hippocrates gets dissed

In my never-ending search for truth and wisdom, I decided that as an Internet Medical Doctor, I should take some Continuing Medical Education credits. Since I have absolutely no medical training whatsoever, I decided to start at the beginning, kinda like opening the Bible at Genesis. I decided to start with the Works by Hippocrates. He’s that Oath guy, so if people swear an oath towards or about him, I figured he must be somebody.

He was a pretty important guy, so it seems. They called him the Father of Medicine, and he lived from about 460 BC to 370 BC. Ninety years is impressive for a time before flushing toilets and Dyson vacuums.

Turns out he wrote a lot, and his works are collected into something called the Hippocratic Corpus. I figure strolling through his writings should be worth a handful of CMEs.

I picked one called, Aphorisms. It is presented in Roman-numeral section and then numbered paragraphs within each section. Let’s stroll …

I.21. Those things which require to be evacuated should be evacuated, wherever they most tend, by the proper outlets. (“Evacuated … by the proper outlets.” Man, starts right in with the anal bit. Just remarkable. How did I know that was coming?)

II.11. It is easier to fill up with drink than with food. (This sounds like a proverb. “There is no ‘I’ in teamwork.” “‘Gullible’ is not in the dictionary.” “Orville Redenbacher’s brother is a colonel in the Air Force.”)

II.21. Drinking strong wine cures hunger. (“I’m hungry!’ “Shut up! Get blasted – you won’t think about it as much!”)

II.24. [Concerning acute disease] The fourth day is indicative of the seventh; the eighth is the commencement of the second week; and hence, the eleventh being the fourth of the second week, is also indicative; and again, the seventeenth is indicative, as being the fourth from the fourteenth, and the seventh from the eleventh. (Where’s my slide rule? I know I left it around here somewhere …)

II.48. In every movement of the body, whenever one begins to endure pain, it will be relieved by rest. (“Doc, it hurts when I move.” “Then stop moving.” Brilliant!)

III.10. Autumn is a bad season for persons in consumption. (Back in his day, Consumption/Tuberculosis was characterized by coughing up blood, fever, and was almost always fatal. Seems to me, Hippo, the time of year isn’t dispositive.)

V.3. A convulsion, or hiccup, supervening on a copious discharge of blood is bad. (Good rule. Got it. Thank you.)

V.34. When a pregnant woman has a violent diarrhoea, there is danger of her miscarrying. (“Dear Diary, about two months ago I got pregnant with Spyro’s child. Last week, I began to feel a quivering in my toes that worked its way the entire distance of my legs. I thought it would result in a real howitzer of an orgasm. Alas, to my dismay, the result was explosive flatulence. Now, the flatulence has given way to violent diarrhoea. What could be next? Methinks I am not well. I must stop eating hummus as very often.”)

V.72. Persons disposed to jaundice are not very subject to flatulence. (Um, OK. “Johnny, I haven’t heard you fart lately, and you look a little yellow under the gills. I think your liver is failing. I could be wrong.”)

VI.9. Broad exanthemata are not very itchy. (“Not very”? Rather loose language for a doc, eh? If it’s a rash and it was itchy when it was little, you can be damn sure it will be itchy when it spreads. “Itch” isn’t proportioned to a condition, like you only get so much “itch” per condition. The broader the condition, Hippo, the more it frickin itches.)

VI.13. Sneezing coming on, in the case of a person afflicted with hiccup, removes the hiccup. (Yes, and if you read a few posts below, sticking your fingers in his ass will also “remove the hiccup.” Surprised you didn’t come up with that.)

VI.17. It is a good thing in ophthalmy for the patient to be seized with diarrhoea. (Let’s see … “ophthalmy” is an inflammation of the membranes or coats of the eye or of the eyeball. “I can’t see nothing, doc. My eyes are all inflamed. Big time.” “Yes, they are, Spartacus, I can see that. How’s your butt?” “Hunh?” “I said, ‘how’s your butt?’” “Um, OK, I guess. I could lose a pound or two. You know it is.” “I think we need to aid in the evacuation through the proper outlets.” “Doc, it’s my eyes. My eyes are weirding out on me.” “I know, Sparty. Trust me on this one. We’ll ream you out a good one, give you a tonic to induce violent diarrhoea, and in a few days you’ll be good as new! You aren’t pregnant, are you?”)

VI.28. Eunuchs do not take the gout, nor become bald. (Now here is news you can use! The heck with that Propecia or the Gessippi Whoever with the Beverly Hills salon that hugs all his customers while he charges them $500 for the same product you can now get for $19.99 but wait order now and we’ll give you a second bottle for free who has time for all that nonsense look I don’t own the company in fact I don’t know anything about them they just agreed to give my 20% of gross if I would do this commercial so I am and stop staring at that zit above my right eyebrow I am fully aware the pancake didn’t cover it completely just buy the product you bovine freak. You want to stop hair loss or jumpstart re-stimulation or re-growth? Easy – cut your nuts off! And as an added bonus, if you chop the mud flap off within the next 15 minutes, we’ll guaranty that you’ll never get gout! “Honey, where’s the hedge clippers?”)

VI.46. Such persons as become hump-backed from asthma or cough before puberty, die. (And if it happens after puberty, people will just spend a lifetime being pointing at you and hiding their children from your view. Man, how hard do you have to cough to create a hump on your back?)

VI.53. Delirium attended with laughter is less dangerous than delirium attended with a serious mood. (“How is he, doctor?” “He’ll be fine, Ma’am. Just keep him laughing. Whatever you do, keep him laughing.”)

VII.4. A chill supervening on a sweat is not good. (I know. This happens every time I drink myself into oblivion and evacuate through all the proper outlets. I always hear this voice, “This is not good.” Voice sounds familiar. I think it is me.)

VII.14. Stupor or delirium from a blow on the head is bad. (OK. How long did it take to figure this one out? Did you use live subjects?)

VII.34. When bubbles settle on the surface of the urine, they indicate disease of the kidneys, and that the complaint will be protracted. (I always make bubbles. It’s fun!)

VII.43. A woman does not become ambidexterous. (Whew! Is the next line, “burn the witch!”?)

VII.55. When the liver is filled with water and bursts into the epiploon, in this case the belly is filled with water and the patient dies. (I think you got a little off track here, Hippo. It seems to me that the patient died because of the burst liver. I really do think the water in the stomach is secondary. You may want to look over your data again.)

Interesting guy.

So I figure since “real” docs take the Hippocratic Oath, maybe I should read it. Good rule: Always start with the original text when doing research. Then, silly me and somewhat to be shock and awe, I wanted to find the modern version, and found instead a bunch of “modern” versions. I have three of them following the original.

Here is the original version (yes, translations differ, but that is your problem, not mine).

“I SWEAR by Apollo (wasn’t he a god or sumptin?) the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses (smile. Pagan!), that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents (mentor = daddy. Interesting concept. Sounds like a blood oath, Kemo Sabe.), to share my substance with him (are you selling Amway?), and relieve his necessities if required (mentor = sex daddy?); to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation (getting whored out just to learn a trade. Wow.); and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others (was there a secret handshake? I picture Fred Flintstone with his big blue hat while at the Loyal Order of Water Buffalos Lodge). I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous (OK). I will give no deadly medicine to any one if asked (OK), nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion (WHAT?!? You will NOT induce an abortion? Um, wait a minute … roughly 45MM abortions since 1972 in the US and the original text of the Oath includes a prohibition? Oh, it is to laugh.). With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work (Ewww! What pray tell is behind this crack? Cutting the tendons so they cannot escape?). Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males (and since docs were all guys, here’s a little gay reference.), of freemen and slaves (don’t go banging the patient – good rule). Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot! (whew, it ends like a spell. Eerie!)”

Well, old Hippo didn’t support abortion, did he? He’d get on all fours and let his teacher bang him doggy-style, but wouldn’t do his patients. Gotta draw lines somewhere, I guess. Interesting world.

Let’s see how the Oath was updated. Here’s the first modern version:

“I SWEAR in the presence of the Almighty (down to one god) and before my family, my teachers and my peers that according to my ability and judgment I will keep this Oath and Stipulation.

“TO RECKON all who have taught me this art equally dear to me as my parents (but you’re not going to sleep with them, right?) and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations (all?), so long as (funny, didn’t take long for the “but” to come in)the treatment of others is not compromised thereby (well, cowpoke, there is only so much of “you,” so in order to not compromise this fee-paying patient over here …), and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient (the origins of the referral system).

“I WILL FOLLOW that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous (tip of the hat to Hippo). I will neither prescribe nor administer a lethal dose of medicine to any patient (… any patient …) even if asked nor counsel any such thing nor perform the utmost respect for every human life from fertilization (oh my, methinks a prohibition against abortion has reared its head) to natural death and reject abortion that deliberately takes a unique human life (Oh! I should have read ahead, eh? “Reject abortion” coupled with previous reference of “life = fertilization” seems very clear. How interesting. I wonder how fully this position lies with Aristotle’s delayed ensoulment.).

“WITH PURITY, HOLINESS AND BENEFICENCE I will pass my life and practice my art. Except for the prudent correction of an imminent danger, I will neither treat any patient nor carry out any research on any human being without the valid informed consent of the subject or the appropriate legal protector thereof, understanding that research must have as its purpose the furtherance of the health of that individual. Into whatever patient setting I enter, I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient. (There’s that “seduction” bit again! Must’ve been a real problem. Something just dawned on me – in all the usages, it is the doc seducing the patient. Always that form. So if she (or he!) starts it … weird demarcation. Why not just prohibit sexual relations with patients?)

“WHATEVER IN CONNECTION with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad, I will not divulge, reckoning that all such should be kept secret.

“WHILE I CONTINUE to keep this Oath unviolated may it be granted to me to enjoy life and the practice of the art and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse by my lot.”

Alright, substantially intact. Added a few bits about human research and informed consent. Good issues. Let’s see another “modern” version. Methinks the Indians are discussing leaving the reservation.

“I swear to (now down to zero gods) fulfill, to the best of my ability and judgment, this covenant:

“I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. (A little soft around the edges, but still very Fred-like.)

“I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. (But sometimes the exact appropriate amount of treatment is nihilistic. How do you handle that?)

“I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. (Oh man. How many docs do you know that skipped this paragraph?)

“I will not be ashamed to say "I know not," (ditto) nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery (share the wealth).

“I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life (in theory); this awesome responsibility must be faced (application) with great humbleness and awareness of my own frailty. Above all, I must not play at God. (Capital G? But you axed Him in the opening. Odd.)

“I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. (No comment.)

“I will prevent disease whenever I can, for prevention is preferable to cure.

“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

“If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.”

That was an interesting shift in the treatment of abortion – from clear to cryptic. Still present, in some carnival mirror sort of way. Notice what is missing entirely? Docs can now nail their patients – male and female – regardless of who initiates it!

Last and, yes, least I found the AMA approved version. The reservation is now devoid of human inhabitants.

“You do solemnly swear, each by whatever he or she holds most sacred (Hunh? “whatever”? Good lord, talk about politically correct): That you will be loyal to the Profession of Medicine and just and generous (read, “make referrals early and often”) to its members. That you will lead your lives and practice your art in uprightness and honor.

“That into whatsoever house you shall enter, it shall be for the good of the sick to the utmost of your power, your holding yourselves far aloof from wrong, from corruption, from the tempting of others to vice. (Is this code for boning patients?)

“That you will exercise your art solely for the cure of your patients, and will give no drug, perform no operation, for a criminal purpose, even if solicited, far less suggest it. (Cure = good; criminal = bad. Silent on preventing abortion. Silent on assisted suicide. But neither “cure” do they?)

“That whatsoever you shall see or hear of the lives of men or women which is not fitting to be spoken, you will keep inviolably secret.

“These things do you swear. Let each bow the head in sign of acquiescence. And now, if you will be true to this, your oath, may prosperity and good repute be ever yours; the opposite, if you shall prove yourselves forsworn.”

The AMA sucks. Remarkable how much they changed from Hippo’s first writing. Why do they even continue to use the name?

acidic spouses and fair use

It was a tough decision, but I finally found a winner: Here is the Spouse of the Week! We long suspected she would win, but we needed to wait until this headline was published: Wife Convicted in Husband's Acid Murder. YES!!!

Let’s peek inside …

Now-widowed Larissa and now-dead Tim owned a chemical lab. They had an assistant, James “The Gullible One in Apparent Need of Money” Fagone. The year was 2003. Larissa, or “Iss” as she was called by her friends, and Timmy were in the midst of a nasty divorce. A double shot – divorcing your spouse and business partner! Talk about your social, economic, and spiritual life going down the shitter in one fell swoop.

Having done my fair share of divorces – both as an attorney and a spouse – I understand thoroughly the financial implications of death when it occurs on either side of the court decree. Seems Iss understood, too.

Here’s how it went down …

Iss: Hey, Jimmy, I got a business proposition for you.
Jimmy: Yeah?
Iss: See that guy over there?
Jimmy: Tim? Your husband?
Iss: Yeah.
Jimmy: Yeah, I see him. He’s, like, the only other person here.
Iss: Exactly.
Jimmy: Hunh?
Iss: You’re not getting it. Focus with me.
Jimmy: I’m trying.
Iss: See that 55 gallon drum over there?
Jimmy: Uh, yeah.
Iss: See this stun gun?
Jimmy: The one in your hand?
Iss: Yes, Jimmy, the one in my hand.
Jimmy: Uh, yeah, I see it.
Iss: Guy, stun gun, barrel.
Jimmy: Guy, stun gun, barrel.
Iss: Exactly.
Jimmy: Exactly what?
Iss: You’re an idiot, Jimmy.
Jimmy: You say that a lot.
Iss: You prove that a lot.
Jimmy: I’m sorry. You gonna hit me again?
Iss: No. Jimmy. I want to give you $2,000.
Jimmy: OK. Do I have to have sex with your pets again while you tape it?
Iss: No, Jimmy.
Jimmy: OK.
Iss: You ready?
Jimmy: Ready for what?
Iss: Guy, stun g-- …
Jimmy: … -un, barrel.
Iss: Exactly.
Jimmy: Exactly what?
Iss: Oh, my f---king lord you are stupid.
Jimmy: You shouldn’t talk about God that way.
Iss: Jimmy, focus with me.
Jimmy: OK.
Iss: I want you to walk over to Tim, use this stun gun on him, then I’ll use chloroform on him, and then you put him in the barrel. Upsidedown.
Jimmy: Why would I do that?
Iss: $2,000.
Jimmy: OK.
Iss: Go ahead and do it now.
Jimmy: OK.
Iss: Hey, Jimmy. You need the stun gun.
Jimmy: OK.

Jimmy: Hi, Tim!
Tim: Hi, Jimmy, what can I d--- ZAP! ARGGgghhh …
Jimmy: Sorry, Tim.

Iss: OK, Jimmy, pick him up.
Jimmy: OK. Upsidedown, right?
Iss: Yes, Jimmy.
Jimmy: OK. Thump! Do I get my $2,000 now?
Iss: In a minute. We aren’t done yet.
Jimmy: That’s that acid stuff, Iss.
Iss: Yes, it is, Jimmy.
Jimmy: Whacha gonna do with it? We got another experiment to do?
Iss: Something like that. Get his feet out of the way.
Jimmy: OK.
Iss: I’m just going pour this hydrochloric acid in here with Tim, and we’re going to time it and see how long it takes for him to dissolve.
Jimmy: OK.

Poor Jimmy was convicted in December 2006 of first-degree murder and sentenced to life in prison without parole. Looks like Iss will get the same.

You just have to love a spouse that refuses to out quietly. I think the dissolving-in-acid was a nice touch.

We aren’t done yet. This notice appeared with the article: “Copyright 2007 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press.”

That seemed broad enough to piss me off. “Fair Use” came to mind. “Screw you, AP” also flashed by.

Let’s go to a rather reliable source for such issues, the U.S. Copyright Office. US Code 17 Section 107 lists four considerations for fair use:

1. the purpose and character of the use, including whether such use is of commercial nature or is for nonprofit educational purposes;
2. the nature of the copyrighted work;
3. amount and substantiality of the portion used in relation to the copyrighted work as a whole; and
4. the effect of the use upon the potential market for or value of the copyrighted work.

Is my work commercial? No. I generate no income from this blog. The ads to the right are de minimus and if measureable, the amount attributable to this post is 1 divided by infinity, so zero.

The alleged copyrighted work was publicly distributed. I found it on the open internet. That does not defeat the alleged copyright, but it does put into perspective the nature of the work – it is intended to be read by the general public.

How much of their work did I use? A very small percentage. In fact, many other sources are available both subject to copyright and not (court docs). I, um, I read at least 25 different sources, filling my head with each, before I composed the vignette above. I merely chose to link to AP because I detest them and believe they need the business.

Do I affect their value? Oh no, they trashed that a long, long time ago. Have I touched their potential market? Yes. I increased it by linking to them.

A little more for the USCO: “The 1961 Report of the Register of Copyrights on the General Revision of the U.S. Copyright Law cites examples of activities that courts have regarded as fair use: ‘quotation of excerpts in a review or criticism for purposes of illustration or comment; quotation of short passages in a scholarly or technical work, for illustration or clarification of the author's observations; use in a parody of some of the content of the work parodied; summary of an address or article, with brief quotations, in a news report …’” Yeah, that’s me, particularly the I’m-your-clown part.

AP pisses me off. Stick your pseudo-broad copyright claims.

peeing on the trailer skirting is normal, ain't it?

I always watch for suggestions of links when people die. The inventor of Gatorade died from liver failure. Don’t know if it means anything. I only play a doctor on the internet. But I will make an entry in my Book of the Dead for future reference. I have noted a strong correlation between Rap singers and gun shot wounds. As a result, I make a habit out of humming the tunes and dancing only with the lights out and shades drawn. Seems safer to me that way. Gun shot wounds are not like in the old movies where the guy falls slowly backward and gasps a few final words. They hurt. A lot.

I found my new favorite site on the internet. I was surfing for internet radio stations. Found all sorts of listings. Got frustrated pretty quickly because they all make money through advertising of one form or another. Then I found Pandora Radio. An incredibly well-designed and well-run site. It claims to have taken the genome approach to music. You select an artist and create a radio station around that type of music. Each song that comes up, you put your cursor over the image and give it a thumbs up or down. The station is refined according to your choices. You can create a lot of different stations. The only limit I have run into has been the amount of songs you can skip within one hour – seems to be about 5, then it tells you that their licensing agreements only allow so many skips per hour (but doesn’t give you the number). There is no advertising, no feed issues – amazing site. I have two stations – one built around Frank Black, the other B.B. King. My daughter has about 15, but she’s a rock star and is allowed.

I rarely watch movies. Way to ADHD-Hyperactive for that. Funny, I can sit for hours and watch sports or work on my computer, but even a 30-minute sitcom drives me to pacing. I think it has to do with being able to fully engage. If I cannot, I am psychological toast. My body begins to thump inside. If I ignore it, it feeds back into my thought processes and I have to change locales. Physical movement helps a lot, even just standing. However, when I did watch movies, I enjoyed tracking data on Box Office Mojo. Lots and lots of detail. Sometimes you will get a screen that tells you that you have to register – just hit “back” on your browser and make your selection again. It will bypass the registration screen.

Daytime is 30s and 40s, nighttime 20s and 30s. Winter temperatures have arrived. I am drinking coffee in the afternoon and tea at night. My sweater is on most of the time.

I told this mutt to pee on the rug, but it won’t. Sure, it’ll die, but it won’t pee. Not very realistic in that way. Oh well.

Do you live in the Philadelphia area and suffer from heavy, long-lasting, or frequent menstrual cycles that seriously impact your regular lifestyle? If so, this guy named Larry wants to talk to you. I think he has some experimental drugs with your name on them.

Learn something new every day. I thought a “nocturia” study in Lancaster, PA, would be related to Amish cows keeping you up at night. Guess not. I will say this, however, the description is written very poorly.

I remember years ago my boss reviewed a memorandum of mine and said to me, “you say ‘stocks’ up here and ‘certificates’ down there. Those two different things?” Uh, no. “Then why do you use two different names?” It was a great lesson in consistency. Jonathan Wolter, Failure Analysis. Best boss I ever had.

Want to know what “nocturia” is? Choose from the following: 1. Wake up more than twice a night to use the bathroom; 2. Wake up with an urge to go to the toilet during the night; or 3. Waking too often with an urge to pass urine at night.

Using the bathroom more than twice could be from Explosive Bowel Syndrome, wherein the patient presents micro-blasts into the porcelain god on a frequent basis. No bladder involvement. Having an urge to go to the toilet could be a fetish the specifics of which I am uncomfortable describing, or could be a problem masturbator. Having an urge to pass urine is an old drinking game. Someone would pee in a cup, and the cup got passed until the music stopped, then, well, you complete the sentence. More often than not, however, the last one to hold the cup still tried to pass, and (laughing) the n-n-ext guy (oh, god, such fun times!) would t-t-try to refuse it, and (snort!) the cup w-w-would (Stop IT! You're KILLING me!!) tip and piss would fly all over the place and (oh, boy! Such great times those were!) ... of course, with all the drinking going on, there would be sometimes be 3 or 4 cups in circulation! OK, enough. Fifth grade was so much fun - ah, the good old days! God bless Artie's dad for being such a drunk that we could plow through his keg on tap and he would just buy a new one! Alright, back on track ... defining "nocturia." Let’s not forget that where I come from, if you had to pee during the night, you could bet the dog did, too – so we all went outside and pissed on the trailer skirting (women included). No bathroom involved.

How about this: “Nocturia is a condition wherein the patient has an urge to urinate frequently during nighttime hours, where such urges cause the patient to actually leave the bed more than once each night to urinate.” I mean, you clowns are doctors with grant money, right? And you wonder why us internet docs have no respect for you anal-obsessed “real” docs. Man. Get an editor.

How do you approach a website that lists an item as, ”U.S. G.I. Innertube FUN, FUN, FUN !!!”. The site has an incredible array of stuff, and I have been to their location. Good stock, good prices. But, “FUN, FUN, FUN”? The superlatives may be more apt when describing a Finnish Gas Mask (“Yaw, I smell dat, too”), an M-856 Projectile (“INCOMING!!”), a Dutch Military Geiger Counter (“Read the meter, Private, what’s it say?” “It says, ‘We’re fucked,’ Sir”), or even a Dummy Pineapple Grenade (“Pull the ring and threaten gramma! Loads of fun at every party!!”), but an innertube? Naw.

All done.

cosmic dancer

I was looking up at the sky and idly thinking what would happen if, say, some space-originated hunk of iron (with a typical density of, say, 8000 kg/m3) with a diameter of something like 100 meters, crossed into the atmosphere at, like, a 45 degree angle at a speed of roughly 50 miles/second, and then slammed into some sedimentary rock (with a density of something like 2500 kg/m3) about ten miles or so from where I sit. Would I be safe?

When in doubt, go to the internet. It just so happens that there is a Earth Impact Effects Program just waiting for your variable inputs – and mine!

If you just want the math behind the results, go here. Otherwise, read on – looks like I’ll be ok. Maybe. Wait, no. I think. Not sure. Sounds bad, actually.

First, there is some garbage about, “Energy before atmospheric entry” being 1.36 x 1019 Joules = 3.24 x 103 MegaTons TNT. I could not care less what happened before entry. I want to know about the impact on my ass where it sits – and I may not be a math or science or space guy, but I do know that energy before entry won’t blow down my walls.

We next learn that one of these things will slam into whatever I said it slammed into about once in every 56,000 years. That is not comforting. I checked the records. Ain’t nothing hit about ten miles up the road in the last 56,000 years. I know the probability is calculated as “average interval between impacts of this size somewhere on Earth,” but that is stupid – how am I supposed to figure that out? If it ain’t local, it didn’t happen – a true Appalachian attitude. Got a problem with that? Wanna squeal like a pig? Here piggy, piggy! So adjust the 1:56,000 for the proportion of the Earth’s surface up the road those ten miles. Something-a-helluva-lot-bigger-than-56,000 – still didn’t happen. So there.

There is a spot of good news in that the thing that’s gonna hit will start to break up about 128,000 feet away. That’s like over by Hazleton, a couple two three miles away. No problem. That’s the town that hates illegals. Good thing Jerry Farewell is dead else he’d be screaming, “God’s revenge!” That’s the guy that whacked off in front of prostitutes, right? Bet he’s already bought his season pass to the porn drive-in in Hell. All forty foot penises and sweaty asses – he forgot all about Heaven by the second half of the first double feature. He’s hooked up with some sleazy pharmacist already and is popping Viagra like they’re Tic Tacs. “If your erection lasts more than four hours, seek prompt medical attention”? Hell, no – he’ll be counting on it! Probably trying to negotiate a lifetime movie pass for him and his 12-year-old, um, son (that boy over there in the dress and pink bow – the one that knows the true meaning of Hell).

Here’s the best news. The resulting complex crater will have a transient diameter of 2.83 miles with a depth of one mile, and a final diameter of 3.47 miles and depth of 0.309 miles. With a decent rainy season, I may have another fishing spot pretty close. The volume of the target melted or vaporized is 0.0159 miles, and roughly half the melt remains in the crater, where its average thickness is 13.3 feet. Fishing may not be too good for a millennium or so until the iron content fades, but I’m patient. Also, tain’t no hole close to ten miles. I could not care less what happens over there.

So what do we see? Visible fireball radius of 2.71 miles, with the fireball appearing 61.6 times larger than the sun. We’ll see it for 56.9 seconds. That’s long enough to get a video camera and say all sorts of stupid things like, “Wow, do you see that? Thelma, go get me a beer! Shut-the-fuck-up-and-get-me-a-beer! I’m taping it, dumbass, you can just watch the tape!”

What’s really cool is the effects of the thermal radiation: Clothing ignites, much of the body suffers third degree burns, newspaper ignites, plywood flames, deciduous trees ignite, and grass ignites. Very cool! When! When! When!?! 0.0618 seconds after impact. Wow! Sucks to be them. Distance, as in ten miles, does make the heart grow fonder, eh? No, wait, the thermal radiation effects can’t be for ground zero – that would be a hole. This affects me? This sucks! You mean their hole is going to become my problem? WTF? At least I don’t read newspapers, so I don’t have to worry about that part. Won’t have to badger the boy to cut the subsequently non-existent grass, either. One less thing to worry about. That’s good. Wait. In 6/100s of a second it will get to me? That’s kinda fast. Could that really be ten miles away? But if like this thing slams into the back of your head and leaves a hole about three miles wide, what the hell is someone calculating that the newspaper would combust? Gotta be ten miles away. This really sucks. Let me try some math to see if I can figure this out. If a train leave the station traveling northbound for 6/100s of second and travels ten miles, toasting all the grass and newspapers along the way, how fast is it going in MPH? Damn. Um. Wait, I know this one. Um. Let’s see. If I take miles/hour, and substitute 10 for miles, and the fractional hour in that lower thingey on the other side of the slash. No wait. I don’t know. Gimme a minute! Um. OK, I think I’m right. 6/100s of a second, figuring 3,600 seconds in an hour is 0.00001667 hours or something like that. OK. 10/that number I just said is 600,000 MPH. But the speed of light is the theoretical maximum speed, and that’s 186,282.397 MP--, MP--. Damn! Miles per SECOND. OK, if a train leaves the station traveling northbound at 600,000 MPH, toasting clothes and trees in its wake, how many miles will it travel in a second? Um. 600,000 miles divided by the number of seconds in an hour, right? This seems familiar. Um. 600,000 / 3,600 = 166.67 MPS. Is that right? If I take 6 times 16, that’s 96, close enough to 100 (being one second) and then 10 times 16 is 160 … OK. Rough check correct. So the, what were we talking about? Thermal radiation, right – yeah, in less than a second it would fry everything around me. Damn. “On second thought, Thelma, here, you hold the camera. I’ll get my own beer.”

There would be a touch of seismic activity, of course, but I’ve ridden out a 7+ before. Let’s see what this would do in light of being 10 miles from the epicenter. I would feel it at 3.22 seconds after impact. Not bad. Would still be locked into the drop-and-roll thing to put my clothes out – or laughing my ass off as Thelma did it as I watched comfortably from inside with cold beer in hand. Richter 6.9 – pussy strength. What does Mercalli say about damage here? Damage negligible in buildings of good design and construction; slight to moderate in well-built ordinary structures; considerable damage in poorly built or badly designed structures; some chimneys broken. Damage slight in specially designed structures; considerable damage in ordinary substantial buildings with partial collapse. Damage great in poorly built structures. Fall of chimneys, factory stacks, columns, monuments, walls. Heavy furniture overturned. Piece of cake. Except that it followed the radiation thingey. This is beginning to suck. For Thelma.

There will be an air blast, too. Good – time to cool off. Get to me about in 48.8 seconds at 69.2 psi and a maximum velocity of 1,130 mph. Ouch! Multistory wall-bearing buildings will collapse. Wood frame buildings will almost completely collapse. Multistory steel-framed office-type buildings will suffer extreme frame distortion, incipient collapse. Highway truss bridges will collapse. Highway girder bridges will collapse. Glass windows will shatter. Cars and trucks will be largely displaced and grossly distorted and will require rebuilding before use. Up to 90 percent of trees blown down; remainder stripped of branches and leaves. OK, this really sucks big time.

Before we get too depressed, we have to remember that ejecta is going to come. When? Approximately 57.4 seconds after the impact. So Thelma cooks in situ, add a little shake to the bake, turn on the cosmic-sized hairdryer, and then I have to dodge shit?!? How big? Average thickness of 36.5 inches and mean fragment diameter of 14.4 feet. That could hurt. Better go inside – Thelma can take care of herself. Are her clothes off yet? Didn’t mess up my hair, did it? I’m trying to grow it out. Damn!

This really blows. Maybe I should move about ten more miles away.

the doctor is in

OH YEAH, BABY! The doctor be IN! No intro. Straight to the pic – this just came in moments ago. Here you go:

(Hand raised – bouncing in seat.) Pick me! PICK ME! I got it! I KNOW THIS ONE! Know that with no more data! This boy done got the scratch! He been doin’ some ho’s and shit! Been banging and shit with the nasty girls! See where that is, way up along the top part? WTF wrong with this man? He ain’t using no rubber! He be just banging and banging and banging! Dumb motherf—ker. Serve him right. I hope his dick falls off. Stupid motherf—ker out there making it nasty for the rest of us.

Let’s see what this man has to say for himself …

BACKGROUND. (“Background” shit – this man doing ho’s with no rubber. Get the f-ck outta here. Alright, alright. I’ll shut up. Let the man say his piece, lying motherf—ker.) A 52-year-old man (52! You should know better, stupid motherf—ker. Where you head at, besides buried in some ho’s twat?) with no clinically significant medical history presents to the emergency department with a chief complaint of a “rash” on his penis (A rash? A RASH?!? You dumb motherf—ker, that be the scratch and you know it! You trying to get free medical or sumptin? F—cking lying piece of sh—t you be.). The patient states that the rash first appeared 1 week before presentation. He denies any dysuria, urethral discharge, pruritus or pain in the area of the lesion. This is the first time he has had such a rash (lying piece of shit, you be lying like a motherf—king rug). He admits to having had several recent sexual partners(ho,ho,ho, motherf—ker wit no rubber).

On physical examination, his vital signs are normal (you check for a brain?). The patient has a well-demarcated, ulcerated lesion (always is) on the ventral aspect of his penis (see Image). The lesion is not tender to palpation (never is). No other lesions are noted (better hope not, mofo, else that dick be falling off!), and no discharge is observed from the urethra (just wait.). The findings of his testicular examination are unremarkable (“Hey baby, whachu doin after work? Maybe you and me go steppin’ out. I gots some blow with your name on it.” "Not with that dick you ain't steppin' out wit nobody like me."), with the exception of bilateral prominent inguinal lymphadenopathy (that means sumptin be big down there that ain’t aposta be big, like Swollen Nut Syndrome. This stupid motherf—ker be sick!). The remaining physical findings, including the cardiac and abdominal findings, are unremarkable.

What is the diagnosis, and what empiric treatment is necessary? (The boy gots the scratch. Give him some penicillin and a handful of rubbers. Better check him for The Drip and Crabs. I hopes he’s gots them all. Serve him right. Dumb motherf—ker.)

(I’ll just let the answer run. I don’t care nuttin for this jackass.)

ANSWER. Primary syphilis: Syphilis, an infectious disease caused by the spirochete Treponema pallidum, is usually transmitted by means of sexual contact; the usual route of transmission is the skin or mucous membranes of an uninfected sexual partner coming in contact with the mucosal ulcerations (eg, in the genital area, mouth, or anus) of an infected partner.

In the United States, the rate of primary and secondary syphilis declined by 89% from 1990 to 2000; however, in November 2005, the Centers for Disease Control and Prevention (CDC) reported that the number of primary and secondary cases of syphilis had been increasing, from 2.6 cases per 100,000 population in 2002 to 4.7 cases per 100,000 population in 2004 (an increase of 87%). This rise was partially attributed to increased rates of infection among men who have sex with men, who in 2004 represented 64% (up from 5% in 1999) of all cases of primary and secondary syphilis in the United States.2

Primary syphilis manifests as a nonpainful ulcer (chancre) at the site of infection. The lesion is usually on the genital area, but it may also occur on the lips, tongue, cervix, or anus of the infected person. This lesion usually develops within 3-4 weeks after infection, but it may occur as long as 3 months after. The primary lesion spontaneously heals in 3-7 weeks, and it may go unnoticed, especially if it is on the cervix or anus; therefore, infected individuals may not realize that they have an infection. Unilateral or bilateral regional painless lymphadenopathy is also a characteristic finding of primary syphilis.

Secondary syphilis is the next phase of the disease, developing 4-10 weeks after the primary lesion appears. This phase is marked by nonspecific systemic complaints, such as fever, headache, fatigue, and lymphadenopathy. A characteristic rash that consists of round, discrete, nonpruritic macules on the trunk and proximal extremities and penny-sized, reddish-brown sores, appears on the palms, soles, scalp, and face in this phase. These sores may coalesce to form highly infectious lesions called condylomata lata. Symptomatic secondary syphilis also spontaneously resolves, and the disease then enters a latent period where few if any symptoms are seen; the latent phase is divided into “early” and “late” periods. Symptoms may recur in the early latent stage (during the first 2 years of infection). The disease then goes into the late latent phase, when patients remain asymptomatic and noninfectious.

About one third of patients with primary syphilis develop a form of the disease called tertiary syphilis, which is a chronic inflammatory process that progresses over years and decades and results in varied symptoms and physical findings, including mental illness, blindness, heart problems, and eventual death. Cardiovascular syphilis can cause devastating damage to the heart, including aortic endarteritis with medial necrosis and aneurysm formation. Gummatous syphilis manifests as coalescent granulomatous lesions affecting the bones, joints, skin, or almost any part of the body. Finally, symptomatic neurosyphilis can lead to meningitis, brain parenchymal infection, endarteritis, or stroke.

Standard treatment for primary syphilis or for syphilitic infection <1 year after exposure is benzathine penicillin G 2.4 million U given by intramuscular (IM) injection. Alternate regimens for patients allergic to penicillin are a 2-week course of doxycycline 100 mg given orally (PO) twice daily (BID) for 14 days, tetracycline 500 mg PO 4 times daily (QID) for 14 days, or ceftriaxone 1 g given IM or intravenously (IV) once a day for 8-10 days. A recent study also demonstrated efficacy with azithromycin 2 g PO as a single dose; however, the authors suggested caution in applying this finding to patients in the United States, because the trial was conducted in a geographically limited area outside of the US, and because macrolide resistance has already been demonstrated in the US.1

If the patient was infected for >1 year at the time of presentation, benzathine penicillin G (2.4 million U IM once a week for 3 consecutive weeks), or doxycycline for 4 weeks is recommended. Neurosyphilis requires treatment with aqueous crystalline penicillin G 2-4 million U IV every 4 hours for 10-14 days. Patients with neurosyphilis should also be followed up every 6 months for 3-4 years for cerebrospinal fluid (CSF) and serologic testing.

Given this patient’s allergy to penicillin and current social situation, he was treated with azithromycin 2 g PO instead of a 14-day course of doxycycline. The ulcerative lesion was swabbed and sent for darkfield microscopy. Rapid plasma reagin (RPR) and Venereal Disease Research Laboratories (VDRL) serum studies were also ordered. A urine sample was sent for Neisseria gonorrhoeae and Chlamydia polymerase chain reaction (PCR), and the patient was counseled about concomitant sexually transmitted diseases (STDs), including HIV. He was referred for HIV testing and given a fast-track follow-up appointment for the laboratory results.

i be a doctor!

One thing I love about the internet is that you can be anybody you want to be. I don’t mean like the 58 year-old perverts that pretend to be teenagers “just looking for someone to talk to, that might like me for who I am” (ironic, eh?) For those guys, I laugh my ass off when they show up in Denny’s parking lot with a case of Viagra and case of condoms, big jar of body lotion, rope, and video equipment, get busted, and say, “I was just showing up to tell her how dangerous it is to meet people on the internet.” “Tell her”? More like, “Show her,” eh Perv? I know a lot of guys in prison – mean guys – piss-your-pants-when-they-walk-in-the-bar-and-glance-your-way guys. All Perv gets there is, “You better lather up bobo good in your mouth, so it rams more easily into your ass.” Ah, poor baby!

So anyway, I got all these sites that somehow or another – for the life of me I don’t know how or why think I am a doctor! I mean, go figure, eh? Me? A doctor? I went to law school. Don’t need no job where I have to put my finger in someone’s ass. I’d rather clean out their wallet without touching their privates, thank you very much.

One site that thinks I am a doc is eMedicine.com. Every once in a while I get these case studies e’d to me. They call them … wait for it … “eMedicine Case Studies.” Now there’s a large dose of marketing angle all bundled up into a catchy name.

So this latest one is called, “A Toddler With Fever and Abdominal Tenderness.” I get pics and facts, and have to guess what the problem is. I get a hint, too! A hint? WTF? Doctors get hints? Can you imagine me in my law office, “Sounds like you have a big issue here. You may have a case. Can you give me a hint as to what kind?” Must be nice to work in a profession with hints …

So we get three pics, X-Rays it seems to me, an untrained-yet-apparently-licensed doctor. Let’s look at the first one.


Ah, we have the word, “Upright” and the letter, “R” on it. Must be clues. Tucked away on the upper-right side (you may need to click the pic to see it larger), it reads, “Abdomen with Upright.” Hmmm … abdomen with upright. “Upright” must be a thing. Like, “Abdomen with Dog.” What’s an “upright”? Maybe it’s a tool of some kind, a doctor tool. This is interesting! What’s this?!? Below the tool name it reads, “8/31/2005.” This X-Ray is old! How can I do my job with old information? No wonder MedMal rates are so high. They use information that is over two years old to diagnose something in my in-box today! I am appalled! I might resign from the Medical Board! Send a nasty letter to the Chief Whatever They Call Him or Her at the hospital. It is to laugh. Fine. You know what? I will persevere in the face of adversity – in the face of incompetency – and solve this case. Let’s look closer at that X-Ray thingey.

Seems kinda hollow up top. That’s weird. Might be a problem. Better write that down. “Patient presents hollow top as she/he holds Upright tool.” Making progress.

The kid seems all kinda milky white in the lower half. Marked difference from the hollow top. “Patient presents half-full lactose container in lower half as he holds Upright tool.” I like being a doctor! I’m like really good at it.

Now, in the milky stuff (I’ll try to keep the technical jargon to a minimum. You’re welcome.) there seems to be holes, and then something pointing at them. See it? Left to right. Holes. What could the holes be? Think outside the box, Dr. Clyde. Think, think, think. Maybe they are not holes at all! Ah ha! Maybe they are not holes at all! Maybe, now follow me here, maybe they are the opposite of holes! Like something Stephen Hawking would say about something in space: Maybe the holes are actually the substance! They are like balls and that pointy thing is a cue stick! I GOT IT! The kid is a problem masturbator and he’s playing pocket pool!

Ta da! Case solved. I am soooo good at this doctor thing.

Wait. Can’t rush into a diagnosis. Let’s count the horizontal thingeys that look like spare ribs. Well, I see … ok … one minute. OK, well, the kid could still be playing 9-ball, but if he’s that into pocket pool his dick is pretty high up there. Whoa, Nellie, this boy must be hung like a horse!

We need more data. Let’s go to the 2d pic.


Looks like the milk spilt. Just can’t get good techs these days. Amazing. There’s that pool stick again. Look at those things standing up at the bottom, running the full length of the X-Ray. “Patient presents sticky things,” no wait, “stick-like th—“ snap Damn! Pencil broke. One sec. OK. “Patient presents a series of apparent hard substrate thingeys that resemble rowing boat oars along the entire length of X-Ray. NOTE TO STAFF: Be sure the spilt milk is cleaned up. It’ll stick to somebody’s ass in a day or two and that is all I need is to stick my finger into a sticky ass.”

What else can we learn? Well, if you turn it 90 degrees CCW, it looks like a clown with a stick in his eye. “Note to self, get milk and bread on the way home.”

OK, that’s all here. Last pic coming up.


What the hell is that? Looks like something you’d see in war room of a 3d world country as it is planning an invasion of the neighboring country’s rice paddies. Must be misfiled. Let’s move onto the facts they give us.

“BACKGROUND” (That’s a good way to start. Maybe this will explain how we got the rice paddy picture in with our medical files.)

A 14-month-old boy is brought to the emergency department (ED) (ED? Erectile Dysfunction? You see, they’re thinking a “pocket pool” diagnosis, too) by his parents for an evaluation of persistent fever, vomiting, and diarrhea that has lasted for 3 days. (The kid’s barely a year old, ralphing for three days, and now you bring him in? Where’s Social Services? Do that hall? 3d door on right? Thank you.) The mother states that the child was examined by his pediatrician 2 days before (likely story. CYA. lying bitch.) this presentation for a “viral illness“; however, the child has appeared increasingly ill since then(I’m sure he has, ma’am. Let’s take a look. Oh, I think those folks with the clip boards and hemorrhoids want to talk with you.). He has become irritable, and he has been minimally active and feeding poorly. He has had a normal stool output and appearance, as well as normal urination frequency. The parents deny (deny, deny, deny, white trash) observing a runny nose or any coughing, wheezing, or stridor in the patient. The child lives at home with his parents, he is not in day care, and he has had no contact with people who are sick. (More like, “No contact with the outside world so we can watch him puke for three days.)

On physical examination, the boy is crying, fussy, and poorly consoled (that’s because he doesn’t have the speech skills to say, “get me the fuck out of that house! They’re crazy). His vital signs include a rectal temperature of 101°F (38.33°C) (you see, docs are all “rectal” this and “rectal” that – no thank you), a respiratory rate of 32 breaths/min, a blood pressure of 98/56 mm Hg, and a heart rate of 168 bpm. His oxygen saturation is 100% while he is breathing room air (as opposed to the closet air he breathes when Jim-Bob and Thelma-Lou go bowling?). The patient’s weight is 22 lb (10 kg). Palpation reveals diffuse abdominal tenderness without rigidity or guarding. The patient has diffusely hypoactive bowel sounds (I’m telling you, that ain’t no bowels – it’s a pool table). His stool is negative for occult blood. The rest of the physical findings are otherwise unremarkable (except for the fact that his 14-month old dick is longer than his left leg).

Conventional abdominal radiography and computed tomography (CT) scanning are performed (see Images (yeah, thanks, did it. including the misfiled one.)). The laboratory investigation reveals the following results: white blood cell (WBC) count, 19.4 × 109/L, with a predominance of neutrophils; hemoglobin, 8.4 g/dL; hematocrit, 26.6%; platelets, 310 × 109/L; sodium, 136 mmol/L; potassium, 3.8 mmol/L; chlorine, 105 mmol/L; CO2, 20 mmol/L; blood urea nitrogen (BUN), 6 mmol/L; creatinine, 17.7 µmol/L (0.2 mg/dL); and glucose, 4.1 mmol/L (73 mg/dL). The urinalysis shows trace ketones, but the results are otherwise normal. (I learned a long time ago that if Word underlines something in red, it means that it isn’t important. About half this paragraph is underlined – so just ignore it.)

What is the diagnosis? (Problem masturbator with abnormally large dick.)

“HINT” (Here we go. The cheating profession.)
The patient’s symptoms developed approximately 2 days after the mother dropped a box of pins on the carpet at home. (Social Services!!!)

A “hint”? You call that a “hint”? Why not give a map to the treasure with a big red X on it, a geo-thing-a-ma-bob that tells you where you want to go, and a fist full of McDonald’s coupons?

“ANSWER” (Well, this oughta be incredibly reduncant. See “hint.”)
Appendiceal perforation by a foreign body (a pin) (oh!): A foreign body was easily apparent on conventional abdominal radiographs in the right lower quadrant (it’s a pocket-pool cue stick, thank you very much). CT scanning (I didn’t see no CT Scan. They hiding information?) of the abdomen and pelvis revealed a radiopaque pin and a multiloculated fluid collection at the level of the L5 vertebra. The prominent bowel loops superior to the pin likely represented focal ileus. (Those last two sentences are all underlined in red by Word – meaningless.)

Ingestion of foreign bodies is relatively common among pediatric patients, who account for approximately 80% of cases. Most objects pass spontaneously; only 1% of all foreign body ingestions require surgical intervention. Among adults, foreign body ingestions most frequently occur in patients with psychiatric disease or in those with a potential secondary gain. (That’s a good story.)

Management of cases of foreign body ingestion depends on the type of object ingested. (Duh!) The objects most commonly ingested are coins, buttons, parts of small toys, pins and thumbtacks, and disk-shaped batteries. For known ingestion of nontoxic, smooth, or small objects, management is conservative because approximately 80-90% of these foreign bodies spontaneously pass though the GI tract without causing harm.

Initial radiographic localization and serial abdominal radiography should be performed every 24-48 hours (and people wonder why insurance rates are so high – Swallowing a pin: $2.00 a dozen. Two X-Rays: $795.00. Taking a picture of my shit as it flows through my system every one to two days: Priceless!) to monitor the progression of the object until it is passed in stool. Foreign bodies may lodge at any site in the GI tract, but most often they lodge at anatomic sphincters (sounds like something that would invade Earth), sites of previous surgery, or areas of narrowing or acute angulation, where they tend to cause obstruction or perforation. The esophagus has several sites of potential obstruction (yadda, yadda, yadda – does this ever end?), and perforation at these sites is a particular concern because the rates of related morbidity and mortality are high. The complications of foreign bodies in the esophagus include mediastinitis, lung abscess, pneumothorax, and pericarditis. (red, red, red) Approximately 90% of foreign bodies that reach the stomach pass through the remaining GI tract. Most smooth objects pass within the normal bowel transit time.

(OMG, Shut up already!) Because of the high risk of intestinal perforation, urgent intervention is indicated for all patients who have ingested a long, thin, sharp, or stiff foreign body that fails to progress through (oh wait, I can shut them up! I forgot.) …

So what did they do for the problem masturbator?

A laparotomy, drainage and excision of an intra-abdominal abscess, as well as an appendectomy and removal of the foreign body, were performed. The appendix was 4.3 cm, and a metallic pin was found piercing the bowel wall. The histology revealed acute serositis with fibrinopurulent exudates in the lumen and on the serosal surface of the appendix.


YOW! They took out the boy’s gizzard! Damn! And they got his Pocket-Pool Cue Stick, too! I always wondered what those things looked like. Neat.

stupid is as stupid does

I had a transient ischemic attack about a month ago. The prognosis for something bigger hitting for me is termed "moderate." There are only three categories for future big ones as predicted by a TIA and its aftermath: Naw; Probably; and Brace Yourself. I'm in that middle one.

It is interesting to me to watch myself now. I am in a period of aftermath declination as I write. It comes and goes. Ordinarily, I am focused and ready for whatever life feels like kicking me with today. Then comes the wave. I feel it settle over me like a wool blanket. My typing just sucks - missed letters, slowly typed, reversing letters constantly. I am forever going back on the post and correcting stuff.

I also can't seem to type without speaking the words. That is really annoying. My physical movements right now are greatly slowed. My balance isn't good.

I think of the next thing that I want to type, and by the time I start, I remember only the first two or three words. Sometimes that is enough to spark the thought back to life. Other times, I have to bail.

What I observe most in these times is my inability to recall virtually anything. It is profound in its scope. If I want to remember something that happened this morning, yesterday, or, God forbid longer ago, I have to stop all of my physical activity and let pictures come. If I concentrate, I get nowhere. If I think around a memory, then a picture comes. I stare at the picture, and then a second more comes or that first one goes 3D for me. Then I get the time and place of the memory, but still, few specifics.

What I have learned is that when this hits, I need to just sit and push away as much stimuli as I can. I have been dealing with this - do you call it an episode? - for about two hours now. My daughter has a friend over and we were watching the Yankees. I couldn't handle the low level of conversation between them without getting frustrated. I had to block as best I could the announcers, too. What happens is I have to think to interpret the words, and that thinking precludes further listening, so I fall behind. I just got up several times to be alone, to blank my slate, then I was able to go back ... for a little bit!

I have to move my hands and arms slowly as I sit here. That was not so much a lesson, but merely a limitation. I can't seem to move them quickly, and something inside says that it would not be a good idea anyway.

It is all rather peculiar to me. It is much more fun watching myself like this, and following my brain around, than it wouldbbe to watch a loved one go through it. At least this way, I have a good measure of intellectual curiosity that I can satisfy. It is just no fun watching someone else when they can't tell you in any detail what is happening.

They termed it a TIA, but most of those resolve completely. Mine has not. This period I am having right now occurs a few times a week. It was two or three as often before, so maybe there is some measure of resolution occurring.

I am out of words.