A former policeman told me about a case he dealt with in the late 1970s. A man had got up in the morning, had breakfast, got in his car and drove off to work. Halfway to work he had coughed a large amount of blood onto the windscreen of his car, collapsed over the wheel and died - crashing the car in the process.
He interviewed the man's spouse. They had a cocktail party at home the previous night and had been drinking heavily. At a certain point in the evening her husband had knocked back his drink so energetically that he had swallowed the cocktail pick along with the drink. The people talking to him saw what happened and everybody thought this was extremely funny, including her husband.
The pathologist confirmed that the cocktail pick had worked its way through the lining of his oesophagus and had eventually reached his heart.
I swallowed a shirt pin as a child. Went to hospital, x-rays, etc. Originally the set me nil by mouth and were set to operate, but the consultant overruled and luckily it passed naturally. (:
Yeah don't swallow things which cannot be digested. I have one anecdotal story of a person swallowing dried bay leaf which then got stuck "at the exit".
Wow .. I had no idea. I'd always assumed you were supposed to remove them from cooking because they would taste bad if eaten directly - not that you couldn't actually digest them!
Yeah a lot of different leaves don't break down well in the digestive track without friction or longer digestion periods (which are adaptations that actual herbivores have).
This is also why they (bay leaves or more generally all laurel leaves) are such a massive pain in the ass to compost in most places.
The wonders of insoluble fiber and wax coatings on leaves.
A good example of one of my favorite diagnostic axioms, Hickam’s dictum:
Hickam's dictum is a medical principle that a patient's symptoms could be caused by several diseases. It is a counterargument to misapplying Occam's razor in the medical profession. A common version of Hickam's dictum states: "A man can have as many diseases as he damn well pleases."
"They also looked at his medical history, which was relatively short. He was born in Central America, but he had lived in the US for 16 years."
Interesting constellation of sentences. So, the most important thing in a medical history seems to be where you've been born. Is Central America or the US better/worse for your health I wonder? That is not going to be clear here.
"have you traveled outside the country?" is a pretty common question. Doctors trained and practice in a specific context - an American hospital - may not recognize symptoms of common parasites or illnesses in other places. 16 years is a long time to incubate something but it could also be related to imported food, travelling back home, or a recent arrival of someone else.
your geographical whereabouts are part of your medical history yes, that's important. Far from the most important thing, but definitely important in case of diagnosing weird stuff
Or...it could be as simple as his being born in Central America and this taking place in the U.S. means they didn't have access to his earlier health records.
Certain groups of people have certain genetic predispositions. Ie when pregnant there is calculation of down syndrome probability, they take your origin into account. We had something like 1:4000 IIRC, my french teacher who comes from Algeria had 1:200 with his wife.
Alcohol tolerance is another (native south americans have lower, as do some asian populations). Over time, env effects also creep up in the genome (ie altitude acclimatization for sherpas).
But could be also societal, level of healthcare, level and types of vaccines received and so on.
> Is Central America or the US better/worse for your health I wonder?
Better in some ways, worse in others. Central America will be better if you're considering asthma and allergies. It will be much worse if you're thinking about parasites.
Since moving from the northeastern U.S. to Honduras all my chronic allergy and asthma problems have disappeared. I think it’s mainly the absence of oak trees, but I probably benefit from other differences in the flora as well.
>A mild, dull pain had developed in the patient's right lower abdomen and back. Nine days later, a fever and body aches also developed. The next day, he went to urgent care, where clinicians gave him intravenous fluids and an intravenous pain reliever.
Seriously? All this and you just get some painkillers?
I wonder what unknown condition this woman had? And if the condition itself is what caused her to get so close to homicide, or if it was the man’s drunken behavior?
I have now gone over 1,000 days without drinking alcohol. I was not an alcoholic as conventionally defined, I drank less than what my friends or colleagues or others around me did. But occasionally I would drink a few too many and not feel well the next day. I began tracking exactly how many drinks a day I had (I did not drink every day), and it was eye opening. I decided to cut down from there and after a few years of trying I eliminated alcohol entirely from my diet.
I highly recommend every person that drinks alcohol track the number of drinks you have on a calendar and rate how you feel the next day.
The author says "This one seems ready-made for a television medical drama." In fact an almost identical case was featured in House when a Romani teenager swallowed a toothpick. The episode was titled Needle in a Haystack in season 3.
Now I want ChubbyEmu to do a video on this and perhaps one on a case of ingestion of a grill brush brass bristle. And obligatory plug of @SmarterEveryDay's chain mail brush.
These days I look somewhat disdainfully upon heavy drinkers, not only do they often disturb others when drinking (being noisy, obtrusive, drunk driving, etc.), but even ignoring long term health effects, I'm in my 40s now and it's definitely a factor too, but for at least a day after even very moderate drinking I know my mental faculties are reduced, so I can only imagine how much theirs are.
I very rarely have alcohol these days, it's just not worth the feeling of fatigue and brain fogginess the next day that's pretty much guaranteed for me afterwards, even from just 2 beers.
I suspect it's not unique to South Africa, but there is a somewhat pervasive culture here of excessive drinking. Back when I lived in a complex, I would often see people pitch up in the common area at midday with a cooler box full of beer, and basically sit there for the next 6 hours just drinking, what a waste of a day in my view. And most people don't even raise an eyebrow when someone casually mentions in the workplace this is how they spent their weekend. That the police here are both incompetent and readily bribe-able also makes the effects of excessive drinking particularly pronounced, like traffic lights being regularly knocked over.
I barely drink anymore at my age but I don't look down on other people for doing so. It's their time and their body who am I to tell them what to do with it?
You’re an (apparently high functioning) member of society who has a moral obligation to help police individuals who negatively affect the people around them. People don’t drink in padded rooms.
You can make society better by policing individual choices. E.g., in part by policing alcohol and caffeine consumption, Mormon men live 10 years longer than white men in the U.S. generally: https://www.deseret.com/2010/4/13/20375744/ucla-study-proves....
I don't think anyone's recommending you pull on black tights, a kevlar vest with molded nipples, and a black cape and go knocking beers out of strangers' hands.
There is, however, such a thing as noticing if your friends and loved ones are suffering from addiction and intervening to see what can be done before the addiction becomes someone else's problem. And speaking from some limited personal experience? Sometimes the problem someone is trying to medicate out with alcohol is feeling like nobody cares if they live or die. You might be surprised how much someone going out of their way to care does for a person's psyche.
Tattoos don't generally correlate causally with vehicular manslaughter; overindulgence in alcohol does, we have the numbers on it.
>You’re an (apparently high functioning) member of society who has
I'm sure I'm low functioning on some other axis then.
>a moral obligation to help police individuals who negatively affect the people around them. People don’t drink in padded rooms.
You saying that doesn't make it so. I could just as easily say you have an obligation not to interfere in other's matters except in the most flagrant cases of it directly affecting you.
I really don't think you (as an apparently high functioning member of society) are in a position to lecture other people on their moral obligations on how to improve society. Mote, beam etc. Op is modest enough that they know their limits, that's a virtue, not a defect.
Except mormons don’t police it; they make it shameful and morally wrong.
Most western societies rely too heavily on laws to govern every aspect of their society when laws and police are there for the extremes; the rest must be managed by shaming and talking to people who break the unwritten moral rules.
The reason for this is that societal morals evolve, change and adapt more organically than any rigid bureaucratic processes can. You don’t want law based dress codes beyond a certain bare minimum (ie. naked), but instead you want people to govern themselves and be encouraged to tell others off for dressing inappropriately around others in the community.
Western liberal societies in particular have slid down into depravity because we’ve made it _immoral_ to be individual moralists. If it’s not against the law, it’s all acceptable. A man that abuses drugs and lives off welfare all his life is as lawful as a man that works hard every day for himself and his family and pays taxes that contribute to supporting the former’s lifestyle. But they are not morally the same, and it’s obvious to most of us. But we risk losing our livelihoods if we say so out loud.
As soon as a hangover shifted from an acute headache to a day or more of drowsiness I started to substantially limit the amount I drink. You can't tackle that with paracetamol or caffeine and it's not worth it any more, and that's just from what would consider casual drinking (a few pints at the pub) in the UK.
I can't imagine how badly drunk you have to get to swallow something like a toothpick without knowing.
Socialising is good, but consuming large quantities of alcohol as part of that seems wasteful to me as you're also intoxicating (which is another word for poisoning) yourself at the same time, which probably means you have less time afterwards due to possibly sleeping in more the next day and even after that still not as inclined as you normally would be for doing anything else (perhaps like at least chores).
Then you're possibly putting on weight from drinking (having lots of beers definitely contributes to getting a "beer belly"), which is another potential health issue, which although can be mitigated by doing physical exercise (which you should be doing anyway), part of your time exercising is to just undo the "damage" from the drinking meaning you need to spend even more time exercising now.
Perhaps instead consider other healthier (or at least less unhealthy) forms of socializing, like board games, multiplayer computer games, outdoor physical group activities, etc.
As a business owner, I ultimately get more money if I manage to get in some extra work in on weekends or after hours, but between family, friends, children's extra murals and generally managing that I don't burn out, I absolutely don't have time to waste sitting around intoxicating myself for half the day.
Oh, and most people I know aren't proud to say they spent all day watching TV, although I confess that I used to do it on occasion when I was younger with less responsibilities. TV watching can be as good an activity as any when you need to take a break from anything mentally or physically challenging and the negative health effects do pale in comparison to the consumption of large amounts of alcohol.
One of the things that interests me is that, by all accounts, people used to drink ENORMOUS amounts of alcohol prior to the 20th century. The most common figure I saw is that Americans used to drink like 7 gallons of PURE alcohol per year. That's 26 liters of pure alcohol. I dunno what beer is like in the US, in Switzerland 4.5% alcohol content is standard. So they were drinking like 577 liters of beer a year, 1.6 l per day. 500kcal or so (so like 1/5 of reference for a "normal" man) coming from alcohol.
My friends group has gone down the ZBiotics route. Some of us swear by it, others don't find much help. I've taken it a bit further by adding a handful of other products that purport to have similar benefits via different mechanisms.
My experience as someone deep in their middle age is that it seems to have turned the clock back about 10 years or so in terms of the next day effects.
A former policeman told me about a case he dealt with in the late 1970s. A man had got up in the morning, had breakfast, got in his car and drove off to work. Halfway to work he had coughed a large amount of blood onto the windscreen of his car, collapsed over the wheel and died - crashing the car in the process.
He interviewed the man's spouse. They had a cocktail party at home the previous night and had been drinking heavily. At a certain point in the evening her husband had knocked back his drink so energetically that he had swallowed the cocktail pick along with the drink. The people talking to him saw what happened and everybody thought this was extremely funny, including her husband.
The pathologist confirmed that the cocktail pick had worked its way through the lining of his oesophagus and had eventually reached his heart.
A toothpick did in the writer Sherwood Anderson, in his case by piercing part of the digestive track and bringing on peritonitis.
I swallowed a shirt pin as a child. Went to hospital, x-rays, etc. Originally the set me nil by mouth and were set to operate, but the consultant overruled and luckily it passed naturally. (:
Yeah don't swallow things which cannot be digested. I have one anecdotal story of a person swallowing dried bay leaf which then got stuck "at the exit".
> Yeah don't swallow things which cannot be digested.
This gentleman would have disagreed: https://en.wikipedia.org/wiki/Michel_Lotito
Quote: "His digestive system allowed him to consume up to 900 g (2.0 lb) of metal per day."
Spiders^wMetals Georg, who lives in cave & eats over 10,000 each day, is an outlier and should not have been counted
Fortunately it’s not always bad news!
https://pubmed.ncbi.nlm.nih.gov/30565781
Surely that wouldn’t survive the stomach acids.
They do: https://www.webmd.com/vitamins/ai/ingredientmono-685/bay-lea...
Wow .. I had no idea. I'd always assumed you were supposed to remove them from cooking because they would taste bad if eaten directly - not that you couldn't actually digest them!
Yeah a lot of different leaves don't break down well in the digestive track without friction or longer digestion periods (which are adaptations that actual herbivores have).
This is also why they (bay leaves or more generally all laurel leaves) are such a massive pain in the ass to compost in most places.
The wonders of insoluble fiber and wax coatings on leaves.
s/track/tract/g
lol yep. idk how I managed to do that one.
I stand corrected. Something to watch out for
Except for dietary fibre :)
A good example of one of my favorite diagnostic axioms, Hickam’s dictum:
Hickam's dictum is a medical principle that a patient's symptoms could be caused by several diseases. It is a counterargument to misapplying Occam's razor in the medical profession. A common version of Hickam's dictum states: "A man can have as many diseases as he damn well pleases."
https://en.wikipedia.org/wiki/Hickam%27s_dictum
"This one seems ready-made for a television medical drama"
Yep! In fact there was an episode of House MD where the patient had ingested a toothpick and had all sort of symptoms like these.
Damn, so all the savant in the article did was remember that House episode.
There are a lot of episodes though, so that is still quite a feat.
At least second real life saved by Dr House. A German doc saved a a patient from cobalt poisoning from a hip replacement.
"They also looked at his medical history, which was relatively short. He was born in Central America, but he had lived in the US for 16 years."
Interesting constellation of sentences. So, the most important thing in a medical history seems to be where you've been born. Is Central America or the US better/worse for your health I wonder? That is not going to be clear here.
"have you traveled outside the country?" is a pretty common question. Doctors trained and practice in a specific context - an American hospital - may not recognize symptoms of common parasites or illnesses in other places. 16 years is a long time to incubate something but it could also be related to imported food, travelling back home, or a recent arrival of someone else.
your geographical whereabouts are part of your medical history yes, that's important. Far from the most important thing, but definitely important in case of diagnosing weird stuff
Or...it could be as simple as his being born in Central America and this taking place in the U.S. means they didn't have access to his earlier health records.
Certain groups of people have certain genetic predispositions. Ie when pregnant there is calculation of down syndrome probability, they take your origin into account. We had something like 1:4000 IIRC, my french teacher who comes from Algeria had 1:200 with his wife.
Alcohol tolerance is another (native south americans have lower, as do some asian populations). Over time, env effects also creep up in the genome (ie altitude acclimatization for sherpas).
But could be also societal, level of healthcare, level and types of vaccines received and so on.
> Is Central America or the US better/worse for your health I wonder?
Better in some ways, worse in others. Central America will be better if you're considering asthma and allergies. It will be much worse if you're thinking about parasites.
Since moving from the northeastern U.S. to Honduras all my chronic allergy and asthma problems have disappeared. I think it’s mainly the absence of oak trees, but I probably benefit from other differences in the flora as well.
>A mild, dull pain had developed in the patient's right lower abdomen and back. Nine days later, a fever and body aches also developed. The next day, he went to urgent care, where clinicians gave him intravenous fluids and an intravenous pain reliever.
Seriously? All this and you just get some painkillers?
I wonder what unknown condition this woman had? And if the condition itself is what caused her to get so close to homicide, or if it was the man’s drunken behavior?
I have now gone over 1,000 days without drinking alcohol. I was not an alcoholic as conventionally defined, I drank less than what my friends or colleagues or others around me did. But occasionally I would drink a few too many and not feel well the next day. I began tracking exactly how many drinks a day I had (I did not drink every day), and it was eye opening. I decided to cut down from there and after a few years of trying I eliminated alcohol entirely from my diet.
I highly recommend every person that drinks alcohol track the number of drinks you have on a calendar and rate how you feel the next day.
The author says "This one seems ready-made for a television medical drama." In fact an almost identical case was featured in House when a Romani teenager swallowed a toothpick. The episode was titled Needle in a Haystack in season 3.
House, MD had an episode with the same scenario.
Also, Sherwood Anderson in real life.
If the show was still on the air, tbhe writers would have definitely ised this.
Now I want ChubbyEmu to do a video on this and perhaps one on a case of ingestion of a grill brush brass bristle. And obligatory plug of @SmarterEveryDay's chain mail brush.
Save you the handful of minutes of skimming: He swallowed a toothpick. "Medical mystery" my foot.
This is like when you spend 3 day chasing a race condition, and the PR is a one line fix, and someone comments "yes anyone could have spotted that".
These days I look somewhat disdainfully upon heavy drinkers, not only do they often disturb others when drinking (being noisy, obtrusive, drunk driving, etc.), but even ignoring long term health effects, I'm in my 40s now and it's definitely a factor too, but for at least a day after even very moderate drinking I know my mental faculties are reduced, so I can only imagine how much theirs are.
I very rarely have alcohol these days, it's just not worth the feeling of fatigue and brain fogginess the next day that's pretty much guaranteed for me afterwards, even from just 2 beers.
I suspect it's not unique to South Africa, but there is a somewhat pervasive culture here of excessive drinking. Back when I lived in a complex, I would often see people pitch up in the common area at midday with a cooler box full of beer, and basically sit there for the next 6 hours just drinking, what a waste of a day in my view. And most people don't even raise an eyebrow when someone casually mentions in the workplace this is how they spent their weekend. That the police here are both incompetent and readily bribe-able also makes the effects of excessive drinking particularly pronounced, like traffic lights being regularly knocked over.
I barely drink anymore at my age but I don't look down on other people for doing so. It's their time and their body who am I to tell them what to do with it?
https://knowyourmeme.com/photos/2565163-smugjak-but-how-does...
> who am I to tell them what to do?
You’re an (apparently high functioning) member of society who has a moral obligation to help police individuals who negatively affect the people around them. People don’t drink in padded rooms.
You can make society better by policing individual choices. E.g., in part by policing alcohol and caffeine consumption, Mormon men live 10 years longer than white men in the U.S. generally: https://www.deseret.com/2010/4/13/20375744/ucla-study-proves....
Why do I have a moral obligation to police individuals who negatively affect those around them?
That seems awfully subjective and likely to devolve into vigilante anarchy.
There was a time when having a tatoo would mean you were negatively affecting those around you. Where do we citizens police draw the line?
tragedy of the commons strikes again
There's "police" and police.
I don't think anyone's recommending you pull on black tights, a kevlar vest with molded nipples, and a black cape and go knocking beers out of strangers' hands.
There is, however, such a thing as noticing if your friends and loved ones are suffering from addiction and intervening to see what can be done before the addiction becomes someone else's problem. And speaking from some limited personal experience? Sometimes the problem someone is trying to medicate out with alcohol is feeling like nobody cares if they live or die. You might be surprised how much someone going out of their way to care does for a person's psyche.
Tattoos don't generally correlate causally with vehicular manslaughter; overindulgence in alcohol does, we have the numbers on it.
>You’re an (apparently high functioning) member of society who has
I'm sure I'm low functioning on some other axis then.
>a moral obligation to help police individuals who negatively affect the people around them. People don’t drink in padded rooms.
You saying that doesn't make it so. I could just as easily say you have an obligation not to interfere in other's matters except in the most flagrant cases of it directly affecting you.
I really don't think you (as an apparently high functioning member of society) are in a position to lecture other people on their moral obligations on how to improve society. Mote, beam etc. Op is modest enough that they know their limits, that's a virtue, not a defect.
Except mormons don’t police it; they make it shameful and morally wrong.
Most western societies rely too heavily on laws to govern every aspect of their society when laws and police are there for the extremes; the rest must be managed by shaming and talking to people who break the unwritten moral rules.
The reason for this is that societal morals evolve, change and adapt more organically than any rigid bureaucratic processes can. You don’t want law based dress codes beyond a certain bare minimum (ie. naked), but instead you want people to govern themselves and be encouraged to tell others off for dressing inappropriately around others in the community.
Western liberal societies in particular have slid down into depravity because we’ve made it _immoral_ to be individual moralists. If it’s not against the law, it’s all acceptable. A man that abuses drugs and lives off welfare all his life is as lawful as a man that works hard every day for himself and his family and pays taxes that contribute to supporting the former’s lifestyle. But they are not morally the same, and it’s obvious to most of us. But we risk losing our livelihoods if we say so out loud.
As soon as a hangover shifted from an acute headache to a day or more of drowsiness I started to substantially limit the amount I drink. You can't tackle that with paracetamol or caffeine and it's not worth it any more, and that's just from what would consider casual drinking (a few pints at the pub) in the UK.
I can't imagine how badly drunk you have to get to swallow something like a toothpick without knowing.
Spending all day drinking and socialising is a waste of a day? As opposed to what, working? Or maybe watching Netflix at home?
Socialising is good, but consuming large quantities of alcohol as part of that seems wasteful to me as you're also intoxicating (which is another word for poisoning) yourself at the same time, which probably means you have less time afterwards due to possibly sleeping in more the next day and even after that still not as inclined as you normally would be for doing anything else (perhaps like at least chores).
Then you're possibly putting on weight from drinking (having lots of beers definitely contributes to getting a "beer belly"), which is another potential health issue, which although can be mitigated by doing physical exercise (which you should be doing anyway), part of your time exercising is to just undo the "damage" from the drinking meaning you need to spend even more time exercising now.
Perhaps instead consider other healthier (or at least less unhealthy) forms of socializing, like board games, multiplayer computer games, outdoor physical group activities, etc.
As a business owner, I ultimately get more money if I manage to get in some extra work in on weekends or after hours, but between family, friends, children's extra murals and generally managing that I don't burn out, I absolutely don't have time to waste sitting around intoxicating myself for half the day.
Oh, and most people I know aren't proud to say they spent all day watching TV, although I confess that I used to do it on occasion when I was younger with less responsibilities. TV watching can be as good an activity as any when you need to take a break from anything mentally or physically challenging and the negative health effects do pale in comparison to the consumption of large amounts of alcohol.
Commenting on the internet is the best way to spend the day. Obviously.
One of the things that interests me is that, by all accounts, people used to drink ENORMOUS amounts of alcohol prior to the 20th century. The most common figure I saw is that Americans used to drink like 7 gallons of PURE alcohol per year. That's 26 liters of pure alcohol. I dunno what beer is like in the US, in Switzerland 4.5% alcohol content is standard. So they were drinking like 577 liters of beer a year, 1.6 l per day. 500kcal or so (so like 1/5 of reference for a "normal" man) coming from alcohol.
for better or worse, a combo of cheers and zbiotics actually seems to work to reduce hangovers
My friends group has gone down the ZBiotics route. Some of us swear by it, others don't find much help. I've taken it a bit further by adding a handful of other products that purport to have similar benefits via different mechanisms.
My experience as someone deep in their middle age is that it seems to have turned the clock back about 10 years or so in terms of the next day effects.
Vibe based debugging. Very impressive.
I’m surprised wood doesn’t show up more clearly on imaging though.