Sunday, January 24, 2010


I saw Daybreakers the other night with my cartoonist husband. We both had a better time than we thought we would. I had such a good time in fact, that I can recommend this movie as very entertaining. I have to admit that I was the only one in the theater laughing at the projectile vomiting, but everyone joined in when the guy's head exploded.

Why would I laugh at projectile vomit? I'll tell you.

Edward Dalton (Ethan Hawke) is a vampire hematologist hard-pressed to create a blood substitute for the world's vampire population, which is practically everybody. There are very few humans left and their blood is harvested to feed the starving masses (of vampires). Time is running out. Dalton's mission is humanitarian on two counts: he is trying to save the lives of the last human beings, and he's trying to prevent vampirekind from mutating into horror movie style vampires, which is the fate of any vampire who doesn't get human blood.

This starving vampire has degenerated into a more
monstrous form. Notice the elongated phalanges (finger bones).

In a scene early on in the movie, our hero has decided to push forward with his vampire subject trials, in his search for a synthetic "human" blood substitute that will save vampire populations from starvation. Dalton's non-beating heart is in the right place, but he really should have had an IRB(1) read his study proposal before he carried it out.

Dalton is in the lab with his study subject. They are about to see if the vampire subject's body accepts this new blood substitute. So what does Dalton do with this blood substitute? He injects it into this vampire. (Record skip noise goes here.) Yup! That's right. Dalton is testing a food product by injecting it intravenously. That's like putting someone on an IV drip that full of chocolate milkshake, or pureed cheeseburger. We have one seriously flawed study. There is no external validity here because most vampires are going to want to drink this blood. Who wants to shoot up their food? Sam Neill's character, Charles Bromely, will back me up on this.

Chis (Vince Colosimo) and Edward reflect on whether or not soaking
fabric in cold water will get rid of vomit stains.

Needless to say, the whole clinical subject scene sent me into a fit of giggles(2). How would I test a synthetic food product for nutrition and safety? I'd feed it to someone. Food, be it liquid or solid is chemically altered by digestive enzymes the moment you put it in your mouth. Your saliva has enzymes in it that start breaking down carbs before you can even say "Pass the ketchup" with your mouth full.

From your mouth, the food makes its way through the long tube that is your esophagus, stomach, small intestine, large intestine (aka the colon), then passes out your anus. You may have noticed that the food you put in your mouth looks nothing like its former self when coming out the other end, one hopes.

Although the stomach absorbs some molecules from your food and drink, most absorption of nutrients happens in the small intestines. Molecules absorbed from the stomach go directly into the bloodstream, molecules absorbed in the intestines go the the liver for processing before they get into the rest of the bloodstream.

If a vampire is feeding on blood, that blood is going to have to be digested (broken down into little bits) and absorbed as something smaller than blood cells(3) to get through the lining of the gut and be of any use to the vampire, nutritionally.

Flawed study. Entertaining film!

1. Internal Review Boards check medical studies for ethics violations, legal issues, and flaws in design.
2. I was sitting next to a couple who were obviously really into vampires. They seemed a little put out because I wasn't taking this movie seriously.
3. Blood carries a lot of stuff in it other than blood cells and platelets. There are all sorts of proteins (I'm thinking of albumins specifically, for you trivia buffs), glucose, hormones, carbon dioxide, cholesterol, etc. Some of which might get absorbed directly, but not the bigger stuff.

Sunday, January 17, 2010


Hey everyone! I've been invited to give a presentation on Friday January 22, as part of the line up for a great evening of live geekiness.

Kevin Geeks Out is the comedy-variety show hosted by writer and comedian Kevin Maher. A monthly confabulation of vintage film clips and videos, new finds, guest experts, games and curiosities. To geek out with Kevin you don't need to be a geek, you just need to love cool stuff.

I, Kriota, as The Cinematologist, will be appearing in Kevin's Visions Of The Future show. We'll explore the wonderful world of mutation expressed(1) through cutting-edge science from films such as I Am Legend, Total Recall, and the X-Men series. It promises to be a fun night. If you're in New York City with time on your hands, come on by!

1. ..."mutation expressed"....Ha! It's a pun!

AVATAR #2: The Impotent Scientist

There I was Christmas day in LA on Christmas vacation, wearing my Christmas sweater, confident of my abilities in getting my Christmas gluteus maximus to the gym after the holidaze were over, sitting in a movie theater and watching Avatar while wearing my Christmas 3D glasses.

You'd think that Sam Worthington, Sigourney Weaver, and 3D action on a moon with floating islands would keep me from being distracted by other thoughts. If I was distracted, you'd think I would be fantasizing about what I was going to buy with my Christmas gift cards, but no. What was this movie making me think of? The extinction of the aboriginal Tasmanian population in the late middle of the 1800s and the weird role of scientists in the study of vanishing races.

Human Remains: Dissection and its Histories is a book about the treatment of the dead by doctors and medical educators, with the main focus on dissection and collection practices in England and Tasmania in the 1800s. MacDonald pays close attention to the value of the "exotic" cadaver. Most cadavers available for dissection were those of white males. She spends a lot of time discussing the political power of someone in possession of a female (her examples are white female convicts) or non-white male (in this case Tasmanian aboriginal) cadaver, for dissection and display. It's a very interesting book.

Back to Avatar, Dr. Grace Augustine (Sigourney Weaver) leads a science team that has grown avatars of Na'vi bodies, used by humans to get around Pandora without the need for gas masks. The use of a Na'vi body also makes the scientists look like the Na'vi, although their behavior is less disguised.

Augustine clearly cares deeply for this indigenous people. She has studied them up and down, in and out. The science team has compiled enough information on the Na'vi to grow them in a vat.

How did they get this information? How many years did it take? You'd have to start studying alien metabolism almost from scratch. You could do a lot of non-invasive study, but you'd also need tissue and fluid samples, and you'd probably want to get your hands on some Na'vi bodies for dissection and analysis(1). Where would they get those bodies? Would the Na'vi go for this? They give their dead to the neural-net-tree-system on the planet. I can't imagine they'd be okay with some human science team cutting up grandma into smaller and smaller bits.

Tasmanian medical men resorted to grave robbing in their quest for Aboriginal bodies and skeletons, since no one (aboriginal) wanted to give their loved one's cadaver up for scientific study(2).

She comes closer than anyone else I know
to making a lab coat look attractive and almost sexy.
This is not an easy task.

Augustine as a scientist is impotent against the company that funds her research. She really can't do anything to protect the Na'vi from corporate interest. She and her research team are positioned to dominate the Earth's Alien Biology and Anthropology scenes for decades to come based on their research. They posses the biological artifacts of a race doomed to extinction. Their careers are guaranteed. As this race of people is exterminated, their knowledge and documentation of these people will become even more valuable.

Augustine will be famous and dominate her field, thanks to the persecution and extinction of the people she loves. She can dole out tissue samples, information, and patent all sorts of new techniques for melding human psyches into Na'vi bodies(3). She loses big and wins big as the world she studies is destroyed. Wow. Now I'm going to shop with my Christmas gift cards.

I wonder if Helen MacDonald has seen Avatar yet?

1. Yes, even in 2154 they are still going to need to take bodies apart in invasive ways to study them. I'll bet you five bucks. We have MRIs and 3D imaging these days, but I'll tell you from experience you can study the human body all you want, but the day you start cutting one up, you learn about it like you've never learned before.
2. The circus involved with the cadaver of the last native Tasmanian man is not to be believed. You should read the book.
3. SPOILER ALERT! Of course I am looking at this from Augustine's and our perspective before she dies, or gets her spirit sucked up into the tree. But had she lived, this scenario would have been the case.

Sunday, January 10, 2010

AVATAR #1: Paraplegia

Sigourney and Sam

A miracle has occurred! I get to blog about characters played by two of my favorite actors! Sigourney Weaver and Sam Worthington! Both in Avatar! Yippee! Although there are some disturbing racial themes to this film(1), there's also dramatization of the forces behind aboriginal genocides, great action, and a decent story that ends "happily" (but doesn't really.)

Jake Sully (Sam Worthington) is a paraplegic ex-marine, replacing his dead twin brother on a mission to a moon called Pandora, orbiting a planet called Polyphemus. Jake sustained a spinal cord injury in combat. Symptoms and signs of spinal cord injury will vary with the amount of damage to the cord (complete or partial) and the location of the damage.

Generally speaking, nervous function will remain above the level of the cord lesion. Function below the injury will be absent or diminished. It's hard for me(2) to tell from the movie, how much control Jake has over his hip muscles.

A variety of deep and superficial flexors of the hip, from an old copy of Gray's Anatomy, 1918.
Don't worry, muscles haven't changed that much in the last ninety-two years.

It is easy to see that Jake clearly has no control over knee or foot movement. If we use the chart below, which I lifted from the Merck Manual online, we can assume that Jake's injury is at the spinal cord, between the 11th and 12th thoracic nerves. This is an area between the lower thoracic vertebrae, where the floating ribs attach(3).

Effects of spinal cord injury on the body, from the Merck manual online.
I love the Merck as a resource.

Grouping #2 in this illustration shows the thoracic nerves.
The lowest of these are T11 and T12.

We see in the film that Jake does not have the use of his legs, which have atrophied due to lack of use. I understand that James Cameron's production crew cast prosthetic legs for Jake from a paraplegic man who was of Worthington's build. I thought they did a really great job of making Jake's atrophied legs blend with Worthington's body. I have no idea how they did that.

If you want to watch a film that will educate you about different types of disability, spinal cord injury and the variables of paralysis, I highly recommend Murderball. This documentary is about exactly the types of character Jake Sully represents: young, competitive, loaded with testosterone, and male. It humanizes victims of spinal cord trauma in a way I've never seen before. It made me cry(4). I show it to my pathology classes.

Athletes playing wheelchair rugby, a.k.a. murderball, from the movie.

Where does Sigourney Weaver come in to all this? Wait for my next post about Avatar....

1. There is a very strong message that it takes a white guy to "go native" and save an indigenous population that clearly can't save itself.
2. It doesn't look like he has control over any of the gluteals, adductors, tensor fascia latae, etc. The way he moves his body in relationship to his legs, it appears that he has psoas function, but I'm not a doctor (I just watch one on TV.)
3. See the 12/30/09 post for more on floating ribs.
4. What can I say? I cry at the movies unless they're stupid.

Tuesday, January 5, 2010


The Holiday Quiz question received a "black hole" response. So few people replied that "less than zero" replied. No matter (or anti-matter), it was a rather daunting task. As you recall, the assignment was to list the musculoskeletal injuries that should have been sustained by Ann Darrow (Naomi Watts) during her encounter with the Eighth Wonder Of The World in King Kong (2005).

For fun, I've included additional injuries. My cartoonist husband points out that since Darrow's injuries would have killed her in the first two minutes, this exercise is futile. Here's the list in chronological order.

Rope burn at the wrists - Darrow struggles in her bonds.
Stubbed toe - The frame she is tied to drags her forward and there is a close up of her feet.
Muscle spasm and rotator cuff strain - She is suspended over a pit by her wrists.
Sore throat - Lots of screaming

Right and then left shoulder dislocation due to traction - The King yanks Darrow from her bonds
Pectoralis major and subscapularis muscle tear
Rib fracture

Internal bleeding
General bruising (ecchymosis)
Lacerations to face and arms - Whipping by local flora.
Severe whiplash, cervical dislocation
Cervical spinal cord compression resulting in spinal shock and quadriplegia

Pott's or Dupuytren's fracture - Darrow pokes Kong in the hand and he drops her on the rock from a height of 15-20 feet. She is barefoot. (See posts 6/3/09 and 6/26/09 for more on dislocation-fractures of the ankle.)
Multiple cranial fractures, hemorhage, contrecoup injuries (see 6/8/09 and 8/10/09 for more on contrecoup), swelling, and compression on the brain, pneumothorax due to lung puncture from broken ribs - Kong, with Darrow in fist, gallops along on all fours.

Coccygeal sprain - Darrow falls back on the ground in Kong's lair
Additional bruising and lacerations - she performs floppy acrobatics to entertain the great ape.
Patellar fracture - Landing from a back flip
Broken jaw, loose teeth - Kong hits Darrow in the face

For the sequence where Kong saves Darrow from three T-rexes, repeat all of the above four times, and add fracture-dislocation of the lower thoracic vertebrae from her fall through the vines. Add shock, coma, and death.

I love this stuff. Avatar coming next time.