There’s mysterious fire damage and Superboy — with his heat vision — just happens to be there? That has Kryptonian-related arson written all over it.

SuperboyHey cats, dig the crazy use of teen slang: “Let the whole town get hep to the rules”

SuperboyWhy are there quotation marks around “junk” and why are they keeping it in closets (when everyone knows junk belongs in the trunk)?

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New Amsterdam, Again

Time to pick — briefly — on New Amsterdam again. This appears to have been the third episode, so they must have shown a second episode that I missed last week.

The first topic is Civil War medicine.
Good: Morphine was available and used as a painkiller (though many Civil War veterans ended up addicted to it)
Good: Ether was used as an anesthetic (in roughly 30% of surgeries. Chloroform was the most common, but also more dangerous than Ether)
Bad: The term “Phantom Limb” was not coined until well after the Civil War, in 1872.

In terms of the more modern medicine:
Bad: Intramuscular shots aren’t given in the antecubital fossa (the inside of the elbow). IV medication is given, well, through IVs.
Bad: The doctors have an exaggerated sense of how effective antipsychotic medications are. Patients don’t miraculously become lucid, even after a few hours.
Good: I saw nothing wrong with the doctor’s physical exam technique.
Bad: There have been some studies suggesting beta-blockers will help victims of post-traumatic stress disorder, but they need to be given shortly after the traumatic event, not years later. That being said, beta-blockers still have some important other uses that may apply here: they are good for high blood pressure, certain social anxieties (public speaking, for instance), tremors, and a racing heartbeat. Overall, I find the studies suggesting beta-blockers for PTSD not particularly compelling or convincing.

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Grand Rounds

Grand Rounds

Grand Rounds is held over at Canadian Medicine this week. Head over there to check out the best in medical blogging of the past week.

Next week, I’ll be hosting Grand Rounds here at Polite Dissent. Please send all submissions for Grand Rounds to grand@politedissent.com by Sunday, 16 March, no later than 6PM (Central Time).

Green Arrow and Black Canary #3, #4, and #5: A Medical Review

Spoiler Alert!

Green Arrow and Black Canary #3, 4, and 5
Judd Winick, writer
Cliff Chiang (issues #3 and 4), André Coelho (issue #5), pencilers

Connor shotEscaping from the island of Themyscira, Connor Hawke (Green Arrow II) is shot through the heart1.

Panic ensues. Oliver Queen (Green Arrow I) tries direct pressure to stop the bleeding, while Mia grabs the first-aid kit.

Mia: It’s a full surgical kit including plasma2 and some high tech field dressings.

Oliver is able to contact Superman who swoops in and flies Connor off to the hospital where he is rushed into surgery. Oliver wants to enter the operating room, but Dinah (Black Canary) stops him, pointing out that he’s not sterile. Hal Jordan (Green Lantern) goes in instead3
He returns hours later after the surgery with bad news:

Hal: It wasn’t an ordinary bullet…it was laced with a toxin. Like a corrosive. It flooded his tissues just a few seconds after it entered his bloodstream4. It was in his brain Ollie4…he’s in a coma; he’s brain dead.5

Oliver enters the OR and cries over his son.

Notes:
1. It looks to me like a through-and-through shot — that’s a pretty good exit wound.
2. What is comic writer’s fascination with plasma? Plasma is not used for general fluid resuscitation, it is only used in rare and specific circumstances (a clotting problem, for instance). If you absolutely have to keep a blood product around for emergencies, store Type O- packed red blood cells. Blood products have a short shelf life and require refrigeration, so you would probably be better off just storing some bags of IV fluid instead.
3. I guess Hal’s ring must make him sterile (snicker).
4. I was thinking it was unbelievable that a bullet that left such a spectacular exit wound would have enough time to “flood his tissues” with toxin in the millisecond it was inside the body, but I queried my friend Karl — who knows much more about ballistics than I do — and he was able to suggest a couple of scenarios that could account for both an exit wound and a retained portion of the projectile. Unlikely, he’ll admit, but certainly possible — so I’ll give Winick a pass on this (for now).
5. There’s a special membrane known as the Blood Brain Barrier that needs to be considered. As the name suggests, the barrier separates the tissues of the brain from their blood supply and protects the brain from chemicals and infections by only allowing select molecules to pass through. The mysterious toxin would not only have to specific enough to target the brain, but also able to pass through the blood brain barrier. Again, not impossible (especially in comics books), but still unlikely.
6. Hal is very wrong about Connor being brain dead. First, being in a coma and being brain dead are two different things. Brain death, by definition, is irreversible — a coma is not. Additionally, at the end of this issue and in the next issue we can see that Connor is clearly breathing on his own — people who are brain dead have no spontaneous respiration.

Finally, take a look at this scene from Green Arrow and Black Canary #5:

scene from Green Arrow-Black Canary #5
Why is the blood pressure cuff giving an EKG reading — and a bad one at that?

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Jonah Hex, Again — This Time the Eyes

cover, Jonah Hex #12Dwayne, he of the Jonah Hex obsession, asks an excellent question: what’s up with Hex’s right eye? He points out that it remains open even when Hex is unconscious, and it’s been suggested that he may be blind in that eye.

As I said, it’s a very good question:

Hex’s permanently open eye could be due to several different things, all ultimately related to the hot tomahawk torture that left his face permanently scarred.
1. The eyelid could have been sliced off.
2. There could be scar tissue that keeps the eyelid open (this seems most likely to me).
3. There could be nerve damage or muscle damage affecting the eyelid in question.

Regardless of the cause, having a permanently open eye is going to lead to blindness in that eye. A functional eyelid and being able to blink lubricate the eye to keep it from drying out, and protect the eye from foreign bodies and irritants.

Without the lid, Hex’s eye will dry out and be more susceptible to scratches and abrasions of the cornea (especially when he takes those long rides through the desert he’s so fond of taking). Without being able to close his eye or blink, these scratches will not have time to heal and more and more of them will occur. Eventually, it will be like trying to look out through a frosted pane of glass — and that’s the best-case scenario.

Infection of the eye is a strong possibility, and there’s a risk of developing corneal ulcers, which if untreated can lead to a perforation of the eye. This can develop into a particularly nasty infection resulting in the loss of the eye itself.

The muscles and reflexes should still be functioning (unless there’s muscle or nerve damage as mentioned above), so if you were talking to Jonah, the eye would still appear to look at you and follow you — but he wouldn’t be able to actually see you out of it. The eye would probably look a little cloudy and worse-for-wear if you took a close look at it.

Thanks to modern medicine, we have several ways to deal with this problem. There are a variety of eye lubricants and drops that can be applied. Surgery can be performed to correct the eyelid defect, or weights can be added the eyelid so it closes. Of course, Hex didn’t have these options back in the 19th century (though he could have worn an eye patch, which would have offered some protection).

Let me use another famous one-eyed cowboy for demonstration purposes:

Rooster Cogburn, OS Rooster Cogburn, OD
What Jonah Hex would see, if he were to look at Rooster Cogburn out of his left eye. This would likely be followed by a great deal of drinking and/or shooting. The same scene, if Hex were looking out of his right eye. Bear in mind that this is the best-case scenario, and the vision would likely be much worse — or absent entirely.

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Grand Rounds Reminder

Grand Rounds

This coming week, I’ll be hosting Grand Rounds here at Polite Dissent. Please send all submissions for Grand Rounds to grand@politedissent.com by Sunday, 16 March, no later than 6PM (Central Time).

Your Weekend Moment of Nosebleed Zen: Blue Beetle

Scene from Blue Beetke #2In this scene from Blue Beetle #2 (current series), Probe, an eyeless1 member of “The Posse”, is trying to read Jamie’s mind, but the scarab is providing too much interference.

Or else her piercings are too tight…

Blue Beetle #2 is by John Rogers, Keith Giffen, and Cully Hamner.

 

1And before anybody mentions it: Yes, she’s wearing sunglassess — that’s to hide the fact that she’s eyeless.

 

nosebleed zenAll previous Psychic Nosebleed Zen posts

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Healthcare Crisis…In Riverdale

cover, Archie #546cover, Archie and Friends #19
cover, Archie's Pal Jughead #48cover, Archie at Riverdale High #86cover, Archie Comics #30

The crisis, clearly, being that there are apparently no good medical jokes in Riverdale. (Or good doctors either apparently, as the one shown is listening for Betty’s heart on the wrong side*.)

 

*insert crude joke here

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Monday PSA: Be Your Own Boss!

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

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

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

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

Grand Rounds

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

Vacation

cover, Justice League of America #34

I’m off work and on vacation for the rest of week. Nothing exciting, mostly just staying at home and catching up on paperwork and CME — though I’m sure I’ll find the time to play a video game or two.

Posting will continue, but expect lighter, less substantial fare for the remainder of the week.

Young Liars #1: A Medical Review

cover, Young Liars #1Young Liars #1 “At a Thousand Miles an Hour”
David Lapham, writer and artist

Today, I’m going to talk about brain injuries and personality, primarily focusing on Sadie, one of the main characters from Young Liars #1. Sadie suffered a bullet wound to the brain which did extensive damage and has led to an extensive change in her personality, including increased aggression, lack of social restraint, and inappropriate sexual behavior.

According to the doctor, Sadie suffered injuries to the “moral and emotional centers of her brain,” including:
1. Cingulate Gyrus/Limbic System
2. Frontal Lobe
3. Temporal Lobe
4. Amygdala
5. Hypothalamus
He also mentions that — at some point in the future — the retained bullet will sink lower in brain and damage the brainstem, killing her.

The cingulate gyrus is part of the “limbic system” (but not, as the text implies, the entire system). Like most of the limbic system, it plays a major role in emotion, mood, and memory. More specifically, the cingulate gyrus seems to affect aggression, emotional response to pain, and the connection between the senses and emotions. Damage to the gyrus could affect any or all of these components.

scene from Young Liars #1Frontal lobe injuries can cause severe neurological symptoms up to and including paralysis. Other common symptoms include difficulty performing complex activities, an inability to focus on a task, lack of flexibility in thinking, and difficulties with problem solving.
Frontal lobe injuries can also have a severe effect on a person’s personality. The normal social responses are often blunted. Extreme emotional lability — switching rapidly from one mood to another — is common. The damage can also cause significant changes in behavior including pseudodepression and pseudopsycopathy. Sadie most likely is pseudopsychopathic, in which a person with a frontal lobe injury demonstrates immature behavior and marked lack of restraint, but without the mental/emotional symptoms that an actual psychopath has. Inappropriate sexual behavior has also been seen after frontal lobe injuries (though just as often a frontal lobe injury leads to a decrease in libido).

Temporal lobe injuries mainly affect memory and memory processing. Depending on the side of the brain injured, memory and processing of shapes and sounds can be compromised, or the use of words and language can be damaged. Aggression can be affected by temporal lobe injuries. Personality changes can also be seen, but not the type that Sadie is showing.

The amygdala is another part of the limbic system. It plays a role in emotional memories as well as converting short-term memories into long-term memories.

The hypothalamus is a particularly complex portion of the brain. Among other functions, it helps to regulate the autonomic nervous system and it plays a large role in hormone production and regulation. The hypothalamus affects hunger, blood pressure, heart rate, sexual arousal, and the sleep/wake cycle.

Overall, I’d say that Sadie’s personality changes are consistent with the brain damage she has suffered, particularly the damage to the frontal lobe. (For the record, I’m a little doubtful of her doctor’s suggestion that the “bullet will eventually drop and damage the brain stem” — but if it does occur, he’s right that it would be fatal.)

This topic suggested by Douglas Wolk over at the Savage Critics.

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Happy Easter

In the past years, it’s been the Avengers, the Justice League, and even the Legion of Super-Heroes. This year…

The Uncanny X-Peeps

Happy Easter from the Uncanny X-Peeps

Ultimate Spider-Man #30: A Medical Review

scene from Ultimate Spider-Man #30Ultimate Spider-Man #30 “Emergency”
Brian Michael Bendis, writer
Mark Bagley, penciler

Spider-Man has been shot in the shoulder by an overzealous police officer. With some help from Mary Jane, Peter Parker arrives at a nearby Emergency Room and collapses on the floor.

There’s clearly a little confusion in the scene, as the doctor is asking for the blood pressure just after the nurse tells him what it is, but you can chalk that up to the stress of the resuscitation, or maybe misplaced speech balloons.

Let’s take a look at what everyone is saying:
Number 8 ET tube — the doctor is considering intubating Peter and is ordering a 8.0 endotracheal tube, a normal size for an adult male. There’s no indication that Peter is having trouble breathing or protecting his airway, but the doctor is probably just being prepared. After all, “Airway” is the A in the ABCs of trauma.

Pulse Ox is Low, 82 — The Pulse Ox gives a quick approximation of the how oxygenated a patient’s arterial blood is. A normal reading is 99-100%. A reading of 82% is very low, and could be caused by a couple of things: First, it suggests that Peter may have lost much more blood than his other vitals show. Second, given the location of the wound, I’d be very suspicious that the bullet may have clipped the lung and given Peter a pneumothorax (collapsed lung), explaining the low oxygenation. Finally, a Pulse Ox machine fits over the finger and uses light shined through the nailbed to work, so anything that obscures light can cause bad readings — maybe Peter has web fluid or blood under his nails.

BP’s 132 over 82 — That’s a blood pressure in the normal range, or at most slightly elevated for a patient Peter’s age and size. A moderate blood loss should give a low diastolic reading (the second number), and a more severe blood loss would show up in the systolic (top number) as well. Certainly pain and stress can raise the blood pressure, but at this point he’s 1) passed out, and 2) has had the wound for quite some time so their effect should be minimized.

Pulse 110 — A slightly elevated heart rate, could be related to blood loss or stress.

A and O times four — Here’s the problem: this result is impossible. “A” stands for “Alert” and “O times four” means that Peter is oriented to person, place, time, and situation. It’s a quick neurological test. The difficulty is that peter is unconscious, and thus by definition in not alert, or able to talk to answer the nurse’s questions about orientation. Oops.

Monday PSA: Superman says: “Lend a Friendly Hand!”

Superman says 'Lend a Friendly Hand!' Click for the full page.In this PSA, Superman (who sure seems to eavesdrop on kids’ conversations an awful lot), shows two children the error of their way (and apparently the lesson is not to treat refugee children as equals, but instead to pity them).

Wonder if Superman had to get the kid’s parent’s permission to fly them to refugee camps overseas, or if he just grabbed them and took off? Seems there’s a kidnapping charge or two there.

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

Unlike many of DC’s PSAs which they re-ran every few years, this one only appeared in the August 1960 edition of DC comics. I assume this is because of the reference to the “World Refugee Year” which ran from July 1959 - June 1960 (it helps to remember that the cover dates for comics are for several months later than when they actually were sold, thus the August 1960 issues were still published during the World Refugee Year, though just barely).

World Refugee YearMore information on World Refugee Year, primarily from a philatelist point of view.

This PSA was once again written by prolific PSA writer Jack Schiff, with art by this time by the legendary Curt Swan. This copy comes from The Brave and the Bold #31).

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Colorful Diseases of the Golden Age: The Green Plague

scene from Yankee Comics“The Green Plague”
Sure sounds impressive. What does it do?

It turns your skin green…but only temporarily.
Anything else?
Nope, that’s all it does: turns your skin green for a few days.
I changed my mind. That’s not impressive at all.
True, but it was still enough to base a Golden Age story on:

Patrons of the most expensive restaurants in Washington D.C. are mysteriously turning green. Lawsuits have been filed. Customers are actually choosing to eat at home. Senators and lobbyists have nowhere to go. It’s nothing sort of pandemonium.

Scene from Yankee ComicsIt turns out the Green Plague is nothing but a plot by one of the local mobs. It’s all part of a classic protection scheme: the mob demands a restaurant pay them $500 to provide “protection.” If the restaurant owner refuses to pay, his customers mysteriously develop the Green Plague. Well, it’s not so mysterious really: one of his mobsters — who just happens to be wearing a chef’s out — knocks out the real chef and then dumps a chemical in the soup. Anyone who eats the soup turns green.

Luckily, the Enchanted Dagger is there to save the day. The Enchanted Dagger, as his name suggests, got his powers from an enchanted dagger. Thanks to his magic cutlery, he could fly, make pithy comments, hypnotize criminals, and smoothly slice a tomato even after cutting through a concrete block. The Enchanted Dagger appeared just four times in the Golden Age (in Yankee Comics #1-4, 1941-2) and then disappeared, never to be seen again (except in the occasional black and white reprint like this one). He was drawn by George Tuska, so at least he had that going for him.

Thanks to his amazing powers, the Enchanted Dagger is able to stop the evil chef, locate the mob boss, escape a Rube Goldberg-ian deathtrap, and finally capture the entire mob, making the Washington D.C restaurant scene safe for all once again.

scene from Yankee Comics

The Green Plague: a lame disease, but not too lame for a fourth-string Golden Age hero!
(Tomorrow, a different plague, a different color…and in color!)

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Colorful Diseases of the Golden Age: The Purple Plague

scene from Action Comics #19A mysterious disease has struck Metropolis. Citizens are turning purple and dropping dead. No cure is available and no one knows the cause of the disease. The populace is terrified and people are barricading themselves in their homes and refusing to venture outside. “Bring out your dead” carts parade through the city collecting the dead and dying.

scene from Action Comics #19Dr Travers, a young scientist, recognizes the symptoms as belonging to the “Purple Plague,”, a disease from the middle ages long thought extinct. He is able to isolate the germ and develop an “antidote” against it. Unfortunately, when he gives a demonstration of his serum to the local scientific society, it doesn’t work and he is derided as a fraud and kicked out of the organization.

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

scene from Action Comics #19scene from Action Comics #19

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

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

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

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

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

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

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

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

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Tony Stark’s Heart - The Last Word

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

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

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

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

Scene from Iron Man (v. 3) #31

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

Scene from Iron Man (v. 4) #1

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

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

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Your Weekend Moment of Psychic Nosebleed Zen: Lost

I’m finding fewer psychic nosebleeds in comic books recently (or maybe I’m reading the wrong books), but on the other hand, more seem to be making their way into other media, especially television and the occasional movie.

For example, here are couple of psychic trauma/time travel related nosebleeds (and Spoiler Alert, by the way) from a recent episode of Lost (“The Constant” — episode 5, season 4).

scene from Lost
George
scene from Lost
Desmond

nosebleed zenAll previous Psychic Nosebleed Zen posts

Comments Fixed

The upgrade to WordPress 2.5 caused problems with the comment-preview plugin I had been using — even the updated version — so anyone who tried to post or preview a comment got a wonderful error. I uninstalled it, so comments are working again, but comment-preview is not currently an option, at least until I find a comment-preview plugin in that works.

Monday PSA: The Hit That Ended the Ball Game

The Hit that Ended the Ball Game! Click for the full page.Since it’s the opening day of the baseball season, I thought it would be a good idea to start with a baseball-related PSA.

This ad comes from Supergirl #5 (June 1973) and is an anti-drug PSA from the makers of Huskie shoes. (Of course, in today’s climate, this ad still applies, only this time it’s referring to steroids or HGH). It’s one of the few PSAs I’ve seen that is part of an actual company-sponsored advertisement as opposed to the ususal “public service” ad.

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

BaseballFor another baseball-related PSA, check out “Danger: Prejudice at Work
DrugsThere are too many anti-drug PSAs to choose from, so here are a few choice ones from the files: “We Can Stop the Enemies of Youth,” “The Amazing Spider-Man in Double Trouble,” and “The New Teen Titans as part of the President’s Drug Awareness Campaign.”

More PSAs

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