Category Archives: The Barbarous Craft


A public apology

To my nonagenarian patient:

Ma’am, when you asked me, “I want to know how long I’m going to be here,” I truly believed you were being existential. Hence my shocked reply, “On this planet?”

It’s not my fault. You were my third GOP* for the afternoon, and I didn’t think I could be that unlucky.

Back to work on the Thursday Thirteen, folks, or what may soon be the Friday Fourteen.

D.

*Grumpy Old Person. Like the fellow today who, in reply to my usual opening question, “What can I do for you today?” said, “I don’t know. What can anyone do for me anymore?”

Friday Flickr Babes: nude, of course

Untrusting, originally uploaded by Delerina.

Dean, I think you’ll like Delerina’s portfolio. Let me know.

I would like to take this opportunity to alert you to an overlooked health problem that afflicts roughly 50.5% of the general population: PSAS — Priapic Sleep Arousal Syndrome. While REM Sleep Behavior Syndrome (violent physical outbursts during dream sleep) has a more dramatic presentation, it is still an uncommon condition. Priapic Sleep Arousal Syndrome, on the other hand, can strike anyone burdened with unsatisfied erectile tissue.

Extreme cases are easily recognized (pdf):

His wife also reported episodes of amnestic sexual behavior that began 4 years before referral. During the episodes, the patient typically procured his wife, achieving complete sexual intercourse with total amnesia. Episodes of sexual behavior during sleep occurred once a month. His wife remained in bed with him after the episodes. The patient did not consent to being videotaped.

The 50.5% figure may be an underestimation by nearly 100%, as erection during REM sleep (dream sleep) is not limited to men.

A man experiences penile erections; a woman experiences clitoral engorgement.

Priapic Sleep Arousal Syndrome: a silent killer!

Prevent Priapic Sleep Arousal Syndrome!

Fuck Your Spouse Today

D.

A memory without pain

Flickr Blogging explained.

Let every man in mankind’s frailty
Consider his last day; and let none
Presume on his good fortune until he find
Life, at his death, a memory without pain.

-Sophocles, Oedipus Rex

I wonder when we started dying in hospitals. Not by accident (we’ve been doing that, I’m sure, for as long as we’ve had hospitals), but by intention.

All four of my grandparents died in hospitals. My mother’s brother died alone, his body undiscovered for a few days; that’s even worse. But I’m not sure it matters where we die. Dead is dead, right? And yet, like many people, I play with the fantasy of dying in my own home with at least one loved one by my side.

Anyone in medicine can tell you stories of patients’ last days. Nearly all of the terminally ill grab for that desperate last chance — salvage chemotherapy, anyone? — rather than admit to the inevitable. Many times during training, my senior residents and my attending physicians would, when presented with one horrid diagnosis or another, say, “Someone should give him a one-way ticket to Hawaii and tell him to stock up on good booze and strong narcotics.”

Today, I finally met someone who decided to go to Hawaii.

He’s coming back, he says, and when he does, he’ll take that last stab at radiation therapy. But dammit, he’s going to enjoy Hawaii while he can. Radiation can wait; he’s gonna live.

I’m sad about his diagnosis, but I’m happy for him. Somehow, I don’t see this fellow dying in a hospital.

D.

Innards

First things first. Anyone undergoing major surgery* needs to set his affairs in order. I took care of it this morning.

Next, a brief video explanation of the problem.

And finally, photos from the procedure . . . below the cut.

(more…)

Thirteen operations

Quite apropos, don’t you think? I’m surprised I’ve never done this before. Gott in Himmel knows there must be at least thirteen interesting operations.

Yes, I realize it’s Wednesday, but as I’ve mentioned before . . . somewhere in the world, it’s Thursday. Consider this a preemptive strike. And yeeessss I know it’s Halloween, but I don’t have it in me this year. If you really, really need a Halloween post, here’s my Hellraiser compendium from 2005.

In any case, some of these operations are pretty damned scary.

(more…)

Turnabout

This Friday, I go under the knife. My umbilical hernia is back, and I thought it would be wise to get it fixed before we have to call 911. I suppose I shouldn’t be nervous about this; it’s a minor procedure, day surgery; I’ve known this surgeon since ’98, and I have confidence in him. But it seems like health care workers are magnets for mistakes, and I’m no exception.

Take that first umbilical hernia. My previous surgeon (whose technique was lacking, but who cares — she was cute) didn’t use mesh, and that’s why I’m in this predicament. If you repair a hernia using mesh, the failure rate is 1 in 1000. If you don’t, it’s 1 in 5 (I hope I’m remembering that right. It’s a BIG percentage, anyway).

Back in 2000, though, that was the real screw-up. I woke up with a headache, one of those “worst headache of my life” headaches they warn you about in med school (you’re supposed to think: bleeding aneurysm, brain tumor, etc. etc.), a headache that laughed at aspirin, ibuprofen, and whatever pain med my wife was using at the time. I called my physician and he told me to go to the ER to get a lumbar puncture. At that point, I was feeling crappy enough that if he had told me to lie down on the railroad tracks, I’d have done it. By comparison, a spinal tap seemed reasonable.

(more…)

Salt pork. No, really.

I’ve written about nosebleeds before, but not in any helpful way. Since Dan wants a post on nosebleeds, and since I’m easy, here it is. But read my disclaimer first.

(more…)

Tonsillectomy redux

I feel like the publisher of Playboy. While most of my hits come from this cleavage photo or that J-Lo butt photo, occasionally rarely, newcomers are here to read things. In response to last year’s post on tonsillectomy, KC writes,

here’s one for ya…. i used to get tonsillitis a lot as a child. my mom asked the dr. if he thought i should have them removed and he said “No, they’ll probably rot out on their own.” What the HECK? I don’t have trouble with tonsillitis as an adult, but I do have crypts in them like crazy so suffer the dreaded tonsil stones. YUCK. Wish I had them out years ago so I wouldn’t have these nasty tonsil stones to deal with.

What’s up with my doctor saying that my tonsils would rot out on their own?

This was in the 1970’s by the way.

KC, I have an answer for you . . . below the fold.

(more…)

Best laid plans

Just settling down to write a post on tonsillectomy, when wouldn’t you know it: the ER calls. I have to go stop a bad nose bleed.

See ya later. Maybe.

D.

Hell, you don’t need me. CORN DOG IS BACK!

The heart of things

Mi Corazon, originally uploaded by Pinkbell.

Interesting article in the October 12 issue of Science: Matters of the Heart, by A. J. Wells:

Is there any truth in the long-standing association of emotions with the heart, or is it merely the stuff of superstition and myth? “Heartfelt Emotions,” a symposium that brought to a close a program of events supporting The Heart exhibition at the Wellcome Collection’s recently refurbished building in London, explored this question. The symposium included contributions from the exhibition’s curators, heart scientists, poets, writers, historians, psychologists, and a keenly interested audience.

It must have been a delightful symposium, but we can only guess; Wells provides few details of the proceedings. We’ll have to speculate.

(more…)

Next page →
← Previous page