by Mark Leyner
CAN YOU LOSE A CONTACT LENS IN THE BACK OF YOUR HEAD?
It is common for people to come into an emergency room because they can’t find their contact lens. Sometimes it is found folded and tucked beneath the eyelid, but other times it is nowhere to be found. So where is it???
Probably on the bathroom floor at home. A little anatomy lesson: there is nowhere else for it to go.
Other commonly “misplaced”; items that lead people to the ER: tampons, condoms, and car keys.
CAN YOU LOSE A TAMPON INSIDE YOUR BODY IF THE STRING COMES OFF?
This is a surprisingly frequent question, and often a reason women find themselves in the emergency room. Patients often come in either because they cannot remove the tampon or because it has disappeared and they don’t seem to know where it went.
Time for another anatomy lesson. The vagina is a potential space, not a hole or cavity inside the body. The walls of the vagina are normally in contact with each other unless something is inserted between them. When something enters the vagina, the body makes room for it. At the end of this potential space is the cervix. Therefore, there is no place for the tampon to go. It cannot be lost inside that small area and you should be able to remove it, or it can be easily removed by any doctor. Often we find nothing inside, and that means you probably forgot you removed it. Leaving a tampon inside too long can put you at risk for a serious infection, so don’t be embarrassed to ask for help.
IS IT TRUE THAT THE TONGUE IS THE STRONGEST MUSCLE IN THE BODY RELATIVE TO ITS SIZE?
Now, we are sure there are many possibilities as to why someone would need the answer to this question. We never asked our friend who asked this question why this was important, but surely she had her reasons.
Some sources do agree that the tongue is the strongest muscle per size, but the tongue is actually made up of four muscles. The heart has also been mentioned, but since it moves involuntarily and is mainly an endurance muscle, it doesn’t really get to the heart of this question (bad pun intended).
The sartorius, which slants across the thigh to the knee, is the longest muscle in the body. As for the strongest, there are two other candidates, the masseter, used for chewing, and the gluteus maximus. By gluteus! Who knew that our asses were so strong!
Another tidbit for you trivia geeks, here are Billy and Leyner’s two favorite ass-vocabulary words:
callipygian: having beautifully proportioned buttocks
steatopygic: an extreme accumulation of fat on the buttocks
WHY DO YOUR TEETH CHATTER WHEN YOU ARE COLD?
The body usually maintains a constant temperature of 98.6 degrees Fahrenheit. At this temperature the cells of the body work best. If there is any significant change in temperature, it is sensed by an area of the brain called the hypothalamus. When the body gets too cold, this center alerts the rest of the body to begin warming up. Shivering, the rapid movement of the muscles to generate heat, then begins. Teeth chattering represents localized shivering.
WHY DO YOU HAVE AN APPENDIX IF YOU CAN LIVE WITHOUT IT?
The appendix is a small pouch off the large intestine. The wall of the appendix contains lymphatic tissue that is part of the immune system for making antibodies.
Removing the appendix doesn’t cause any harm because there are several other areas in the body that contain similar tissue—the spleen, lymph nodes, and tonsils. The spleen and the tonsils can also be removed.
Gberg: You were going to give me a little something to add to the appendix question, Why do you have one if you can live without it?
Gberg: Some expert Leynerisms on vestigial organs.
Leyner: God put certain internal organs in the human body for purely aesthetic reasons. They just look nice when the forensic pathologist opens you up.
4:05 P.M.
Leyner: How do we know yet what all the vestigial organs are? A lot of the organs that seem crucial now may seem vestigial pretty soon.
Gberg: Please explain to me what is so beautiful about the appendix. It looks like a little wet caterpillar.
Leyner: It’s so subjective, though . . . a little wet caterpillar is beautiful . . . vulnerable, bespeaking the evanescence of life and the unbearable limpness of it all. I’m sure at some time, somewhere, the appendix had its moment, its evolutionary “15 minutes” of utility.
Gberg: What the hell are you bespeaking of?
Leyner: There was probably some predator that only ate people without an appendix so that gene flourished for a while. . . .
Leyner: Speaking of vestigial.
Leyner: What other supposedly vestigial organs are there?
Gberg: The tail.
4:10 P.M.
Leyner: Wouldn’t body hair also be considered vestigial now, since we don’t live naked out on the primeval savannah?
Leyner: I try to live naked on an inner sort of primeval savannah, but you know what I mean. Body hair is surely some sort of atavistic throwback too.
Leyner: What’s the purpose of pubic hair or back hair or even hair on the head?
Gberg: Hold on, I have to look up “atavistic.” I need a freakin’ thesaurus.
Leyner: It’s all economics. There’s not enough of a service industry devoted to the appendix, so it’s anathematized as “vestigial” . . . hair’s cool, what with the waxing industry and salons and shampoos and conditioners, etc. etc.
Gberg: You know, I love the word “merkin,” but do people really wear those?
Gberg: Why would anyone really want a pubic toupee?
4:15 P.M.
Leyner: The whole idea of a merkin is so great! I think this whole culture of plucked women is pretty perverse, actually. It’s sexually infantilizing. Who wants a woman who looks like a six-year-old down there?
Leyner: How big can an appendix get?
Gberg: I know, but by the same token, you don’t want someone who looks like a Yeti.
Gberg: Is that how you spell it?
Leyner: A Yentl?
Leyner: Yentl?
Gberg: No, the abominable snowman.
Gberg: Are you saying that Babs wears a merkin?
Leyner: Well . . . I know we’re digressing a bit . . . but rather a Yeti than a glabrous, waxen thing.
Leyner: Streisand is famous for the merkin. Made by the finest Venetian merkin-makers.
Gberg: Let’s not digress. We can get back to the book.
Leyner: From Yak scrotal hair.
Leyner: OK . . . back to the book.
ARE CANKER SORES CONTAGIOUS?
One of the great secrets of medicine and one of the things that doctors aren’t quick to admit is that we often don’t have all the answers. Canker sores are one of those cases. Canker sores, medically known as recurrent apthous ulcers, are the most common oral disease and something that many of us have experienced. They differ from cold sores in several ways. Canker sores occur inside the mouth while cold sores show up on the lips. Cold sores are caused by the herpes virus and are definitely contagious. The etiology of canker sores is still unknown, although scientists have spent a great deal of time searching for the answer. Studies have suggested that this inflammatory disease is a result of abnormal immune response directed toward the oral membranes. Several bacteria and viruses have also been investigated as the culprit, but none has been found to be responsible.
WHAT ARE GOOSE BUMPS?
It’s all about the arrectores pilorum.
What, you say, are arrectores pilorum?
These tiny little hair erector muscles that contract and raise the hair follicles above the skin. These are goose bumps or goose flesh or chicken skin.
What causes them?
They start with a stimulus such as fear, cold, or the sight of yourself in the mirror after a night of vodka-induced debauchery. This causes the sympathetic nervous system to become activated. The sympathetic nervous system is responsible for the body’s “fight or flight”; response. This sends a message to the skin and activates those little muscles.
WHAT REAL
LY IS HAPPENING WHEN MY FOOT FALLS ASLEEP?
Saturday night palsy is a condition often seen in the emergency room, not a sequel to a John Travolta film. It is caused by the same mechanism that makes your foot fall asleep but is a tad more severe. Saturday night palsy is caused when someone, who is usually really wasted, is unable to move an arm or leg in response to the pins and needles caused when a limb “falls asleep.”; It can lead to temporary or even permanent nerve damage.
Here is what happens in normal conditions. When pressure is exerted on part of your leg or arm, several things occur. Arteries can become compressed, making them unable to provide the tissues and nerves with the oxygen and glucose they need to function properly. Nerve pathways can also become blocked, preventing normal transmission of electrochemical impulses to the brain. Some of the nerves stop firing while others fire hyperactively. These signals are sent to the brain, where they are interpreted as burning, prickling, or tingling feelings. It is these sensations, paresthesias, that alert you to move your foot. Shaking your foot releases the pressure and nutrient-rich blood flows back into the area and nerve cells start firing more regularly. The “pins and needles”; feeling can intensify until the nerve cells recover. That is why it is painful when you try to “wake up”; your sleeping limb.
Persistent numbness or tingling can be a sign of certain medical conditions, and in those cases you should see your doctor.
WHY DO YOU GET BAGS UNDER YOUR EYES WHEN YOU ARE TIRED?
Feeling exhausted? Wondering why you have bags under your eyes that make you look like Droopy Dog or John Kerry?
Lack of proper restful sleep seems to cause dark rings for reasons not properly understood. The skin around the eye is the thinnest found anywhere on the body, and this thin skin allows dark, venous blood to show through.
Dark rings around the eyes are a common problem. They appear to be genetic and can get worse as you age and your skin gets thinner. Adequate rest, good nutrition, and overall good health tend to make the circles less noticeable. You can also wear sunglasses all the time.
WHY DO YOU LAUGH WHEN TICKLED?
You definitely don’t spend a great deal of time learning about laughter in medical school. I know that doesn’t surprise you since physicians are such serious people. The closest they come to humor is the physiological study of laughter—gelotology. There is even a form of seizures called gelastic seizures that causes sufferers to laugh incessantly.
Laughter is a complex process that requires the coordination of many muscles throughout the body. Laughter also causes an increase in blood pressure and heart rate, breathing changes, reduced levels of certain neurochemicals, and a potential boost to the immune system. So, overall, it is very good for you.
Researchers have attempted to decipher the purpose of laughter and many believe that the reason for laughter is related to making and strengthening human connections, a kind of social signal. Studies have shown that people are thirty times more likely to laugh in social settings than when they are alone. Reports also suggest that the origins of laughter may predate human evolution.
So, what about the connection between tickling and laughing?
Well, this tickling-induced laughter is actually a reflex. Scientists don’t fully understand how this works, but because you cannot tickle yourself, the reflex seems to require an element of surprise.
WHY DOES SWEAT STINK AND STAIN?
Have you ever used the expression “sweat like a pig”;? Think again. Pigs don’t sweat. Pigs don’t have sweat glands, which explains why they have to wallow in puddles and mud to cool off.
As for us humans, we routinely sweat as a way of eliminating excess heat and maintaining a normal body temperature. The average person has 2.6 million sweat glands distributed over the entire body except for the lips, nipples, and external genitalia. There are two different types of sweat glands, eccrine and apocrine. These glands are different in size and produce different kinds of sweat. Eccrine glands are located all over the body. Apocrine glands are different because they are found mostly in the armpits and groin. They are larger and open into hair follicles. Though sweat is mostly water, it is the small amount of protein and fatty acids in the apocrine sweat glands that gives armpit sweat that wonderful milky or yellow color. It is also what causes it to stain.
Sweat itself is odorless whether it comes from the armpits or other areas of the body. The funk begins when sweat mixes with bacteria that occur naturally on the surface of the skin. This distinctive odor is called bromhidrosis—foul-smelling sweat.
Gberg: I was going to add a New York cab driver joke to the “Why does sweat stink?” question.
Gberg: Any thoughts?
Leyner: What’s the joke?
Leyner: I love jokes.
Leyner: What’s the stinky cabbie joke?
Gberg: I don’t know one, but the scents of a taxi are so rude.
Gberg: It’s either that overwhelming air freshener or wretched body odor.
Leyner: See!! It’s all economics . . .
cabbies won’t run the AC . . . so of course they’re gonna stink—especially the ones who wear the Irish fishermen’s sweaters and the Latex underwear in the middle of the summer.
Leyner: Air freshener is, to me, worse than the smell it’s supposed to obscure . . . it just makes me think of what the person is trying to camouflage, so my mind creates an even greater fetid fiction.
Gberg: I don’t know. It depends what scent you are talking about. The hospital has some particularly vicious scents that need covering, like . . .
Gberg: Butt pus and
Gberg: bloody stool, which . . .
Gberg: They both sound like punk bands.
Leyner: Isn’t the smell of sweat supposed to produce certain subconscious (or conscious perhaps) sexual responses? And . . .
Leyner: What the hell is “butt pus”?
Gberg: Like a perirectal abscess or a pilonidal cyst—you drain them and the scent is horrible.
Leyner: Oh . . . that’s not so bad.
Leyner: I’ve smelled that.
Leyner: I have a pilonidal cyst—a dormant one though.
Gberg: You always were scent obsessed.
Leyner: I met a girl at Brandeis who also had one, and we soaked ours together. That’s true.
Gberg: Sitz baths.
Leyner: Fond memories of her.
Gberg: A sitz schvitz.
Leyner: Yes . . . sitz baths—we were young and idealistic.
Leyner: Isn’t a pilonidal cyst somehow related to a vestigial tail?
Gberg: I don’t know.
Leyner: That’s a fucking simple medical question, and your answer is “I don’t know”!!!!!!!!!!
Gberg: It brings back the original point of this book. They never teach you the obscure stuff that people actually ask.
4:30 P.M.
Leyner: My grandfather used to go to Hot Springs, Arkansas, for “baths.” Or so he told my grandmother.
Gberg: I can describe in detail the technique for draining a pilonidal cyst or talk about marsupialization, when you sew down the sides.
Gberg: Nobody wants to know that.
Gberg: And then I get mocked by some pumped-up little writer who couldn’t marsupialize his way out of a peper bag.
Gberg: Not a pepper bag but a paper bag.
Leyner: Do people ask you strange questions in the ER? Or are they too freaked out by having meat cleavers embedded in their heads to make small talk with you?
Leyner: You gotta explain that, dude!!
Gberg: Explain what?
Leyner: What’s marsupialization?
Gberg: You cut open the cyst and sew down both sides so it doesn’t come back. You create a little pouch.
Leyner: Maybe I’ll get that! I’ll have the ass of a kangaroo!
WHAT IS SNOT?
Phlegm, snot, spit, boogers, sputum—all different varieties of the same thing. These terms are used to describe different forms of mucus, a slimy material that lines various
membranes in the body (called, of course, mucus membranes). Mucus is composed chiefly of mucins (lubricating proteins) and inorganic salts suspended in water. Mucus aids in the protection of the lungs by trapping foreign particles that enter the nose during normal breathing. Mucus also makes swallowing easier and prevents stomach acid from harming your stomach wall.
As for the different varieties, phlegm is one type of mucus. By definition phlegm is limited to the mucus produced by the respiratory system, excluding that from the nasal passages (that is what we refer to as snot), and that which is expelled by coughing (sputum). In medieval medicine, phlegm was counted as one of the four bodily humors, possessing cold and wet properties. Phlegm was thought responsible for apathetic and sluggish behavior, which is how we get the word phlegmatic. Boogers are less historical, a slang word for dried nasal mucus or snot.
The presence of mucus in the nose and throat is normal. When you are sick the mucus can become thicker and change colors. Color is not a clear indication of a bacterial infection, but persistent rust-colored or green mucus tends to indicate a more serious condition.