I Knew It!

Hey, did anyone see the story on the news the other day about Face Blindness? I've been joking for years that my inability to recognize people out of context was really a neurological problem. Turns out I was right!

There's an actual medical condition called prosopagnosia, in which people are literally unable to recognize others' faces. People who have the most severe form don't even recognize their loved ones. They rely on voices, hair color, mannerisms... but shown the faces of their own children, they won't know who those kids are!

The condition can be caused by brain injury, or a person can be born with it. It also tends to run in families, although not everyone will be affected equally.

Want to know more? Here's a link to the Prosopagnosia Research Centers, based at Harvard and at University College London. The "Research" page has links to TV news stories and newspaper articles about Face Blindness.

p.s. Here's a cool self-test for recognition memory, including facial recognition. I scored above average on verbal and object recognition, but slightly below average on faces (although nowhere near prosopagnosia level). See? I knew there was something medical going on!

Times Flies

....and, it's July.

Last time I checked in was, what, March?! Road to you-know-where and good intentions...

So tonight, I thought we could talk about time. What I'm about to tell you is still very much in the research stages, so don't go getting ideas that it's definitely true. I just thought it was kind of cool, and a neat jumping-off point for a science fiction tale...

This comes from Virendra Desai, an undergrad at UPenn. She studied the effect of aging and of brain damage on people's perception of time. I'd once heard that as we age, time seems to "speed up" due to changes in the nervous system--a nice excuse for my having been incommunicado for FOUR MONTHS when I promised monthly blog updates. Unfortunately for me, Desai's older subjects perceived time just the same as her younger ones, so there goes my excuse.

What Desai did find out is that damage to the parietal lobe of the brain can mess with time. When an image appears on a computer screen for five seconds, normal people can guess pretty accurately that it was five seconds. The brain-damaged person thinks it was ten. Fifteen seconds seems like thirty, and so on. Basically, something in the damaged brain tissue causes the person's internal clock to speed up.

Pretty cool, huh? Would someone with this condition get impatient more easily than a normal person? Would they be able to get their work done twice as fast?

Teenage Confidential

Quick post--

I hear that a recent Gray's Anatomy featured a teenage girl brought in to the clinic by her father, who wanted a woman doctor to teach her about menstruation. The scene where the doctor tells the dad that the daughter is having sex? Wouldn't happen. Well, might happen, but shouldn't happen. Anything a minor tells a doc that has to do with sex and reproduction is confidential. Confidential!!

Frostbite

I just got home from a Preventive Medicine conference in Miami. The weather in Florida sure was gorgeous--high 70's, blue skies--but I gotta say, I'll take New York City any day. I love our hundred-year-old buildings and crowded streets. And how do folks in Miami make do without the subway?

Since it's winter, at least up here in the north, I'll make today's post about frostbite. Did you see the article about the guy up in Minnesota who decided to run around in the snow during the Super Bowl half time? He's a quick lesson in what happens when you walk barefoot, outdoors, when it's seventeen below zero. Yes, seventeen below. Check out the details at msnbc.

At least the folks at the University of Minnesota have a clue about the dangers of extreme cold. You can read about frostbite prevention and treatment at the U of M Children's Hospital's web site.

Want to know what frostbite looks like? You'll find a smattering of pictures on Google images.

Happy New Year!

Wow, it's been a while since I've had time to attend to this blog. I've only got a minute today, but here are some things I have planned for the coming year.
*What's right and wrong on your favorite medical TV shows
*Translations of common medical terms
*More medical information you can use to make your characters sick and get them healthy again.

Check back monthly to see what's new.

P.S. Suggestions and requests are welcome. If it's something simple, I'll try to answer it here. More in-depth help is available for a writer-friendly fee. Drop me a line at thefictiondoctor@yahoo.com and let me know what you need.

Hot enough to fire pottery on my desktop

Whew! I forgot about NYC heat waves. It hit 101 degrees today, and I finally broke down and got an air conditioner. I feel like I should do some kind of penance for adding more strain to the grid, but my brain was baking and I just couldn't take it anymore. Mayor Bloomberg, I promise to keep it set no lower than 78 degrees and to turn it off when I leave my apartment!

So this seemed like a good day to talk about heat stroke. Maybe your heroine just parachuted into a remote area of the Sahara. Let's see... perhaps she's a saleswoman for Victoria's Secret and some non-English speaking guerilla group got that confused with other kinds of secret. Like the Secret Service. So our gal had to jump out of a hopelessly damaged plane, the only survivor of a missile hit (so much for the supermodels), and now she's on her own with nothing but a bag of Body By Victoria bras...

Here's what she's in for as she tries to cross the desert:
*First, she'll sweat heavily. Without water, she'll soon start to feel faint and maybe nauseated.
*After a day or so in the burning desert, she'll stop sweating. Her skin will feel hot and dry.
*She won't be able to think clearly. Instead of resting in the shade, she might decide to march all day in the sun.
*Her heart will pound and she might have trouble breathing normally.
*If she doesn't get help, she'll faint. And if she isn't rescued (which of course she will be! happy endings, people, please!) she'll die.

So there she is, passed out in the sand, only a few hundred yards from a hidden oasis--if only she knew. Luckily, a handsome, dashing archaeologist, who's knowledgable in the ways of the desert, happens to be passing by.

Here's what he'll do:
*He'll rig a temporary shelter to get her out of the sun.
*He'll cover her with damp cloths. (Or maybe he doesn't have any cloths. Hey, a use for all those bras!)
*He'll use a valuable papyrus to fan her, helping the water to evaporate and cool her skin.
*As she begins to wake up, he'll encourage her to take sips of cool water (because in the wilds of the desert, it's hard to rig up an IV).

Of course, they'll fall in love and live happily ever after. Or not. That part is up to you!

Ok. Time to get back to my actual work, the stuff I get paid for. Stay cool, everyone!

Docs and Dark Humor

Greetings, all! It's Sunday, and I'm sitting at my computer here in Manhattan, watching the rain come down. I was supposed to go camping this weekend, but the Weather Channel foiled my plans. They were prediciting Armageddon out there, five and six inches of rain with severe thunderstorms and major floods. As a doc with wilderness medicine training, I decided it would be foolish to head out with that sort of weather on the way. Well, actually, I decided it would be embarassing to get caught out in it, get hit by lightning or washed away in a torrent, and wind up on the front page of the newspaper. I could just hear fellow camping enthusiasts going "that idiot, should have known better..."

So here I am at home, watching what's little more than a light drizzle, no thunder or lightning, sun peeking through now and then, and I'm thinking evil thoughts at the meteorologists.

Anyway.

Since I'm in a dark mood, today's post will deal with dark humor: the painful, even cruel, things that make docs fall over laughing.

It starts in med school. Everyday activity and conversation deal with things you'd never imagine saying or doing in the ordinary world. When reviewing for exams in the local coffee shop, one's anatomy textbook invariably falls open to the pages on penises. The shape, smell, and quantity of feces--important in diagnosing certain digestive problems as well as some cancers--becomes a topic of dinner conversation.

And then there's anatomy lab. Death ceases to be a frightening mystery and becomes a part of daily life. And nothing can remain sacred when you deal with it every day, not even a corpse. Confronted with the visceral horror of severed limbs being carried past on the way to the sink for a good rinse... it wouldn't be cool to shrink away or cry. It's not macho to run away screaming. Remaining silent somehow doesn't seem an option. And so we laugh.

We laugh at each other. We assign psychiatric diagnoses to ourselves, our friends, our teachers. We laugh at our textbooks. We make fun of the writing, the photos, the descriptions of microscopic findings and major diseases. And we laugh at our patients. "He said what?" "You won't believe what this guy did." We even give them nicknames. I still giggle every time I see a garden gnome.

After med school? It just gets worse.

If you've never worked in the medical field, I doubt you can imagine some of the things we laugh at--or why we think they're funny. Sometimes I get up from rolling on the floor with laughter and think, "my god, I can't believe I find that amusing."

Want a better idea of what makes doctors pee our pants? Check out the Placebo Journal, a monthly mag created by a doc and filled with contributions from doctors, dentists, nurses, paramedics, and other health professionals. Just remember: it's for us, by us. Don't come after me--or them--if you're offended. It's not that we don't care about you, or that we take disease and suffering lightly. It's just that laughing is what keeps us sane.

Urban Legends and Other Hoaxes

I'm all moved in to my new place in New York! The boxes are unpacked (well, all except for that one in the corner), the kitchen organized (except for the fact that I can't reach anything on the top shelves), and the curtains up (although later today I have to see about hanging blinds, because I'm not QUITE sure my sheer white curtains aren't transparent from the outside). In general, though, I'm now officially a New Yorker!

Now, on to those medical "facts" that are floating around the internet and shared at dinner tables everywhere.

How can you tell if a medical story is true or just an urban legend? Should you believe that e-mail from your best friend's mom? What about the story you heard from your neighbor, or the medical disaster that supposedly happened to your co-worker's cousin? I know of two web sites that do a great job of tracking modern myths. They print the original e-mail, article, or story and then reveal what is or isn't true. Both sites cite their sources, so you can double-check their research.

When I get one of those "health warning!" emails, I usually turn first to the Urban Legends page on About.com. I almost always find the story I'm looking for, along with a well-researched response. I've noticed some lower-quality entries lately, with information I felt the need to double check--but since the articles offer links to other reports and experts' sites, About.com is still a good place to start.

Snopes.com is maintained by a husband-and-wife team who've made it their mission to track and investigate urban myths. The site owners check the stories' validity and provide all their sources at the end of each article. The site is extensive, and the writing is good and usually feels balanced. If there's some truth to the story, Snopes.com will let you know.

Scambusters.com, which publishes a free newsletter on internet fraud, also has a section on Urban Legends. The site claims to tell you if a story is true or not. It's a fun place to visit if you're curious about what's out there, but the entries are brief and no sources are given.

By the way, in case you were wondering... No, you're not likely to contract necrotizing fasciitis (flesh-eating bacteria) from imported Costa Rican bananas. Yes, there actually is a reported case of someone dying as a result of eating outdated pancake mix. It's in the September, 2000, issue of the American Journal of Forensic Medicine and Pathology. As for the rumor that deodorant causes breast cancer... the truth is, researchers aren't quite sure if there's a connection, or what it might be. Check here for the National Cancer Institute's take.