the fiction doctor

I Knew It!

2007-07-13T20:01:00.000-07:00

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

2007-07-13T19:42:00.000-07:00

....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

2007-03-22T12:31:00.000-07:00

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

2007-02-26T21:20:00.000-08:00

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!

2007-01-01T14:04:00.000-08:00

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

2006-08-02T17:23:00.000-07:00

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

2006-06-25T11:35:00.000-07:00

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

2006-06-10T09:05:00.000-07:00

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.

The Immortal Tom Cruise

2006-05-23T21:44:00.000-07:00

Ok, I know I owe everyone some info on urban legends, but bear with me for a minute, if you will. I've been thinking about the CPR scene in Mission Impossible 3. Anyone seen that movie? The scene where—well, if I describe it I'll ruin it for anyone who hasn't seen it and wants to. So let's just say there's a hilariously unrealistic CPR scene.

I started to write a rant here about just HOW unrealistic it was, and then I thought… well. It was a fun scene in a fun movie, and does it really matter if it couldn't have happened in real life? I'm not sure! It would matter if the writer were trying to be realistic, certainly. Or if they were trying to make a statement about something. But in a big summer blockbuster with giant plot holes anyway...?

My only fear is that some kid will see this scene, which involves an intentional electrocution, and think, Cool! Let's try that! And the filmmakers will have a real-life death on their hands.

Any authors out there want to chime in about this?

Finding Helpful Medical Info Sites

2006-05-20T08:59:00.000-07:00

Good morning and Happy Saturday! Congratulate me--I found an apartment in New York City! It's about the size of a shoebox, but it's home. Or it will be, as soon as I get my stuff packed up and carted over there. I'll be on the Upper West Side, shouting distance from the Fairway Market, if anyone wants to come say hello.

Now, I believe I promised some advice on finding useful web sites for medical information. As you probably know, one problem with the internet is that anyone can post a web site and call himself an expert. A "medical society" with a fancy name might be a group of highly-respected, board-certified doctors... or it might be one person with an axe to grind.

That's not to say that sites started by laypeople are necessarily bad. For example, there are some very smart, conscientious moms out there who've lost kids to cancer or other diseases, and want to help other parents who are going through the same thing. Unfortunately, there are also people and groups spreading erroneous information. Sometimes these folks really believe in what they're saying, even though it's bad science. Sometimes they have something to sell.

Sites run by doctors aren't always that much better. Outdated information is a common problem: medical knowledge changes fast. Some of the sites hire journalists to write their articles, and misinterpretations can creep in. And physicians aren't above making sales pitches, either: some docs make extra money by selling vitamins, medical devices, and other products. There isn't always good research to back these things up.

So how can you tell if a web site's giving you good info?

1. Who's behind the site? Click on the "about us" link and give it a good read. If it's a one-person site, what's that person's background? If it's a group, how does one become a member? For doctors' organizations, does the group certify doctors in a specialty?

2. Is the site selling something? Sometimes it will be obvious: ads for products will be prominently displayed. Sometimes it's more subtle. There are several sites run by plastic surgeons that offer information about cosmetic surgery--but the point is really to sell you on the idea of having something done, not to give you full details. Be wary, too, of "keyword" sites that exist just to get you to click on ads. Some of these sites pay their writers only a few dollars per article, and accuracy tends to suffer.

3. If it's a sales site, are there superlative descriptions or exaggerated claims? If a site tells you that a treatment works for everyone, be suspicious. Look out for words like "incredible," "amazing," and "secret ingredient." Real doctors rarely keep secrets about ingredients that could help people!

4. If it's a purely informational site, where does the information come from? The best medical sites give their sources. Look for a bibliography at the end of each article, or references to studies within the article itself. Quotes from experts are of mixed value. Again, you really need to know where the original information came from. Medical journals, which are reviewed by teams of physicians, are generally considered good sources. Research institutions like the Mayo Clinic are also considered trustworthy.

5. What's the tone of the site? If it's angry or suspicious--"Doctors won't tell you..."--be especially wary. Doctors certainly do make mistakes, and there are plenty of things we could do better. But I've read quite a few of these "angry" sites, and I fear that emotion often clouds people's judgement. The information is frequently based on hearsay and misunderstandings, not on fact.

6. How often is the site updated? Some information is probably ok even if it's old; measles, for example, hasn't changed much over the years. But last year's web page about infertility treatments might already be outdated. A good medical site will keep up with the newest drugs, latest recalls, and most recent discoveries.

Sometimes, the only way to know for sure that a medical site is giving you good information is to have an idea about what's true in the first place. Going to medical school is a good start! Of course, if you don't have four years to spare, you can always drop me a line. I'll be glad to help.

p.s. A doctor named Stephen Barrett maintains a watchdog site called Quackwatch. It's a good place to visit to get an idea of how much questionable medical information is out there. The site is updated only sporadically and Dr. Barrett certainly has his own agenda, but he does a good job of debunking myths and raises red flags about some questionable organizations.

Next time: Medical Urban Legends

Resources: Some Places to Start

2006-04-29T20:11:00.000-07:00

Happy Saturday, all you writers and anyone else who may be reading this!

Here's hoping you've all had a great Saturday evening. I've been looking at apartments in New York City all week and am just happy to be home! BTW, if anyone knows of a nice place in NYC, west side, not too expensive, view out the windows of something other than a brick wall, June 1 move-in...

Ok. Now to the reason why (I hope) you're actually here. This blog is intended to be a resource for writers of both fiction and non-fiction. It's a place to turn when you need a bit of medical insight to make a story ring true.

I added a couple of links to the sidebar today, and I'll add more as I think of them. eMedicine and the Mayo Clinic are my current favorites for medical information written in ordinary language. They cover a wide range of health issues and disease states. Articles are either written or reviewed by M.D.'s and the information is usually up to date. Medline Plus, from the National Institutes of Health, provides links to health-related sites run by reputable organizations. Some of these sites are updated more often than others.

Speaking of which... Out-of-date information can be a problem, both on the internet and out there in the non-virtual world. There's also a lot of info that's erroneous or, worse, deliberately incorrect. It's important to be able to tell when you're looking at reliable info and when you should be skeptical.

Next time I'll give a quick overview of the types of medical web sites--and some ways to decide if you're looking at one you can trust.

Welcome!

2006-04-27T06:12:00.000-07:00

They say you should write what you know.

But where's the fun in that?

Being a writer means you get to make stuff up. You get to invent characters and breathe life into them. You can build houses, design workplaces, even construct planets if you want to. You can write about aspects of life you've never experienced. You can give your characters jobs you've never done.

If you're writing about real-life stuff, though, you'll want to make sure you've got your information right. You'll want your cave explorers to use the proper gear. Your congressman to know some legal lingo. Your doctors to talk like they went to medical school.

That's where I come in.

I help writers get their medical facts straight.

I'll make sure your passionate pediatrician knows her medical terms and how to use them.

I'll save your hero, the world-famous surgeon, from swooping in to do surgery when all the patient needs is a band-aid.

If your dashing detective discovers the patient was poisoned, I'll help you figure out exactly what the killer used--and whether or not the victim would have noticed a funny taste in his coffee that morning.

I can tell you what life's really like in the hospital. What happens in a typical day. What doctors talk about when the patient's out cold in the operating room. I know what's behind the scenes in a country doctor's office and in a big-city practice. And if I haven't been where your characters need to go, I probably know someone who has.

Before you send that medical story off to an agent, a magazine, or a book publisher, check with me.

The Fiction Doctor. It's like malpractice insurance for your story.