Biomedical Ephemera, or: A Frog for Your Boils

JOHN IS NOT REALLY DULL - He may only need his eyes examined

Back in the 1920s, my grandpa (of course also named John) was held back in first grade for seven years. Despite being able to recite poetry and do mental math very proficiently, he couldn’t read worth a ding dang half-rotten cabbage. When he was 12, though, his school instituted the first vision iteration of vision testing of students, and his parents found out that he wasn’t illiterate because of a disability an inability to comprehend written words, but because he couldn’t see the letters! And because he didn’t know this, he couldn’t have articulated that.

After he got glasses, he managed to not only catch up with, but surpass his peers - he graduated a year early, and became an accomplished engineer, serving his country in the Signal Corps in WWII, and going on to outfit many schools and other public buildings with modern power distribution centers.

Source: WPA Federal Art Project. 1936-1937.

ETA: I should have been more clear when I said “he wasn’t illiterate because...” - I repeated the story just as my grandma told it, but should have considered wording!

Osteosarcoma, before and after operation

Osteosarcoma are cancerous bone tumors found in immature bone, most often in those over 10 and under 25 years old. This particular case is in a man named Robert Penman, who was twenty-four. 

These days, in those whose tumor is non-malignant (has not spread beyond its original tumor site), the five-year survival rate is about 75%. Back in 1839, I cant imagine this lad was quite as lucky, but it appears that at least the primary tumor was removed for a time.

Case of Osteo-sarcoma of the lower jaw, as operated upon Robert Penman, aged twenty-four years. 1839.

Osteomyeltis of the femur, as a result of scarlet fever

Osteomyelitis is an intensely painful, often disastrous infection of the bone, which can have grave consequences. This case was the sequelae of a case of scarlet fever (a body-wide rash caused by strep throat), and resulted in amputation of the limb. This patient survived, but a large percentage of patients did not. Prior to antibiotics, many who contracted osteomyelitis (due to scarlet fever or other reasons) developed severe bacteremia (bacteria in the bloodstream), which often progressed to sepsis and death.

Think you have strep throat? See a doctor!

An American Text-Book of Surgery, for Practitioners and Students. Ed. William W. Keen & J. William White, 1899.

“A skeleton of an adult put into this posture to show it in a greater scale. It was thought better not to figure it, all these bones being explained in former plates, and the design of this being to show them together without being defaced with references.”

The Anatomy of the Human Body. William Cheselden, 1750.

Sagittal section of the uterine pelvis

Relevant muscles, bones, and organs shown, with their supporting ligaments and relative angles and measurements shown.

An American Text-Book of Obstetrics. Ed. Richard C. Norris, 1895.

The Human Head

Ever wonder what your head would look like if it were cut in half?

Well, probably not like this. These are “average” heads. But we’ve all got some fun structures inside of us that are rarely considered by most people. Check out those beautiful conchae!

Atlas of Applied (Topographical) Human Anatomy. Dr. Karl von Bardeleben, Dr. Heinrich Haekel. Translated by J. Howell Evans, 1906.

Caricatures of Death Personified

So I put off getting my flu shot in 2018...

Y’know, I ain’t around these parts too much anymore (Yahoo can go huff a dong), but I just wanted to tell y’all my tale of the 2018/2019 holiday season...

December 17-20: Got the flu (later confirmed to be one of the strains protected by this season’s vaccine). Felt shite, took cold meds, still felt shite but not so much that I could justify not starting the Q1 spreadsheets at work.

Dec 21: Knew the crackles in my lungs were pneumonia. Couldn’t keep my blood oxygen above 90%. Went to the ER that night. They wanted to send me home. I said “I know something is wrong, I would be very uncomfortable going home.” They managed to find a bed in the hospital, said “fine, we’ll give you observation until tomorrow.”

Dec 22: Decompensated quickly. Parents apparently came up north, though I don’t remember seeing them before I woke up again. Couldn’t get aortic O2 saturation above 65% so I ended up intubated.

Late Dec 22-Early Dec 30: Completely unconscious, with the first two days on paralytics so that the ventilator did 100% of my breathing. The 36 hours on either side of my sedation are completely blank in my memory.

At some point my secondary infection (which was never discerned, though extensive testing for bacteria and fungi was done) caused me to become critically ill, and there were preparations made to fly my to Mayo for ECMO. Thankfully, the high-dosage steroid treatment they gave me when I started getting worse helped, and I began improving slowly.

Dec 31: I start to see the world again. My first "memories” are strange delusions brought on by the anesthetics. I thought I had been in a coma for 6 years, and that I was in Cleveland. Why the fuck would I be in CLEVELAND?

I remember seeing the news, something about New Year’s Eve. I fell back asleep, into Seroquel dreams.

Jan 1: My memories start genuinely coming back. I discovered I was too weak to extend my arm fully, and too shaky to eat Jell-O. The Jell-O DID get delightfully wobbly.

Seriously though, have you ever gone from being exceptionally strong to literally being unable to eat unless you did little T-rex arms? It’s a funny mental picture, but frustrating as hell. I would have been humiliated if I had more brain cells to spare.

Jan 2: Little Raven’s Birthday. Finally get out of ICU. Moved up to the general wards. Still can’t breathe easily. Food is vile-tasting. Can barely eat. Choke down a lemon bar and cry about how much better Brendan’s were and how much I miss my brother and how I refuse to make my parents go through that again.

Jan 3: Manage my first wobbly steps with a walker. The floor hurts my knees and feet. The blood in my eyes is finally being cleared by my body.

Jan 3-5: Slow improvement. Slow for an otherwise-healthy young adult, at least. It feels like forever. My dad and I watched an unbearable amount of cross-country ski qualifying races for the Olympic teams. There’s a terrifying night-vision cam in my hospital room, which wouldn’t bother me if it didn’t have a creepy smiley face.

Jan 5-9: Transitional care, getting physical and occupational therapy. I finally got home to my apartment (and cat!) that afternoon. I spent the next week regaining my strength and seeing specialists to try and find out why I got so sick. Consensus so far is “flu sucks and you’re unlucky?” I’m hoping to have better answers next month at my secondary follow-ups.

I aged my husband and parents about a decade during my hospital stay. I missed a month of work and am still fixing problems that arose with the backlog.

My Christmas dinner was a 10% dextrose solution, since I was still paralyzed and couldn’t have anything down my NG tube yet. New Year’s Eve drinks? “GIVE ME SOME FUCKING WATER!” - but not being able to have any, because I was still overloaded with fluid due to the standard protocol to prevent hypoperfusion when someone goes into septic shock.

Just to make it clear: I would not have survived without the tens of thousands of hours of training and practice that my medical team devoted their lives to acquiring. I would not have survived without the millions of hours of research and trials that allowed the machines that kept me monitored, cooled when my fever continued to spike, and breathing in a life-sustaining way when my lungs weren’t able to exchange gasses.

I am a fat bitch, but I am physically active, eat fairly decently, and don’t smoke or drink excessively. I am not someone who “should” be threatened by deadly complications due to influenza-caused pneumonia. Yet I was. 

And YOU could be, too. Get yer flu shot, if you can. If you can’t, yell at others until they do.

It’s not too late in the season, trust me. People still die in March. People like you.

Blood Transfusion Following Delivery

This illustration shows a novel way of transfusing blood from one person to another, in 1865. The kit, prepared by Dr. Aveling, consists of a trocar to pierce the veins of both patients, and a cannula, to transfer the blood. The cannula has a bloat in the center, which can be squeezed while the device is underwater, to remove all air bubbles. The higher blood pressure of the donor is how the blood is transferred.

At this point in time, blood types were unknown. However, in 1818, Dr. James Blundell performed the first successful series of transfusions between post-delivery women suffering from blood loss, and their husbands. Five of the ten patients survived (as would be expected, given England’s blood type ratios), and husband-to-wife transfusions among stable-but-critical hemorrhage patients became something that the more elite physicians increasingly used.

It took another century to establish and incorporate blood typing into transfusion science.

Catalogue and report of obstetrical and other instruments. 1867, Royal College of Physicians.

Suction-powered Breast Pump

I had no idea that non-manual breast pumps haven’t even been around as long as computers. For as much of a frustration as my friends go through to pump their milk at work, I can’t imagine the pain and time it took to get breast milk through suction or hand-pump devices.

Druggist’s Ready Reference, issued by Morrison, Plummer & Co., importers and jobbers in drugs. 1887.