Tag Archives: Medicine

Medical Microfiction: Diaphragmatic Aponeurosis

Making New Friends

Nolan had friends. Nolan had loads of friends. 1,224, to be exact.

Whenever he threw parties, he invited all 1,224 of them and received 1,224 RSVPs.

Of course, this always meant one hell of a grocery run. It took Nolan three trips to schlep all the 2-liters of Shasta, cocktail wieners, and pizza bites home in his hatchback.

8PM came and went, but nobody showed.

Later, Nolan brooded over his Facebook list of 1,224 disappointments.

Oh, well. Time to make new friends.

He clicked the “new account” button and got to work on Friend# 1,225. Maybe this one wouldn’t disappoint.

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I’m very excited about today’s medical term, because it’s an anatomical feature I learned about in my Anatomy of Speech class fairly recently. The diaphragmatic aponeurosis, also known as the central tendon, is a strong band of material located in the center of the diaphragm muscle. Together with the rest of the diaphragm, it forms a floor upon which your lungs and heart sit inside your rib cage, and plays a major role in pumping air into and out of your lungs.

The diaphragm. Under surface. Quadratus lumbor...
The diaphragm. The white part’s the aponeurosis. Not pictured: Nolan’s 1,224 friends. (Photo credit: Wikipedia)

While most other tendons in the body connect muscle to bone, the diaphragmatic is unique in that it connects a muscle (the diaphragm) to itself, allowing it to form a roundish shape while still allowing for several large passageways through the middle, so that you can both eat and breathe without the two interfering with one another.

Have you figured out how Nolan factors into this picture?

Much like the diaphragmatic aponeurosis: he only connects with himself.

*Rimshot*

Get it? Get it…? Hey, why aren’t you laughing?!

I hope this finds you better connected than the central tendon, and without a car filled with Shasta. Later this week I’m hoping to have another “Anatomy of a Sentence” feature out, so keep your eyes peeled!

Medical Microfiction: Keratinocytes

The Little Dutch Girl

“We’ll draw straws. Long straws stay. Short fixes the hull.”

“Sounds fair.”

Olga proffered a fistful of sticks to her crewmates. Hal, Zarina, and Ken drew one apiece. There was a sharp intake of breath as they opened their palms.

Olga grimaced. “Guess it’s me. Let’s roll. We’re losing oxygen.” She stepped over the airlock threshold. She scanned the area and gasped in surprise. “Wait. Where are the tools? Where’s my space suit?”

“Sorry, Olga,” said Zarina.

The airlock whooshed shut.

Hal shut his eyes as Olga’s body, distorted by the vacuum of space, plugged the breach in the hull.

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ISS science officer and flight engineer, astro...
When you go outside the airlock, don’t forget your space suit. (Photo credit: Wikipedia)

If I were a cell in the human body, I think one of the most miserable work environments would be the epidermis, also known as your skin. Your skin’s your body’s biggest organ, and one of the most important ones. It keeps the bad stuff out and the good stuff in and represents the boundary between the body and the environment.

Given that important role, it’s still a raw deal to be a keratinocyte, the type of cell that makes up 95% of the epidermis. Keratinocytes are born deep in the basal layer (the stratum basale) of the skin. There they spend a short childhood multiplying before they’re shoved upwards toward the surface of the skin. As they rise in rank, they’re cut off from the nourishing blood supply found in the deeper layers. Eventually they die off and are packed full of keratin, which hardens them and makes them waterproof. By the time they reach the surface of your skin, their dead bodies form a tough, waterproof wall that keeps all the living cells in your body protected from the outside world.

Keratinocytes are born to die. It’s a heroic deed, yes, but still a raw deal. Much like being thrown out of the airlock to plug the breach in the hull.

In case you’re not familiar with it, the title and inspiration for this story comes from an American folk tale called The Little Dutch Boy. In this story, a young boy becomes a hero by using his finger to plug a leak in a dike. Of course, the big difference between the boy of this story and keratinocytes is that the boy got to choose his fate!

Medical Microfiction: Trypanophobia

Cringe-Worthy

In dark alleys and back rooms, in bars and clubs, the kids have invented a new thrill. They’re lining up for miles to experience the rush.

The ritual goes like this. There’s a man with a needle. The silvery point hovers in the air, just over a bulging blue vein. The audience stands at attention, hushed. The needle touches skin. It digs in. The onlookers feel it: a rush of chills, a tingling, bells in the ears and clouded eyes. Knees buckle, breath releases, and they’re out cold.

They’re not looking for a chemical high. They’re seeking their own terror.

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Fear of needles
Fear of needles (Photo credit: david anderson : da-photography)

In the past, I’ve written about using what your body already produces to save lives. There’s always a demand for blood and bone marrow donations, which save lives in a way so straightforward that I feel no embarrassment in using the cliche. Such activities are easy, international, and cost you nothing.

I talk about this stuff a lot because I hope by getting the word out, a few more people might consider giving it a shot. Recently, a friend pointed out a problem with my advocacy: some people refrain from donating blood or joining the marrow registry because they suffer from a paralyzing phobia that renders it impossible.

Trypanophobia, or the fear of needles, is quite widespread in the populace. In the United States, roughly 1 in 10 people suffers from this phobia. Unlike many other phobias, the most common type of trypanophobia induces a physical response that can lead to wooziness and fainting. To put it another way, if you’re afraid of spiders and you see one in your shower, you’ll startle and try to squish it or run away. If you’re afraid of needles, your vasovagal syncope will kick in and you may pass out if you see or even think about needles.

മലയാളം: വെള്ളിലത്തോഴി എന്ന ശലഭം
This was going to be a close-up of a needle, but I decided to be nice. (Photo credit: Wikipedia)

What on earth is “vasovagal syncope”? If you’ve ever jumped out of bed after a hard sleep and found yourself feeling a little dizzy, then you’ve experienced it yourself. Your heart rate fails to provide enough blood to your brain, so you feel weird and woozy until your heart catches up.

People with trypanophobia can experience this reflex just from thinking about needles. So what’s a needle-phobic person to do? Fortunately, there are some ways to deal with it. Doctors can numb the area with different anesthetics before they use the needle. They can also make use of some of the new needle-less drug injection methods, which are very cool indeed. A third option is behavioral therapy, which aims to desensitize you to the stimulus through gradual exposure. Trypanophobics can also take anti-anxiety medications which help prevent the sudden drop in blood pressure.

All this talk of phobias makes me think of horror movies, and how we watch them even though they scare us. Or because they scare us. Thus, today’s story: where teenage trypanophobics deliberately seek out vasovagal syncope just for kicks. It’s no dumber than huffing aerosol from a plastic bag, and probably a good deal safer!

Are you afraid of needles? What tips or tricks do you use to deal with it?

Link Roundup 7-9-13

English: Henry, the world's oldest Tuatara in ...
English: Henry, the world’s oldest Tuatara in captivity at Invercargill, New Zealand (Photo credit: Wikipedia)

Science news and writing-related links from around the blogosphere, and a brief review of my favorite podcasts of the week:

In a huge breakthrough, scientists were able to derive tiny livers from human skin cells. Very awesome.

Whose heart skips a beat for epigenetics? Learn all about this innovative new branch of genetics from the fine folks at Discover Magazine.

The Artificial Selection Project is calling for submissions for the first edition of their new literary magazine. I like these guys and their project, and am polishing a few pieces to submit. If you write and are looking for interesting new markets, check ’em out!

Rochelle Wisthoff-Fields ponders the problem of sequels. It was good brain-fodder for me, as I’m prepping to write a sequel when NaNoWriMo starts up again in November.

Meanwhile, on MissKZebra’s blog, they’re talking about the tricky business of incorporating sexual elements into a story.

A coat made out of human chest hair: the ultimate upcycling project, or just plain gross? I vote gross, but I’d certainly buy one as a gag gift for my more hirsute friends.

And just for fun, Jason tells the traumatizing story of the first time he saw “A Clockwork Orange”. Yes, I’m responsible for the fact he had to watch it twice. Personally, I thought the movie was brilliant. Just as twisted as they say it is, though.

Favorite podcasts I heard this week (I’m almost always behind, so these are “new to me”):

  • Escape Pod #400: “Rescue Party” by Arthur C. Clarke. Full-cast production of this amazing golden-age sci-fi classic. The episode blew me away, and epitomizes everything a fiction podcast can be, what with amazing performances and production values. It went nicely with my Kubrick marathon as well; I promptly rented 2001: A Space Odyssey after listening to this episode.
  • Drabblecast #286: “Unique Chicken Goes in Reverse” by Andy Duncan. A bizarre and appropriate send-up of one of my all-time favorite short story authors. I won’t give away the twist ending, but I’ll give you a hint: think “Southern Gothic”. Don’t miss my Twabble at the end, too!
  • Drabblecast #42: “40 Quarters” by Tom Williams. The life you save may be your own, so compensate those public servants properly, folks.

What’s happening on your blog? What interesting articles have you seen around the blogosphere this week?

Medical Microfiction: Orbit

In Orbit

Marie hadn’t intended to cause a war between the planets. She’d just gotten something in her eye while cycling.

The more she rubbed at it, the further it worked its way into her eye socket. She rushed home, stuck her face under the faucet and pried open her eyelid. The water stung the microscopic scratches on her cornea, but eventually the particle dislodged.

Thanks to her blurred vision, Marie completely overlooked the sand-sized spacecraft swirling down the sink, and with it, the ambassadors of peace.

A few days later, the aliens declared war.

Remember, kids: when cycling, wear eye protection.

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Orbit has a double meaning. We usually use it in its astronomical sense, to mean the course of one object traveling around another. The moon orbits the Earth. In anatomy, orbit refers to the eye socket in the skull.

English: This picture, adapted from Gray's Ana...
The bones that make up the orbit. (Photo credit: Wikipedia)

The skull’s a very strange and unique component of the human body. For one, it’s not just one bone. It’s difficult to say just how many bones are in the skull because it depends on what you mean by “bone” and how you count them.

Why the trouble with counting? You see, your skull doesn’t finish developing until after birth. Infants have four “soft spots” on their noggins called fontanels which are places where the skull bones haven’t fused together yet. The fontanels serve two purposes: to allow for easier delivery, and to allow space for the brain to finish development after birth. When these fontanels finally fuse, they’re joined together with sutural bones that can vary in number from person to person.

My anatomy textbook goes with a fairly traditional count of 22 bones forming the skull. Of these, 7 bones help make up the orbit.

I had fun writing today’s story because it captures orbit in both its meanings. A microscopic fleet of alien ships is in orbit over the Earth, attempting to make peaceful contact. One of their ships is in the orbit of Marie’s eyeball. All this orbiting adds up to be one huge headache for everyone.

For those of you in the United States, happy July 4th! I hope you enjoy the holiday with good food and good company, and hopefully better weather than we’re having in Georgia today. For those of you outside the US, hang in there. Friday’s coming soon.

And whatever you do, remember: wear eye protection. Peaceful intergalactic relations might depend on it.

The Penniless Altruist’s Guide to Saving Lives

“I was sick, and you looked after me.” — Matthew 25:36

So you’re an altruist. You’ve seen the commercials with the sick puppies and sick children asking you to please help. But you’re also broke. You’re a student, maybe, or on a tight budget, or perhaps you already give money to another good cause.

Hermione
You’re not Hermione. But you can still help. (Photo credit: ursulakm)

You wish you could help, but don’t think there’s much you can do. You’re not a doctor, a scientist, or even a wizard; there’s nothing you can do to cure someone’s heart disease or cancer.

But what if I told you that right now, you can contribute to the health and well-being of a total stranger for free? Guess what: your own body’s already producing several things that would make a difference.

I now present my round-up of 10 free things you can do to heal the world using your own body. All of these things are free, and most are also low-effort and require very little time. How’s that for a win-win situation?

  1. Give blood. The Red Cross hosts periodic blood drives in most cities. They also have physical donor centers where you can drop by any time and make a donation. My husband Jason donates every two months because of his high-demand blood type, and he loves the organization and the experience.
  2. Become an Organ and/or Cornea Donor. If you’re not already an organ donor, here’s instructions on how to join the team. While 95% of Americans support organ donation, only 45% are actually registered. This is a problem, as the waiting list for organs such as kidneys, hearts, livers, and lungs is depressingly long. I love knowing that my last act in life will be to leave a legacy of life for others. While you’re at it, share your donor status on Facebook!
  3. Join the Bone Marrow Registry. I’ve talked about this process ad nauseum because it’s simple, free, and it lets you freakin’ cure someone’s cancer. How cool is that? It’s also one of the simplest things to do on this list as it only takes about 15 minutes to sign up, and the testing process happens by mail.
  4. Donate Cord Blood. This one’s for pregnant ladies only. Many hospitals accept donated umbilical cords containing cells that can cure leukemia the way bone marrow donations do. The best part? The umbilical cord’s just biological waste anyway, so you’re recycling! How cool would it be to give birth and cure cancer, all in the same day? To donate, discuss it with your doctor or midwife and find out if the hospital you’re delivering at accepts donations.
  5. Donate your hair. Several organizations collect hair to make wigs for cancer patients. Locks of Love is the most well-known. I love this option for so many reasons. I think it would make for a fun and awesome activity to do as a family as they can accept any hair of the right length. Kids can do it, and gray hair’s fine too! Just go to the hair dresser when your mane’s long enough and get that ponytail lopped off. See the website for all the details.
  6. Donate your body to science. Similar to organ donation, except the whole body will be used for medical research or for teaching medical students. I worked with human cadavers while learning anatomy, and it was one of the most deeply moving experiences of my life. I am so grateful to people who give this ultimate gift. Now you can’t donate your organs and your body; it’s a one-or-the-other proposition. But there are some good reasons to consider body donation. Perhaps you love the idea of going to med school! Perhaps due to your medical history, your organs wouldn’t be usable for transplants. Also, you usually get a free cremation in the bargain (I’m not one to look down on the benefits!). You can donate directly to universities or through various mediators.
  7. Volunteer for medical studies. If you live near a university, I guarantee that their science and health departments run experiments that need volunteers. Last summer, I participated in a study comparing the way women of different weights metabolize vitamins like folic acid. I hung out in the research lab all day, taking vitamins and watching movies while they collected my data. I made some new friends, too! The best part about volunteering for medical studies is that they often pay you for your time. Make sure you only volunteer through reputable organizations that are accountable to review boards that ensure you’re not doing anything dangerous. The National Institute of Health offers this program if you don’t live near a university.
  8. Donate unused prescription drugs. I cheated; this one doesn’t involve something you make with your own body. Leftover prescription drugs can be recycled and donated for use by sick people who can’t afford them. These programs are regional and vary from state to state. Contact your local Health Department for information.
  9. If you’re able to do any of the above, brag about it. Brag loudly, in the hearing of many people. Brag obnoxiously, until your friends disown you. Share what you’ve done on Facebook, Twitter, or wherever you lurk. It sounds strange that tooting your own horn is on my list of altruistic deeds, but seriously, it’s actually quite helpful. We need to normalize donations and overcome what I like to call the “I’ll-do-it-tomorrow hump”. We need to make everyone else jealous so they give it a shot too. That means talking about it lots.
  10. Share this list. Some people will not be able to make the donations on this list because of personal circumstances. That’s completely understandable — don’t feel bad! But one thing you can do is pass on the word. Post this list on your favorite social media, or mention these things to your family and friends.

This list isn’t comprehensive. In fact, if you’ve got more ideas, please share them in the comments below! If I can get another list together I’ll share your ideas in a follow-up post. Also, many of the links I’ve shared only apply to people living in the United States. If you live in another country and can share links to your national programs, please post them. I’d love to add them to this post for everyone’s benefit. What else can you think of that would save a life today?

Medical Microfiction: Metastasize

Scatterbrains

“Let’s build it in Kansas,” they said! “It’s the middle of nowhere,” they said!

Some geniuses they turned out to be. Sure, it’s isolated. I’ll give you that. If you’re going to build Area 52, what better place than the most boring stretch of farmland in America?

But really, it’s Kansas. Didn’t anyone consider the weather?

They built it anyway. Two months after the ribbon-cutting ceremony, an EF4-level tornado made short work of the holding pen roof, sending all the test subjects spiraling into the funnel.

The apocalypse began two hours later, when 500 angry zombies rained down on Wichita.

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Today’s story illustrates the word metastasize, which describes the spread of a cancer from one organ or location to another one. Cancer’s a frequent topic here at Medical Microfiction because it’s a disease that may touch all of our lives at some point, whether it touches one of us directly or a loved one. We find it in our deepest fears and embedded in our books and movies.

Although we hear about cancer often, it’s rare that anyone bothers to explain how cancer works, its treatments, and the words used to discuss it. This is a problem because the unknown holds greater power over us than the known. We’re afraid of the monster under the bed.

In the past, I’ve written about leukemia, bone marrow donation, and graft-versus-host disease to  help clear the waters. Today we turn our attention to a general concept related to cancer: metastasis.

English: The Hesston, Kansas tornado of March ...
The ultimate zombie-dispersal mechanism. (Photo credit: Wikipedia)

To explain it, let’s take breast cancer as an example. It begins when cells in the breast tissue multiply at an abnormal rate. These cells create the stereotypical “lump” in the breast that’s the first tip-off that you’ve got a problem. That’s bad. Metastasis ups the ante. Cells from the cancerous tumor break off into the bloodstream or lymphatic system and use them as highways to spread to other parts of the body. What was once just breast cancer is now also liver cancer or bone cancer.

Think of this process like the zombies in today’s story. As long as the zombies are contained to Area 52, you’ve got a lid on the problem. They’re easy to exterminate. But when the zombies take to the sky and rain down all over Kansas, it’s going to be much, much harder to control the outbreak. The zombies have metastasized.

Explains my recurring zombie nightmares, I suppose.

Monsters Inc
What does the monster under your bed look like? (Photo credit: Cyberslayer)

I know cancer isn’t the most cheerful of topics, but I want to demystify it so that you know exactly what the invisible fear looks like. I’m shining a flashlight under the bed. The monster may be there, but once you see it, you know exactly what you’re dealing with, and you can pick the right tools to combat it. Maybe it’s a little smaller, a little less scary than you expected.

For anyone interested in the practical approach, remember that you can personally become a cancer-slaying zombie hunter by joining the Bone Marrow Registry. I mention this program a lot on my blog because it’s both an easy and practical way to do something. Each of us has within our own bodies the potential to be someone’s unique cure for cancer, but there’s no way you’d know it unless you sign up.

What sorts of things scare you? Do you think the unknown is scarier than the known?

Medical Microfiction: Graft-Versus-Host Disease

S.C.A.T

Ernie strolled into the captain’s office with something lumpy tucked under his arm. “Hey Captain, I bagged another one!”

Captain Jackson was afraid to look. Ernie had been guilty of occasional… misunderstandings… ever since he’d been hired to the Supernatural Creature Annihilation Team. Warily, he asked, “Whatcha got there, Ernie?”

“Werewolf.” Ernie shoved the severed head of Cindy Reeves into Jackson’s hands. Startled, Jackson gagged and dropped the thing. “I caught her right after she changed back into a girl. There was hair everywhere. Definitely a werewolf.”

Jackson smacked Ernie upside the head. “Ernie, you moron! Cindy’s a hair stylist!

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modern straight hairstyles for women
Werewolf, or hairstylist?

If you’re like me, perhaps you first heard about Graft-Versus-Host Disease, or GVHD, through the TV show Arrested Development. For those of you who’ve missed out, on the show a bald man named Tobias gets hair plugs. Unfortunately, his hair transplant begins “rejecting” his body. As his new hair grows more and more luxurious, the rest of Tobias wastes away until all he can do is limply sit in a wheelchair.

In reality, hair plugs don’t cause GVHD, but the Arrested Development parody is a pretty good analogy to explain how it works. With most transplants (such as organs or skin grafts), the patient’s body needs to accept the new part. If the body sees the new kidney or liver as foreign, the immune system will attack the invader and attempt to destroy it.

This is all well and good, but what if the thing you’re transplanting into the patient is a new immune system? This is where GVHD comes in. It’s a common concern with leukemia patients receiving bone marrow donations. As we’ve discussed in previous posts, leukemia is a cancer of the white blood cells which make up your body’s police force or military. To cure leukemia, doctors must wipe out the patient’s existing bone marrow and give her new marrow from a donor. If the new marrow views the body as foreign, it will attack the body and try to destroy it.

Keystone Cop Paddy Wagon
Here come the Keystone Cops!

Think of GVHD like hiring a new police officer who for some reason views all the citizens as criminals and starts attacking them. If you’re Ernie, you see werewolves where you should see hair stylists.

So what’s the cure? Generally speaking, the goal’s to get the disease manageable. Patients take medicine that somewhat suppresses the overactive immune system. This is a tricky thing, because obviously you want cancer survivors to have an immune system to fight cancer if it returns, and to fight other common sicknesses that we all get.

We can’t just fire Ernie. We’ve got to teach that moron the difference between a werewolf and a person. If you see him coming, better to run for cover. Just to be sure.

Medical Microfiction: Leukocytes

“The Charge of the White Brigade”

“Rodgers, stand down!” I commanded.

Behind his gun, Rodgers sneered. An army of clones swarmed behind him. “Screw that. I don’t take orders anymore. The universe is mine. Surrender.”

I touched my insignia. Meaningless. I’d lost my whole army fighting Rodgers. “The clone multiplication’s destabilized the universe. Your rebellion’s destroying it. We won’t survive the next radioactive shockwave.”

“You’re bluffing.” Rodgers took aim. “Die.”

The universe spoke. Its booming voice threw us to our knees: One more round of chemo. Then the marrow transplant.

I understood. For the universe’s sake, the faithful and corrupt must perish alike. “Rodgers. Please… proceed.”

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Fighting Rodgers
Fighting Rodgers (Photo credit: Wikipedia)

Leukocytes (white blood cells) are your body’s military, responsible for defending the homeland against invaders. Leukemia is a cancer where immature white blood cells proliferate much too rapidly to the point where they crowd out other important cells. It’s a particularly vicious form of cancer. It’s a military coup, if you will. Rodgers is trying to call the shots, and the General’s outgunned.

Fortunately, many forms of leukemia can be treated with a bone marrow transplant. Leukocytes originate in the bone marrow, so if you can replace the marrow, you can stop the abnormal multiplication. It’s like doing a hard reset on your immune system. You nuke all the bone marrow in your body–the good with the bad–and receive bone marrow from a donor, which will regrow and return your leukocytes to factory settings.

There’s something inherently tragic about cancer treatments, in that they’re invariably destructive rather than constructive. Cancer’s hard for your body to fight because from your body’s perspective, the cancer cells look like they belong there. They contain the same identity markers as the other cells produced in your body. Treatments like chemotherapy kill off a lot of harmless cells with the harmful ones. This is why chemo often causes hair loss. The weapon that harms Rodgers also harms his neighbors.

From left to right: erythrocyte, thrombocyte, ...
From left to right: erythrocyte, thrombocyte, leukocyte (Photo credit: Wikipedia)

Today’s story is an homage to these innocent bystanders in the fight against cancer. Faithful, loyal, sticking to their jobs until the bitter end, these cells must die that the universe be saved. But their sacrifice is not forgotten.

A dear friend of mine will soon be undergoing another round of chemo for her leukemia while she waits for an update on a possible bone marrow match. This is cool: the doctors think they might have a match with someone on another continent! Amazing, huh? I never knew the network extended so far!

I recently joined the National Bone Marrow Donor Program. Please consider joining the registry too, if you meet the requirements. Leukemia is a terrible disease. Somewhere in the world, a much-loved man, woman, or child may be battling Rodgers, and reinforcements from your personal army might be the key to his defeat.

The odds of two people matching is roughly 1 in 20,000, which is why it’s so incredibly important to have lots people on the registry. If you’re between the ages of 18 and 44, the process is 100% free. Just click the link, fill out a short survey about your health, and they’ll mail you some cheek swabs to collect a few of your cells. After that, your data stays on file in case someone who matches you gets sick.

Donation is ridiculously safe and easy. It’s not often that we have the opportunity to help fight cancer in such a tangible way. This will help! Let’s join forces and fight off Rodgers.

If you or someone you know has dealt with/is dealing with cancer, I’d love to hear your story. Let me know in the comments section below!