Funtabulously Frivolous Friday Five 348

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 348

Question 1

What is the percentage reduction in an anaesthetist’s performance if the surgeon is rude to them?

Reveal the funtabulous answer

Close to 40%.

Now, I’m not meaning to pick on surgeons. The same is true across our entire workforce. And this rudeness is not a case of screaming and shouting. It’s mild rudeness, a little chirp, a little dig or a huff.

But what about onlookers who see this interaction or event? They drop their performance by 20%. It is incredible to me to think that one tiny intervention of being polite and nice to each other at work will maximise our performance.

We espouse the Harvard basic assumption in simulation (Everyone participating in training is intelligent, capable, does their best, and wants to improve) but I doubt many of us apply this in real life.

I had the pleasure of listening to Chris Turner at a conference recently, and I would encourage you to listen to his TEDtalk and start your civility journey:

Reference:

Question 2

When I look back at those days I have no doubt that Providence guided us, not only across those snow fields, but across the storm-white sea that separated Elephant Island from our landing place on South Georgia. I know that during that long and racking march of thirty-six hours over the unnamed mountains and glaciers of South Georgia it seemed to me often that we were four, not three. I said nothing to my companions on the point, but afterwards Worsley said to me, “Boss, I had a curious feeling on the march that there was another person with us.” Crean confessed to the same idea. One feels “the dearth of human words, the roughness of mortal speech” in trying to describe things intangible, but a record of our journeys would be incomplete without a reference to a subject very near to our hearts.

Shackleton, South

What is the scientific term for what Shackleton and his men experienced on their 36-hour march seeing an additional man?

Reveal the funtabulous answer

Ganzfeld-induced hallucinatory experience.

German for ‘entire’ and ‘field’, as seen in the photo below, where a subject has their entire visual fields covered by two ping-pong balls.

German psychologist Wolfgang Metzger (1899–1979) originally developed the experiments, and he demonstrated that subjects who were presented with a homogeneous visual field would experience perceptual distortions that could rise to the level of hallucinations. Often related to the subject’s past experience, but many people do get flashes of very real images.

A Ganzfeld experiement

This work was later taken to try and prove telepathy, where someone would try to insert a thought into a person who was mildly sensory deprived, and much of the history of Ganzfeld experiments fell into pseudo-science.

It is the theory, however, that when you are sensory deprived, i.e. Shakleton and his men in a ‘white-out’ storm for 36 hours, it is entirely possible that they were getting the same hallucinations first seen in the Ganzfeld experiments

Reference:

Question 3

How many bursae are in the human body?

Reveal the funtabulous answer

~ 150-160.

You are born with most of your bursae.

A few may develop later in areas of high friction, such as a bunion which is an adventitious bursa caused by lots of friction in that area (usually tight, ill-fitting shoes).

The iliopsoas bursa is the largest in the body, which inserts at the femur where the iliacus and psoas major muscles combine.


Question 4

What is ‘Bendopnea‘?

Reveal the funtabulous answer

Shortness of breath when leaning forward.

In 2014, Thibodeau et al reported this novel symptom. They observed that patients with severe heart failure complained of shortness of breath when bending over to tie their shoes.

With invasive testing, they were able to measure ventricular filling pressures as these subjects bent forward. They found this only occurred in patients with low cardiac index and high ventricular filling pressures at baseline (so advanced heart failure).

When subjects bent over, they further increased the ventricular filling pressure worsening their heart failure. As yet, we do not have data on whether this has any prognostic value, but it is hypothesis-generating.

A 2021 BMJ case report recounts a patient with an SVC obstruction having bendopnea that resolved after SVC recanalisation and may be an additional examination finding as you are trying to remember how to perform Pemberton sign.

Reference:

Question 5

Which of these eponymous terms is correct?

  • Bell’s palsy
  • Alzheimer’s disease
  • Crohn disease
  • Graves disease

Reveal the funtabulous answer

None, or all, or some…who knows…

Okay, so this FFFF might be one for the pedants out there, especially as we try to move away from eponymous terms in general. There is continued debate over the use of the possessive form for eponyms, and a transition toward the nonpossessive form.

The AMA Manual of Style and Stedman’s Medical Dictionary recommend dropping the ’s in eponymous terms to represent “the adjectival and descriptive, rather than possessive, sense of eponyms” and to “promote clarity and consistence in scientific writing.”

Eponyms are names or phrases derived from or including the name of a person or place. These terms are used in a descriptive or adjectival sense in medical and scientific writing to describe entities such as diseases, syndromes, signs, tests, methods, and procedures. These eponymous terms should be distinguished from true possessives (eg, Homer’s Iliad).

AMA Manual of style

Dorland’s Illustrated Medical Dictionary notes that the ’s is becoming “increasingly less common,” and includes some diseases with the ending and some without, reflecting the “ongoing change in usage.”

A major step toward preference for the nonpossessive form occurred when the National Down Syndrome Society advocated the use of Down syndrome, rather than Down’s syndrome, arguing that the syndrome does not actually belong to anyone.

AMA Manual of style

Medical toponyms (diseases named after a place) don’t have apostrophes. For example, “Rocky Mountain spotted fever” or “Lyme disease” (named for Lyme, CT).

Technically, the ’s associated with eponymous terms is not possessive but genitive. Genitives show associations and relationships and are much broader than purely ownership. In a genitive construction such as “last night’s bed block,” refers to “associated with” or “related to,” rather than “possessed by.”

The American Medical Association’s style guide acknowledges that the issue is still somewhat controversial, but says that the use of the ’s in medical eponyms is a thing of the past.

Dr John H. Dirckx counters with…

Some of the arguments offered by editors and others to justify exclusion of the genitive from eponyms are simply ludicrous…and display ignorance of linguistics, a superficial and mechanistic view of language, disdain for tradition, and, sometimes, the arrogance of authority.

Dirckx

You, the erudite readership can make up your own mind minds mind’s minds’, whatever

References


… and finally, quotes:

I thought I’d move away from our usual randomness of ‘…and finally’ and insert quotes from prior inspirational leaders. I’d like to start with a famous line from Nelson Mandela:

If you think back to some of your greatest achievements, maybe it was passing your last set of exams. It was hard, it was a long process and a challenge, but I bet you felt great after all that struggle and still have that sense of achievement. What gave you the greatest sense of satisfaction, that exam versus doing an online module? Embrace the struggle, dream big, and you will live a full life.


FFFF

Funtabulously Frivolous Friday Five

Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Kelowna hospital, British Columbia. Loves the misery of alpine climbing and working in austere environments (namely tertiary trauma centres). Supporter of FOAMed, lifelong education and trying to find that elusive peak performance.

Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

One comment

  1. Gentlemen, I take your work seriously, I take your views seriously, but I think you’ve dismissed a very valid possibility regarding the experience of Shackleton and his 2 colleagues. You categorize their experience as hallucination. I want to stake a claim for the alternate possibility: that they were in the presence of Christ. This might seem odd, but it is unfair to classify the part of their experience that they describe as “a subject very near to our hearts” as a mistake of perception. It might have been the highest form of perception, and of life, possible. They did a feat of endurance that would by definition force transcendence of what is commonly understood to be mortal life. They may have reached nirvana, heaven, the presence of Christ – and that same presence may have revealed itself to support them. They were united with in each in a mission to save their brother’s lives. If that doesn’t open your eyes on Heaven’s doorstep I don’t know what does. Their story is a treasure to humankind. It in no way deserves to be unwritten by post-hoc analysis. Please don’t dismiss their experience, it’s poor practice of thought. – Ken Schaefle, MD New York City

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