No deductible: Operating on yourself


DRAWING BY DEBORAH DERR McCLINTOCK

Q. Is DIY ("do it yourself") surgery ever done? –J.D. Aller

A. Necessity mothers much, as they say, including the recent case of the 27-year-old mountaineer forced to amputate his own arm with a pocketknife after being trapped five days under an 800-pound boulder in a remote desert canyon. He eventually went back to climbing. Oddly, the climber as a kid was reportedly so squeamish during a biology dissection that he opted for the hard sciences.

Most of the self-surgery literature involves amputations, says Columbia University surgeon Allan Stewart. This is not unique to humans; coyotes caught in a trap will bite off an extremity to avoid capture. In a rare case, a 40-year-old woman in Mexico performed a crude C-section on herself when she went into labor and ran into trouble, according to the International Journal of Gynecology and Obstetrics. She had previously lost a baby in childbirth and feared this might happen again. After three glasses of hard liquor, she cut through skin, fat and muscle, reached inside and pulled the baby out. She cut the umbilical cord, then passed out. Amazingly, both Mom and baby survived.

In a very different case, a surgeon at the South Pole out of necessity did her own biopsy, made a fateful diagnosis and wrote a book about it.

"I have in fact sutured a laceration on my hand," says San Francisco surgeon Carlos Corvera. "Of course I used local anesthetic. Once you get over the issue of cutting into flesh, I doubt it matters much that it is your own."

Q. You love playing baseball, but your batting average hovers around .200. You go for an eye checkup, reading letters off the chart: "20/15, better than average," the doctor pronounces. So it's not your eyes, right? –A. Popkin

A. Maybe wrong. For starters, a standard eye chart will check "static" visual acuity but not "dynamic" visual acuity, which is the ability to see moving objects.

Batters with good dynamic acuity can see the spin on the ball right away, a vital source of information, says A. Terry Bahill in American Scientist. This occurs within about the first 1/7th second of the pitch: Is it a 4-seam fastball, a 2-seamer or something else? The fascinating thing is that the ball has really only one long continuous seam of 108 stitches that can appear as multiple seams and "flicker rates" as the spinning pitch approaches.

To get a feel for this, try reading the label on an old 33-rpm phonograph record. Most of us are taxed to our limit trying to do this. The great Boston Red Sox slugger Ted Williams could read a record at 78 rpm, vision that no doubt helped propel him to record-breaking feats and to the Baseball Hall of Fame.

Q. Imagine you suddenly find yourself with X-ray vision like Superman. Fun, but one big catch: Now instead of seeing faces, you see skull bones! How will you ever be able to tell people apart? –B. Karloff

 A. Everybody's skull is a little different– overall shape and size, eye sockets, nose holes, says zoologist R. McNeill Alexander in Human Bones. Then there's the mouth, important in forensics– patterns of dental fillings, crowns, missing teeth. For real specificity, there are the patterns of sutures between the skull bones, showing telltale wiggles. Some skulls have a clear suture down the middle of the forehead, most are fused.

"It would take us some time to become familiar with the details of skulls, but I am confident we would soon learn to distinguish our friends."

At an X-ray bar, you could tell men vs. women, especially age 20-55. Male skulls are larger, with marked eyebrow ridges, plus larger, squarer lower jaws and more prominent chins. Forensic experts can peg a male or female skull about 85 percent of the time. With the pelvic girdle, the figure jumps to 95 percent, even higher with stature bones. Super! Now if you could just turn off those X-rays to see that attractive face, the real fun might begin.

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