Hair of the Dog

Not all alcohol's are created equal. Defined by the telltale -OH group, alcohol ranges from deadly toxin to delightful intoxicant, all dependent on the number of carbon atoms it carries. Ethanol, the friendly molecule in vodka, cause of merriment and only a modicum of increased cancer risk and cirrhotic liver damage, is the safest of all these. But we have not always restricted ourselves to consumption of this only moderately toxic iteration. Prohibition carried with it an epidemic of blindness, a side effect of cheap bootleggers using woodchips in their fermentation process. Methanol, you see, that solitary carbon alcohol, is acutely toxic, both in the pleasant warming nervous system depressant way, and in the terrible formaldehyde producing metabolism kind of way.

We still see methanol induced blindness. We see it mostly in suicide attempts, but the acute (drinking methanol to end it all), and the long form (alcoholics who are too broke for regular booze). The toxin starts off like regular alcohol, inducing inhibitory effects throughout our brain, slowing our breathing, making everything just a bit distant and complicated. The issue arises when we try to get rid of it, our cellular machinery breaking it down into component parts. The components, with methanol, are worse than the whole, and formaldehyde courses through us, blocking our energy metabolism at every step. The damage to our cellular resources can be staggering, and deadly.

We can help though. We can decrease the metabolism of methanol, forcing it into a slower elimination with less acute toxicity. We do this with alcohol. Ethanol, to be precise, straight into your veins. You will be drunk as a skunk, and the ethanol will block the metabolism of methanol, using up all the available alcohol dehydrogenase.

How is that for hair of the dog that bit you?

Better Know Your Hermaphrodites

We all began this world as girls. The male genome differs from the female in the key fact of extra genetic material (well, extra expressed, less overall). A tiny Y chromosome, with a tinier gene known as SRY, informs the masculine fetus that the uterus and vagina they were developing are of no use, instead growing a second set of tubes (our former embryonic kidney), into a new, more standing up to urinate appropriate set of equipment. This duct, known in medical circles as the appropriately manly "wolffian duct," is activated by Testosterone, the overproduction of which is the definitive physiological trait of manhood. The external genitalia, the organ on which we of the far less fair sex place so much importance, is derived from signals using dihydroxytestosterone (DHT), otherwise known as the hormone that makes you go bald and get a swollen prostate (about 40-60 years down the road). At the same time, mullerian inhibiting factors are obliterating your once promising female genital tract, obliterating the paramesonephros.

But remove these signals, and we develop along the baseline, into someone that is almost a women. You see, we still express baseline levels of estrogen, so in the absence The signals can be broken in several different places, causing several different outcomes.

One breakage can be in the production of testosterone. A 17-alpha hydroxylase deficiency we can't manufacture the copious testosterone needed to inform our bodies what to do, and without the testosterone, there is no DHT. Depending on the damage, the XY fetus would develop as either a partial hermaphrodite (small penis, blind vaginal pouch), or as a women. This all depends on the degree of insufficiency, a sliding scale of gender.

A 5-alpha reductase deficiency will block the production of DHT, leading to an entirely male form, except for that ego and gender defining locus, the genitalia. Ambiguous at best, these infants force the doctor to say "I'm not sure" when announcing the sex. They are male, of course, but will need hormone shots, and possibly a bit of surgery, to function normally.

Androgen insensitivity implies a child whose cells blithely ignore the flood of testosterone, developing quitely into almost female. These children are sterile, presenting with complete lack of internal genitalia. The testicles do develop marginally, and have a distinct tendency to get stuck in the inguinal canal (the site of the hernia), where they also need to be removed to prevent any cancerous development. They are the simplest, because genome aside, they are essentially girls. Typically tall, slender girls, with symmetrical bodies, larger than average breasts, and no body hair. (think about that next time you look at a model)

The true hermaphrodite, the fully formed penis and vagina, is the rarest of breeds. In class, one day, discussing this phenomenon, we heard a professor utter the most odd of screeds: "Its easier to dig a hole then build a pole." These children are almost always forced into feminity, regardless of their intention, because thats the way our society directs the outcome.

Masculinity is a narrow thing. Perhaps we shouldn't take it so seriously?

Mythomania

They want your blood. The beasts of our unruly imaginations, the vampires and werewolves of our gothic past, they want that vital stuff that drives you. The myths have existed for centuries, these dark companions of humanity. Our shadow siblings have survived ages in the comfortable dark, serving as the stuff of nightmares for all of us who have ever started at an unknown shape in the night. These creatures represent our collective fear of the black, the unknown. But these creatures, oddly enough, are based on reality. In fact, they are based on biochemistry.

It all comes down to the blood. Uroporphyrinogen decarboxylase, a simple (well, not so simple) enzyme, designed to help break down you assemble your hemoglobin. Hemoglobin, of course, is the wonderful material that serves your blood so ably as a sherpa of oxygen. Oxygen, however, is the hazardous trade of biochemistry. We need it to drive the reactors that keep our cells flush with energy, but like any source of energy, it comes with risks. As a substance, it loves to attack us for our electrons, to damage the infinitely delicate material that makes up cells and DNA, our molecular identity. To tame this unruly resource we have harnessed equally dangerous materials, locking reactive intermediates into a closed ring, our own tamed beast: hemoglobin.

Each stage of hemoglobin assembly has an intermediate flush with potential destructive capability. It is this chain of manufacture, this biochemical supply line, that gives us our favorite myths. The vampire involves a form of porphyria (a breakdown in the enzymes for hemoglobin assembly) in which a byproduct forms that is extremely reactive to sunshine. This leads to someone who is constantly anemic (and thus hungry for the salty iron of blood), and prone to immediate and dramatic burns upon exposure to sunlight.

The werewolf suffers from hypertrichosis, hair growing from every surface. These poor individuals might suffer from a slightly different porphyria, that of cutanea tarda. They also burn, but the more dramatic side effect of failed synthesis is an overgrown thatch of hair. everywhere.

These deep dark myths, these reflections of the lost soul of humanity, are merely the deranged impressions the sick leave on the uninformed. This extends to our other monsters in human form, the zombie (most likely suffering from hansen's leprosy), the cyclops (holoprosencephaly), and the mermaid (sirenomelia).

Funny how understanding makes it less mysterious, but more disturbing. These creatures aren't the stuff of legend. They are the sad reality of disease.

Make Room for Dinner

One of the most disturbing and odd facets of masculine culture is the reflection and embrace of our digestive systems, particularly the strange communion many men have with the porcelain throne. Beyond the establishment of gaseous expulsions as a hilarious form of art, men commonly seem to want to discuss the quality, quantity, and enjoyment of eliminating solid waste.

Descendants of this fascination include numerous euphemisms and contexts for when one really has to take a shit. Dropping the kids off at the pool, the deuce, and a myriad of others have become commonplace, if unpleasant, phrases. One of the more common concepts of this milieu is the idea of "making room for dinner." The concept underlying this is that if one was to use the facilities, dinner would be better received, as one would have "made room."

It always bugged me when people said this. In general, I never really enjoy hearing about folks fecal fun. It bugs me only slightly less now that I know that this mythos of masculine misanthropy is actually a legitimate fact.

The gastroileal reflex is a system by which distension of the stomach actually triggers increased movement in the ileum (part of your small intestine), and dilates a sphincter allowing food to pass from the small intestine (where it is absorbed into the body as nutrients) to the large (where it is prepared to be expelled). A natural peptide called gastrin, released to increase stomach acidity and break down the various products you consumed, teams up with your autonomic nervous system to literally "make room for dinner."

Which doesn't actually make saying it any less tacky.

Party Trick

The patient perched on the corner of the exam table. He stood up gingerly, a snap and crackle underlying his every move. An younger man, his delicacy was premature, the cautious movements of a man twice his age. His eyes could have used a good cleaning, the whites anything but. Grey orbs with a brown center, he looked at us nonchalantly, a cup of fresh urine in his hand.

The doctor takes the cup, places it on the table, and tells me to keep an eye on it. Nonplussed, I examine the urine, looking for the typical marks of illness. It wasn't cloudy, or discolored. It didn't smell sweet, or musty. I saw no crystals, no blood. So I looked away, taking in the interview, wondering what the doctor thought was going to happen.

After the final reflex hammer falls, the doctor looks up at me, asking for a diagnosis. The only thing I noticed was arthritis, the reason for his care in movement. Gambling, I toss out rheumatoid arthritis, and receive for my trouble a slow shake of the head, and an extended arm pointed at the cup of urine, now sitting there rather dark shade of black.

The patient had alkaptonuria, a fairly benign metabolic disease, a failure of tyrosine metabolism. His buildup of homogentisic acid has stained his connective tissue, darkening his eyes and causing pain in his joints. He eliminates it in the urine, and on exposure to air, it turns itself black.

As diseases go, its a fairly innocuous one to be stuck with. Unless you are the guy at the urinal next to him.

French Pox

Kurt Vonnegut used to discuss the lurching old men of his youth, ambulating irregularly about downtown Indianapolis. His wandering examination of the terrifyingly possessed men, mumbling and bumbling in their confusion and discordance, paints a fairly terrifying picture of the disease once known by names varying from the French Pox to the scourge of royalty: Syphilis.

Treponema Palladium, a gram negative spirochete, has brought down rulers and vagabonds, and remains today one of the most prevalent (if slow moving) sexually transmitted disease around. It's readily treatable (simple penicillin does the trick), but if you let it go, it begins to run amok in your cerebellum, corkscrewing its way through the all important cognitive matter. Over years, you slowly go crazy, lose your ability to sense your arms and legs (except for pain and temperature), and develop a series of unsavory skin conditions.

The trick with syphilis is that it spends so much time with no clinically apparent symptoms. (although also decreased chance of catching it). The diagnosis can be tricky because the little spirals are adept at avoiding tests, and the symptoms are erratic and transitory. Perhaps the best (not most effective, just most hilariously named) diagnostic technique for the final stages of syphilis is the the eye exam. A person with late stage syphilis will have normal eye constriction with general eye use (known as accommodation), but not respond to light. This is known as the "prostitute's pupil," although in deference to modern terminology, it has recently been rebranded the Argyll Roberston pupil. Which honestly just makes me associate syphilis with sweaters for some reason (perhaps its because the human race most likely got syphilis in the first place by having inappropriate relations with sheep?)

Recruitment

At some point, something threw a wrench in your machinery. Cosmic rays, bad food, invading microbes, or piss poor protoplasm, but somewhere along the way, something in you got knocked out of place. Your roadmap, your building blocks, got altered. DNA alkylation, cross-linking, deletion.

It had happened before, but this one, this one was different. That single mistake happened to be in just the right place. It amplified, expanding in flawed protein designs, processes erroneously instantiated or failed. The mistake prospered, through luck and tenacity. It defeated or ignored your internal defenders, hiding behind a protective mask of your own flesh. It made a place for itself, even as it made more of itself, reinforcements in its desperate effort to expand.

You have a tumor. Reproductive drive incarnate, an invasive expanding riot of your constituent cells, demanding that the rest of you be more like them. These renegade cells, in their zeal to expand, have lost what defined them. Increasingly ill-shaped and deformed, the multiplying cells have lost their function, their irreplaceable role in the community that is your body. They swarm, they hustle, and dedicate resources in one vast effort to outcompete everything around with sheer numbers.

I’m here to stop them. I have an arsenal of methods, from futuristic rays to simple reinforcements for your beleaguered immune system. But this mistake, it is crafty. It hides itself behind the hostages of your healthy cells, component human shields staying my hand. Its hustle is it’s weakness, its sheer drive to reproduce differentiating it from your more sedate and helpful cellular citizens. Its growth makes it a target for my toxins, my rays. Some cells hide, biding their time, hoping I will accept the elimination of their more eager brethren as total.

I pump you full of poison, indiscriminate and wild. But I have been careful. My agent won’t kill you or your unruly cellular mob, but it will hurt. The tumor shrinks under the onslaught, even as your hair wilts and your immune system surrenders, casualties of friendly fire. When I withdraw my horsemen of alkylation, my carmustine, my mechlorethamine, the tumor will spring forth, hustling to reproduce and replenish, secure in the belief that it has resisted modern medicine. It doesn’t see me, waiting in the wings, an army of specific anti-neoplastics chomping at the bit. It was a trick you see, a con, a bamboozlement.

Your tumor got hustled.