THE CINEMATOLOGIST SPEAKS (LIVE)!

COMMERCIAL MESSAGE

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!

Visions of the Future Show,

Friday, January 22, 2010 (in the future)

8pm

92Y Tribeca, 200 Hudson Street, NYC

$10

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

AVATAR #2: The Impotent Scientist

PANDORA'S BOX

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, by Helen MacDonald

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.

Jake (Sam Worthington) and his vat-grown avatar.

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).

Weaver as Augustine

She comes closer than anyone else I know

to making a lab coat look attractive and almost sexy.

This is not an easy task.

PRESERVER OF A DYING RACE

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.

Helen MacDonald

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.

AVATAR #1: Paraplegia

Sigourney and Sam

IT MUST BE (BELATED) CHRISTMAS

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.)

REVISITING PARALYSIS

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.

MORE HUNKY YOUNG MEN

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.

HOLIDAY QUIZ ANSWERED!

FIRST POST OF 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

The cast of King Kong all screaming together

Right and then left shoulder dislocation due to traction - The King yanks Darrow from her bonds

Pectoralis major and subscapularis muscle tear

Whiplash

Rib fracture

Some ribs

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

Cervical dislocation. Horrible.

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.

Pneumothorax (collapsed lung)

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

Mandibular fracture

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.

SPARE RIBS

Sherlock Holmes (Robert Downey Jr.) is a brilliant sleuth but a lousy anatomist. At the very beginning of this delightful film(1), Holmes narrates a sequence of strikes he is about to execute on an adversary, predicting the physiological results from the various blows he will inflict.

Mr. Downey as Sherlock Holmes.

Get me some barbeque sauce for those ribs(2)!

What is this big faux pas in the context of this narrative? The statement that took me a full three minutes to recover from? Holmes says he's going to punch this guy in his floating ribs, and poke them into his liver. Argh! See what I mean? This is so elementary, my dear Holmes! There are no floating ribs over the upper right quadrant of the abdomen. False ribs, yes. Floating ribs, no. Sheesh!

The liver is the big red blob in the upper right quadrant of the abdomen.

It is nestled up under your diaphragm(3). Some livers make excellent pate.

Everyone has twelve pairs of ribs. True ribs are pairs 1-7. They attach directly to the sternum, in the front of the body. False ribs (rib pairs 8-12) do not articulate directly with the sternum. Ribs 8-10 indirectly attach to the sternum. Floating ribs are pairs 11 and 12. They are called "floating" because they only attach to the thoracic vertebrae and don't make it around to the front of your torso to attach onto the sternum. Do they really float? No. They are anchored by bands of muscle. The tip of rib 11 can often be felt at the side of the waist. Rib 12 is in the back, hovering over your kidneys(4). Floating ribs are always false, but not all false ribs float.

True ribs, false ribs, and floating ribs, grouped above.

If you punch a kidney, you punch floating ribs. You could punch the liver without hitting a rib at all, but you are most likely to hit false ribs 8-10, or rib 7, a true rib(5).

Posterior view of the skeleton.

The floating ribs have the little red arrows pointing to them.

Holmes' lack of anatomical acumen doesn't keep him from incapacitating his enemies with his bare hands. I am not pooh-poohing his prowess in the manly arts, just his medical training. Great movie! Now I am hungry for skirt steak, BBQ ribs, and pate. All washed down with a pint of ale!

Barbecue ribs.

1. Yes, delightful. Jude Law and Robert Downey Jr., plus an allusion to resurrectionists and the dissection of criminals after their execution (which would have been a part of English culture even though the Anatomy Act of 1832 opened the non-criminal cadaver door, so to speak) plus fights, plus an evil villain looking (Mark Strong) oh-so-very Jeremy Britt truly makes for one fun movie!

2. I have a very loving and tolerant vegetarian husband.

3. The diaphragm is skirt steak in meat cut vocabulary.

4. Okay, the 11th rib also has some kidney coverage, too.

5. Don't get me started on true ribs.

HOLIDAY QUIZ!

Who doesn't feel like this at some point during the holidaze?

Answer this question by New Year's Day: 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).*

Happy Holidays! Time for Avatar!!!!!!!!

*Theatrical cut only! 187 minutes is enough of ANYTHING. Lists need not be in alphabetical order, although it would be helpful.

CASINO ROeYeALE

FOR HIS EYES ONLY

In Casino Royale, Mads Mikkelsen, playing the evil villain, Le Chiffre, "weeps blood." This, in addition to what I assume is asthma, makes him appear eviler.

Why does Le Chiffre weep blood? He tells us not to be alarmed(1), that it is only a derangement of his tear duct. Now, the bloody tears thing is a great theatrical trope. When I heard this statement I laughed out loud in the theater. It reminded me of the people with the bleeding eyes from the X Files episodes 'way back in the... 90's?

If you Google "bleeding tears" on Youtube, you will see a newsreel about this kid, Calvino Inman. He seems to have been diagnosed with hemolacria. That's like diagnosing a person who faints as having syncope(2). I find medical "news" broadcasts infuriating generally, for their tone and sensational tactics. There are also a lame commercials buttressing this clip, so watch at your own peril.

Click here for the Youtube file, I'm only the cinematologist and don't

know how to add video to this blog (yes I'm pathetic.)

This condition seems rather benign if this kid has no other underlying health issues. It looks kind of gruesome, but it doesn't seem fatal. The kid doesn't have asthma, and probably isn't evil, either.

EYE, EYE-YI!

When someone says "tear duct" they are often mistakenly thinking of the lacrimal puncta, two holes on the nose side of the eye, in the upper and lower lid by the pink part in the corner (the lacrimal caruncle.)

The lower lacrimal punctum.

These holes lead to the superior and inferior lacrimal canals, which join together to form the lacrimal sac, which dumps fluid (tears) leaving the eye, into the nose, via the nasolacrimal duct.

Ducts and glands of the eye.

This is why, when you cry, your nose runs. Your true tear ducts are a series of excretory ducts that squirt tears out of the lacrimal gland along the upper, outer, eyelid. Perhaps he is bleeding from here.

These models cry very convincingly, don't you think? They are so sad!

Their performance might be improved with some real blood on their faces,

flowing from their lacrimal glands.

BLOODY NOSE

When Le Chiffre tears up blood, these bloody tears would come from the lacrimal glands, seep across the surface of the eye, making everything look rosy, and then exit into the nose via the route described above. If Le Chiffre bleeds from his tear ducts, the blood would also run out his nose, making him look like a sissy, instead of evil. Calvino Inman gets a bloody nose when he bleeds tears, but he still just looks like a cute and bloody kid.

BLOODY HELL

Le Chiffre should go to an optometrist. You can't avoid a machete blade if your depth perception is screwed up from blood in your eyes. I bet the blood would clot on your contact lenses, too.

1. Who is ever alarmed for the bad guy?

2. Hemo- means blood, -lacr- refers to tears, and -ia is a "state of." So Calvino is in a state of bloody tears. I hope he has insurance to pay for that diagnosis. FYI, syncope means fainting.