Funtabulously Frivolous Friday Five 240

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Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 240.

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Question 1

Colonial India, under British rule may seem a strange place for medical ethics but during this time the ‘Cobra effect’ was observed. What is the Cobra effect?

Hmm… No ear holes, no eyelids, and broad ventral scales… [Photo by Gregor Younger]

Reveal Answer

  • When an attempted solution to a problem makes the problem worse (at first do no harm – Primum non nocere).
  • The British government were concerned about the number of venomous cobra snakes in Delhi and therefore offered a bounty on dead cobras. Those member of the population who were more enterprising started breeding cobras to gain the rewards offered. Once the government because aware of this ‘loop hole’ they stopped the program. As a result the wild cobra population increased and made the situation worse. [Freakonomics podcast] [Der Kobra-Effekt. Horst Siebert (2001)]

Question 2

What is tradus et parvus?

Reveal Answer

  • A slow rising pulse, indicative of arterial stenosis, (tardus = prolonged and parvus = small amplitude).
  • It can be appreciated on clinical exam when feeling the radial pulse in aortic stenosis or visually with ultrasound, for example with renal artery stenosis. [Reference]
    • Kotval PS. Doppler waveform parvus and tardus. A sign of proximal flow obstruction. J Ultrasound Med. 1989;8(8):435-40.
    • Dodd GD 3rd. What is the tardus parvus spectral Doppler waveform, and what is its usefulness in the detection of hepatic or renal artery stenosis? AJR Am J Roentgenol. 1995;165(5):1299-300.

Question 3

What was the first TV advert in the UK about? 

+ Reveal the funtabulous answer

  • Toothpaste
  • Gibbs SR toothpaste on the 22nd of September 1955 with the launch of ITV.
  • Apparently sales did increase slightly but not as much as predicted due to the fact many people were still loyal fans of the BBC and missed the adverts.

Question 4

What is the average speed at time of impact when a professional wrestler performs a body slam?

Reveal Answer

  • 23 miles per hour.
  • Apparently the kinetic energy released is about 1100 foot pounds. This all sounds very impressive until you use Wolfram Alpha to find out that it is only 0.32 x the energy released by the explosion of 1g of TNT. Pitiful really…

Wilton P, Fulco J, O’Leary J, Lee JT. Body slam is no sham. N Engl J Med. 1985 Jul 18;313(3):188-9. PMID: 4010719.

Question 5

What is the connection between Edgar Allan Poe, quackery and the history of informed consent?

Reveal Answer

  • Edgar Allan Poe’s 1845 tale ‘The Facts in the Case of M. Valdemar‘ suggests that informed consent was an important issue even then. At the time people were concerned about the effects of mesmerism, especially in those who were dying. Poe’s story concerns the impending death of Monsieur Valdemar, who was dying from tuberculosis and has an aortic aneurysm. In a last ditch attempt at saving the man’s life, mesmerism is used. This is how the consent process is related:

“I spoke freely with M. Valdemar on the subject of his approaching dissolution, as well as, more particularly, of the experiment proposed. He still professed himself quite willing and even anxious to have it made, and urged me to commence it at once. A male and a female nurse were in attendance; but I did not feel myself altogether at liberty to engage in a task of this character with no more reliable witnesses than these people, in case of sudden accident, might prove. I therefore postponed operations until about eight the next night, when the arrival of a medical student with whom I had some acquaintance, (Mr. Theodore L—l,) relieved me from farther embarrassment. It had been my design, originally, to wait for the physicians; but I was induced to proceed, first, by the urgent entreaties of M. Valdemar, and secondly, by my conviction that I had not a moment to lose, as he was evidently sinking fast.

It wanted about five minutes of eight when, taking the patient’s hand, I begged him to state, as distinctly as he could, to Mr. L—l, whether he (M. Valdemar) was entirely willing that I should make the experiment of mesmerizing him in his then condition.

He replied feebly, yet quite audibly, “Yes, I wish to be. I fear you have mesmerized”—adding immediately afterwards, “deferred it too long.”

  • The old man died anyway — in Poe’s fiction, just like the real world, mesmerism proved to be just another form of quackery.

Altschuler EL. Informed consent in an Edgar Allen Poe tale. Lancet. 2003 Nov 1;362(9394):1504. PMID: 14602460.

…and finally

Funtabulously Frivolous Friday Five 240 Neil Long

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Author: Neil Long

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