How do doctors get their kicks? They write letters to medical journals. About us.
In news articles, the New England Journal of Medicine is often described as "prestigious." Among physicians, there is no more, well, prestigious place to publish. Every scientific article is screened by editors, other specialists and statisticians, and only five of every 100 submitted make it into this rigorously selective publication.
Like medicine itself, however, this journal has its light side, as it must to survive with some balance. This side is seen in its letters column, unique among medical journals for its picaresque nature. Now, these letters are immortalized in "Hunan Hand and Other Ailments: Letters to the New England Journal of Medicine (Little Brown, $15.95).
Why a book of these for us, the public? We learn that it's a difficult world and yet a wryly humorous world, that in our difficulties -- even the way overstuffed wallets cause back pain and batteries find their way into children's ears -- we patients sometimes teach doctors useful lessons. And this happens even while they, and, if possible, we, also smile a little.
Here are some of the Modern Age disorders these doctors have reported:
Hunan Hand, a painful burning of a patient's fingertips, after he first abraded them slightly while sandpapering, then handled dried red chili peppers for a Chinese meal. Also Jalaproctitis, a burning sensation during, shall we say, elimination, caused by eating fiery jalapenåo peppers.
Stiff and painful Space Invaders' Wrist and Video Game Palsy, induced by repeated operation of the knobs or controls used to avoid bombs, rocket the enemy or sink a basket electronically.
Frisbee Finger, abrasion of the right middle finger caused by over-Frisbeeing. Also Joggers' Nipples (abrasion suffered by both men and women as the jogging jogs these tender appendages), Handlebar Palsy (prolonged numbness of the hand muscles caused by pressing down on the handlebars during a two-week bicycle trip), Goggle Migraine (caused by overly tight swim goggles) and Sunglass Syndrome (nasal discomfort, almost like a cold, caused by the pressure of heavy and showy sunglasses).
Jeans Folliculitis, inflammation of the groin caused by ultratight jeans. "Further cases may well be seen in younger patients in view of the rash of advertisements aimed at children," warned Dr. Bruce Heckman of Ossining, N.Y.
Ponderous Purse Syndrome, pain and spasm of the shoulder and neck muscles caused by lugging one of those mammoth handbags. Closely related to Waiters' Shoulder, pain caused by carrying trays shoulder-high. Loosely related to Dog-Walkers' Elbow, inflammation caused by a doctor's Labrador tugging constantly "to sniff most bushes, poles, trash containers, fireplugs, dogs both male and female" and "cats and squirrels in particular."
Tight Girdle Syndrome, accelerated pulse, gastrointestinal discomfort, a displaced diaphragm and difficulty in breathing, all caused by a torturously tight corset and relieved by loosening it.
Just as serious, Back Pocket Sciatica, back and leg pain, blamed on a "bad back" but really caused or aggravated by sciatic nerve irritation when a thick wallet is carried in the hip pocket. Or maybe golf balls.
Then there's Carsonogenous Monocular Nyctalopia, a case of left-sided night blindness caused by watching Johnny Carson and other TV lateniks from bed, with the right side of the face buried in the pillow.
Life ain't easy. So the correspondents of the New England Journal ever remind us. Life as it is lived in these times has produced such grievous modern maladies as: Jaws Neurosis, "rigidity, jerking of the limbs and hallucinations of being attacked by sharks," suffered by a terror-stricken 17-year-old Kansas girl after seeing the film "Jaws," this though she admitted to her doctor "that the risks of shark attack in western Kansas were indeed remote." Celtics Fever, marked cardiac arrhythmia -- unsteady heartbeats -- while watching a Boston Celtics-Philadelphia 76ers playoff game on TV, detected because the excited Celtics fan was undergoing round-the-clock ECG monitoring while recovering from a heart attack. At the opposite end of the spectrum, Bowl Game Pulmonary Embolism, a blood clot in the lungs of a 40-year-old Bostonian who emerged from his bed one New Year's Day, managed to make it to the sofa, watched three straight football games on TV, then returned to bed, having stirred a bit only for food and drink. Might also have been called Couch Potatoitis. ::
In other ways too, comments Dr. Arnold Relman, editor of the New England Journal, "the physician's practice is a mirror of society." And doctors fret about society's ills.
In New York, Dr. Simeon David called attention to Reflex Horn Syndrome, "found predominantly among males," consisting of tense and frustrated drivers, commonly the second or third in line waiting at a red light, who persist in honking after the light turns green. Dr. John Clark and Nancy Johnson of the University of Utah Medical School proposed increasing seat-belt use among drivers ages 16 to 29 by wiring the car radio so it could be turned on only by buckling the seat belt.
Harvard dietitian Virginia Aronson worried because millions of Americans watch TV characters "wolfing down doughnuts and coffee," "swigging alcoholic beverages," ceaselessly eating and drinking yet remaining ever "lithe and healthy" without diets or exercise. No wonder, she said, so many sedentary, incessantly snacking, TV-gazers get middle-age spread, often before age 21.
And then there are the perils of raising children. Four Minneapolis letter-writers measured an infant's spontaneous screaming. It reached levels 30 times louder than normal conversation, about the same as a pneumatic hammer. In Allentown, Pa., Dr. Joseph Sembrot was puzzled by a discolored area at the corner of his daughter's mouth. He found she habitually ate a popsicle there because when she ate it more normally it "tickled her teeth." Minneapolis Drs. Lance and LoAnn Peterson told of an 18-month-old girl with what appeared to be cold sores. On closer examination, they proved to be frostbite caused by eating her first ice cream cone for 30 straight minutes while "never removing her mouth from the delightful treat." Dr. Leslie Rachlin of Pine City, N.Y., told of a boy, 6, who suffered two weeks of ear trouble before his mother, not the doctor, discovered he had pushed a button-sized watch battery into his ear canal so he might have a "bionic ear."
Three Swiss doctors reported a Hollywood horror-like danger to runners:
"During the past two years we have cared for 12 joggers, all attacked by birds, one even twice . . . The birds attacked by diving from behind and continuing to dive as long as the joggers were in motion." The victims' scalps suffered scratches or cuts up to five inches long.
A Pennsylvania doctor suggested a possible cause. His son and son's friends had experienced similar attacks while mowing grass. Perspiration on their heads attracted gnats, the real target of the hungry birds.
Finally, two quintessentially 20th century episodes of rampant radiation:
A California doctor tried to use his magnetized bank card to get money, but it was repeatedly rejected. Then a computer-linked restaurant refused to honor his VISA and American Express cards. All had been demagnetized when he stuck his head and torso inside an MRI (magnetic resonance imaging) scanner to help a patient.
And in Washington, in two separate incidents, two recent patients set off the White House alarm system while on a public tour. Both had undergone exercise-treadmill testing for heart disease after injections of radioactive thallium. In this test, a scanner measures the radioactivity reaching the heart muscle to ascertain the state of the coronary arteries.
Both patients hence remained slightly radioactive.
The editor of the New England Journal book called this one of Washington's many "problems on Pennsylvania Avenue."
Next Week: Doctors berate each other for "Medispeak" and more.