Funtabulously Frivolous Friday Five 091

Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF, introducing the Funtabulously Frivolous Friday Five 091

Question 1

To whom is the following quote attributed:

The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in place of exercise. Children are now tyrants, not the servants of their households. They no longer rise when elders enter the room. They contradict their parents, chatter before company, gobble up dainties at the table, cross their legs, and tyrannize their teachers

Reveal the funtabulous answer

Socrates… It seems that some things never change, eh.

  • The quotation was attributed to Socrates by Plato, according to William L. Patty and Louise S. Johnson, Personality and Adjustment, p. 277 (1953).
  • Unfortunately, the attribution of this quotation is probably spurious.
  • Astute, longtime readers of LITFL may rember this quote featuring in Lessons from Osler 001 — The Master Word.

Question 2

What do the red and white stripes of a traditional barber’s pole symbolise?

Reveal the funtabulous answer

Blood and bandages (there are plenty of other explanations but I like this one best!).

  • Prior to 1800 and the formation of the Royal College of Surgeons most surgeons were members of the Royal College of Barbers and Surgeons and had no formal medical qualifications. In other words, the chap who cut your hair and shaved your beard would also chop your leg off if so desired.
  • In remembrance of these origins surgeons in the UK and the former colonies often still use the exclusive designation “Mister” rather than “Doctor”.
  • According to Wikipedia:

“The original pole had a brass wash basin at the top (representing the vessel in which leeches were kept) and bottom (representing the basin that received the blood). The pole itself represents the staff that the patient gripped during the procedure to encourage blood flow.”

Question 3

What is a ‘zebra retreat’?

Reveal the funtabulous answer

 A type of cognitive bias coined by Pat Croskerry that occurs when a rare diagnosis (zebra) figures prominently on the differential diagnosis but the physician fails to pursue it.

This can occur for any one, or a combination, of the reasons below:

  1. perceived inertia in the system and barriers to obtaining special or costly tests
  2. self-consciousness and underconfidence about entertaining remote and unusual diagnosis and gaining a reputation for being esoteric
  3. the fear of being seen as unrealistic and wasteful of resources
  4. under- or overestimating the base-rate for the diagnosis
  5. the ED might be very busy and the anticipated time and effort to pursue the diagnosis might dilute the physician’s conviction
  6. team members might exert coercive pressure to avoid wasting the team’s time
  7. inconvenience of the time of day or weekend and difficulty gaining access to specialists
  8. unfamiliarity with the diagnosis might make the physician less likely to go down an unfamiliar road
  9. and fatigue or other distractions might tip the physician toward retreat.

This explanation of ‘zebra retreat’ is excerpted from this must read textbook:

  • Crosskerry P, Cosby KS, Schenkel SM, Wears RL. Patient Safety in Emergency Medicine. Lippincott Williams & Wilkins, 2009. [Google books preview]

Question 4

Which famous surgeon is purported to have been the inspiration for both ‘Jekyl and Hyde’ and ‘Dr Doolittle’?

Reveal the funtabulous answer

The legendary John Hunter

Hunter had a fascinating collection of animals and oddities, hence the purported inspiration for Hugh Lofting’s Dr John Doolittle.

His brilliance and mixed reputation for walking the fine line of ethical practice (he employed grave robbers for instance) is believed to have inspired Robert Louis Steven’s Strange Case of Dr Jekyll and Mr Hyde.

Question 5

Which famous medical man described ‘semen held in the mouth as having a warmth similar to spices’?

Reveal the funtabulous answer

The legendary John Hunter… again.

Among a myriad of other amazing discoveries, Hunter also who proved the contagiousness of venereal disease by self-inoculation (if you believe the legend) though he thought he’d shown that gonorrhea and syphilis were manifestations of the same disease, not realising that STIs have a tendency to hunt in packs…

Do you know John Hunter? Every doctor should…

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Funtabulously Frivolous Friday Five

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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