Climbing stile over fence to feed mohair goats, slipped and fell to ground.
Feeding donkey from bucket. Donkey nudged patient, pushing her over backwards.
Slipped on puddle of urine from new Labrador pup. Fell against wooden arm of armchair.
Fell forwards while trying to prevent young puppy from diving into fish tank.
Fell sideways in garden while trying to stop cat catching a blue tongue lizard.
Tripped over black cat in darkened hallway.
Fall while attempting to move quickly out back door as cat carried live snake in through side door.
‘There were no deaths recorded as a result of the fall-related fractures’, Kurrle et al. tell us, ‘but one of the animals involved (a cat) died when its owner fell and landed on it.’
Kurrle, Susan E., Robert Day, and Ian D. Cameron (2004). ‘The Perils of Pet Ownership: A New Fall-Injury Risk Factor.’ Medical Journal of Australia 181: 682–83.
Addressing the Karaoke Pandemic, Vocally
A scientific experiment may look like torture, and sound like torture, yet still be free of legal ramifications. At the University of Hong Kong, Edwin M.-L. Yiu and Rainy M. M. Chan did an experiment that smacks of torture for the participants, the experimenters, and anyone within earshot. Their published report has a title that evokes wretchedness: ‘Effect of Hydration and Vocal Rest on the Vocal Fatigue in Amateur Karaoke Singers’.
The experiment brought several hours of continuous, mounting, painful discomfort to a group of human volunteers. Yet the scientists’ aim was noble. They write that ‘karaoke singing is a very popular entertainment among young people in Asia ... It is not uncommon to find participants singing continuously for four to five hours each time. As most of the karaoke singers have no formal training in singing, these amateur singers are more vulnerable to developing voice problems under these intensive singing activities.’
This modestly understates the problem. Many thousands of young persons sing karaoke. Multiply that by the duration of singing – four or five hours. Now multiply that by the average number of times per week each person sings karaoke. Then multiply by fifty-two weeks. The resultant sum represents a groaning annual burden of painful singing, on a continental scale. And that’s just Asia. Karaoke is pandemic on at least six continents.
The experimental subjects were a carefully chosen bunch, all in their early twenties, in good health, and in the habit of singing karaoke at least twice a week. They had no formal voice or singing training, no history of voice problems, and no chronic psychiatric problems worth mentioning.
Yiu and Chan performed this experiment at the university’s voice research laboratory. Each person ‘was asked to sing in a quiet room with karaoke facility, which provided music video on a television and background music with echo effects ... The participants were required to sing continuously until they reported feeling fatigue with their voices and could not sing anymore.’
Ten of them got to rest for a minute after each song, and drink some water. The other ten received neither hydration nor rest; they bopped till they dropped, so to speak.
The hydrated singers sang longer, if not better, than those denied liquid. The former averaged more than one hundred minutes of warbling, the latter about eighty-five. (The four to five hours they claim to sing while at karaoke clubs presumably includes lots of down time.)
Yiu and Chan did find a surprise. They had expected the wet singers to sing better than the dry. This expectation was largely unmet. Assessments by trained ears and eyes (the latter involving phonetograms – electroacoustically produced graphs of pitch and loudness) showed that, warble for warble, vocal quality levels were roughly the same for both groups.
Unskilled singers, one might infer from this, seldom exceed mediocrity yet seldom fail to achieve it. Occasional water and rest can help them prolong their remarkable record of achievement.
Yiu, Edwin M.-L., and Rainy M. M. Chan (2003). ‘Effect of Hydration and Vocal Rest on the Vocal Fatigue in Amateur Karaoke Singers.’ Journal of Voice 17 (2): 216–27.
Hives on the Pitch
‘This is the first reported case of an urticarial rash apparently caused by the frustration of watching England play football.’
With these words, written in 1987, a London general practitioner trainee named P. Merry alerted readers of the Journal of the Royal Society of Medicine to a little-suspected risk of rooting for a World Cup football team. Rooting can cause emotional upset, which can cause urticaria. Urticaria is also known as ‘hives’.
Here’s what happened to the patient, who followed the game on TV: ‘When Portugal scored the only goal of the match to win 1-0, he became extremely upset, and developed the rash of urticaria affecting his trunk and limbs. This persisted for 36 hours and then settled.’ Four days later, the man watched England vs. Morocco. ‘When a member of the English team was sent off, he became agitated and subsequently developed the same rash of urticaria on his trunk and limbs.’
Then, in 2006, thirty-four-year-old Paul Hucker, of Ipswich, Suffolk, UK, made headlines because he bought an insurance policy against possible trauma brought on by an England defeat in the World Cup. Many chuckled at the news. A wander through the medical literature suggests the chucklers should temper their amusement.
Five researchers at the University of Bristol published a warning in 2002, in the BMJ, that ‘myocardial infarction can be triggered by emotional upset, such as watching your football team lose an important match’. Their main evidence: British hospital statistics accumulated at the time of the 1998 World Cup. ‘Risk of admission for acute myocardial infarction’, the doctors point out, ‘increased by 25% on 30 June 1998 [the day England lost to Argentina in a penalty shoot-out] and the following two days.’
Number of deaths from myocardial infarction, French men vs. French women. France played Brazil in the final of the World Cup on 12 July 1998.
Four researchers in Lausanne, Switzerland, say a similar thing happened during the 2002 World Cup. They lay out their stats in a 2006 issue of the International Journal of Cardiology. The number of sudden cardiac deaths was sixty-three percent higher during the World Cup than during the equivalent period a year earlier, when there was no World Cup competition. The doctors try to analyse it: ‘We explain this by an increase in mental stress and anger and possible unhealthy behaviour (increased alcohol and tobacco consumption, decreased medical compliance) of football supporters. The lethal effect of mental stress and anger has been attributed to its activation of the sympathetic nervous system leading to hypertension, impaired myocardial perfusion in the setting of atherosclerotic disease and a high degree of cardiac electrical instability precipitating malignant arrhythmias.’
Fandom carries danger, yes, but there’s a special payoff for those whose side does capture the ultimate glory. Or so implies a study that appeared in 2003 in the journal Heart. Written by two French doctors, the title proclaims: ‘Lower Myocardial Infarction Mortality in French Men the Day France Won the 1998 World Cup of Football’.
Merry, P. (1987). ‘World Cup Urticaria.’ Journal of the Royal Society of Medicine 80 (12): 779.
Carroll, D., S. Ebrahim, K. Tilling, J. Macleod, and G. D. Smith (2002). ‘Admissions for Myocardial Infarction and World Cup Football: Database Survey.’ BMJ 325: 1439–42.
Katz, Eugène, Jacques-Thierry Metzger, Alfio Marazzi, and Lukas Kappenberger (2006). ‘Increase of Sudden Cardiac Deaths in Switzerland during the 2002 FIFA World Cup.’ International Journal of Cardiology 107 (1): 132–33.
Berthier, F., and F. Boulay (2003). ‘Lower Myocardial Infarction Mortality in French Men the Day France Won the 1998 World Cup of Football.’ Heart 89 (3): pp. 555–56.
Object RCSHC/P 192
The rectum of the Bishop of Durham sits on display in London, awaiting your examination. No longer attached to the bishop, it rests alone inside a glass jar in the Hunterian Museum at the Royal College of Surgeons of England. The museum calls it by the formal name: Object RCSH
C/P 192.
Visitors can casually admire the object’s beauty. Scholars and poets can find unexpected delights in studying and writing up the bishop’s rectum. This apparently humble body part can boast a historic connection to John Hunter, the surgeon whose collection of medical memorabilia eventually grew to become the Hunterian Museum.
The museum officially gives a simple description of Object RCSHC/P 192: ‘A rectum showing the effects of both haemorrhoids and bowel cancer. The patient in this case was Thomas Thurlow (1737–91), the Bishop of Durham. Thurlow had suffered for some time from a bowel complaint, which he initially thought was the result of piles. He consulted John Hunter after a number of other physicians and surgeons had failed to provide him with a satisfactory diagnosis. Hunter successfully identified the tumour through rectal examination but recognised that it was incurable. Thurlow died ten months later.’
Hunter wrote extensive notes about how he entered the case, examined the rectum (which at the time was, of course, still an integral part of the bishop), and immediately recognized, by feel, that it had an incurable tumour.
The notes also tell how events played out. The bishop, disbelieving Dr Hunter’s diagnosis, then tried to cure himself with a nostrum called Ward’s White Drops. He was choosing to rely on past experience with a lesser ailment, rather than accept Hunter’s professional assessment. Hunter notes that ‘his Lordship had, about ten years ago, the piles, for which he took Ward’s Paste, and was cured’.
The White Drops did not cure the bishop’s cancer. Instead, his discomfort increased. Hunter writes that the family then called in ‘Taylor the cattle-doctor to attend him, and I was asked to examine this doctor, to see whether it was likely he should do mischief or not’. Hunter concluded that Taylor would do no mischief. Taylor deferred happily to the renowned physician’s opinions and, with his approval, gave the bishop opium and ointments, to ease the distress.
Ten months later, the bishop breathed his last. John Hunter performed an autopsy, savouring the opportunity to write a detailed technical assessment of the tumour and of its role in killing a patient who doubted the doctor’s diagnosis.
The copious details are a bit grisly for a general audience. Hunter’s notes were intended for himself or for others of his profession, should he or they encounter a similar rectum or a similar patient. Now, more than two hundred years later, the story, and a good view of the rectum, are available to anyone who seeks enlightenment.
Steve Farrar noticed the bishop’s rectum and brought me to visit it. That resulted in tea with Simon Chaplin, the museum’s director, who has a special fondness for and knowledge of historic body parts. I am and will eternally be grateful to both men for their insights into the remaining bit of bishop.
May We Recommend
‘No-Scalpel Vasectomy at the King’s Birthday Vasectomy Festival’
by Apichart Nirapathpongporn, Douglas H. Huber, and John N. Krieger (published in the Lancet, 1990)
101 Uses for the Sacred Foreskin
A study called ‘The Circumcision of Jesus Christ’ pioneers a new flavour of interdisciplinary research: urology at last joins forces with theology. Published in the Journal of Urology, the study focuses on what happened to Jesus’s foreskin during and especially after biblical times.
Lead author Johan J. Mattelaer brings a broad perspective to this narrow topic. A past chairman of the History Office of the European Association of Urology in Kortrijk, Belgium, and professor emeritus of psychiatry at the University of British Columbia in Vancouver, Mattelaer earlier wrote a book called The Phallus in Art and Culture. And shortly before taking on the sacred foreskin project, he teamed up with Austrian-Canadian neuropsychologist Wolfgang Jilek to write a study called ‘Koro: The Psychological Disappearance of the Penis’. For the Jesus circumcision study, Mattelaer and colleagues Robert A. Schipper and Sakti Das delved into two thousand years’ worth of religio-phallocentric writings, paintings, sculpture, music, and theological disputes.
There is art aplenty, they explain, but ‘it seems paradoxical that uncircumcised Christian artists created so many images relating to the circumcision of Jesus in painting and sculpture. In Belgium alone there are no less than fifty-four listed works in churches, museums, and public buildings relating to Christ’s circumcision, including paintings, grisaille, frescos, statues, altarpieces, stained glass windows and keystones.’ Greek and Russian Orthodox church icons, they report, commonly contain circumcision images.
Musicians produced only a few works. The most prominent is ‘Missa Circumcisionis Domini Nostri Jesu Christi’ (‘Mass for the Circumcision of Our Lord Jesus Christ’), composed by Jan Dismas Zelenka of Dresden in 1728.
Churches, museums, crusaders, and kings sought to have and hold the actual foreskin. The study notes that ‘the Dominican scholar A. V. Müller, writing in 1907, could list no fewer than 13 separate locations, all of which claimed to possess the sacred foreskin as their holiest relic. We have been able to extend this list to 21 churches and abbeys, which at one time or another are reputed to have held Christ’s foreskin.’
The study also reports that King Henry V stole the genuine article – the one so identified by Pope Clement VII – from the French in 1422, and that ‘the monks of Chartres were only able to recover it with great difficulty’.
Several theologians devoted their lives to the foreskin. Two remain emblematic. St Catherine of Siena (1347–80), to symbolize her marriage with Christ, ‘was reputed to wear the foreskin of Jesus as a ring on her finger’. A generation or so earlier, the Austrian nun Agnes Blannbekin ‘led a life devoted to the foreskin of Jesus’. The study says: ‘She was obsessed by the loss of blood and the pain which the redeemer had suffered during his circumcision. On one occasion when she was moved to tears by the thought of this suffering, she suddenly felt the foreskin on her tongue.’
The study reproduces a 1523 painting of St Catherine and her ring, but, perhaps deferring to current tastes, supplies no visual image of Agnes Blannbekin.
Mattelaer, Johan J. (2003). The Phallus in Art and Culture. Arnhem, The Netherlands: European Association of Urology History Office.
––, Robert A. Schipper, and Sakti Das (2007). ‘The Circumcision of Jesus Christ.’ Journal of Urology 178: 31–34.
––, and Wolfgang Jilek (2007). ‘Koro: The Psychological Disappearance of the Penis.’ Journal of Sexual Medicine 4 (5): 1509–15.
Death by Aspiration
One’s aspirations can kill – if Dr Sakae Inouye, of Otsuma Women’s University in Tokyo, is correct – and Chinese aspirations are particularly deadly.
Inouye devised a simple theory about a vexing public health problem. His theory is this: the English language, when spoken by someone who normally speaks the Chinese language, can be lethal.
Inouye drove his train of logic through the pages of the Lancet: ‘Severe acute respiratory syndrome (SARS) is transmitted via droplets spread by infected individuals. Droplets are generated when patients cough and, to a lesser extent, when they talk during the early stages of disease. I believe that the efficiency of transmission of SARS by talking might be affected by the language spoken.’
Here are the details of Inouye’s reasoning. They are subtle. They are breathtaking. They should perhaps be read silently.
The disease called SARS seems to have originated in China.
China has had millions of visitors from the US, and even more visitors from Japan.
Some American visitors (about seventy out of 2.3 million) got the disease – but no Japanese visitors did.
There must be a reason for that.
The reason must be: language. In both Chinese and English, many sounds have a strong accompanying exhalation of breath – but Japanese has no such sounds.
The final step in the chain brings these pieces together. It is frightful. Dr Inouye writes that: ‘A Chinese attendant in a souvenir shop probably speaks to American tourists in English, and to Japanese tourists in Japanese. If the shop assistant is in th
e early stages of SARS and has no cough, I believe American tourists would, hence, be exposed to the infectious droplets to a greater extent than would Japanese tourists.’
Inouye does not specify a particular dialect of Chinese, so at the moment all are suspect.
If one’s spoken language is dangerous, can it be altered? Nearly a century ago, future Nobel Prize winner George Bernard Shaw raised this very question. In the printed preface to his play Pygmalion, about a professor who painstakingly alters the speech patterns of a young woman, Shaw wrote: ‘The change wrought by Professor Higgins in the flower girl is neither impossible nor uncommon ... But the thing has to be done scientifically, or the last state of the aspirant may be worse than the first.’
Inouye, Sakae (2003). ‘SARS Transmission: Language and Droplet Production.’ Lancet 362 (9378): 170.
In Brief
‘Attempted Suicide or Hitting the Nail on the Head: Case Report’
by A. S. Spears (published in the Journal of the Florida Medical Association, 1994)
The authors at H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, report: ‘A case is reported of attempted suicide by hammering nails through the skull into the brain. This unique attempt at self-destruction was unsuccessful and the treatment, initially by an untrained first-aider and then by a neurosurgeon, was surprisingly simple.’
Nine
Seriously Deadly
In Brief
‘A Partially Mummified Corpse with Pink Teeth and Pink Nails’
by C. Ortmann and A. DuChesne (published in the International Journal of Legal Medicine, 1998)
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