Vivid Language in the Emergency Department

“You need to put her under — deeply — and basically recreate the injury. Don’t be wimpy about it: you have to go medieval on her. There’ll be a nasty crunch as you complete the ulnar fracture; don’t worry about that. Make sure you have the parents sitting down or out of the room.”

Dr. Shadowfax talks about the value of using really vivid, colourful language when giving directions in the ER. Maybe it’s not for you if you’re squeamish, but I enjoyed this post.

Earwax Suction

THIS IS THE MOST DISGUSTING / SATISFYING THING I’VE EVER SEEN.
Man, I loved watching it. The music is so inspirational! And when he gets that tricky one at the end, doesn’t your heart just soar? This video made me so horribly delighted that I had to yell AAAAUUUGGGGHHH the whole time I watched. I want this done so bad.

Via MeFi.

Awake endotracheal intubation

Dr. Michael Bailin performs an awake entodracheal self-intubation (ie, puts a tube into his throat through which a machine will be able to keep breathing for him if he stops).

I’ve had a scope down my throat once (not this deep) to check for vocal nodes, because I performed the voice of a talking televised hamster for a few years and the character’s high-pitched scratchiness eventually took its toll. It was a somewhat unnerving, uncomfortable procedure which I certainly didn’t handle with quite as much rodeo glamour as this guy. I’ve also been intubated for surgery, and woke up with a barking, busted voice, like this guy’s at the end of this video. I think that’s my favourite part, actually, when he goes back to teaching and sounds like a giant teenaged boy. Fun.
Thanks to Greg for the tip.

Nina Arsenault

Nina's the one on the right.

Nina Arsenault is a Toronto writer, performer, fashionista, and media personality who has undergone a whole lot of body modification (60+ cosmetic surgeries) to transition from male to female and to end up looking as… I don’t even know how to put it, as “ultra”?… as she does today. She’s a great writer and I enjoy her blog, particularly the photos.

Here’s a video about her, including some rare pics from when she was living as a male. (Probably a little sexy for most workplaces):

Raised by a single mom

Meg is a med student in NYC whose blog is one of the highlights of the whole wide internet for me, usually because it’s really funny. The other day she wrote a particularly lovely, heartwarming, thought-provoking post about her work in the Neonatal Intensive Care Unit:

I say things that sound important at my job all the time:

We’ve found the mutation that is causing your child’s lung disease. I’ll need DNA from every living relative so we can see who else might be a carrier. I’m sorry. We still don’t know why your baby can’t breathe on her own.

Those are all important-sounding things. And they are, in fact, important things to the family and to the medical team, and there is a lot of science involved and research and papers and that is the reason I can say those words, and that is the reason people care about them.

But sometimes at my job, without anyone’s permission or direction, without any papers in hand or abbreviations or acronyms or any right except a self-imposed one, I say something that feels very, very important to me. It’s this:

It’s going to be okay. I was raised by a single mom, and I turned out just fine.

Go read the whole post, it’s so great. Then add her blog to your RSS feed and get ready for a great post every week or so.

The Caster Semenya story made me wonder about gender* testing.

Caster Semenya is a record-breaking South African sprinter whose times are so crazy good that the opponents she smoked last month claim that her muscular physique and lack of lipstick are indicators that she’s secretly male.

I’ve been following this story with interest, because I think Semenya’s case raises some discussion-worthy equity implications (1, 2, 3, to name a few). And no matter what the ruling is regarding the sport’s determination of her biological sex, the whole issue is being spectacularly mishandled.

Anyway, here’s a fabulous roundup of the history and procedures surrounding gender testing in sports. Turns out sex-verification is more complex than it sounds, and here’s an interactive quiz where you get to examine, test, and then ascribe a sex designation to a fictional, virtual athlete.

* PS, the scientist in me hates using the word “gender” (a sociological term) where I should be using the word “sex” (a biological term). But it doesn’t sound right to say “sex-testing”, that sounds kind of… like… what kind of tests are we doing, exactly, and who’s doing the grading? I’m just saying.

PPS, Whatever. I pretty much conked the scientist in me over the head with a liberal dose of theatre school and a lifetime of snacking on artificial cheez products which are not technically food at all, so her complaints are quite faint.

Phineas Gage walks into a bar…

Phineas Gage was a railway worker who survived an accident that blew a large iron rod through his brain in an accidental explosion in 1848. The subsequent brain injury changed his personality from friendly to belligerent, a phenomenon that challenged the then accepted theory of personality, and opened people’s minds to the idea that the physiology of the brain was involved in personality and disposition.

The above photo- the only known photo of Phineas Gage- was recently identified after being posted on Flickr by its owners, who, not realizing who the subject was, had titled it “One-eyed man with harpoon”. A random internetter correctly identified the photo’s subject in a Flickr comment, supposing that the “harpoon” he held might actually be the iron tamping rod that had injured him. Awesome. Here’s lots of info in a solid post on Metafilter. Internet for the win.

Breathing liquid

You could breathe liquid, if it was the right liquid. Kind of mindblowing.

In order for any fluid to work for human respiration, it has to perform two main functions very well: delivering oxygen to the lungs and removing carbon dioxide. Air obviously does both quite well; so do some other combinations of gases (such as those used in diving). But it’s reasonable to think some liquids may be able to do the same thing

More here. Via AskMeFi.

Foot Model, Part One: The Moldening

My friend James is a prosthetist who makes body parts, either for people who need extra body parts, or for moovies who need extra body parts.

He asked if he could make a cast of my feet, and I pretty much threw my socks off in about 0.05 seconds and screamed HELL YEAH and he was like, well maybe in a few weeks when I have some materials and stuff and I was all yeah, I know, I was just feeling warm in here.

Anyway we finally got around to it. And I documented the hell out of it.
So, for your edification, here is how to make plaster feet!

Basically the procedure is to mold the feet in something soft (in this case, alginate gel). You make a negative mold- basically a hole shaped like a foot- in that material. Then you fill that soft, flexible negative mold with something hard and durable (in this case, plaster) to make the positive model of le foot.

This entry will show part one: the soft mold.
I’ll do the second step later in the week.

First, you need feet! Here are two! They are brown and oddly featureless, like tanned piglets.

I rubbed vaseline all over them to make them slip out of the mold better. This also had the effect of making Maybe The Adorable Boxer Dog desperately want to lick my toes. She stared at me with ridiculous longing, wishing and hoping for just a taste of my delectably oiled tootsies. But I refused and took some crappy grainy photographs of her emotions instead.

Meanwhile, James prepped a mold and mixed up the molding gel, which is called Alginate.

It’s essentially seaweed jello, and it’s pretty much edible (although, ew). You may in fact have tasted this stuff yourself, as it’s used for dental molds. Since it’s food-safe, James used his beer cooler as a container.

He built two little compartments inside with aluminum flashing and some duct tape. Then he poured in a 1-inch layer of alginate and laid in a piece of burlap netting to form a sturdy bottom layer for the mold.

He rubbed my feet all over with cool, gluey alginate, taking care to get it between my toes. This tickled tremendously and I squealed like a small hog and thrashed like a carp in a sandbox.

He covered the netting with another layer of alginate, and then in went my feet, and on went more alginate, until I was buried up to my ankles in cold, slimey, stiffening glue.

Then it was time for some waiting.
We played trivial pursuit while the goo dried.

This is a little chunk of gelled alginate. Its texture is like a cross between silly putty and feta cheese- smooth and flexible, but if you bend it far enough it breaks and some water leaks out.

Within about 20 minutes it was set enough for me to start working my feet loose. James used a popsicle stick to cut the gel away from my ankles, which let in some air and loosened things up. Air squeezing into the miniscule space between a moist jello block and a greased foot feels weirdly like a high-pitched toot, I’m just sayin’.

I wiggled and shifted my feet very gently to help- just hard enough to help the alginate weep a bit of water to lubricate my feet, but not too hard, or the alginate would crumble and the mold would lose detail. A few minutes of wiggling, and we could gently slit the alginate so I could start giving birth to my own feet.

It felt to me like a clean job- I predicted that the alginate hadn’t broken at all inside. If we were lucky, the texture of my skin would be captured in the mold, and in an ideal world, each of my toes might even be separated, creating a very lifelike foot model that could be used to make a realistic-looking prosthesis…. but there’d be no way to tell until the plaster molds were done.

I expected my feet to come out all naaaasty but they weren’t at all. In fact, being rubbed with vaseline then soaked in wet alginate actually left my feet almost perfectly clean, not to mention baby soft and reeeally smooth.

In fact if there was a smoothness competition between my feet and LL Cool J, my feet would kick his butt in the smooth department. Oh crap he heard me.

Well I’m SORRY LL Cool J, but look how smooth they are.

LL Cool J, come on. You can’t argue. Those dawgs are smooth. What? Smooth and adorable? Why, thank you for noticing, LL Cool J. It’s gracious of you to concede.

Oh, yeah, LL Cool J, of course I’ll keep it on the down-low. You’re totally still smooth, guy. The smoothest. We cool?

A’ight, man. Let’s talk later. Bye LL Cool J.

God he gets so defensive. Anyway here’s the cooler with the hollow alginate foot-holes all ready to go.

That brown stuff in the right foot is a little hint of the burlap layer poking through the alginate.

Next step: fill the alginate negatives with plaster, let that harden, then pull off the mold to get the finished cast, or model, of my feeties.

Stay tuned for Foot Model, Part Two: The Sequeling… coming later this week, or whenever I drink enough coffee to write it in a caffeine-fueled evening haze.

Proteus Syndrome

Mandy Sellars, a 34 year old British woman, has a rare medical condition that confuses many doctors, but is most often diagnosed as something like Proteus syndrome (the same condition as so-called “elephant man” John Merrick). The congenital condition has caused her legs to continually and unevenly grow for her entire life.

Sellars’ legs now weigh over 200lbs (not counting the weight of her torso) which causes her mobility issues, ongoing medical complications, and pain. There’s a short print interview with Sellars here, and more photos here and here.

The other woman in the above photo also has PS and has had one of her legs amputated to increase her mobility; Sellars plans to do the same at some point in the future. She’s the subject of a number of documentary pieces, and lives in England, where she helps organize fundraisers for the Proteus Syndrome Foundation.
Via Metafilter.