The Ghost in the Figurine

Ventriloquism emerged as a religious practice that branched off from necromancy. 

Necromancy was a form of divination that involved communicating with the dead to predict the future. Gastromancy (ventriloquism) had the same objective, but with a different technique. 

Ventriloquists could supposedly converse with the dead and divine the future but, for such a bold claim to be credible, the dead needed to talk back. And they did. The creepy disembodied voices of the unliving spoke through the stomach noises of a gastromancer because, well, he had demons living in his stomach. Unsurprisingly, our word “ventriloquism” comes from the Latin venter (belly) and loqui (speak), which gives us a term meaning “to speak from the stomach.” In ancient Greece, ventriloquists were also called “engastrimyths”.

Let’s get this straight. The souls of the dead lived in the stomach of a ventriloquist. The noises made by a ventriloquist’s stomach were the voices of the dead telling fortunes. That sounds about right. 

Ventriloquism continued its dangerous tradition into the Middle Ages when throwing your voice could get you thrown off a cliff. On the other hand, a skilled ventriloquist priest could perform spectacularly convincing exorcisms. 

When stage magic became more profitable than fortune-telling, ventriloquy’s relationship with demonic possession broke and speaking through a dummy turned performance art. 

“Typhoid Mary”

Whenever I see people going into Mary Brown’s for chicken & taters, I can’t help but chuckle. Mary Brown was the assumed name of an infamous carrier of Salmonella typhi (the microbe that causes typhoid fever). “Typhoid Mary” spread disease while working as a cook. She posed such a threat to the public that she spent the last 23 years of her life in forced isolation!

Mary Mallon was born in 1869 in Cookstown, Ireland, before emigrating to the US to cook for wealthy households. When one of these well-to-do families suffered an outbreak of typhoid fever, George Sober (a sanitary engineer) was commissioned to investigate. Typhoid fever usually spread among the poor in unsanitary slums, so this case was peculiar. At the time, typhoid fever was fatal in 10% of cases with antibiotic treatment unavailable until 1948. Sober pursued a few red herrings before his attention turned to the cook, Mary Mallon.

Mallon refused to cooperate with Sober’s investigation. She was unwilling to submit stool and urine samples and could not see the value in handwashing because she felt perfectly healthy.

Sober discovered that seven families who Mary previously served had reported typhoid illness and death. When Mary Mallon was taken into custody and samples were forcibly obtained, they tested positive for typhoid. Doctors offered to remove her gallbladder to stop her shedding the microbe, but Mary refused. With Mary’s stubbornness posing a threat to public health, she was forced into quarantine.

After three years in isolation, Mary was released under the agreement that she would not work as a cook and that she take reasonable steps to prevent infecting others. After her release, however, Mary assumed false names and continued to work as a cook, changing jobs frequently.

In 1915, Manhattan’s Sloane Maternity Hospital experienced an outbreak of typhoid fever resulting in two deaths. An investigation was launched. The staff at the hospital had a nickname for their hospital’s cook: “Typhoid Mary.” The cook was, in fact, Mary Mallon! She was working under the assumed name of Mary Brown. After her second apprehension, Mallon spent the last 23 years of her life in forced isolation until her death on November 11, 1938.

He Touched His Own Heart

Cardiologists have saved countless lives by threading a tube through blood vessels in the groin, neck, or arm into the heart. But did you know that the first doctor who performed cardiac catheterization did it on himself?!

German urologist Dr Werner Forssmann believed he could catheterize a human heart without killing his patient. His superiors were skeptical and refused to sanction such an experiment. Forssman, unable to obtain access to sterile instruments, tricked a nurse into cooperating with him.

In 1929, Forssmann persuaded nurse Gerda Ditzen to be his guinea pig. Assured that the procedure was perfectly safe, Gerda agreed to be Forssman’s patient. After providing Forsmann with sterile instruments, Gerda was told that she would have to be restrained. Forsmann explained that patients sometimes collapse from the local anaesthetic. Gerda agreed. With the nurse tied up, Dr Forssmann proceeded to jam a ureteric catheter into a vein in his left arm, advancing it about 30 cm. He then released Gerda and walked to the X-ray room to check if the catheter had reached his heart. Using a mirror to watch the screen, Forsmann could see the tip of the catheter was not in the desired location. He proceeded to push the catheter further until it was in his heart and then took a final X-ray to document his success.

Dr Forssmann’s stunt got him fired. He ended up joining the Nazi party in the 1930s to serve as a surgeon in the German army. Following Germany’s defeat in World War II, Forssmann became a prisoner of war of the United States. After his release, he was forbidden to practice medicine and worked as a lumberjack in the Black Forest.

Today, we can operate on birth defects of the heart, perform heart bypass surgery, insert pacemakers and stents because of the trailblazing contribution of Dr Werner Forssmann; a pioneer who never received professional recognition when in his prime.

Dr Forssmann died of heart failure in 1979. A few months before his death, he said the following about his professional alienation: ”It was very painful. I felt that I had planted an apple orchard, and other men who had gathered the harvest stood at the wall, laughing at me.”

In 1956, he received the Nobel Prize for Medicine or Physiology together with André Cournand and Dickinson Richards.

A Disease Contraction Figure

In recent news, Nike designed an athletic shoe targeted explicitly to doctors and nurses who Nike referred to as “everyday heroes”. The profits from Nike’s Air Zoom Pulse will be donated to OHSU Doernecher Children’s Hospital in Portland. 

That got me thinking. Has any company released a range of medical action figures? What about a patient figurine? The answer to both questions is an awkward ‘yes’. 

When kids in the 1980s were clamouring to get their hands on the latest  Masters of the Universe, G.I. Joe, or Thundercats action figures, a French toy company, Berchet, tried to sell a Médecins Sans Frontières (Doctors Without Borders) line of non-violent action figures. Amid doctor and nurse figurines, their creative team also came up with a character called “Samba”, a 10-year-old emaciated African child. Samba came with two accessories, a stretcher and a hot water bottle. The back of Samba’s packaging card provided a backstory. Roughly translated from French, it reads: “Samba is ill. Has a snake bitten him, is he a victim of an epidemic, or is he suffering from a lack of food?”

The idea was wincingly tone-deaf, even for 1988, but the vulgarity of it was offset by the promise that each figure purchased would fund a vaccine. 

 

The Shake of Water

The Jacuzzi was invented, out of necessity, as a medical device.

After 15-month-old Kenneth Jacuzzi contracted rheumatic fever from untreated strep throat, he went on to develop juvenile rheumatoid arthritis. His rheumatologist recommended hydrotherapy (water treatment) to soothe his joint pain.

Although young Kenneth responded well to treatment, travelling to and from the hospital hydrotherapy tank proved challenging. His father, Candido Jacuzzi, set about designing a massaging whirlpool water pump to use in their home’s bathtub. Ken’s doctor was so impressed that he encouraged Jacuzzi to market the device to hospitals.

Medicalese on the euphemism treadmill.

Did you know that the words idiot, imbecile, and moron were all quantitative clinical definitions? Idiot referred to an IQ (intelligence quotient) below 25, while imbeciles measured in the IQ range 25 to 50. Moron described an IQ score between 50 and 70.

Cultural appropriation of medical language by laypeople transforms clinical definitions into terms of opprobrium so that Medicalese runs on an interminable euphemism treadmill. Many doctors no longer feel comfortable using the word ‘obesity’ (another quantitative definition describing a BMI > 30 kg/m2).

George Carlin told a classic joke of how ‘shell shock’ became PTSD. Carlin’s commentary is not only socially critical but medically accurate. Diagnoses of ‘wind contusion’ became ‘shell shock’ with the First World War. After the Second World War, medical terms evolved into ‘battle exhaustion’, ‘combat fatigue’, and finally ‘post-traumatic stress disorder’.

  • Wind Contusion: In the pre-World War I era, some believed that the shockwaves from exploding shells could cause physical harm without direct impact, a condition termed ‘wind contusion’. This idea, while not entirely accurate, highlighted an early recognition of the impact of the battlefield environment on soldiers’ health. 
  • Shell Shock: During World War I, the term ‘shell shock’ was coined by British psychologist Charles Myers. It was initially thought to be a physical injury caused by the impact of shells, but later, it became clear that it was a psychological condition. Shell shock brought widespread recognition to the psychological toll of war, although understanding and treatment were still rudimentary. 
  • Battle Exhaustion and Combat Fatigue: In World War II, terms like ‘battle exhaustion’ and ‘combat fatigue’ were used. These terms indicated a growing understanding that the condition was not just a result of a single event (like a shell explosion) but could also stem from prolonged exposure to the stresses of combat. 
  • Post-Traumatic Stress Disorder: The term PTSD was officially recognized in 1980 with its inclusion in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). PTSD expanded the understanding of the condition beyond the military context, recognizing that traumatic stress can arise from various life-threatening or deeply distressing experiences. 

Did you know that during the Civil War, a similar condition was referred to as “soldier’s heart” or “irritable heart”? This term highlighted the observed physical symptoms like rapid heartbeat, but it also missed the psychological aspect we understand today. 

Today, the word ‘nostalgia’ is associated with fond memories, but it originally referred to a medical condition.

From the Greek terms “nostos” (return home’) and “algos” (pain), nostalgia described the state of deep despair experienced by Swiss troops in foreign countries. Sufferers of nostalgia used to be treated with purges to improve digestion and free up vital spirits. Physician and Swiss scholar, J. J. Scheuchzer, thought that the Swiss were especially vulnerable to nostalgia because they were mountain people who inhaled and consumed refined air in their food and drink. When they descend to the lowlands, their skin fibres become compressed, forcing blood into the heart and brain, thus slowing circulation. Soldiers incapable of resisting these effects could be successfully treated by moving the soldier back to the mountains or administering youthful wine and saltpetre to increase internal body pressure.

Catgut and Cobwebs

Catgut and cobwebs: Medical science has always looked to nature for inspiration.

In Shakespeare’s comedy, “A Midsummer Night’s Dream”, he names four fairy characters after folk remedies of the time. One of them was called “Cobweb”.

“I shall desire you of more acquaintance, good master cobweb,” said the character Bottom. “If I cut my finger, I shall make bold of you.”

Yes, spider webs were bandages in ancient Greece and Rome. Even today, the unique properties of spider silk have promising medical uses. Artificial tendons, ligaments, implants, sutures, adhesives, and bandages could all be improved if we could tap into the molecular properties of cobwebs. Rich in vitamin K, webs have antifibrinolytic features to go with their antiseptic, anti-fungal, and mechanical properties. They are also biocompatible (our immune system does not freak out when exposed to silk). Unfortunately, spider silk is far too complicated for us to recreate and farming large quantities poses a difficult challenge.

The first known absorbable sutures (stitches) were made of the intestines of sheep. Doctors call them ‘catgut sutures’.