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August 31, 2004

BehindTheMedspeak: should you get a full-body CT scan?


Business is booming as more and more healthy people seek out elective full-body CT scans to detect potential health problems.

A paper just published today in Radiology, the flagship journal of the specialty, reports that one such scan exposes a person to 13 millisieverts of radiation, the same exposure suffered by people 1.5 miles from ground zero at Hiroshima and Nagasaki.

A single full-body scan will cause fatal cancer in one of every 1,250 45-year-olds who receives one.


One scan increases a person's lifetime cancer risk by a fraction of 1% - a small amount, considering that about one in five Americans overall die of cancer.

But opponents of the scans say even a small increase in mortality is significant because full-body screenings have never been scientifically proven to benefit healthy people.

About 65 million CT scans are done in the U.S. every year.

The number of healthy people getting full-body scans increased 25% in the past year.


If you're interested, scandirectory.com has all the info you need to get the ball rolling.

[via Liz Szabo in today's USA Today]

August 31, 2004 at 09:01 PM | Permalink | Comments (0) | TrackBack

'When the going gets weird, the weird turn pro'


Perhaps the most profound bumper sticker to emerge during the 20th century.

Patrick Anderson's thriller reviews for the Washington Post appear each Monday.

Last week, he questioned whether it was truly possible for someone to do the old knot-the-cherry-stem-with-only-their-tongue trick.

He received a barrage of responses, and wrote a most amusing note about them which appeared at the end of his review in yesterday's Post.

As I noodled around online looking for an illustration for this post, I came upon a most fascinating website - with a movie clip, no less - about a guy who can make tiny animals out of chewing gum in his mouth using only his tongue and teeth.

Videre est credere, as the Romans used to say.

You probably say "Seeing is believing."

Same difference.

Here's Anderson's item from the Washington Post:


Note: Last week I questioned whether it is truly possible for someone, using only his or her tongue and teeth, to tie a cherry-stem into a knot.

Readers were quick to assure me this feat is no urban legend.

"I am one of the rare ones who possess this dubious talent," one woman confessed.

Parents told of teenage sons and daughters who have mastered the art.

One man was nostalgic about an ex-girlfriend "who possessed remarkable glossal dexterity."

And a Sherlock Holmes fan in Nashville reports that "a nationally recognized Sherlockian scholar" once demonstrated her cherry-stem skills at a Sherlockian gathering in St. Louis.

My thanks to all those who cast light on this important matter.

August 31, 2004 at 06:01 PM | Permalink | Comments (0) | TrackBack

BehindTheMedspeak: Laura Branigan dies suddenly from a cerebral aneurysm at 47


The Grammy-nominated pop star, famous for her 1982 platinum hit "Gloria," died in her sleep last Thursday night at her home in Quogue, New York.

Her brother Mark said she had complained of a headache for about two weeks before she died, but had not sought medical attention.

What to do about a persistent headache?

My best friend was troubled by a fierce, persistent headache for years; it got worse when he coughed, forcing him to bend over in agony.

Complicating things: he has high blood pressure, and is on medication for it.

Making things even more interesting: he's a board-certified, practicing clinical neurologist, with training under one of the greatest diagnosticians ever in the field.

So if even I, a gas-passer, know that he should've gone to see someone about two years ago, you'd thing he'd have come to a similar conclusion himself, right?

You'd be wrong.

He never went in, because, like me, he's petrified of doctors and medical work-ups.

We know what can happen when the rock starts to tumble down the hill.

So he waited to wake up dead one day, and lo and behold, the headaches went away a few months ago.

What were they?

Who knows?

Should Laura Branigan have gone in to see someone?

I don't know.

Most headaches go away on their own, so why bother?

If everyone with two weeks of persistent headache that was worse with coughing went in for an exam and cerebral angiography, the country would come to a halt and be bankrupt.

What's going on when you have a cerebral aneurysm, anyhow?

Well, it's a stretching/bulging/thinning of the arterial wall, is the pathophysiology.


When it gets thin enough, it bursts, and blood pours out under high pressure.

The bleeding continues until the pressure inside the skull is so great that the brain is forced downward through the hole at the base of the skull (the foramen magnum).

When that happens, the brain stem stops working, the heart stops, breathing ceases, and you're dead.

If you diagnose an aneurysm in time, it is an entirely curable condition.

The surgeon can clip it (isolate it from the main part of the artery); a radiologist can embolize it


(fill it with inert material that essentially isolates it from the main part of the artery).


These are tricky things: you can easily die during these procedures, or wake up hemiplegic.

I used to specialize in giving anesthesia for such neurosurgical vascular procedures, back when I was in academic anesthesia.

Nothing like taking the old blood pressure down to 60/35 and keeping it there so the surgeon can get a clip around the thing. Yee-ha!

Read my book if you need details on how to do it yourself.

When I was a med student at UCLA, the actress Patricia Neal came to the UCLA ER with complaints of an overpowering headache.

She was rushed to the angiography suite, where she became the unwitting star of one of the most stunning movies (medical diagnostic category) ever made.

As she lay on the table, the radiologists around her watched in awe as her brain aneurysm exploded in real time inside her unconscious head.

They rushed her to the operating room with their catheter still in her brain, and the neurosurgeon-on-call did a STAT craniotomy in record time, zipping off the top of her skull before the inexorable compression of her brain stem killed her.

She survived, and with intensive physical therapy recovered most of her capability.

Talk about luck.

August 31, 2004 at 03:01 PM | Permalink | Comments (2)

Liu Xiang, China's hero, records the most profound accomplishment of the 2004 Athens Olympics


The 21-year-old Chinese hurdler equaled the 1993 world record of Britain's Colin Jackson, running a near-perfect race to finish in 12.91.

His gold is the first ever by a Chinese man in track and field - but it won't be the last, not by a long shot.

Liu, interviewed in Sports Illustrated, said, "Asians are not known for running fast."

Maybe not in the past, but as L.P. Hartley wrote in "The Go-Between," "The past is a different country; they do things differenty there."

What most amazed me about this new superstar is that he's not at all like the prototypical hurdler or sprinter at the world-class level in terms of his physique: he looks relatively soft and uncut compared to his peers.

Could it be that there's a different way to the top?


We'll be hearing lots more about Liu and his coach, Sun Haiping, in the coming years as the Beijing 2008 Olympics approach.

August 31, 2004 at 12:01 PM | Permalink | Comments (1) | TrackBack

Zembla magazine


"Fun with words" is the motto of this new Brit-lit magazine. (Their website, though it's rife with Flash - usually a deal-ender for moi - is actually quite stylish and interesting)

Supposedly meant to be an amalgam of The Paris Review and Paris Vogue (what? don't they know Italian Vogue is the cynosure of the country-specific editions?), Zembla is named after a fictional land in the Nabokov novel "Pale Fire."

The magazine is published by the antiquarian book dealer Simon Finch, and offers a mix of fiction and nonfiction.

Each issue features an irreverent posthumous interview with a literary giant.

So far they've attracted advertising from Marc Jacobs, Gucci and Issey Miyake, and contributions from Hedi Slimane, Manolo Blahnik, and Nicole Farhi.


Published six times a year (now isn't that easier than bi-monthly?), it's $40/year for a subscription if you live in the U.S.

August 31, 2004 at 09:01 AM | Permalink | Comments (1) | TrackBack

Interpol's greatest hits


Every six months, Interpol publishes a poster of the "World's Most Wanted Works of Art."


There's also a CD-ROM profiling nearly 20,000 stolen art works, as well as daily updates on the agency's website.

The next poster, due out in December, will undoubtedly feature the Munch paintings


recently stolen from an Oslo Museum


in broad daylight on a Sunday afternoon.

August 31, 2004 at 06:01 AM | Permalink | Comments (0)

What do Habitat for Humanity and Enron have in common?


Jeffrey K. Skilling has worked for each of them.


Indicted on dozens of counts of fraud, conspiracy, and insider trading,


Skilling has begun working for Habitat for Humanity while he awaits trial.

He took his new (unpaid, but maybe he has stock options) position at the suggestion of a federal magistrate, as part of an agreement that lets him remain free after also posting a $5 million bond.


He works in a Houston warehouse that stocks materials for Habitat for Humanity's various building projects.

August 31, 2004 at 03:01 AM | Permalink | Comments (0) | TrackBack

How far is it?


This is the best site I've found to tell quickly the distance between two places on our blue planet.

August 31, 2004 at 12:01 AM | Permalink | Comments (0) | TrackBack

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