Men Love Siri, Women Still Looking for Mr. Good Signal Strength Bar

A study in the current issue of Virtual Science has confirmed what many already suspect: men are falling in love with Siri. When Apple introduced Siri – the iPhone 4S virtual assistant – this past October, tech geeks became very excited. But few had the foresight to see that this excitement would also become a bad double entendre.

The just-published research was conducted by virtual scientists at the University of Wisconsin. Based upon telephone interviews with iPhone 4S owners, 79% of men in committed relationships (defined as completely monogamous for greater than 12 months, any recent office Christmas party activities of course exempted) found Siri to be a more desirable romantic partner than their current significant other. Despite the apparent strength of these data, the authors were quick to point out that the Siri preference may be overstated as the male study participants were all involved with women from Wisconsin.

The Siri phenomenon is not just a scientific one. The latest entry in the hugely popular Girls Gone Wild video series, Virtual Assistants Gone Wild, includes footage of Siri (some truly amazing stuff happens just past the 4 minute mark, or so I’m told) and is poised to be their biggest seller yet. Plus, the rumor mill has it that Esquire magazine’s 2012 Sexiest Woman Alive is setting up to be a close battle between Siri and Megan Fox.

Apple has been quick to notice these trends and will soon be offering Siri-themed apps through its iTunes Store. “Sexting Siri” will substantially expand upon her vocabulary and allow her to answer those personal questions to which she now refuses. The specific details of another app, “Siri Love You Long Time”, have not yet been made available, but a hardware purchase of some sort will be needed to take full advantage.

The Virtual Science study also asked women iPhone users about Siri, with 63% describing her as a vapid, catty ogress who they long ago disabled from their phones. When these women were then questioned about what they’d like in a virtual assistant, many expressed a preference for a yellow, nonverbal, smiley-faced character with glasses. When told that this description identically matches that of Microsoft Bob, the colossal Windows virtual assistant failure from the 1990s, the response would typically switch to “Well, just anything but that Siri b*tch”.

[The blogger reserves the right to occasionally go off topic and flat out make things up, and he did receive an iPhone 4S as a holiday gift]

This was originally posted in the Buffalo Grove Patch on 12/28/2011.

Foreign Body Misadventures

My introduction to the wild and wacky world of x-rays and foreign bodies came late one night during the first year of my radiology residency. I was asked to read an abdominal x-ray on a young woman, the concern being that a rectal thermometer had become misplaced – and inaccessible – within her urinary bladder. I asked the attending emergency medicine physician why the patient was certain that the thermometer was in her bladder rather than the appropriate – or other regional – orifice. The emergency doc paused, gave me a wry smile, told me she asked the patient the very same question and was given an angry reply. I’m paraphrasing after 20+ years, but the response was something along the lines of, “It’s in my #@!*% bladder – I’m not stupid!!”

X-rays done to locate a foreign body usually don’t lead to such acerbic confrontations, the most common situation probably being a cute toddler who accidentally swallowed a coin. But variants of “I have no idea how that wine bottle got in there” do occur fairly often, and I have yet to meet the radiologist without a foreign body anecdote. A book published earlier this year, Stuck Up! 100 Objects Inserted and Ingested in Places They Shouldn’t Be, has probably been long in coming. I do regret that it was written by three non-radiologists, the authors being two psychiatrists and an emergency medicine physician. I have known two radiologists who collected dozens of similar – and in my opinion better quality – images, one of whom I used to regularly beg to pursue publishing as a coffee table book. But to no avail.....

Before I come off callous and uncaring, let me assure you that I completely empathize with these patients who must be horribly embarrassed having to explain their predicaments. And the people described in such a book deserve anonymity and respect, as well as prompt and appropriate treatment for what can be a true medical emergency. I like to think that this is why my radiologist colleagues never “went public” with their collections. But the x-rays – and even more so the stories – can be fascinating, and the ones in Stuck Up! do not disappoint.

I personally have only a handful of noteworthy foreign body tales. In addition to the “thermometer debacle”, my most memorable – and disturbing – case involved a woman (despite my examples, men are much more likely to be involved in such incidents) who would bend and break razor blades prior to swallowing them. When asked why she broke them before ingesting, her reply – again paraphrasing – was very matter-of-fact, “They’d be far too big and difficult to swallow otherwise.”

While often sad, such sagas provide a unique window and insight into human behavior. People do peculiar things, some of which are dangerous and require medical attention. And – for better or worse – unexpected metal in the human body can make a really cool x-ray.

This was originally posted in the Buffalo Grove Patch on 12/20/2011.

Thanksgiving, Tom Robbins and Other Oxymora

I’m not working this week, so no medical musings from me as I take my vacation responsibilities very seriously. But lots of meandering…..

I am without a doubt one of the world’s least well-read people, so the idea of me blogging about literature is as much of an oxymoron as “least well-read”. The only time I read for pleasure is on vacation, and I began this one by finishing the book I started months ago during my last break from work, Tom Robbins’ Fierce Invalids Home from Hot Climates. I really like Tom Robbins, but I completely understand why many people don’t. His novels are audacious, absurd, larger-than-life and beyond far-fetched. But there are two things about his writing that I in particular appreciate and enjoy. He confronts life’s most important and contentious subjects (ie, the ones we should never discuss over Thanksgiving dinner) with bold humor, and – especially for an XY author – he creates strong complex female characters. David Mamet should probably spend some time with Mr. Robbins before he next attempts to put an XX into one of his works.

Near the very end of Fierce Invalids, there’s a passage that curiously got me thinking about Thanksgiving and why I like it so much. Domino – the book’s most multidimensional woman – says, “[N]o matter how valid, how vital, one’s belief system might be, one undermines that system and ultimately negates it when one gets rigid and dogmatic in one’s adherence to it.” While the spirit of Thanksgiving – the idea of being thankful for what you have – is every bit as religious as counting one’s blessings, the day itself is an oddly secular – and uniquely American – celebration.

Beginning with the obvious, there’s nothing remotely similar to fasting involved, the idea of a Thanksgiving fast another oxymoron. You don’t have to give anything up in order to respectfully honor the day. And you get to watch professional football when the overeating is finished, this of course only after the strong complex female characters and all of their male counterparts – even the Mamet fans – have together cleaned up the mess. There are no presents to be purchased, and there’s nothing remotely controversial about it. Have you ever heard of a store clerk being instructed to say “Happy Harvest Celebration” instead of “Happy Thanksgiving”? Or seen a bumper sticker on a car that reads “Keep the ‘Thanks’ in Thanksgiving”? Of course not. Thanksgiving is beautiful and special this way – it’s inclusive of all people of all faiths, and even of those with no faith.

For the three or four of you who have made it to the end of this ramble, I want to sincerely wish you a Happy Thanksgiving. And hopefully Detroit loses to Green Bay, as the Bears’ road to a wild card berth has become far more difficult with Cutler perhaps out for the rest of the regular season.

This was originally posted in the Buffalo Grove Patch on 11/21/2011

The death of Apple CEO Steve Jobs has drawn renewed attention to alternative medicine, most of it non-flattering. Jobs had a rare form of pancreatic cancer, insulinoma, which has a better than 75% cure rate when conventional remedies are utilized. Jobs delayed standard treatment – namely surgery – for 9 months while he instead explored dietary therapy. Whether or not his foray into alternative medicine led to his death is pure speculation, but his story does show that you can be brilliant, creative and wealthy yet still make questionable decisions about your own health.

Much of my day-to-day work as a radiologist involves assessing the response of cancer to various medical and surgical treatments, using tests such as CT, PET scanning and ultrasound to actually measure tumor sizes and changes in such over time. Most cancers respond favorably to conventional therapies, but – sadly – some don’t respond well to anything. I have on only very few occasions encountered patients who have opted for alternative regimens over traditional ones, Mr. Jobs’ story thankfully the exception in my experience rather than rule.

A few years back I performed an ultrasound on a woman who had been treating her breast cancer for 4 months with dietary therapy – perhaps similar to what Mr. Jobs tried – by an alternative practitioner based locally in the northwest suburbs. She was by all accounts intelligent, informed and perfectly reasonable, but she was adamant against having breast surgery. Her alternative medicine practitioner had told her that the dietary regimens were working and that her cancer was shrinking. But she was misinformed. I measured the size of her tumor and had a comparison study from the time her cancer was initially biopsied, and it had doubled in size. Based upon this information, she opted for breast conservation surgery – lumpectomy, the standard traditional treatment – and will hopefully not suffer any adverse consequences because of this delay, as her disease was still localized at the time she decided to abandon alternative medicine. But it frightens me that otherwise logical people can be taken advantage of like this, the lure of something labeled as “natural” and “noninvasive” – yet completely unproven – somehow worth such a significant risk.

I have in particular always found it infuriating that some proponents of alternative medicine sincerely believe that there’s a conspiracy against them by those of us who work in the conventional world. I have found the exact opposite to be true. I have seen a complete unwillingness by alternative medical practitioners to subject their treatments – most of which are expensive (these are nearly always cash-only services not covered by insurance) and some of which are frankly dangerous (please look up “coffee enema” if you doubt this) – to any objective scientific testing. I would be proud to be part of any research that could prove that an easy-to-tolerate dietary therapy shrinks cancer, but no one has ever asked me to do so. And as a radiologist who measures tumor sizes daily, I am perhaps the perfect person to be involved with such a study.

A Google search of “Buffalo Grove” and “alternative medicine” will return approximately 600,000 items. While the vast majority are not relevant to treating cancer this way by a local practitioner, the few that certainly are show up near the top of the list. I sincerely invite any of these people to work with me in evaluating their treatments. If I am wrong and these therapies can be shown to work, then alternative medicine gains credibility and these practitioners will rightfully be able to reap any and all benefits. But if unbiased testing continues to be refused, then these individuals are simply selling snake oil. And I wish they’d stop.

This was originally posted in the Buffalo Grove Patch on 11/16/2011.

I'M LOOKING THROUGH YOU

Everyone should have their own cocktail party story, especially if it can clear up confusion about you or help make you sound more interesting than you really are. I am a diagnostic radiologist, but many people incorrectly assume that I take xrays (this would be a radiologic technologist) or treat cancer with therapeutic doses of radiation (this would be a radiation oncologist). I am instead the person who sits alone in a dark room reading xrays, mammograms, ultrasounds, MRIs and CT scans. It’s less lonely and more interesting than that sounds, but it would probably make for horrendously dull reality TV. In any event, when asked about my profession, I tend to highlight the CT aspect, as most people know what it is (and have probably had at least one during their lives). And if I feel fine with how the conversation is going, I will tell my one and only cocktail party story.

The scientific research involved in the development of both CT scanning and MRI occurred at roughly the same time, but CT managed to become a routine medical test nearly 20 years before MRI did. The surprising reason for this is…..the Beatles. If not for the Fab Four, CT might have taken decades – or longer – to be in widespread use. This technological revolution is able to quickly, painlessly and accurately diagnose serious and sometimes life-threatening conditions, having replaced more invasive procedures including exploratory surgery.

In 1962, on the recommendation of an (at the time) obscure music producer named George Martin, the Beatles were signed to a recording contract by EMI, the acronym for Electronic and Musical Industries. EMI started out working with military technology and electronics. But when it purchased Capitol Records in the 1950s, it soon became a major force in popular music.

A middle-aged EMI electrical engineer named Godfrey Hounsfield lead the team that built the first all-transistor computer. Because of this success, the company gave Hounsfield the freedom to pursue his own independent research. Hounsfield conceived of a way to get xrays and computers to come together and create three dimensional images. With a little help from his musical friends (specifically four straight years of Beatles’ record sale profits kept from the taxman), Hounsfield and EMI were able to manufacture and install the first commercial CT scanner in 1971. Hounsfield won the Nobel Prize for Medicine in 1979, was Knighted by the British Empire in 1981 and passed away in 2004 at the age of 84. His name lives on as the Hounsfield Unit (HU), a quantitative measurement of tissue density as determined by CT. From me to you, it’s better to have something in your body with a low HU than a high one.


[Commenters are encouraged to see how many Beatles’ song titles they can find hidden in this little vignette, but no prizes are being offered]

This was originally posted in the Buffalo Grove Patch on 11/08/2011.

POETRY FOR PHYSICISTS

PREFACE

Many liberal arts colleges require non-science majors to take a class entitled “Physics for Poets” or something similarly whimsical. These are survey courses which typically condense the entire field of physics into a single semester for students with little background in math or science (eg, poets). While not rigorous science by a long shot, this may be the only physics exposure that some will ever get. As a self-proclaimed science geek, I never had the need to take such a class. Unfortunately for me, my dorkiness and resulting limited exposure to literature and difficulties with expressing ideas via the written word were never similarly addressed at the undergraduate level. I have always though that a course along the lines of “Poetry for Physicists” would have been very useful for someone like me. Now a middle-aged man, I have had to navigate my own path through the English language without any formal instruction, and my knowledge of literature in particular remains severely deficient. Despite these shortcomings, I have always enjoyed telling stories and have toyed with the idea of serious writing in the past. Until very recently, however, I didn’t think I had that much of interest to say, let alone the ability to say it. A couple of unexpected tragic but related and somewhat fascinating events occurred “around me” in early 2009, these experiences intensifying my desire to put my thoughts on paper, or more accurately on hard drive.

What follows is my attempt at telling the narrative of a time much earlier in my life that only now do I fully appreciate. I admittedly have a short attention span, so this tale has been broken down into short segments that I call “chapters”. Moments of inspiration came and went, so chronologic order is typically not respected. This effort should best be termed “creative nonfiction”, a great expression in my opinion but one for which I cannot take credit. While entirely based in fact, liberties with the truth have been taken to both simplify the writing process and to – hopefully – make reading more enjoyable. This has been quite an educational journey for me, the most important thing learned that I have had the unique pleasure of knowing some truly fascinating people with whom many meaningful moments were shared. Hopefully, what is in my head has translated well to the written word.



ONE: KICKING AT THE PERFUMED AIR

Primarily known as the activist and humanitarian organizer of Band Aid, Live Aid and Live 8 (involvement in such charitable activities leading him to be nominated for the Nobel Peace Prize and granted knighthood by Queen Elizabeth II), Bob Geldof originally gained fame as the lead singer and main songwriter for the Irish rock band the Boomtown Rats. ‘The Rats’ were never very popular in America, having only one song that charted in the states. “I Don’t Like Mondays”, the first single from their third album, limped to #73 on the Billboard Hot 100 List in the summer of 1979. The song tells the true story of an elementary school massacre that took place that past January in San Diego. The shooter was a 16-year-old girl who lived across the street from the school, killing two people and wounding nine others with a rifle she had received as a Christmas present the month before. When asked at the time why she went on this shooting spree, she shrugged and replied, “I don’t like Mondays. This livens up the day.”

I was a big Boomtown Rats fan, having purchased all of their vinyl LPs and, about 10 years ago, managing via eBay to get their second and third albums (the two best by far), A Tonic for the Troops and The Fine Art of Surfacing, on CD for transfer to my iPod. The second single from Surfacing, “Diamond Smiles”, completely failed to chart in the US. This song tells the fictional story of a middle-aged woman who commits suicide. The title character in the song defines herself strictly by her appearance and ability to be sexually attractive to men, Diamond now well past her prime as the aging process has taken its toll on her looks and ability to seduce the opposite sex. The last verse in the song is:

“She went up the stairs,
Stood up on the vanity chair,
Tied her lame belt around the chandelier,
And went out kicking at the perfumed air.”

My old high school and college friend Jay died in his sleep on May 24, 2009. He was a musician of some success, best known for being Second Banana in Wilco during what was their creative peak, the years extending from Being There through Yankee Hotel Foxtrot. He was gradually moving his way up from Second Banana to Co-Grand Poobah when Jeff, the official Wilco Poobah and sole owner of the band’s recording contract, unceremoniously fired him in 2001. The details of the breakup were captured – and manipulated for narrative effect – on a documentary movie made about the band during the recording of YHF. The film unfairly paints Jay as an OCD head case, clearly making him the villain in the contrived narrative. It certainly wasn’t going to help him launch a solo career.

Jay could be his own worst enemy at times, perhaps the most stubborn person I have ever known and also someone with substance abuse issues. A mutual friend of ours who kept in much better contact with him than I during his last few years explained it best. If Jay was thin and looked good, he was doing lots of coke. If he looked fat and bloated, he was probably clean and relatively healthy.

Jay’s solo career was prolific but creatively uneven and not terribly profitable. He released five albums, the first (and best) a collaboration with an old friend and then four proper solo recordings. The first four were released on CD by actual record labels. The last was distributed over the internet for free via his MySpace page, this to me signaling a dwindling fan base. Most of the obituaries mentioned that he was working on yet another solo album at the time of this death, tentatively titled Kicking at the Perfumed Air. Only a few reporters made the Boomtown Rats connection, but there were clearly parallels between Jay’s life and that of the fictional Diamond.

Toward the end of his life, Jay had developed severe arthritis in his right hip, most likely the result of an injury sustained years earlier while “stage diving” during a concert. He posted about this on his MySpace blog at about the same time that information about a lawsuit he filed against Jeff became public. The same blog entry also mentioned that he didn’t have any health insurance. The damages sought in the lawsuit, $50,000, would appear to be in the same ballpark as the cost of the hip replacement surgery he so badly needed. I thought connecting the dots was pretty straightforward.

The initial autopsy was inconclusive, and I immediately assumed that he had overdosed on illegal drugs, either intentionally or accidentally, and with this distinction perhaps not able to be made. As with all such deaths, toxicology testing takes weeks to be completed. I was quite surprised to learn that he died of a Fentanyl overdose, this a pain medication given by patch. While prescription pain relievers are often abused, pain patches typically aren’t. The drug is released slowly from the patch, getting high with this approach quite impractical unless one is willing – and able – to put 20 or so all over your body at the same time. I am certain that Jay was fat when he died, as the published autopsy results describe no other drugs and his body was found with a single patch. Unfortunately, this just makes everything that much sadder.

TO BLOG OR NOT TO BLOG: A QUESTION

I registered this blog over a year ago, and this is my "virgin" entry. Until today, all I have done was change the initial name from Don’t Drink the Kool-Aid (sounds too precious and pretentious to me now) to the current one. Why am I doing this at all, and why has it taken me so long? I believe this is a very good question. And the answer is simple and straightforward: I’m not sure that I philosophically believe in blogging. It would appear that just about everyone has their own, but I don’t find that most blogs impart much valuable information to others. In fact, you could make a pretty good argument that most people’s thoughts are best kept to themselves. So why should my blog be any different or any better? (Another very good question from me.) And if I am writing this strictly for myself as many bloggers claim, then why don’t I just save the text as a Word document and call it my electronic diary? (The good questions continue.) Well, I guess I must honestly believe that I have something to write that will be of interest to others. This statement is likely only semi-correct at best, and hopefully I am not beginning the slide down the slippery slope to egomaniacal self-absorption. Time will tell.