Cutting Through The Crap
"The further a society drifts from the truth, the more it will hate those who speak it." Orwell
"“The price good men pay for indifference to public affairs is to be ruled by evil men.”
Plato
"The secret of freedom lies in educating people, whereas the secret of tyranny is in keeping them ignorant" Robespierre
Wednesday, May 1, 2024
Letter Rip
Wednesday, April 24, 2024
Honest Mike
Garnering little attention, The Washington Post obtained a secret Kremlin document. Containing plans to destabilize the West, especially the US, it proposes to do so by “continuing to facilitate the coming to power of isolationist right-wing forces in America” [Ed. note: MAGA?] and “to escalate the situation in the Middle East around Israel, Iran, and Syria to distract the U.S. with the problems of this region.”
Wednesday, April 17, 2024
Who Thinks You're Stupid?
Playing the system like a kazoo, abetted by a judge feeling a bit too grateful for her lifetime appointment to a plumb job by him, Trump has successfully delayed the most clear-cut case against him. While calling the timing of all similarly delayed cases “election interference.”
Wednesday, April 10, 2024
Signs, Signs, Everywhere Signs
Even a blind squirrel, it’s said, can find an acorn once in a while. Thus it is that Marjorie Taylor Greene, strong contender for Congress’s dumbest and most obnoxious member, yet privy to God’s thinking, came up with a worthy pronouncement. “God is sending America strong signs to tell us to repent,” said she. “Earthquakes and eclipses and many more things to come. I pray that our country listens.”
Wednesday, April 3, 2024
No Foolin'
April Fools’ Day passed with few of the usual prank postings. Or maybe I missed them. These days, who can tell? For example:
Wednesday, March 27, 2024
Names And Places
As right-wingers blame collapsing bridges on President Biden, “wokeism,” and “open borders;” as Hannity says Trump should be allowed death-threat-inducing fulminations against a judge’s daughter and others; and as ever-grifting Trump is selling sixty-dollar (plus shipping and handling) “The only endorsed by Trump” Bibles, let’s change the subject to surgical ruminations before I tear out the last of my hair. So, here’s some fluff, modified from my surgery blog:
It was always with wonderment that I considered the pioneers of medicine, surgery, and anatomy. To conceive of a time when every thought was a new one, when discoveries abounded for those with imagination, boldness, and curiosity, is to be thrilled, jealous, and.... bemused. What could it have been like, opening the body and its mysteries to the world, naming something new on the way out?
When it takes some effort -- maybe a microscope or some really careful dissection -- to discover something, it seems reasonable that your name gets attached. Islets of Langerhans. Ampulla of Vater. Sphincter of Oddi. Valves of Heister. Crypts of Morgani (he got "columns," too, like me.)
But where's the cutoff? I don't get why Gabriele Falloppio got to name something as obvious as an oviduct. That's not discovering. That's noticing. We don't have the Colon of Powell or the Heart of Palm. (I don't know who March was, or why he got to name the Eyes.) The white line of Toldt is sort of macro-observational and a name seems an extravagance. On the other hand, if he was the guy who figured out that it was a dotted line on which a surgeon cuts to mobilize the colon for resection -- a move that thrilled me the first time I did it and still does, for its anatomic simplicity, for its sweet entry into secret space, for the way it translates embryology into practicality -- then he deserves the kudos.
"Foramen" (for-A-men) and its pleasant plural, "foramina" are among those cool words we learn in med school. It means "opening." A hole, is what it is. Many anatomic openings are deserving of the name: foramen ovale (oh-VAL-ee) sounds good and does good; keeps a fetus alive. Lots of bony holes, especially ones through which nerves or vessels pass, are called foramina -- the obturator foramen, optical foramen, foramen magnum... But Jean-Jacques Winslow (shouldn't that be "Winsleau?") discovered he could stick his finger through a hole behind the portal vein, and stuck his name on it, too. Borderline.
I don't want to get into the Zen of what constitutes a hole, but his "discovery" is only about some things that are near each other. Inlet, maybe. We've got islets, why not inlets? Then it starts to sound nautical, which makes me think not of Winslow, but of Winslow Homer. That's it: it's the "Oddity of Homer."
Consider Morrison and his pouch. And Douglas’s. They're just places, areas. To me, it's not earthshaking. On the other hand, Broca claimed his area of the brain with some effort. I'm ambivalent about the Space of Retzius. As an anatomical concept, "space" doesn't have a lot of panache. On the other hand, the surgical dissection of it, developing it into a tissue plane, is cool: another of many places that spread themselves open for and yield to the surgeon, when their secrets are out.
Clearly the Greek and the Latin have fought for dominance of nomenclature. It's a puzzle to me that they made a truce of sorts in the kidney. We speak "nephric" and we talk "renal" interchangeably. Even to the point of naming things twice: that little yellow top-hat to the kidney, the ad-renal or the epi-nephron, as of juice it makes, two names for the same thing: adrenaline, epinephrine. What gives? Like the robin’s egg blue of the gallbladder, the bold yellow of the adrenal is a startling splash of exuberant color among the otherwise earthy tones of the belly. Sure, there's lemony lipid all over in there. But as organs go, the color of the adrenal is a surprise.
Those solid surgical soldiers of old deservedly got operations named after them; and instruments, and procedures. Because there's no end to invention, it still happens, and will. (Cotton Schwab?) Lots of the living have their names (and lucrative patents) on devices; techniques and new operations keep unfolding.
Then there’s having a position named after oneself: Trendelenberg, Fowler (and its kin, Semi-) managed to do it. If I had a position named after me, I'd rather...
Nearly unique, though, among namings, is to be remembered for a maneuver. Like Theodor Kocher, name-bearer of many things: clamps, incisions, and this, a way to make the duodenum handy and hold the pancreas in your hand. An elegant snip and slide. The Kocher Maneuver. Inspiring. Deserving a whole column in itself. I’ve written about it, here.
Wednesday, March 20, 2024
Don't Care
I don’t care if it’s traditional. It’s a “courtesy,” not a law. The fact that a party’s nominees for president have been read in to national security briefings doesn’t mean Trump should be. Not unless he, gods forbid, becomes “president” again,” in which case it won’t matter. It’d be game over for the US and jubilee for Putin, Xi, Kim, Orbán, and MBS. It’d all be for sale. We might never know the price, but by then it’d be moot. We’ve seen the carelessness with which he handles America’s secrets, and not just where he stores them after illegally retaining them. With enemy sources and fans alike, he shared them like a teenager sexting to impress. Bad analogy, maybe, if what Stormy Daniels described is accurate. In any case, entrusting Trump with state secrets would hand him trading cards for Putin’s help. Again.
Wednesday, March 13, 2024
SOTU+
No comment on Senator Katie Britt’s (R-AL) melodramatic, bizarre, scary-on-many-levels response to President Biden’s State of the Union Speech: embarrassed Republicans have been panning it enough. Okay, well, since she harped on the border crisis (and lied about it, MAGAly), let’s note that she was one of the bipartisan group of senators that hammered out a bill addressing the crisis more significantly than any previous attempts. And then, as demanded by Trump, under indictment, out on bail, voted against it. It’s doubtful she’ll take this advice from one of her constituents.
Wednesday, March 6, 2024
Getting Real
The Supreme Court was right to overrule the Colorado decision to remove Trump from the state’s ballot, unanimously. It can’t be up to individual states to decide, on their own, who can be on the ballot for a national race. But, going further, five asserted it’s up to Congress to define and declare who is and isn’t an insurrectionist. Four otherwise concurring justices argued that current federal law suffices; that the majority made it nearly impossible for candidates to be disqualified for insurrection. In effect, they rewrote the Constitution. You know: originalism.
Wednesday, February 28, 2024
Chilly Children
Wednesday, February 21, 2024
Putin Love
Vladimir Putin is a murderer, killing with impunity, by defenestration, poison, bombs on planes, imprisonment in life-threatening circumstances. Whatever the proximate cause of death, and no matter the length of his arm from Alexei Navalny, Putin, to whom Trump seems ready to hand Ukraine, is directly responsible for his death.
Wednesday, February 14, 2024
Memories...
Appointed by Attorney General Garland to investigate President Biden’s handling of documents, Robert Hur, after exonerating him, dwelt on memory lapses, as if they were relevant to the law. And unique. In prior depositions, Trump may have set the record.
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