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Hundreds of Questions You’d Only Ask
a Doctor After Your Third Martini
Mark Leyner and Billy Goldberg, M.D.
A DF Books NERDs Release
Copyright © 2005 by William Goldberg, M.D., and Mark Leyner
All rights reserved.
Published in the United States by Three Rivers Press, an imprint of the Crown Publishing Group, a division
of Random House, Inc., New York.
Three Rivers Press and the Tugboat design are registered trademarks of Random House, Inc.
Library of Congress Cataloging-in-Publication Data
Leyner, Mark.
Why do men have nipples? : hundreds of questions you’d only ask a doctor after your third martini / Mark
Leyner and Billy Goldberg.
p. cm.
1. Medicine—Miscellanea. I. Goldberg, Billy.
II. Title.
R706.L49 2005
e-ISBN 0-307-33704-9
This book is dedicated to all those special doctors who inspired us:
Dr. Marcus Welby, Dr. Dre, Dr. Seuss, Dr. Cliff Huxtable, Dr. J, Dr. Scholl’s, Dr. Phil,
Dr Pepper, Dr. Strangelove, Doc Baker, Dr. Who, Dr. Doolittle, Dr. Johnny Fever, Doc
Gooden, Dr. Moreau, Dr. Jekyll, Dr. John Rooney, Dr. Kildare, Dr. Hibbert, Dr. No, Dr.
Zhivago, Dr. Ruth, Dr. Evil, Dr. Joyce Brothers, Dr. Ben Casey, Doc Holliday, Dr.
Doogie Howser, and the fight Dr., Ferdie Pacheco.
What you are about to read is mostly true, as far as we know. But this book in no way
should substitute for a visit to your doctor. Remember, doctors are trained professionals.
Also, do not attempt to answer these questions yourself unless you are a mother. Mother
always knows best.
When you’re at a cocktail party, someone inevitably asks you what you do for a living. If
you say that you are a doctor, the barrage begins.
Soon you’re looking at someone’s mole, consulting someone else on his brother-inlaw’s painful flatulence, racking your brain to explain the etiology of your hostess’s
episodic vertigo, and that’s just the beginning. You would think that after twelve years of
rigorous training and sleepless nights, doctors would have all the answers. But no! Not
so. The sad fact is that one of the medical establishment’s great shortcomings is its failure
to teach what the general public really wants to know about medicine.
This book is an attempt to rectify this unfortunate situation. Inside these pages we
will begin to answer some of the medical questions that real people ask. Pressing
questions such as “Why does my pee smell when I eat asparagus?” “Is it true when they
say ‘beer before liquor, never sicker; liquor before beer, never fear?’” “Is sperm
fattening?” “What causes an ice cream headache?”
This is not a self-help book or a medical manual. It’s a glimpse at some of the strange
things that people want to know from their doctors, but are too embarrassed to bring up in
the ER or during an office visit. They only seem to find the courage to ask these
questions after their third martini.
That’s when the party begins.
Billy Goldberg:How did Mark Leyner and I come to know each other and pursue this
heroic project,Why Do Men Have Nipples?
This is a long dark tale, a quixotic quest. A journey of two friends attempting to
accomplish a nearly impossible task. We are an unlikely pair. I am a New York City
emergency room doctor and Mark is a successful novelist and screenwriter. Not exactly
the perfect literary match, but, our paths crossed and the rest is history. . . .
It began one frigid, blustery night in a busy New York City emergency room. I had
been thinking about doing this book for many years. I had compiled questions and
pondered answers but was never able to fully steel myself for such a perilous exploration
and actually write any of them down. I had just been hired as a medical adviser on the
ABC medical drama Wonderland . This short-lived show was a realistic drama based on
the daily lives in a psychiatric emergency room and a prison psychiatric ward. The show
added an ER character and I was hired to integrate the medical ER reality into the show.
It was my job to bring the writers into our world of chaos. Most movie and TV writers
knew nothing of real hospital medicine and were taken aback by the controlled disorder
and gore of the emergency department and my world of science and human suffering.
I had been told by one of the producers that my visitor for that shift was going to be
Mark Leyner. I consider myself to be well read, but I had never heard of this Dionysian
postmodern superhero (Mark’s description). A quick Google search revealed that he had
published many novels, one of which was called My Cousin, My Gastroenterologist . I
also found that he had written a television pilot for MTV entitled “Iggy Vile, M.D.” I was
confused and had no idea what to expect, but I was intrigued.
That night, I was at the bedside of a patient, assisting a resident in the placement of a
nasogastric tube, when the nurse told me that there was someone to see me. I took off my
gloves, pulled back the curtain, and there was Leyner. Nothing in my medical career
could have prepared me for the character I was about to meet. He had the heavily
muscled torso of a Bulgarian weight lifter and the weepy histrionic temperament of a
teenage girl. He was babbling to no one in particular as he scarfed down fistfuls of
Skittles from a paper bag. It soon became apparent to me that Leyner wasn’t like the
other TV writers I had met. He was a medical autodidact with an astonishingly bizarre
and encyclopedic store of arcane medical knowledge. Within five minutes Leyner had
regaled me with the precise pharmacokinetics of jimsonweed, a Fijian folk remedy for
cannibal indigestion, the history of turf toe and crotch rot, and the inexplicable
prevalence of supernumerary testicles in Wilkes Barre, Pennsylvania.
I knew it was going to be an interesting night.
As I made rounds with Leyner at my side, the first new patient to arrive was an
“EDP.” This is the term that we use for an emotionally disturbed patient. He was wildly
agitated and a dozen burly New York City EMS personnel and cops were barely able to
keep him restrained on a stretcher. Mark and I hurried over to see him wide-eyed and
ranting psychotically. He was screaming in Spanish and English, “I am Superman,
motherfucker. Get me Jimmy Olsen. I am faster than a speeding bullet, more powerful
than a locomotive.” I stepped up to the bed with the goal of getting an IV in and calming
Superman down. He screamed again, “I am Superman, goddammit, your medications
won’t work on me.” Leyner, who had been coolly observing the scene with clinical
detachment, popped some Skittles in his mouth and made a stunningly unorthodox
suggestion. “Give him kryptonite.” I know that as you tell a story many times it begins to
get embellished, but I remember that these words and these words alone calmed the
patient enough so that we could get the drip going and get him under control.
The night continued to be a strange mix of the bizarre and touching, and I left my
shift feeling that this strange little man would somehow have a profound effect on my
Mark Leyner: Even though I come from a long line of lawyers—and, in this society,
lawyers and doctors are like warring sects in the Balkans—I’d always had a deep
fascination with medical matters. Whereas most boys would subscribe to Sports
Illustrated and Boy’s Life, I waited eagerly for the mailman to deliver Annals of
Gastrointestinal Surgery and Journal of the American Society of Investigative Pathology .
Most kids begged their parents for trips to Disney World. I annually implored mine to
take me to the Mütter Museum in Philadelphia, which houses this country’s most glorious
collection of medical oddities, including conjoined fetal quintuplets in formaldehyde and
the preserved remains of the world’s largest colon. I did seriously consider becoming a
doctor, until I went to Brandeis, that is. There I saw firsthand the future doctors of
America. Bunch of whining, ass-kissing, unscrupulous, morbidly neurotic premed
students. My fascination didn’t die though—in fact it became my secret inner life
resulting in my first book of fiction being entitled My Cousin, My Gastroenterologist .
So I guess that my obsessive inclusion of graphic medical detail in all my subsequent
books and a script I wrote for MTV entitled “Iggy Vile, M.D.”—featuring an ale-swilling
football hooligan punk of a surgeon—is what prompted Peter Berg to invite me to write
for a television hospital drama he’d created called Wonderland . I’d just begun working
on my first Wonderland script, when Peter called me one night raving about this guy who
worked in the ER—this guy Billy Goldberg—and I took it all with a grain of salt,
expecting him to be a grown-up version of the Brandeis pre-meds, but I agreed to meet
him anyway. It turned out to be a glorious night. Billy was not the simultaneously insipid
and officious physician I expected at all. The night was a revelation. What I saw that
evening was amazing—a Chinese chef hit in his head with a meat cleaver, a Russian guy
who came in with his ear in a bag of ice after his Rottweiler bit it off, and of course
Superman. But it wasn’t just the voyeurism. There was an immediate genuine connection
between Billy and me, and there was something deeply compelling about the way he
responded to the human needs of the people he treated in that chaotic and bizarre
Billy:Several days later I showed up at the Wonderland production offices and I
apparently had attained a new found level of credibility. Leyner had told the tales of our
evening and I am sure he had added a little bit of writer’s embellishment. I was
introduced to some of the other writers whom I had not met and sat briefly in their
lavishly decorated and organized offices to answer the mundane medical questions from
their respective scripts. My next stop was Leyner, and when I entered his office, it was
like entering a tomb. The room was almost devoid of decoration and furniture, and it had
a monastic feel. Leyner was lying on his stomach typing rapidly on the keyboard of his
laptop. He looked up and without a greeting said, “Tell me everything you know about
Kluver-Bucy syndrome!” We proceeded to discuss the clinical findings of this rare
neurological disorder that causes individuals to put objects in their mouths and engage in
inappropriate sexual behavior—obviously, a disease that was irresistibly attractive to the
likes of Leyner.
Although critically acclaimed,Wonderland was canceled after three episodes. Leyner
and I continued our strong friendship. We would talk about each other’s work, and I
particularly enjoyed reading his scripts and adding my meager suggestions. We decided a
collaboration was in order and pitched several TV pilot ideas together. Working with
Leyner brought me back to my long-standing idea for a book of cocktail party medicine
questions. Leyner greeted my invitation to work on this book enthusiastically.
Mark:I considered it for a moment or two and remember thinking, “Hey, I could
make a shitload of money and do almost no work!”
Billy:I felt that I had offered Mark the opportunity to be the doctor he always wanted
to be. I thought he was ready to share the burden of this project, and what you are about
to read is the result of all our, well, no actually, all my hard work.
Does it really take seven years to digest chewing gum?
Why does your pee smell when you eat asparagus?
Does sugar really make kids hyperactive?
What causes an ice cream headache?
Does eating chocolate cause acne?
Why do you cry when you cut onions?
Do cucumbers relieve puffy eyes?
Why are you served juice and cookies after you donate blood?
Why do women crave chocolate during their periods?
Why do you get bloated when you eat salty food?
What is a food coma?
Why are you hungry an hour after eating Chinese food?
What is MSG, and does it cause headaches?
Can carrots help improve your vision?
Does coffee stunt your growth?
Why does skipping your morning coffee cause a headache?
Why does spicy food make your nose run?
Does spicy food cause ulcers?
Does artificial sweetener cause headaches?
Does licorice cause high blood pressure?
Is it bad to crack your knuckles?
Why do some folks have an “outie” belly button and some folks have an “innie”?
What causes morning breath?
Why are yawns contagious?
Why do men have nipples?
Can you lose a contact lens in the back of your head?
Can you lose a tampon inside your body if the string comes off?
Is it true that the tongue is the strongest muscle in the body relative to its size?
Why do your teeth chatter when you are cold?
Why do you have an appendix if you can live without it?
Are canker sores contagious?
What are goose bumps?
What really is happening when my foot falls asleep?
Why do you get bags under your eyes when you are tired?
Why do you laugh when tickled?
Why does sweat stink and stain?
What is snot?
What are eye boogers?
What are those little half moons in your nails?
Is sperm nutritious? Or fattening?
Can you get pregnant while you are having your period?
Do oysters really make you horny?
Big hands, big _____?
Why do men wake up in the morning with an erection?
Can people in wheelchairs still have sex?
Is it true that you can break your penis?
Does masturbation cause stuttering, blindness, or hairy palms?
Does using a tampon for the first time make you lose your virginity?
Why do nipples become erect?
What causes shrinkage?
Does circumcision lessen the fun of sex?
Does the kind of underpants men wear affect their fertility?
Is there really a G-spot?
Do Kegel exercises really work?
Can hot tubs make you infertile?
Do men need sex more often than women?
Can a man ever run out of sperm?
Are there any specific things that affect the scent of a woman?
Can a woman ejaculate?
What is a hickey?
Can you take the tetracycline meant for fish tanks?
Does cranberry juice cure urinary tract infections?
Will yogurt cure a yeast infection if you put it “inside”?
Does candle flame remove earwax?
Is it smart to put butter on a burn?
Does melatonin work for jet lag?
Should you put a steak on a black eye?
Will toothpaste get rid of zits?
Is it dangerous to pop zits?
If someone is choking at a dinner party, can you do a tracheostomy with an
oyster knife?
Does urinating on a jellyfish sting stop the burn?
Why is it bad to insert cotton swabs in your ears?
Is it dangerous to perform colonic irrigation on yourself?
Does breast milk cure warts?
If you get bitten by a snake, should you suck out the venom?
What are hiccups, and how do you get rid of them?
Does bathing in tomato juice remove the smell of a skunk?
Does eating fresh parsley cure bad breath?
Does warm milk really help you sleep?
“Beer before liquor, never sicker/liquor before beer, never fear”?
Can poppy seeds make you test positive for heroin?
Why do you get the munchies when you are stoned?
Can a hair sample be used in a drug test?
Will a shot of bourbon cure a cold?
Does putting someone in a shower or giving him or her coffee stop a drug
Why do you throw up when you drink too much?
Does taking ecstasy cause you to lose your memory?
Does drinking kill brain cells?
Why does the bed spin after a long night at the bar?
Why do you snore so loud when you are drunk?
Is red wine really good for your health?
Does marijuana help glaucoma?
Should you drink brandy when you have frostbite?
Can you get high from licking a toad?
Why do people seem more attractive to you when you are drunk?
Can you drink your own urine?
Why can you ignite a fart?
Why do you get all “pruney” after a long bath?
Is it more sanitary to be spit on or peed on?
Why do beans give you gas?
Would you die if you ate your own feces?
Will you get hemorrhoids from sitting on the toilet too long?
Why does poo stink if the food doesn’t?
Why does poo float?
Why is poo brown?
Where does gas go when you can’t fart?
If you are stranded on a desert island, should you drink seawater or your own
Can you catch diseases from a toilet seat?
Why do I have to go to the bathroom immediately after a cup of coffee?
Why do cigarettes have a laxative effect?
Why do you have to pee when you hear water dripping?
If you stick a sleeping person’s hand in warm water, will he or she wet the bed?
Is it dangerous to hold it when you have to pee?
What causes the rumbling in your stomach when you have to go?
Is the showER accurate?
Does the kind of amnesia you see in the movies really exist?
What would happen if you stuck someone in the heart with a needle as in Pulp
Why does everyone in the movies go into shock?
Can people really wake up after being in a coma for years?
Do you really need to remove a bullet right away like they do in old Westerns?
Is there really a medication that acts like a truth serum?
What is on the rags that villains use to make their victims pass out?
Can you die from choking on your own vomit, like the drummer in Spinal Tap?
Do people really have multiple personalities, like in Sybil?
Can you get scared to death?
Can you drink yourself to death like Nicholas Cage in Leaving Las Vegas?
Does hysterical blindness really exist?
What would really happen if a junior mint fell inside someone during surgery, as
in the infamousSeinfeld episode?
Is it dangerous to eat another human being?
How many times can you be shot and still survive?
Is there such a thing as a werewolf?
Can you really explode from eating too much?
Do people ever have webbed hands and feet like the Man from Atlantis?
Why do you see stars when you are hit in the head?
What was wrong with the boy inThe Boy in The Plastic Bubble?
Is it true that you have to wait a half hour after eating to go swimming?
Will staring at an eclipse make you go blind?
Should you starve a fever and feed a cold?
Does wet or cold weather cause a cold?
Can you die from chasing Pop Rocks with Coke?
Can lip balm be addictive?
Is it true that left-handed people are smarter than right-handed people?
Will sleeping in front of a fan or an open window cause a stiff neck?
Do microwaves cause cancer?
Will using a cell phone give you a brain tumor?
Will a plate in your head set off a metal detector in the airport?
Is it dangerous to hold in a sneeze?
Can you swallow your tongue?
Is it true that you lose tastebuds as you get older?
Why does hair turn gray?
Why do you shrink as you get older?
Why do old ladies grow beards?
Do your ears continue to grow after the rest of your body stops growing?
Why do you need less sleep when you get older?
What’s up with the ear hair?
Do your nails or hair grow after you die?
What are age spots?
Is life span determined strictly by genetics?
Can taking vitamin C help you live longer?
Is there such a thing as male menopause?
Why are older people such bad drivers?
Is there really a wrinkle cure?
Can aluminum cause Alzheimer’s?
My sincerest thanks to: my family for supporting me when I rambled on about this idea
for years, my friends for asking me hilarious medical questions, and my beautiful and
wonderful wife, Jessica, for appreciating my quirks and giving me the strength to finally
get this done.
I want to thank my wonderful and wise friend Billy Goldberg, who did virtuallyall of the
work on this book and still happily let them put my name on the cover next to his.
Together we would like to thank Amanda Urban and Jud Laghi at ICM; our editor, Carrie
Thornton; and the entire staff at One Jefe Productions.
MARK LEYNERis the author ofMy Cousin, My Gastroenterologist; Tooth Imprints on
a Corn Dog; I Smell Esther Williams;Et Tu Babe; andThe Tetherballs of Bougainville.
He has written scripts for a variety of films and television shows. His writing appears
regularly inThe New Yorker, Time, andGQ .
BILLY GOLDBERG, M.D.,is an emergency medicine physician on faculty at a New
York City teaching hospital. He is also a writer and artist whose paintings have been
exhibited in New York City.
10P.M. , and my partner in writing and crime, Mark Leyner, and I are late as
usual, but the party is in full swing. We brought a bottle of Don Julio tequila, which
Leyner sampled voraciously in the cab, insisting that it needed to be screened for
industrial toxins. We enter the elegantly appointed Park Avenue home of Eloise
Cameron, a philanthropist, patron of the arts, and Botox junkie. Hors d’oeuvres are being
served and the slightly inebriated and flush-faced Leyner grabs a mouthful of Swedish
meatballs, kisses our hostess, and then comments, “Eloise, baby, better lay off the
collagen. Kissing those lips is like making out with the Michelin man.” She attempts to
smirk with disdain, but the Botox leaves her face impassive.
I corral Leyner and we proceed into the living room. No sooner have we entered
when I’m embraced from behind. I turn around and it’s Jeremy Burns, an investment
banker who sits two rows behind me at the Knicks games. Jeremy is well known to the
Madison Square Garden food vendors for his insatiable appetite for hot dogs, cotton
candy, and beer. He is now almost unrecognizable in his new Atkins-induced skeletonlike
state. “Who exhumed you?” Leyner belches. I am overcome by embarrassment but
secretly wetting myself with laughter. Jeremy tries to sidestep Leyner and as their arms
brush, Leyner is covered with the grease that now oozes from Jeremy’s pores. Leyner
whispers to me, “This dude is all greased up like a rectal thermometer.” I push Leyner
away and he uses this opportunity to sneak over to the bar for another blast of Don Julio.
I am left with Jeremy and his insufferable stories about life on the meat-and-fat diet, and
a million medical questions about food.
If we are what we eat, why do we know so little about food and nutrition?
What is it with seven years? You break a mirror, seven years of bad luck. Each
dog year is seven human years. Seven years to digest swallowed gum? What if a
dog broke a mirror then swallowed a pack of gum? Sounds like an algebra
Chewing gum is not digestible but it definitely doesn’t sit in your stomach for
years. Gum actually might help things move through the bowels faster. Sorbitol is
sometimes used as a sweetener in gum and this can act as a laxative. What
does this mean? Yes, if you look carefully, you should see it floating next to all of
those lovely yellow corn kernels.
Asparagus contains a sulfur compound called mercaptan. It is also found in
onions, garlic, rotten eggs, and in the secretions of skunks. The signature smell
occurs when this substance is broken down in your digestive system. Not all
people have the gene for the enzyme that breaks down mercaptan, so some of
you can eat all the asparagus you want without stinking up the place. One study
published in theBritish Journal of Clinical Pharmacology found that only 46
percent of British people tested produced the odor while 100 percent of French
Gberg:Mr. Leyner, sir????
Leyner:Sir, reporting for duty, sir!
Gberg:You ready for a little work, son?
Leyner:Sir, permission to discharge my weapon into the sky,
Gberg:Just don’t hit the keyboard.
Leyner:What should we do today?
Leyner:I have an idea . . .
Gberg:We have several things to do. Finish the preface,
which we need to do together. Then we have 2 more intros.
Gberg:Or else we can add some funniness to some questions.
Gberg:You had an idea?
Leyner:Let’s do that stuff (i.e., the preface and last two
intros) . . . the real “writing” on Tuesday at your
place . . . I think it works better with pacing.
Gberg:So let’s work our way through the book.
Gberg:Let’s start in the food chapter.
Gberg:We need to add something to this mother.
Gberg:Some sidebars.
Leyner:I’m getting a Propel.
Gberg:Okay, so we need to add some expert medical
commentary. By the way, do you think if we keep mentioning
Propel, that delicious vitamin-enhanced beverage from the
makers of Gatorade, we can get some free stuff?
Gberg:Only 20 calories per bottle. Sweet candy water!!!
Where are you?
Leyner:OK, Pops. I’m here, eating my sandwich, drinking
Propel . . . yes, absolutely!!!! We should shamelessly and
unethically claim that Propel cures impotence, Crohn’s
disease . . .
Gberg: . . . and the smell of your urine from
asparagus . . .
Leyner: . . . halitosis, and rectal whatever the hell you
Gberg:Should we add some French jokes?
Leyner:Certainly—let’s claim that Propel deodorizes your
urine EVEN after eating asparagus . . . then we’ll get
cases of the stuff!
Gberg:And you have to be a little less vulgar otherwise my
wife won’t be able to give this book to anyone as a gift
without offending them.
Gberg:Bunch of puritans!
Parents are always looking for an excuse to explain their children’s bad behavior,
and sugar has taken a lot of blame. This may come as no surprise, but the CocaCola Company doesn’t want to take responsibility, and makes it very clear that
studies have failed to find any substantial evidence proving a relationship
between sugar consumption and hyperactivity. Well, the company is correct.
Sugar does feed the body as an energy source, but it doesn’t make kids
It is more likely that kids tend to eat sugary foods at times when they would
be excited and rambunctious anyway (parties, holidays, movies, weddings,
funerals). This can only be good news for the producers of such fine healthy
treats as Cap’n Crunch with Crunchberries, Pixy Stix, cotton candy, and Laffy
Aaaah, the joy of a Popsicle on a hot summer day.
One theory places the source for the brain freeze in the sinuses, where the
pain may be caused by the rapid cooling of air in the frontal sinuses. This triggers
local pain receptors.
Another theory postulates that the constriction of blood vessels in the roof and
rear of the mouth causes pain receptors to overload and refer the pain to your
head. There is a nerve center there, in the back of your mouth, called the
sphenopalatine ganglion, and this is the most likely source of the dreaded ice
cream headache.
A friend of ours suggested a quick cure of rapidly rubbing your tongue on the
roof of your mouth to warm it up. Her demonstration included a bizarre clucking
sound. Leyner tried this and found himself followed by a large goose of whom he
seems to have become inordinately fond.
For those of you who use chocolate as a substitute for sex, you can breathe a
sigh of relief. There is no evidence that acne is caused by chocolate. Acne is
connected more to changing hormones than to food choices.
Links have also been made between stress and acne. Recently, a group of
dermatologists set out to prove that this common belief was also a myth but they
found the reverse. Their study of twenty-two college students found that
emotional stress was directly linked to acne severity.
But back to the chocolate issue, the University of Pennsylvania and the U.S.
Naval Academy both demonstrated that chocolate does not cause acne. At the
University of Pennsylvania, researchers fed subjects “chocolate” bars with no
chocolate, while another group ate chocolate bars with nearly ten times as much
chocolate as in a typical bar. Results of the experiment showed no significant
difference in acne in either group. Other forbidden greasy foods like French fries,
fried chicken, nachos, potato chips, and pork rinds probably don’t cause dreaded
zits either. So lighten up, kick back, and relax, and if that doesn’t work go to
McDonald’s for a supersize fries and a chocolate shake.
Cutting an onion releases an enzyme called lachrymatory-factor synthase. This
starts the process that leads to tears. This enzyme then reacts with amino acids
of the onion and the amino acids are converted to sulfenic acids. The sulfenic
syn-propanethialS-oxide, which is released into the air. When this chemical reaches the eyes, it
triggers the tears by contacting nerve fibers on the cornea that activate the tear
glands. Now you are crying.
Scientists have tried to make a “noncrying” onion but it seems that the crying
enzymes are also responsible for the zesty onion flavor. But there may be some
hope on the way. The group of Japanese plant biochemists that only recently
discovered lachrymatory-factor synthase, the crying enzyme, believe that “it
might be possible to develop a nonlachrymatory onion by suppressing the
lachrymatory-factor-synthase gene while increasing the yield of thiosulphinate.”
Sounds delicious!
In the meantime there are several solutions to try to avoid the problem of
onion-induced tears. Heating onions before chopping, cutting under a steady
stream of water, or wearing goggles.
The most reliable: ordering takeout.
A well-placed cucumber may feel wonderful, but there is no special ingredient in
it that reduces swelling under the eyes. Cucumbers are 90 percent water, and it
is the cooling effect of the water that constricts the blood vessels around the
eyes, therefore decreasing the swelling. The colder the cuke the better.
Some other swollen-eye solutions include black tea bags in cold water, the
tannic acid content being the key to reducing swelling. Hemorrhoid cream also
helps, but I’d prefer puffy eyes.
There is no solid medical reason for juice and cookies after blood donation. The
idea is that this little snack will help to replenish your fluids and raise your blood
sugar. But donating blood shouldn’t really affect your blood sugar, and the small
amount of juice that you drink probably has no significant effect on your fluid
status. The best use of this snack is to allow you to rest and adjust before you go
on your way after doing your civic duty.
Perhaps other food combinations could attract more blood donors:
1. For the upper-crust crowd: champagne and foie gras.
2. For the hipster: Vitamin Water and a PowerBar.
3. For the Atkins crowd: diet soda and a steak.
4. For the hip-hop gangster: a forty and some fried wings.
There is little scientific support for a link between food cravings and the
menstrual cycle. There have been suggestions that chocolate cravings during
menstruation are related to a deficiency of magnesium or are linked to
carbohydrate consumption to self-medicate depression, but no strong evidence
has been found to prove either one. Studies have placed volunteers on liquid
diets that provided plenty of calories and all the essential vitamins and minerals
needed, and participants still craved certain foods. This suggests that nutritional
deficits are not necessary for cravings of any kind and that these desires are
more psychologically based.
Medical texts, however, are filled with fascinating stories about bizarre “food”
Pica is the medical term for a pattern of eating non-nutritive substances (such
as dirt, clay, paint chips, etc.) that last for at least one month in the body. The
name comes from the Latin word for magpie, a bird known for its large and
indiscriminate appetite. Iron deficiency can cause pica and can also cause a
craving for ice, referred to as pagophagia. “Tomatophagia” has also been
reported in a sixty-six-year-old woman with iron deficiency who consumed
several whole tomatoes daily over a two-month period. Her tomato cravings
disappeared when her anemia was treated.
This is a common question that is most often asked by women who feel bloated
because of PMS and believe that it is related to the amount of salt they eat. We
both have learned over the years that you should never upset a woman if she is
having premenstrual symptoms, so we went back to the medical school
textbooks on this one to get the answer right.
Water accounts for 45 to 50 percent of the body weight in adult females and
55 to 60 percent of the body weight in adult males. Approximately 50 percent of
this water is in muscle, 20 percent in the skin, 10 percent in the blood, and the
remaining 20 percent in the other organs. Despite wide variations in dietary
intake, the volume and composition of the body’s fluids are maintained in an
extremely narrow range as we lose (by urinating, sweating, etc.) as much water
as we take in. In other words, the amount of a substance added to the body each
day is equal to the amount eliminated or used by the body. This is called the
balance state or the steady state.
Translation: if your kidneys are functioning normally, the amount of salt you
eat shouldn’t make you feel bloated. Maybe your pants are just too tight because
you ate all that chocolate as a substitute for sex.
We are sitting at i Trulli, a top New York City Italian restaurant, and I have
already unbuttoned my pants as I try to gather strength for dessert. I glance to
my left and my sister-in-law has eaten herself to sleep. Her head is slumped on
my wife’s shoulder and drool is about to begin trickling from her mouth. After
taking several pictures to add this event to family lore, I was again asked about
the cause of the dreaded food coma.
There are many possibilities as to what causes the classic “food coma.” Many
people report drowsiness after eating the traditional Thanksgiving meal. Turkey is
blamed for this soporific effect, specifically the amount of L-tryptophan contained
in turkey. L-tryptophan is an essential amino acid and is a precursor of serotonin.
Both serotonin and L–tryptophan have a calming, sedative effect in the human
L-tryptophan is naturally found in turkey protein but is actually present in
many plants and animals, including chicken and cows. The average serving of
turkey (about 100 grams or 3.5 ounces) contains a similar amount of
L-tryptophan as found in an average serving of chicken and ground beef.
Two other factors that contribute to the desire to sleep at the dinner table are
meal composition and increased blood flow to the gastrointestinal tract. Studies
have shown that a solid-food meal resulted in faster fatigue onset than a liquid
diet. The solid-food meal also causes a variety of substances to jump into action
that ultimately leads to increased blood flow to the abdomen. This increase in
blood flow and an increase in the metabolic rate for digestion can contribute to
the “coma.”
Now, I can tell the end of the family story. A good double espresso can
sometimes be enough of a pick-me-up to get through dessert. But, in an attempt
to resuscitate her comatose sister, my wife took her to the bathroom to splash
water on her face and press her belly against the cold bathroom tiles.
Unfortunately, time is the only true cure for the food coma.
We fear that getting into any diet debate will cause us to be besieged by a gaggle
of Atkins followers in a bacon-induced frenzy. But we may be safe this time,
because the culprit may be carbohydrates—specifically, rice and pasta.
Chinese meals, for the most part, contain rice, little meat, and plenty of lowcalorie vegetables. The rice and noodle dishes like fried rice and lo mein contain
carbohydrates that cause the blood sugar to peak and then plummet, causing
hunger. So, if you are going out for Chinese, don’t forget the Peking duck,
General Tso’s chicken, or the spareribs. You may feel greasy and start quoting
Mao, but you won’t feel hungry later.
MSG is the sodium salt of the amino acid glutamic acid and a form of glutamate.
Mmmm, doesn’t that sound appetizing.
Glutamate is a naturally occurring amino acid that is found in nearly all foods,
especially those high in protein. Monosodium glutamate (MSG) is used as a
flavor enhancer in a variety of foods prepared at home, in restaurants, and by
manufacturers of processed food. It is not fully understood how it adds flavor to
other foods, but many scientists believe that MSG stimulates glutamate receptors
in the tongue to augment flavors.
MSG has been the target of bad press based largely on reported reactions to
Chinese food, the dreaded “Chinese Restaurant Syndrome.”
For those who believe that they may react badly to MSG, the following
symptoms have been reported:
burning sensation in the back of the neck, forearms, and chest
numbness in the back of the neck, radiating to the arms and back
tingling, warmth, and weakness in the face, temples, upper back,
neck, and arms
facial pressure or tightness
chest pain
rapid heartbeat
bronchospasm (difficulty breathing) in MSG-intolerant people with
In 1958 the U.S. Food and Drug Administration (FDA) designated MSG as a
Generally Recognized As Safe (GRAS) substance, along with many other
common food ingredients, such as salt, vinegar, and baking powder, but
consumers continue to have questions regarding MSG’s safety and efficacy.
However, there is general agreement in the scientific community, based on
numerous biochemical, toxicological, and medical studies over the last twenty
years, that MSG is safe for the general population.
The Roman emperor Caligula believed that carrots had the properties of an
aphrodisiac, making men more potent and women more submissive. He is said
to have fed the entire Roman Senate a banquet of only carrots so that he could
watch the senators fornicate like wild beasts. This has nothing to do with
eyesight, but it is quite a tale.
The carrot myth dates back to World War II when the British Royal Air Force
was attempting to hide the fact that it had developed a sophisticated airborne
radar system to shoot down German bombers. They bragged that the great
accuracy of British fighter pilots at night was a result of them being fed enormous
quantities of carrots. It is true that carrots are rich in beta-carotene, which is
essential for sight. The body converts beta-carotene to vitamin A, and extreme
vitamin A deficiency can cause blindness. However, only a small amount of betacarotene is necessary for good vision. If you’re not deficient in vitamin A, your
vision won’t improve no matter how many carrots you eat.
In fact, the ingestion of excess vitamin A can cause toxicity, which can include
symptoms such as yellow-orange coloring of the skin, hair loss, weight loss,
fatigue, and headache.
I, Billy Goldberg, would like to dedicate this answer to my dear friend caffeine. He
has been with me through good times and bad. Without him I would not have
survived the long nights of my hospital residency nor the deadline of this book.
To my friend I proclaim, “I do not hold you responsible that I am only five foot
Actually there has been considerable research on whether caffeine
consumption is linked to osteoporosis. Overall, it can be concluded that moderate
caffeine consumption is not an important risk factor for osteoporosis, particularly
where women consume a healthy balanced diet. Some research suggests that
regular caffeine consumption may lead to loss of calcium in the urine, but this
does not have a measurable effect on bone density either. So as long as you
have a balanced diet with adequate calcium intake, you can enjoy your espresso
with no cause for concern.
So, why did our parents scare us with this myth when we wanted coffee as
children? Probably for the same reason that they invoked the fear of losing an
eye whenever we ran with scissors or snapped a towel. Pure parental mind
control. It also helps if the child falls asleep and leaves Mommy and Daddy alone
to find out if there really is a G–spot (see chapter 3, page 94).
We truly are a nation of drug addicts. With alcohol, nicotine, and caffeine, we are
constantly medicating ourselves to get through our daily activities. Now that
people are commonly found freebasing caffeine in the form of Red Bull, we need
an answer to this pressing question: Does cutting out the morning cup of joe
cause a 4P.M. headache from hell?
It is clear that caffeine can have an effect on headaches. Caffeine is present
in both over-the-counter medications (Excedrin) and prescription medications.
Caffeine acts to constrict blood vessels and therefore helps some headaches.
But, the withdrawal symptoms you experience when cutting out your daily coffee
are not as clear-cut as you may think.
A 1999 study in The Journal of Pharmacology challenged the assumption that
stopping coffee causes headaches. When participants in this study were
unaware of the caffeine-withdrawal focus, the frequency and severity of their
symptoms were much lower and sometimes nonexistent. A recently released
analysis concluded that there is a withdrawal syndrome when stopping coffee.
Symptoms are thought to be worse if you consume more caffeine and then
abruptly stop, although not everyone suffers the same withdrawal symptoms.
Other symptoms include fatigue, drowsiness, irritability, depression, or trouble
If you want to wean yourself off gradually, you can follow Mark Leyner’s
Monday—double espresso
Wednesday—single espresso
Thursday—Snapple iced tea
Friday—soy half-decaf mocha cappuccino
Saturday—a 12-ounce Coke
Sunday—beer (no caffeine and a wonderful breakfast treat)
There is nothing quite like that rush you get when you mistake the wasabi for
pistachio ice cream. But alas, this doesn’t lead to nose running. That is because
wasabi does not contain capsaicin, the extremely irritating chemical found in
jalapeño or habanero peppers. Capsaicin is believed to stimulate central nervous
system fibers that control the quantity and thickness of mucus and other fluids
secreted in the nasal passages and stomach.
For you trivia nerds, heat in peppers is measured on something called the
Scoville Scale:
0–100 Scoville units includes most bell/sweet pepper varieties.
100–500 Scoville units includes pepperoncinis.
500–1000 Scoville units includes New Mexico peppers.
1,000–1,500 Scoville units includes Espanola peppers.
1,000–2,000 Scoville units includes ancho and pasilla peppers.
1,000–2,500 Scoville units includes Cascabel and cherry peppers.
2,500–5,000 Scoville units includes jalapeño and Mirasol peppers.
5,000–15,000 Scoville units includes serrano peppers.
15,000–30,000 Scoville units includes the Chile de Arbol peppers.
30,000–50,000 Scoville units includes cayenne and Tabasco peppers.
50,000–100,000 Scoville units includes chiltepin peppers.
100,000–350,000 Scoville units includes Scotch Bonnet and Thai
200,000 to 300,000 Scoville units includes habanero peppers.
Around 16,000,000 Scoville units is pure
The single hottest known pepper is the Red Savina habanero. If you think the
jalapeño makes your nose run, the Red Savina will leave you wading knee-deep
in a puddle of your own nasal secretions.
No, spicy foods do not cause ulcers. Stomach ulcers can be aggravated by a
nice dash of Tabasco sauce. Drinking alcohol, smoking, or experiencing stress
can also make ulcers worse.
Most stomach ulcers are caused either by infection from a bacterium called
Helicobacter pylori (H. pylori) or by overuse of anti-inflammatory pain
medications such as aspirin or ibuprofen. The ulcers caused by bacteria can be
treated with antibiotics and the others treated by an end to the pill popping.
The artificial sweetener Equal and the food additive NutraSweet are both
aspartame. Approved by the FDA in 1981, this sweetener is hotly debated as the
cause of everything from headaches to seizures. The debate rages on via the
Internet and in the medical literature. The FDA and the Centers for Disease
Control (CDC) both claim that this product is safe, but there are also many
reports that show that headaches may be present as an adverse reaction in
some patients.
There is no solid answer to the question of artificial sweetener causing
headaches, but here are several things that are guaranteed to cause them:
1. Trying to help your child with math homework.
2. Telemarketers who call early on Sunday morning.
3. The map of red states and blue states.
4. Being stuck in traffic when the only clear radio station is playing an Ashlee
Simpson marathon.
To begin with, it is important to understand that the delicious artificial strawberry
or cherry product that we happily eat in movie theaters is not true licorice. True
licorice is black and contains glycyrrhizic acid. Therefore we cannot answer the
more important East Coast versus West Coast debate about whether Red Vines
are better than Twizzlers.
Medical literature contains a great deal of information about the link between
licorice and high blood pressure, and if you happened to be reading the Englishlanguage abstract of an article from the Norwegian journalTidsskrift for Den
Norske Laegeforening in 2002, you might have found out that “the active
component of liqorice is glycyrrhizic acid, which inhibits the enzyme 11-betahydroxysteroid dehydrogenase. This enzyme promotes the conversion of cortisol
to cortisone and is thereby responsible for the specificity of the mineralocorticoid
receptor to aldosterone in the collecting tubules. Inhibition of the enzyme allows
cortisol to act as the major endogenous mineralocorticoid producing a marked
elevation in mineralocorticoid activity, resulting in hypertension, hypokalemia,
and metabolic alkalosis.” I can’t understand why candy companies don’t use this
as a slogan. Imagine the catchy jingles, funny commercials, and booming sales
of black jelly beans.
I am
able to finally escape from the torture of Jeremy’s food inquisition, and I
look around and can’t find Leyner anywhere. The bottle of Don Julio is missing and there
is a trail of shrimp tails that leads to the elevator. I find him sitting in the hallway, playing
Chutes and Ladders with the neighbor’s children, and devouring cocktail sauce with a
straw. I try to get him back inside and he snarls, “Are you out of your mind? I’m down a
hundred and fifty bucks.” His bark is heard inside and several revelers come outside to
watch the action. A crowd has formed around the game and Mark is becoming surly with
the children as his losses mount. It doesn’t help that the children are mocking him by
singing “The Gambler” by Kenny Rogers. The tides turn and Leyner has soon wrestled
the weekly allowances and the school lunch money from the kids, who disperse
crestfallen while muttering to themselves. Triumphantly, Leyner rises and shouts, “Punkass suckers go crying to your mommy. We’re going to bring this party back inside and
play some strip Candyland.” He pockets his winnings, swigs the Don Julio, and we are
Back inside, Wendy Thurston, a senior editor at Half-a-Dozen Ponds Press, has fallen
victim to Leyner’s shrewd, merciless gamesmanship. She is down to her bra, thong, and
socks. As Leyner wins another point, she removes her left sock, revealing the most
beautiful alabaster-hued foot and immaculately pedicured webbed toes. Teary-eyed,
Leyner turns to me and in a choir boy’s piping, soprano weeps, “I have found my
This romantic outburst leaves the party in stunned silence, and then I’m again
besieged by a slew of body-related questions. What is it about sideshow body oddities
that awakens our most primal desires and curiosities?
As I, Billy, was sitting on the beach, relaxing and leafing through an old copy of
the Journal of Manipulative and Physiological Therapeutics, I came across the
answer to this age-old question. I also wish my father had known this, because
maybe he would have yelled at my brother less. Cracking your knuckles is not as
bad as people think. The usual argument is that knuckle popping causes arthritis.
This does not happen. Chronic knuckle cracking may cause other types of
damage, including stretching of the surrounding ligaments and a decrease in grip
strength, but not arthritis.
So what causes the pop? The sound is produced in the joint when bubbles
burst in the synovial fluid surrounding the joint. Really interesting, huh?
I didn’t have the answer to this question until I delivered my first baby. I always
believed that you had an “innie” if the doctor tied a good knot, and if he didn’t,
you were cursed with that funny-looking “outie.” Well, there is no knot tying at all.
We just put on a clip, cut, and wait for the umbilical cord to dry up and fall off. It is
all random.
Sometimes someone can develop an “outie” because they have a hernia at
this site. This also has nothing to do with the doctor’s Boy Scout skills. I have
recently heard of plastic surgeons removing an “outie” for belly beauty. How sad.
One question that cannot be answered, however, is why some belly buttons
collect so much lint.
In Australia, the “poo fairy” comes at night to take a dump in your mouth. In
England, they say a long night at the pub leaves your breath “tasting like the
vulture’s dinner.” And a Scottish friend with a new Hawaiian bride reports that a
late-night fridge-binge of haggis and poi will leave you with the worst morning
breath of your life.
So, given all these tales, we should probably start with the anaerobic bacteria,
the xerostomia (a fancy word for dry mouth), or the volatile sulfur compounds
(which are actually waste products from the bacteria). All these combine to give
you that wonderful get-up-in-the-morning feeling of garbage mouth.
Other things also contribute to this oral smorgasbord: medications, alcohol,
sugar, smoking, caffeine, and dairy products.
But don’t run off and have your tongue sandblasted; there are simple things
that you can do to fight morning breath. Brush regularly (don’t forget the tongue),
floss, and drink plenty of water.
Gberg:I was just thinking that the more chaotic this is,
the harder it is for Carrie to edit. It might even induce a
Leyner:That’s funny!! I think tormenting her is always a
good sort of compass for us when we’re lost and floundering.
Leyner:What is a seizure, actually?
Gberg:Is that the way it usually works in the creative
process? Is your genius always fueled by torment?
Gberg:Abnormal electrical activity in the brain, why?
Leyner:My creative process is fueled by a sense of
Nietzschean aristocracy and a simultaneous feeling that I’m
an abject fraud.
Gberg:I think everyone feels like a fraud. What about me,
trying to answer these unanswerable questions?
Leyner:Coupled with torment and an overwhelming need to be
loved and liked (even) AND horniness AND creditors calling
ALL THE FUCKING DAY LONG. Didn’t you go to medical school
in Ingushetia? You are a fraud.
Gberg:Where the hell is Ingushetia?
Leyner:Directly east of Chechnya. Check MapQuest.
Gberg:Enough of your Chechen obsession. Let’s talk about
the book.
Leyner:I told you...with the amount of money we’re getting
paid for this book, Mercedes and I are getting a time-share
summer dacha in Chechnya.
Here are several things we can be thankful are not contagious:
That said, there are several theories for what causes yawns and why they are
contagious. It was originally thought that people yawned to get more oxygen, but
this appears not to be true.
The most common theory is behavioral. In an article examining contagious
yawns, Dr. Steven M. Platek and others state, “Contagious yawning may be
associated with empathic aspects of mental state attribution and are negatively
affected by increases in schizotypal personality traits much like other selfprocessing related tasks.”
Huh? I find myself yawning right now.
What they mean is that people are unconsciously imitating others when they
yawn. Humans are not the only species that yawn. Yawning is seen in many
animals, including cats, fish, and birds, although we don’t know what a yawning
fish looks like either.
Since our editor thought this question made the best title for this book, we racked
our brains to come up with a hilarious, witty, and informative answer to this
question. Our attempts proved futile, so, in order to finish this book so another
brilliant title wouldn’t go to waste, we went for the boring, straight scientific
response. Sorry.
We are mammals and blessed with body hair, three middle ear bones, and
the ability to nourish our young with milk that females produce in modified sweat
glands called mammary glands. Although females have the mammary glands, we
all start out in a similar way in the embryo. During development, the embryo
follows a female template until about six weeks, when the male sex chromosome
kicks in for a male embryo. The embryo then begins to develop all of its male
characteristics. Men are thus left with nipples and also with some breast tissue.
Men can even get breast cancer and there are some medical conditions that can
cause male breasts to enlarge. Abnormal enlargement of the breasts in a male is
known as gynecomastia. Gynecomastia can be caused by using anabolic
steroids. So, if Barry Bonds ends up coming to the old-timers game with a pair of
sagging 44DD man boobs, then I think we will finally have our answer to the
steroid controversy.
It is common for people to come into an emergency room because they can’t find
their contact lens. Sometimes it is found folded and tucked beneath the eyelid,
but other times it is nowhere to be found. So where is it???
Probably on the bathroom floor at home. A little anatomy lesson: there is
nowhere else for it to go.
Other commonly “misplaced” items that lead people to the ER: tampons,
condoms, and car keys.
This is a surprisingly frequent question, and often a reason women find
themselves in the emergency room. Patients often come in either because they
cannot remove the tampon or because it has disappeared and they don’t seem to
know where it went.
Time for another anatomy lesson. The vagina is a potential space, not a hole
or cavity inside the body. The walls of the vagina are normally in contact with
each other unless something is inserted between them. When something enters
the vagina, the body makes room for it. At the end of this potential space is the
cervix. Therefore, there is no place for the tampon to go. It cannot be lost inside
that small area and you should be able to remove it, or it can be easily removed
by any doctor. Often we find nothing inside, and that means you probably forgot
you removed it. Leaving a tampon inside too long can put you at risk for a serious
infection, so don’t be embarrassed to ask for help.
Now, we are sure there are many possibilities as to why someone would need
the answer to this question. We never asked our friend who asked this question
why this was important, but surely she had her reasons.
Some sources do agree that the tongue is the strongest muscle per size, but
the tongue is actually made up of four muscles. The heart has also been
mentioned, but since it moves involuntarily and is mainly an endurance muscle, it
doesn’t really get to the heart of this question (bad pun intended).
The sartorius, which slants across the thigh to the knee, is the longest muscle
in the body. As for the strongest, there are two other candidates, the masseter,
used for chewing, and the gluteus maximus. By gluteus! Who knew that our
asses were so strong!
Another tidbit for you trivia geeks, here are Billy and Leyner’s two favorite
ass-vocabulary words:
callipygian: having beautifully proportioned buttocks
steatopygic: an extreme accumulation of fat on the buttocks
The body usually maintains a constant temperature of 98.6 degrees Fahrenheit.
At this temperature the cells of the body work best. If there is any significant
change in temperature, it is sensed by an area of the brain called the
hypothalamus. When the body gets too cold, this center alerts the rest of the
body to begin warming up. Shivering, the rapid movement of the muscles to
generate heat, then begins. Teeth chattering represents localized shivering.
The appendix is a small pouch off the large intestine. The wall of the appendix
contains lymphatic tissue that is part of the immune system for making
Removing the appendix doesn’t cause any harm because there are several
other areas in the body that contain similar tissue—the spleen, lymph nodes, and
tonsils. The spleen and the tonsils can also be removed.
Gberg:You were going to give me a little something to add
to the appendix question, Why do you have one if you can
live without it?
Gberg:Some expert Leynerisms on vestigial organs.
Leyner:God put certain internal organs in the human body
for purely aesthetic reasons. They just look nice when the
forensic pathologist opens you up.
Leyner:How do we know yet what all the vestigial organs
are? A lot of the organs that seem crucial now may seem
vestigial pretty soon.
Gberg:Please explain to me what is so beautiful about the
appendix. It looks like a little wet caterpillar.
Leyner:It’s so subjective, though...a little wet
caterpillar is beautiful...vulnerable, bespeaking the
evanescence of life and the unbearable limpness of it all.
I’m sure at some time, somewhere, the appendix had its
moment, its evolutionary “15 minutes” of utility.
Gberg:What the hell are you bespeaking of?
Leyner:There was probably some predator that only ate
people without an appendix so that gene flourished for a
Leyner:Speaking of vestigial.
Leyner:What other supposedly vestigial organs are there?
Gberg:The tail.
Leyner:Wouldn’t body hair also be considered vestigial now,
since we don’t live naked out on the primeval savannah?
Leyner:I try to live naked on an inner sort of primeval
savannah, but you know what I mean. Body hair is surely
some sort of atavistic throwback too.
Leyner:What’s the purpose of pubic hair or back hair or
even hair on the head?
Gberg:Hold on, I have to look up “atavistic.” I need a
freakin’ thesaurus.
Leyner:It’s all economics. There’s not enough of a service
industry devoted to the appendix, so it’s anathematized as
“vestigial”...hair’s cool, what with the waxing industry
and salons and shampoos and conditioners, etc. etc.
Gberg:You know, I love the word “merkin,” but do people
really wear those?
Gberg:Why would anyone really want a pubic toupee?
Leyner:The whole idea of a merkin is so great! I think this
whole culture of plucked women is pretty perverse,
actually. It’s sexually infantilizing. Who wants a woman
who looks like a six-year-old down there?
Leyner:How big can an appendix get?
Gberg:I know, but by the same token, you don’t want someone
who looks like a Yeti.
Gberg:Is that how you spell it?
Leyner:A Yentl?
Gberg:No, the abominable snowman.
Gberg:Are you saying that Babs wears a merkin?
Leyner:Well...I know we’re digressing a bit...but rather a
Yeti than a glabrous, waxen thing.
Leyner:Streisand is famous for the merkin. Made by the
finest Venetian merkin-makers.
Gberg:Let’s not digress. We can get back to the book.
Leyner:From Yak scrotal hair.
Leyner:OK...back to the book.
One of the great secrets of medicine and one of the things that doctors aren’t
quick to admit is that we often don’t have all the answers. Canker sores are one
of those cases. Canker sores, medically known as recurrent apthous ulcers, are
the most common oral disease and something that many of us have
experienced. They differ from cold sores in several ways. Canker sores occur
inside the mouth while cold sores show up on the lips. Cold sores are caused by
the herpes virus and are definitely contagious. The etiology of canker sores is still
unknown, although scientists have spent a great deal of time searching for the
answer. Studies have suggested that this inflammatory disease is a result of
abnormal immune response directed toward the oral membranes. Several
bacteria and viruses have also been investigated as the culprit, but none has
been found to be responsible.
It’s all about the arrectores pilorum.
What, you say, are arrectores pilorum?
These tiny little hair erector muscles that contract and raise the hair follicles
above the skin. These are goose bumps or goose flesh or chicken skin.
What causes them?
They start with a stimulus such as fear, cold, or the sight of yourself in the
mirror after a night of vodka-induced debauchery. This causes the sympathetic
nervous system to become activated. The sympathetic nervous system is
responsible for the body’s “fight or flight” response. This sends a message to the
skin and activates those little muscles.
Saturday night palsy is a condition often seen in the emergency room, not a
sequel to a John Travolta film. It is caused by the same mechanism that makes
your foot fall asleep but is a tad more severe. Saturday night palsy is caused
when someone, who is usually really wasted, is unable to move an arm or leg in
response to the pins and needles caused when a limb “falls asleep.” It can lead
to temporary or even permanent nerve damage.
Here is what happens in normal conditions. When pressure is exerted on part
of your leg or arm, several things occur. Arteries can become compressed,
making them unable to provide the tissues and nerves with the oxygen and
glucose they need to function properly. Nerve pathways can also become
blocked, preventing normal transmission of electrochemical impulses to the
brain. Some of the nerves stop firing while others fire hyperactively. These
signals are sent to the brain, where they are interpreted as burning, prickling, or
tingling feelings. It is these sensations, paresthesias, that alert you to move your
foot. Shaking your foot releases the pressure and nutrient-rich blood flows back
into the area and nerve cells start firing more regularly. The “pins and needles”
feeling can intensify until the nerve cells recover. That is why it is painful when
you try to “wake up” your sleeping limb.
Persistent numbness or tingling can be a sign of certain medical conditions,
and in those cases you should see your doctor.
Feeling exhausted? Wondering why you have bags under your eyes that make
you look like Droopy Dog or John Kerry?
Lack of proper restful sleep seems to cause dark rings for reasons not
properly understood. The skin around the eye is the thinnest found anywhere on
the body, and this thin skin allows dark, venous blood to show through.
Dark rings around the eyes are a common problem. They appear to be
genetic and can get worse as you age and your skin gets thinner. Adequate rest,
good nutrition, and overall good health tend to make the circles less noticeable.
You can also wear sunglasses all the time.
You definitely don’t spend a great deal of time learning about laughter in medical
school. I know that doesn’t surprise you since physicians are such serious
people. The closest they come to humor is the physiological study of laughter—
gelotology. There is even a form of seizures called gelastic seizures that causes
sufferers to laugh incessantly.
Laughter is a complex process that requires the coordination of many
muscles throughout the body. Laughter also causes an increase in blood
pressure and heart rate, breathing changes, reduced levels of certain
neurochemicals, and a potential boost to the immune system. So, overall, it is
very good for you.
Researchers have attempted to decipher the purpose of laughter and many
believe that the reason for laughter is related to making and strengthening
human connections, a kind of social signal. Studies have shown that people are
thirty times more likely to laugh in social settings than when they are alone.
Reports also suggest that the origins of laughter may predate human evolution.
So, what about the connection between tickling and laughing?
Well, this tickling-induced laughter is actually a reflex. Scientists don’t fully
understand how this works, but because you cannot tickle yourself, the reflex
seems to require an element of surprise.
Have you ever used the expression “sweat like a pig”? Think again. Pigs don’t
sweat. Pigs don’t have sweat glands, which explains why they have to wallow in
puddles and mud to cool off.
As for us humans, we routinely sweat as a way of eliminating excess heat
and maintaining a normal body temperature. The average person has 2.6 million
sweat glands distributed over the entire body except for the lips, nipples, and
external genitalia. There are two different types of sweat glands, eccrine and
apocrine. These glands are different in size and produce different kinds of sweat.
Eccrine glands are located all over the body. Apocrine glands are different
because they are found mostly in the armpits and groin. They are larger and
open into hair follicles. Though sweat is mostly water, it is the small amount of
protein and fatty acids in the apocrine sweat glands that gives armpit sweat that
wonderful milky or yellow color. It is also what causes it to stain.
Sweat itself is odorless whether it comes from the armpits or other areas of
the body. The funk begins when sweat mixes with bacteria that occur naturally on
the surface of the skin. This distinctive odor is called bromhidrosis—foul-smelling
Gberg:I was going to add a New York cab driver joke to the
“Why does sweat stink?” question.
Gberg:Any thoughts?
Leyner:What’s the joke?
Leyner:I love jokes.
Leyner:What’s the stinky cabbie joke?
Gberg:I don’t know one, but the scents of a taxi are so
Gberg:It’s either that overwhelming air freshener or
wretched body odor.
Leyner:See!! It’s all economics . . .
cabbies won’t run the AC . . . so of course they’re gonna
stink—especially the ones who wear the Irish fishermen’s
sweaters and the Latex underwear in the middle of the
Leyner:Air freshener is, to me, worse than the smell it’s
supposed to obscure . . . it just makes me think of what
the person is trying to camouflage, so my mind creates an
even greater fetid fiction.
Gberg:I don’t know. It depends what scent you are talking
about. The hospital has some particularly vicious scents
that need covering, like . . .
Gberg:Butt pus and
Gberg:bloody stool, which . . .
Gberg:They both sound like punk bands.
Leyner:Isn’t the smell of sweat supposed to produce certain
subconscious (or conscious perhaps) sexual responses?
And . . .
Leyner:What the hell is “butt pus”?
Gberg:Like a perirectal abscess or a pilonidal cyst—you
drain them and the scent is horrible.
Leyner:Oh . . . that’s not so bad.
Leyner:I’ve smelled that.
Leyner:I have a pilonidal cyst—a dormant one though.
Gberg:You always were scent obsessed.
Leyner:I met a girl at Brandeis who also had one, and we
soaked ours together. That’s true.
Gberg:Sitz baths.
Leyner:Fond memories of her.
Gberg:A sitz schvitz.
Leyner:Yes . . . sitz baths—we were young and idealistic.
Leyner:Isn’t a pilonidal cyst somehow related to a
vestigial tail?
Gberg:I don’t know.
Leyner:That’s a fucking simple medical question, and your
answer is “I don’t know”!!!!!!!!!!
Gberg:It brings back the original point of this book. They
never teach you the obscure stuff that people actually ask.
Leyner:My grandfather used to go to Hot Springs, Arkansas,
for “baths.” Or so he told my grandmother.
Gberg:I can describe in detail the technique for draining a
pilonidal cyst or talk about marsupialization, when you sew
down the sides.
Gberg:Nobody wants to know that.
Gberg:And then I get mocked by some pumped-up little writer
who couldn’t marsupialize his way out of a paper bag.
Gberg:Not a pepper bag but a paper bag.
Leyner:Do people ask you strange questions in the ER? Or
are they too freaked out by having meat cleavers embedded
in their heads to make small talk with you?
Leyner:You gotta explain that, dude!!
Gberg:Explain what?
Leyner:What’s marsupialization?
Gberg:You cut open the cyst and sew down both sides so it
doesn’t come back. You create a little pouch.
Leyner:Maybe I’ll get that! I’ll have the ass of a kangaroo!
Phlegm, snot, spit, boogers, sputum—all different varieties of the same thing.
These terms are used to describe different forms of mucus, a slimy material that
lines various membranes in the body (called, of course, mucus membranes).
Mucus is composed chiefly of mucins (lubricating proteins) and inorganic salts
suspended in water. Mucus aids in the protection of the lungs by trapping foreign
particles that enter the nose during normal breathing. Mucus also makes
swallowing easier and prevents stomach acid from harming your stomach wall.
As for the different varieties, phlegm is one type of mucus. By definition
phlegm is limited to the mucus produced by the respiratory system, excluding
that from the nasal passages (that is what we refer to as snot), and that which is
expelled by coughing (sputum). In medieval medicine, phlegm was counted as
one of the four bodily humors, possessing cold and wet properties. Phlegm was
thought responsible for apathetic and sluggish behavior, which is how we get the
word phlegmatic . Boogers are less historical, a slang word for dried nasal mucus
or snot.
The presence of mucus in the nose and throat is normal. When you are sick
the mucus can become thicker and change colors. Color is not a clear indication
of a bacterial infection, but persistent rust-colored or green mucus tends to
indicate a more serious condition.
For those do-it-yourself types, there are many ways to make home mucus to
prepare yourself for a career in medicine:
1/2–1 pound fresh okra
1–2 cups water (the less water you add, the thicker your mucus will be)
1. Chop the okra into large pieces and place them in a saucepan with a tightfitting lid.
2. Add water to cover and boil the okra, about 10 to 15 minutes, until it is a dark
grayish green and very soft.
3. Turn off the stove and remove the lid. Let your slimy substance cool.
4. Strain the slimy mess into a bowl and discard the okra.
1. Stir 1/8 cup borax into 500 ml (2 cups) warm water. It’s okay if some borax
remains undissolved. Allow solution to cool to room temperature.
2. In a separate container, stir 2 spoonfuls of glue (Elmer’s) into 3 spoonfuls of
3. Stir a couple drops of food coloring into the glue mixture.
4. Add a spoonful of the borax solution to the glue mixture. Stir (if in a bowl) or
squish (if in a Baggie).
To answer this question we called one of my smartest friends, an Ivy League–
educated ophthalmologist who is a retina surgeon at a prestigious university
hospital. He’s the kind of guy who sends me Proust as a birthday gift. Doesn’t
watch TV. Listens to NPR. So, we go to him for the answer. . . .
Nothing. He tells me he will look it up. This just goes to show you that medical
school sometimes misses the really simple stuff.
So, who has the answer? Honorary physician and expert on medical oddities
Mark Leyner wrote about this malady in Maximum Golf magazine. Here, one
pseudoschizophrenic golfer hears two golf announcers having the following
discussion in his head:
Announcer B:Michael’s a bit off center—I’d say less than a foot from the left
edge of the mattress and maybe a good foot and a half from the right rim. He’s
got his left arm tucked under the pillow—
Announcer A:Which looks to me like a 245-thread-count cotton-twill shell filled
with a 95-percent-Canadian-feather-and-5-percent-down blend.
Announcer B:What’s that in the corner of his left eye? A small emerald green
particle. Can you make that out?
Announcer A:That’s the mucopolysaccharide secretion from the lachrymal gland
that’s accumulated and crystalized overnight, Bobby.
Announcer B:Eye gunk. My mama used to call that a “sleeper.”
Announcer A:Well, we’ve got a lovely aerial view of Michael’s sleeper from the
MetLife blimp,Snoopy Two, cruising at thirty-five miles per hour at an altitude of
twelve hundred feet. Our thanks to Captain William Schmickling and his crew for
that shot. Absolutely splendid.
Announcer B:Chris, he’s gotta get that outta there. What would you do in this
Announcer A:There’s the very slightest breeze coming through the open
window, but not sufficiently gusty to warrant any sort of major tactical adjustment.
I’d use an index finger here, position it on the corner of the eye, precisely there at
the lachrymal duct, and just ever so gently, ever so deftly, roll the particle out.
Announcer B:You can’t try to do too much here.
Announcer A:Just get it out, actually—that’s a job well done.
Announcer B:Reminds me of when Ernie Els got an eyeful of sandpiper guano
at the AT&T Pebble Beach National Pro-Am in ’95. Played the back nine
basically half-blind. One of the most courageous exhibitions I’ve ever witnessed.
This eye gunk is nothing serious. While you sleep, a mixture of oil, sweat, and
tears collects near the corners of your eyes. As the tears dry up you get left with
a nice little bit of crust.
The pale half-moon shape at the base of each nail is called the lunule. It shows
where the hardening process is not yet complete.
The American Academy of Dermatology provided these nail facts:
Nails grow about 0.1 mm (or about .004 inch) per day.
Fingernails tend to grow a little faster than toenails.
Toenails are approximately twice as thick as fingernails.
In general, nails tend to grow faster in summer than they do in
Men’s nails usually grow faster than women’s nails.
Nails on your dominant hand tend to grow faster.
party continues and has taken on a much more serene and romantic tone.
Leyner is on the couch with his Cinderella and is eating cocktail egg rolls off her webbed
toes as they share his bottle of tequila. I am finally free from the body questions and at
last can enjoy a drink myself. It seems as though the drama of the evening is over until I
hear Leyner shout, “Can anyone get me some duck sauce?” Leyner is too impatient and
his libido is obviously inflamed, so he is unable to wait for the hired help to procure the
requested Chinese condiment.
I cross the crowded room and find Leyner conducting a focus group on homemade
and alternative lubricants. As I reach the front of the group, Leyner is now meticulously
mixing exact proportions of Tabasco, runny Brie, and a dash of his sacred tequila to form
what he now calls his “spicy sex balm.” I try to suggest that the Tabasco may cause
contact dermatitis on the more sensitive parts of the body, but Leyner chooses not to heed
my medical advice as he leads his new “special” friend to his ad hoc laboratory.
I am left behind to answer a sudden barrage of questions about sex. With
anatomically correct dolls,Sex and the City, and Internet porn, you’d think there’d be
nothing left to learn. But there are still some questions people are afraid to ask until
they’ve had that third martini.
You are what you eat. In this case, it is somewhat true, as sperm contains
important genetic material. But sperm, despite its important load, is not
particularly nutritious or fattening. The average ejaculate, about one teaspoon,
contains between two and three hundred million sperm. Total calories: about five.
These calories are derived from protein, including enzymes and sugars (mainly
fructose) secreted into semen by the prostate gland to provide the sperm with the
energy to swim.
Other good stuff found in semen includes water, vitamin C, citric acid,
phosphate, bicarbonates, zinc, and prostaglandins. A veritable breakfast of
Gberg:I still can’t believe we ended up with this title.
Gberg:I still miss “Cocktail Party Medicine.”
Leyner:I know...I can’t even look at my own nipples anymore
without blushing with shame.
Gberg:Or if you had your way, it would be “Is Sperm
Fattening?” That would be even worse.
Gberg:It hurts the neck to stare at your nipples for too
Leyner:I still love that title.
Gberg:That would have meant the end of my medical career.
Leyner:To the contrary—I think it would have landed you a
Surgeon General nomination in the Hillary Clinton
In the 1970s there was an after-school special on TV where two girls were talking
about whether you could get pregnant from kissing a boy while wearing a wet
bathing suit. That definitely isn’t true, but the answer to this question is a little
more complicated.
The basic answer is yes, you can.
First, not all bleeding is a real period. Sometimes a woman can have spotting
during ovulation and that would be a very easy time to get pregnant.
Also, if a woman has a short menstrual cycle (about twenty-one days), then
she could be ovulating on day seven of her cycle. This would be the seventh day
from the first day of her period, and if her period lasts seven days, then it is
possible that her period is ending just as she is ovulating.
Confusing? It is definitely easier to practice safe sex.
Oysters definitely do resemble a certain anatomical part, but this doesn’t make
them stimulants. There are a lot of different foods and substances that are
thought to be aphrodisiacs. Though there is no science to prove that any of them
work, there are some theories on oysters.
Oysters are full of many vitamins and minerals, especially zinc. Zinc controls
progesterone levels, which have a positive effect on the libido. Other foods and
products that are thought to get your mojo working include:
Spanish Fly
animal crackers (but only if consumed during sex and dunked in
Spanish fly)
When I was in Spain, I learned that the Spaniards believed that the distance
measured from either side of your nose across the tip to the other side hinted at
your penis size. As the owner of a rather large schnoz, I, Billy, was happy about
this. But, by this same measurement, Geppetto must have had quite a task
making pants to hold Pinocchio, and Cyrano de Bergerac wouldn’t have had to
waste so much time writing love letters for others. Unfortunately, none of this is
There also seems to be no evidence that hand size is related to the size of
your package.
When it comes to foot size, two urologists, in a study in the British Journal of
Urology, measured the stretched penile length of 104 men and related this to
their shoe size. They found that there was no relationship.
As for other size issues, a small penis expands more than a big one during
erection. And since a woman’s sexually sensitive parts are in and around the
outer third of the vagina, a big penis is not necessarily needed to satisfy her. Size
doesn’t really matter, ladies.
You must be referring to nocturnal tumescence! Or do you mean Private Willie Is
Playing Reveille, or perhaps Morning Glory? There are many names for this
morning starter, but only one good explanation for its presence.
These erections are experienced in the REM (rapid eye movement) phase of
sleep. REM sleep is more frequent just before waking up.
Erections can also happen at other times without any stimulus. There is no
scientific reason why these spontaneous erections always seem to happen in the
most embarrassing places (parties, holidays, movies, weddings, funerals).
Professor Leyner has written extensively on the subject. The noted scientific
research journal Maximum Golf contained this excerpt:
Announcer B:If you’re just joining us, Michael Neubauer is still in bed—but
we’ve got an interesting development here.
Announcer A:That’s an erection, Bobby. That’s a classic morning erection. You
couldn’t diagram it any better than that. The corpora cavernosa and the corpus
spongiosum are engorged with blood and rigid. Absolutely paradigmatic. What do
you think?
Announcer B:I think you just have to give it a good whack here, Chris.
Announcer A:Apparently you’ve got the ear of Michael Neubauer, because that
appears to be precisely what he’s going to do.
Announcer B:I really like what he’s trying right now. He’s running this frenetic
montage of actresses, models, and athletes through his mind: We’ve got Renée
Zellweger, Neve Campbell, Liv Tyler, Catherine Zeta-Jones, Britney Spears,
Salma Hayek, Foxy Brown, Niki Taylor, Lil’ Kim, Melissa Joan Hart, Charlize
Theron, Sarah Michelle Gellar, Zaha Hadid, Benazir Bhutto, Se Ri Pak, Karrie
Webb, Serena Williams, Anna Kournikova, Jelena Dokic, Mary Pierce. Now he’s
going way back: we’ve got some high school yearbook action; we’ve got some
baby-sitter action. He’s just totally scouring the memory bank here—there’s one
of his grandmother’s mah-jongg partners with the arm wattles....
Announcer A:What are you trying to do in this situation?
Announcer B:You’re trying to get some erotic traction. You’re looking for that
face or that body that just clicks, y’know, that you can fixate on, and then you try
to get the voice, the incantatory exhortations, “Michael...oh yeah...oh Michael...oh
my God!”
Announcer A:How do you like his mechanics right now, Bobby?
Announcer B:Excellent. He’s got a very good rhythm going right now.
Announcer A:Marvelous touch. You sense he has everything to gain and
nothing to lose.
Announcer B:One caution here. You want to avoid the computer and the books
over there—
Announcer A:I think we’re reaching critical mass, Bobby.
Announcer B:They don’t come much better than that, Chris. Absolutely
marvelous shot!
If an aroused male is unfortunately the victim of a spinal cord injury, the ability to
have sexual intercourse depends on the level of injury. In men there are normally
two types of erections, psychogenic erections, which result from sexual thoughts,
and reflex erections, which result from direct physical contact.
Psychogenic erections develop from the nerves of the spinal cord that exit
toward the bottom of the spine at the T10-L2 levels. Generally, men with an
incomplete injury at a low level are more likely to have psychogenic erections
than men with high-level incomplete injury. Men with complete injuries are less
likely to experience psychogenic erections.
Reflex erections arise in the sacral area of the spinal cord. Many men with a
spinal cord injury are able to have a reflex erection with physical stimulation if this
pathway is not damaged.
It pains us to say, but this is true. There is no bone in your “bone,” but you can
rupture the penis, which is called a penile fracture. Sudden trauma or bending of
the penis in an erect state can break the thick fibrous coat surrounding the
corpora cavernosum tissue that produces an erection.
This happens most frequently during sex. Don’t expect to get a cast and
crutches, though. This injury is an emergency and requires surgery to prevent
sexual dysfunction. Ouch!
As a doctor, there is a great deal of medical research to read. Piles of The New
England Journal of Medicine and the Annals of Emergency Medicine surround
the house. Rarely does this drudgery cause excitement, unless you stumble
across the April 7, 2004, issue of The Journal of the American Medical
Association .
As a young boy you get bombarded by the fear that masturbation can cause
stuttering, blindness, or hairy palms. Even if you escape these maladies you can
still be left feeling like a degenerate if you engage in self-love too often. Fear no
more. In the article “Ejaculation Frequency and Prostate Cancer” you finally find
out that whacking off may be good for you. This article states that ejaculation
frequency is not related to increased risk of prostate cancer and that the group
with an ejaculation frequency of greater than twenty-one times per month had a
lower risk of prostate cancer. Great! And no hairy palms.
Dr. Billy’s young cousin’s friend asked him this one, another common question.
There are many different opinions about what constitutes losing one’s virginity,
but most experts agree that women lose their virginity the first time they have
vaginal intercourse.
This question mainly revolves around the idea that only an intact hymen (a
fold of tissue that partly covers the entrance to the vagina) proves that a woman
is a virgin. It is possible for a woman’s hymen to become stretched open during
activities like playing sports or masturbating. Hymens have at least one opening
that will allow menstrual flow out of the body. Tampons may stretch the hymen a
little bit, but they don’t usually stretch it open all the way. Either way, most people
in the modern age believe that the condition of the hymen does not have
anything to do with the definition of a virgin.
Small muscle cells arranged cylindrically within the nipple are responsible for the
nipple becoming erect. This occurs when they are stimulated by cold temperature
or sexual arousal.
A penis whose flaccid length when stretched is more than approximately 2.5
standard deviations below average size for his age group is referred to medically
as a micropenis. This is not a title that any self-respecting man wants to put in his
bio, but perceptions of penis size can be deceiving.
Cold air, cold water, fear, anger, or anxiety can cause the penis, scrotum, and
testicles to be pulled closer to the body, thereby shortening it to micropenis
Warm conditions on the other hand can cause the penis to lengthen. Although
the size of the non erect penis differs widely from one male to another, this
variation is less apparent in the erect state. Even Seinfeld weighed in on the
shrinkage issue.
Some penis reference points:
1.The Kinsey Report, 1948: average length of 6.20 inches (15.25 cm) with a
standard deviation of .77 inches (1.96 cm).
2. Study by Wessells et. al., 1996: average length of 5.1 inches (13.0 cm).
3. Other studies: average length of 5.7 inches (14.5 cm).
The debate over circumcision has been going back and forth for years. Some
American medical experts believe that all newborn males should be circumcised.
The side in favor cites the decreased rate of urinary tract infections and sexually
transmitted diseases among circumcised men, and the other emphasizes the
pain and stress inflicted on a baby during circumcision. Others believe that the
benefits of circumcision are not great enough to justify the possible complications
of the procedure. In 1999, the American Academy of Pediatrics Task Force on
Circumcision found potential medical benefits of circumcision, but decided that
the evidence was not strong enough to recommend routine circumcision. But,
more important, back to sex.
There are several studies found in urology literature that look at the effect of
male circumcision on male sexual satisfaction. These studies found conflicting
The effect of male circumcision on the sexual enjoyment of the female partner
was also examined in a study in the British Journal of Urology . The authors
concluded that “women preferred vaginal intercourse with an anatomically
complete penis over that with a circumcised penis.” Interestingly, the authors of
the study also wrote and published a book entitled Sex As Nature Intended It .
They also recruited some of their volunteers for the study from an announcement
in an anti-circumcision newsletter. We mention this not as circumcised males but
as impartial interpreters of the medical literature.
Interesting circumcision facts:
The twelfth-century physician and rabbi Moses Maimonides
advocated male circumcision for its ability to curb a man’s sexual
Male circumcision was introduced into English-speaking countries in
the late 1800s as a method of treating and preventing
Male circumcision, the most commonly performed surgery in the
United States, removes 33 to 50 percent of the penile skin, as well
as nearly all of the penile fine-touch neuroreceptors.
Everyone has a preference.
President Clinton revealed on MTV that he preferred boxers.
Kramer on Seinfeld said, “I need the secured packaging of jockeys. My boys
need a house!”
The question is whether or not there is any science behind making this
It was originally thought that wearing tight underwear could lead to infertility in
men as it may raise testes temperature to a point where it interferes with sperm
In 1998 in The Journal of Urology, Drs. Robert Munkelwitz and Bruce R.
Gilbert analyzed semen samples from ninety-seven men with fertility problems.
Half of them wore briefs, the other half wore boxers. The researchers measured
the men’s scrotal, internal, and skin temperatures, both while the men were
wearing underwear and again when they were going commando. They found no
significant differences between the two groups of men in scrotal temperature,
sperm count, sperm concentration, or sperm motility.
The purpose of the scrotum is to maintain the testes at a temperature of
approximately five degrees less than the rest of the body (about 93.6 degrees F).
It appears as though the scrotum does its work whether you are in boxers, briefs,
or free ballin’.
So you can make your own fashion choice and your sperm won’t know the
An article in the American Journal of Obstetrics and Gynecology in 2001 called
the G-spot a sort of gynecologic UFO. Well, the authors of that article may want
to start readying themselves for space travel. That is, after they read this paper
from Cairo University: “The Electrovaginogram: Study of the Vaginal Electric
Activity and Its Role in the Sexual Act and Disorders.” In this paper, the authors
investigated the hypothesis that the vagina generates electric waves, which
affect vaginal contraction during penile thrusting. They found electric waves could
be recorded from the vagina. They also postulated that there was a vaginal
pacemaker that seems to represent the G-spot, which is claimed to be a small
area of erotic sensitivity in the vagina.
So what is this vaginal Loch Ness Monster?
The G-spot is simply a small area located on the upper wall of the vagina,
toward the belly, about two to three inches from the vaginal opening. The G-spot
was named in honor of Ernst Grafenberg, a German physician who, in the 1950s,
wrote an article that mentioned an erotic zone on the anterior wall of the vagina
that would swell during sexual stimulation.
There are various opinions on the best way to find the G-spot. Some women
say that being on top during intercourse works best. Others swear by rear-entry
as the best way to hit the G-spot. Some even say that because of its location, a
shorter, smaller penis may actually be more effective at reaching the G-spot. A
clue to its location may be that some women feel a sudden urge to urinate when
their G-spot is touched—not surprising since the G-spot is located right near the
For those of you who have never heard of Kegel exercises, don’t expect to see a
class offered at your gym.
Kegel exercises were originally developed as a method of controlling
incontinence in women following childbirth. They’re named after Arnold Kegel,
the Los Angeles doctor who promoted their development in the 1940s. The
principle behind Kegel exercises is to strengthen the muscles of the pelvic floor,
or the pubococcygeus muscles. These muscles run from the back to the front of
your pubic bone and encircle the openings of the vagina and rectum.
Strengthening them helps improve the urethra and rectal sphincter function.
These exercises are recommended for women with urinary stress
incontinence, but many others do Kegel exercises for more fun reasons.
Advocates believe that there are several benefits for a woman who exercises
her vagina. They claim that it makes it easier for her to reach orgasm, makes
orgasms stronger or better, and makes the vagina more sensitive.
Heat is damaging to the sperm, and theoretically can affect male fertility to a
certain extent. But, there is no clear scientific evidence that implicates hot tubs.
There may be a temporary reduction in sperm function after a soak, and
prolonged repetitive use could cause problems, but none severe enough to avoid
the occasional dip.
Saunas do not appear to influence fertility either. A few studies have reported
decreased sperm count or decreased sperm movement after sauna use, but in
Finland, where saunas are most common, men have high sperm counts and no
apparent fertility issues.
Men are often told that they have sex on the brain, and it appears as though this
may be true.
In one recent study in Nature Neuroscience, a team of researchers had
twenty-eight men and women look at erotic photographs while an MRI took scans
of their brain. The subjects looked at arousing photographs of heterosexual
couples engaged in sexual activity, sexually attractive nudes of the opposite sex,
and at pictures of men and women in nonsexual situations. When analyzing the
MRI results, researchers found that two areas of the brain, the amygdala and the
hypothalamus, were more activated in men than in women when viewing
identical sexual stimuli.
So, do men have sex on the brain? Of course, and do bears shit in the
We really didn’t need a team of researchers to answer this one.
What a nightmare. The well running dry. Could it be possible?
The answer is no, but there is some bad news.
A woman is born with all the eggs she will ever have, but a man’s supply of
sperm is renewed throughout his life. This sounds great, but researchers have
found that men over thirty-five have more abnormalities in sperm movement and
sperm with more seriously damaged DNA than younger men. It also has been
found that over time, average sperm counts have been decreasing. The World
Health Organization guidelines say a normal sperm count consists of twenty
million sperm per ejaculate, with 50 percent motility and 60 percent normal
morphology. This is different than twenty-five years ago when the normal count
was near one hundred million.
My wife’s “friend” once told her that eating pineapple made you smell good “down
there.” The friend had heard this from a call girl. It doesn’t get more evidence
based than that.
There is, however, no scientific research on this sensitive subject. People do
believe that you are what you eat, so what you ingest, ladies, can affect the smell
and taste of your womanly secretions. Foods that are often mentioned as having
the potential to cause problems “down there” are asparagus, garlic, and curry.
There have been many claims about female ejaculation, but this was always
dismissed as urination during intercourse. More recent evidence has found that
higher levels of a compound, prostatic acid phosphatase, has been found in
patients who claim to have female ejaculation. This compound is also found in
high levels in male ejaculate and originates in the prostate.
Researchers have taken an anatomic approach to the issue of prostate-like
components in female ejaculate. They believe that if women ejaculate a fluid that
is not urine, then it must be coming from someplace other than the bladder. The
most likely source was thought to be the female paraurethral glands or Skene’s
Autopsy tests of Skene’s glands have found substances identical to those
found in the prostate. Some experts now call these glands the female prostate.
So, it seems highly likely that some women can, in fact, ejaculate, but causing
that to happen may be as tough as finding the G-spot.
A hickey is a bruise that forms when a person sucks and lightly bites an area on
another person’s body, causing the blood vessels under the skin to break. It is
also a badge of honor for horny fifteen-year-olds all around the world.
I look
at my watch and I can’t believe that it is only 12A.M. I answer the
last of the sex questions and quickly scan the room to make sure that my path is clear to
the bathroom. I see an opening and rush off hoping to avoid any more questions.
The door is slightly ajar and I push it open tentatively to find our hostess, Eloise,
sitting on the edge of the bathtub. Leyner is clutching the massaging showerhead and is
directing a cold stream of water on her burned and blistered cheeks. As it turns out,
Eloise, ever the impeccable hostess, had joined Leyner and Cinderella in their laboratory
to see if they needed their glasses refilled. Leyner then insisted on slathering her with his
spicy balm. Little did he know that Eloise had had a deep-cleansing facial peel just a few
hours before the party, leaving her skin ultra-vulnerable to any corrosive ointments. It
was comforting for me to see that in the heedless anarchy of the moment, Leyner had
actually done the right thing and was correctly caring for her burns.
There are two venerable maxims that rule the professional classes. For doctors it is do
no harm, and in the world of jurisprudence it is anyone who represents himself in court
has a fool for a client. So, if you must be your own physician, do no harm and don’t be a
A patient came to the ER one day for treatment of an infection on her scalp. She
had tried to treat it at home by taking the tetracycline for her fish tank. As it turns
out, she actually didn’t need antibiotics for her rash. Was this self-medicating
ingenuity or insanity on her part?
I wouldn’t exactly call it ingenuity, because the other great idea she came up
with was to rub toothpaste on her head. As for the fish tank tetracycline, it seems
as though those tablets often contain the same dosage as your over-the-counter
tablets, but I certainly cannot vouch for their purity. Logic says to stick with the
stuff you get from the pharmacy.
Maybe. A study in JAMA, or The Journal of the American Medical Association for
all not in the know, demonstrated a significant reduction in the rate of urinary
tract infections in older people who drank cranberry juice daily. We don’t know
exactly why, but the most likely answer is that some chemical in the juice
prevents bacteria from sticking to the wall of the bladder. I know some people
don’t like cranberry juice, but since urinary tract infections can happen after sex,
it’s probably worth it to drink a little bitter cranberry juice instead of smoking a
Yogurt may have some role in helping prevent yeast infections, but only when
you put it in the correct orifice—your mouth.
Yogurt does have some very interesting health properties. Some women find
eating one cup of yogurt a day while taking antibiotics is helpful in preventing the
yeast infections that often follow such treatment; however, yogurt alone will not
cure vaginal yeast infections that are already in full bloom.
Excessive amounts of earwax can cause decreased hearing or pain, but this is
no reason to start lighting your head on fire. “Ear candling,” or coning, involves
placing a cone-shaped device in the ear canal and, with the help of smoke or a
burning wick, removing earwax. The companies that make these devices claim
many other health benefits. The FDA and the Canadian government disagree,
and both have come out against these fraudulent claims. In most cases earwax
will come out on its own, and if not, you should see your doctor. Avoid these silly
products and save the cones for your ice cream.
No. Save the butter for breakfast.
Butter is the wrong thing to put on a burn. It will trap the heat in the skin and
prolong the pain. Use cool water instead.
I do have to say that there are some kitchen supplies that may be useful for
the pain of a burn, straight from the medical literature in India: boiled potato skins
and honey.
Why honey? Honey is sometimes used for its antibacterial effects. Boiled
potato skins may seem to be an unusual treatment, but they maintain a moist
The best thing to do when you grab a hot pan is to cool your burn under
running water, and only after it has thoroughly cooled, apply an antibiotic
ointment. For severe burns you should go to your local ER.
Here is one for all the world travelers. Melatonin may be an effective solution for
your problems with jet lag.
A review of ten studies on the use of melatonin concludes that two to five
milligrams of melatonin taken at bedtime after arrival at your destination is
effective and may be worth repeating for the next two to four days. This should
be done in conjunction with nondrug measures—such as avoiding dehydration
and alcohol, engaging in exercise and activity during daylight hours, eating well,
sleeping well, and adjusting to the local time schedule—for fighting the dreaded
jet lag.
Ice is hardly as dramatic as a carefully placed porterhouse, but it does the same
job. There is no magic in the beef, just cold and a little pressure. Keeping your
head elevated and avoiding aspirin or ibuprofen, which can affect the ability of
your blood to clot, also helps. The best idea is to avoid getting punched in the
first place.
There are many home remedies for skin ailments, and I’ve seen patients come to
the emergency room covered in all sorts of creams and potions. Some common
antizit home remedies people try concocting include baking soda, vinegar, coffee
grounds, Mercurochrome (a red substance no longer sold in this country), iodine,
hemorrhoid cream, sugar, salt, and toothpaste.
It is commonly believed that toothpaste on zits is an excellent home remedy.
There are no scientific studies that I could find on the use of toothpaste for acne
but it may work to dry out those troublesome blemishes.
But if you go the toothpaste route, there are some things to look out for.
Perioral dermatitis is an eruption of discrete papules and pustules on an
erythematous scaling base around the mouth (fancy description for “acnelike”). It
occurs almost exclusively in women between the ages of twenty and thirty-five.
The cause is unknown, but some people think that fluorinated toothpaste may be
a factor.
Fragrance allergies are also a danger with the toothpaste method. Balsam of
Peru is an ingredient that has been known to cause allergic reactions and
cinnamic aldehyde in toothpastes has also been a common culprit. We say to
stick with Clearasil.
In an unrelated but truly bizarre story, one night I was working in the ER and a
patient came in with a bandage over her jaw. I asked her what happened and
she was very timid in responding. She said she was embarrassed because she
had picked her face over and over, which had caused an infection. I tried to calm
her, told her that this was common, and asked her if I could take a look. When
she removed her bandage, she revealed a 4 by 4-inch hole all the way down to
her jawbone. She received some antibiotics and a careful psychiatric evaluation
and at no point did anyone say, “Didn’t your mother tell you not to pick at your
As for zit popping, it definitely can lead to some complications. Squeezing
pimples can actually push the zit-causing bacteria farther into the skin, causing
more redness and swelling. It is also the most common cause of acne scarring.
There is one more deadly complication from zit popping, which is called
cavernous sinus thrombosis, a blood clot in the sinus cavity that runs between
the sphenoid bone, the large bone at the base of the skull, and temporal bone
located near the temple. The real danger zone for zit popping is an area that
some people refer to as the triangle of death, an area stretching from the bridge
of the nose to the corner of the mouth to the width of the jaw. The veins in this
area drain into the cavernous sinus and any severe infection in this area can
cause cavernous sinus thrombosis. Squeezing zits in this part of your face can
cause an infection and start this dangerous process.
Our friend Kim can do pretty much anything. She was like Martha Stewart before
anyone had seen her bake her first cookie. Add to that a rugged edge that allows
her to take on any project. She wanted to know the answer to this one, and we
realized if anyone could do this, it would be her. She also wouldn’t allow the
procedure to interrupt her dinner party.
A cricothyroidotomy (similar to a tracheostomy) is one of the most dramatic
procedures done in the emergency room. This procedure is an emergency
attempt to relieve a blocked airway. Remember theM*A*S*H episode where
Father Mulcahy sticks a pen into some guys throat to help him breathe?
The oyster knife might work too, but definitely avoid trying this at home! Call
911 instead.
We all saw that Friends episode (c’mon, you watch it, too) when Monica gets
stung by a jellyfish. Joey remembers that peeing on a jellyfish sting takes the
pain away, Monica “can’t bend that way,” and Joey gets “stage fright,” leaving
Chandler to save the day. Don’t believe everything you see on TV.
Most jellyfish stings cause only pain and numbness. The Australian box
jellyfish is the most venomous and deadly of all stinging marine creatures.
Approximately 20 percent of those stung by the box jellyfish will die. Portuguese
man-of-war is also dangerous but nothing compared to the box jellyfish.
The following guideline can be applied to most jellyfish stings: The patient
should remove any visible tentacles, using gloves if possible. The area of the
sting should be rinsed with household vinegar. The acetic acid of the vinegar can
block discharge of the remaining nematocysts (stinging cells) on the skin and
should be applied liberally. If vinegar is not available, salt water can be used to
wash off the nematocysts.
In laboratory tests, urine, ammonia, and alcohol can cause active stinging
cells to fire, which means applying them has the potential to make a minor sting
worse, so urinating on a jellyfish sting is both gross and painful.
Oh the pleasure of the forbidden! Those things that you are not supposed to do
are always so enticing.
The ears, for the most part, do not require any routine cleaning. Ears are like
a self-cleaning oven. With the help of gravity and body heat, earwax will
gradually find its way out. If wax appears on the outer ear, a cotton swab may be
used. If you can’t help but go in farther, you are risking wax impaction or injury. If
you do get wax impacted in your ear, you will be in pain and half deaf. There are
over-the-counter preparations that can help relieve wax blockage but warm water
in a syringe often works. As a last resort you can see an ear doctor or come to
the ER for a good cleaning.
It is not uncommon for us to see patients who have violated these rules and
come to see us to remove the tip of the cotton swab that has fallen off inside the
ear. Don’t worry, we are prepared. We also remove other things like
cockroaches, beads, and pen caps, all of which we’ve pulled out of ears.
Gberg:We need a list of things for the cotton swabs in the
ear question.
Gberg:Things that you aren’t supposed to do but can’t
Leyner:Picking scabs.
Gberg:I love it when they bring the food to the table and
say “hot plate.”
Gberg:Can’t help but touch.
Leyner:That’s good!
Gberg:Like Carrie says, “More funny, boys.”
Gberg:Making fun of the editor is one of those things that
you are not supposed to do but can’t resist.
Leyner:More funny like, “How do you extract my size 9 old
school Adidas shell toe from the rectum of a book editor?”
More funny...
Gberg:Should I leave that in?
Leyner:Your call.
Leyner:Might be a little harsh.
Leyner:But it’s from the heart.
Gberg:A dangerous little muscle, that heart of yours.
Leyner:I’m trying to think of more not-to-do stuff.
Gberg:Talk at a woman’s breasts.
Gberg:Eat your young.
Leyner:Pick chicken pox.
Gberg:You just want to pick stuff.
Leyner:Pop pimples.
Gberg:Talk with food in your mouth.
Leyner:I knew some girls who loved popping each other’s and
their boyfriends’ pimples.
Gberg:I wish my lady would groom me like a monkey.
Leyner:It’s all in the eating...monkeys combine grooming
and eating...that’s the special part...picking insects out
of our fur and eating them.
Leyner:Metaphorically speaking.
Gberg:You are at your best when speaking metaphorically.
Leyner:Thank you again.
Gberg:I gotta leave to go to the Knicks game soon.
Leyner:Can we get back at this tomorrow when you get back
from the hospital?
Gberg:Let’s try to finish everything.
Leyner:You have to go, right...we’ll talk about it tomorrow.
Gberg:OK, let’s talk tomorrow.
Leyner:I’ll look at the e-mail...and we’ll drive the final
stake into the heart of this vampiress tomorrow.
Colonic irrigation claims to help indigestion and yeast infections, control blood
pressure, restore pH balance, reduce bad odors, clear colon blockage, induce
proper blood clotting, stimulate production of white blood cells, help prevent
gallstone production, clean the colon of parasites, help loss of concentration, and
aid lung congestion, sinus congestion, skin problems, and nail fungus.
Not a bad day’s work, but not exactly proven, and yes, potentially dangerous.
Colonic irrigation (CI) is a procedure in which very large quantities of liquids
are infused into the large intestine, or the colon, via the rectum through a tube.
The purpose is to detoxify the body through the removal of accumulated waste
from the colon. This may involve the use of twenty or more gallons of liquid.
Liquids used in colonics may contain coffee, herbs, enzymes, or wheatgrass.
The machines used for colon therapy are illegal unless used during
conventional medical treatment. Colon therapy also can be dangerous.
Complications include bowel perforation, heart failure from excessive fluid
absorption, electrolyte imbalance, and several outbreaks of serious infections.
One case linked to contaminated equipment caused amebiasis, a parasitic
infection, in thirty-six people.
Leyner:This book is going to ruin both of us. The editor
will probably get a huge promotion and we’ll end up in the
subway wearing fedoras and playing Andean flute music.
Gberg:Andean flute music sounds appropriate for the theme
music in a colonic ad.
Leyner:Why are people so interested in colonics?
Gberg:Seems insane to me.
Gberg:Who says it’s supposed to be clean, that is, your
Gberg:I sounded like Yoda there.
Leyner:Me too...part of the wonderful Judeo-Christian
legacy of self-loathing...you know...how we’re essentially
filthy inside.
Gberg:I feel like I am rotting inside today.
Leyner:That’s right...If you can’t have a dirty
Gberg:Good title for a pop song.
Leyner:Sounds good for Prince.
Gberg:Imagine Britney Spears singing the Mark Leyner
version of “If you can’t have a dirty colon...c’mon.”
Gberg:Great video too.
Leyner:I love tracking the doings of aging rock stars.
Gberg:Some celebrity colonoscopy cameos.
Leyner:Rod Stewart’s become the new Jim Nabors somehow.
Gberg:What is he up to now?
Gberg:I read something on Page Six about Elton John
injecting himself with lamb’s urine to lose weight.
Leyner:Rod’s singing duets with Dolly Parton, Gershwin
ballads, and children’s songs...and doing an album with the
Wiggles next—wouldn’t surprise me.
Gberg:They also said “Michael Jackson reportedly used to
keep his weight down with lots of self-administered enemas,
but later needed a tampon to control ‘embarrassing
Leyner:How do you get a lamb to pee in a cup?
Gberg:That is going to be my next job after the book—
catheterizing lambs.
Leyner:Jackson should let himself get fat like Elvis did.
Leyner:Is that true about Elton John and lamb urine?
Gberg:Page Six, my friend. Check the New York Post. Isn’t
everything in the newspaper true?
Gberg:Maybe we can add the lamb’s urine question in as an
urban legend.
Leyner:Doesn’t something have to be in the public
subconsciousness for more than a day to qualify as an
“urban legend”?
Here’s one from the June 2004 New England Journal of Medicine. A cream
containing an ingredient of human breast milk appears to be an effective
treatment for stubborn warts. The key ingredient of the cream is a compound
called alpha-lactalbumin-oleic acid. Its Swedish creators have nicknamed the
cream HAMLET, for Human Alpha-lactalbumin Made Lethal to Tumor cells.
This may lead to other areas of research as certain types of warts or human
papilloma virus (HPV) can be linked to cervical cancer.
No word yet on whether Starbucks will be introducing a tall-decaf-breast latte.
I love a good Western and nothing could be more bad-ass than biting into a
snake wound and spitting out the venom. Of course this would be followed by
some whiskey and a good gunfight.
Unfortunately, this is no longer an accepted practice. Sucking at a snakebite
is not only ineffective but could lead to an infection at the wound site.
According to the American Red Cross, these steps should be taken after a
1. Wash the bite with soap and water.
2. Immobilize the bitten area and keep it lower than the heart.
3. Get medical help.
Toxicology experts might also suggest applying a tourniquet loosely above
the bite to prevent the venom from spreading. This must be done with caution, as
the tourniquet itself can cause problems if it cuts off the blood flow entirely.
The person then needs to be transported rapidly to an emergency room.
Antivenin is available for a variety of different snakes. Other treatments include
antibiotics and surgery.
Of the estimated one hundred and twenty different types of snakes found in
the United States, about twenty are poisonous. Most bites occur in the
southwestern part of the nation, but they even occur in New York City. In New
York State there are three species of poisonous snakes, the timber rattlesnake,
the massasauga rattlesnake, and the copperhead. In the city, however, most
bites occur from snakes that are kept as pets.
Doctors are known for using complicated words that make them sound either
extremely intelligent or really out of touch with what most people can understand.
The medical word for hiccups, singultus, is a perfect example of when physicians
sound ridiculous.
Hiccups are caused when the diaphragm becomes irritated and pushes air
rapidly up in such a way that it makes an irregular sound.
Some things that irritate the diaphragm and cause hiccups are distention of
the stomach from food, alcohol, or air, sudden changes in gastric temperature, or
use of alcohol and/or tobacco in excess. Hiccups also can be caused by
excitement or stress.
While most cases of the hiccups last only a few minutes, some cases of the
hiccups can last for days or weeks. This is very unusual, though, and it’s usually
a sign of another medical problem, such as injections near the diaphragm, hiatal
hernias, severe gastroesophageal reflux disease (GERD), or a tumor irritating the
nerves in the chest. Hiccups lasting longer than one month are termed intractable
or incurable. The longest recorded attack of hiccups is six decades. Doctors
sometimes use the antipsychotic drug Thorazine to treat intractable hiccups.
If you don’t want to go the antipsychotic route, you could try one of these
simpler but unproven cures:
1. Breathing into a paper bag.
2. Drinking out of a cup from the side opposite your mouth.
3. Holding your breath.
4. Eating a teaspoon of sugar.
5. Sucking on a wedge of lime or lemon.
6. Drinking a glass of water with a straw while you plug your ears with your
7. Pulling the top of your hair for one to two minutes.
8. Placing a cotton swab in the roof of your mouth and gently rubbing.
9. Pulling hard on your tongue.
For those of you who were watching TV in 1970, you may have seen episode 8
of the first season of The Partridge Family when a skunk finds its way onto the
family bus and turns the Partridges into stinkers. Reuben remembers that tomato
juice can remove the skunk odor, so the family bathes in it. All is well until the
family dog gets them covered again. Without time to take another tomato bath,
the band plays their concert at a children’s hospital from inside a glass-enclosed
operating room. That’s great TV.
The major molecules that make skunk spray smell are sulfur compounds. It is
a common belief that tomato juice removes the smell, but there is no scientific
evidence to support this claim. The tomato juice probably just tricks the nose into
not recognizing the skunk smell through the overpowering red gravy scent. One
recommended treatment for pets is one quart 3-percent hydrogen peroxide, one
cup baking soda, and one teaspoon mild dishwashing detergent. People can try
the same, but be careful; the peroxide can have a bleaching effect.
Parsley was used in the past in medicinal recipes for cure-alls, general tonics,
poison antidotes, and kidney and bladder stone relief. Parsley is rich in vitamins
and minerals, particularly vitamins A and C. It is also said to be rich in
antioxidants. Parsley also can relieve bad breath, although there are no medical
studies linking it to halitosis. It is good to note that there are two varieties of
parsley: curly-leafed and flat-leafed, which has the stronger flavor. Therefore, the
flat-leaf kind is better to cure your chili dog breath.
There doesn’t appear to be a great deal of research on the role of milk as a sleep
aid. Milk is certainly a simpler alternative to prescription sleeping pills or drinking
so much you just pass out, and there are several theories as to why it might
work. Milk contains tryptophan, the same ingredient that makes everyone sleepy
after Thanksgiving dinner (see food coma question on page 44). The warmth of
the milk can have a minimal effect on your body temperature and sometimes
make sleep a little easier. Milk also contains melatonin, which is a natural sleep
aid. One company, Night Time Milk in England, even sells milk from cows milked
at night when the melatonin is increased. The milk is marketed as a sleep aid,
proving that people will buy anything today.
with her wounds cleaned and dressed, is back in business and is
refreshing glasses and making small talk. Leyner appears wounded from his laboratory
mishap and is quietly sitting cross-legged in the corner, sullenly nursing the dregs of his
bottle of tequila. I’ve never condoned casual drug use, but I almost feel compelled to
spike the punch bowl with a strong sedative and sneak out to find my way home. I resist
this evil urge and feel better until I am confronted again by the indefatigable but once fat
guy Jeremy Burns.
Jeremy, aside from his Atkins obsession, has never grown out of his penchant for
fraternity hijinks. Eloise offers him one of her signature frozen daquiris, but Jeremy only
wants a Jell-O shot, a beer bong, or some Ecstasy. Eloise turns her nose up at his boorish
request, and he turns to me to plead for a prescription for some medical-grade marijuana.
I explain to him that prescription pot is not available in New York, and that I wouldn’t
give it to him anyway.
Jeremy is not ready to give up and asks, “Then can you get me any of that shit that
Rush Limbaugh takes?”
“Oxycontin,” I reply.
“Yeah, yeah,” he says. “Oh and also some of that stuff that Matthew Perry and Brett
Favre do.”
“Vicodin,” I reply again.
Jeremy says that he already has plenty of Vicodin and asks if maybe I can just get
him a little ketamine.
I am becoming exasperated and I realize that I have an opening. “Jeremy, you know
that ketamine is a potent horse tranquilizer...and that guy over there is a veterinarian,” I
say, pointing to a portly, balding gentleman in the next room.
Jeremy rushes off, as I breathe a sigh of relief.
With a culture dedicated to the use and abuse of caffeine, nicotine, alcohol, and an
endless array of illegal substances, questions abound about the safest and quickest ways
in which we can intoxicate ourselves and how to avoid the dreaded hangover.
This one isn’t all that clear. Or maybe it’s because of those drinks we just had.
The biggest problem with this rhyme is that nobody seems to remember how
it goes. As for the science, there is no research to prove or disprove it.
One theory about this little ditty attempts to explain that the carbonation in
beer causes increased alcohol absorption. There is no proof that this is true. Nor
should you believe that coffee will help you with a hangover or that bread will
absorb the alcohol in your system. Only time will cure your pain as you wait for
the alcohol to leave your bloodstream.
Intoxication is defined as a blood alcohol level of 100 mg/dL (.10%). In adults,
the level usually falls about 15 to 20 mg/dL per hour. Everyone metabolizes
differently, but on average it would take about six to eight hours for you to return
to normal from a mild drunken state.
Blood Alcohol
mild euphoria
loss of critical judgment
lack of coordination and balance
drunken stupor
Simply put, alcohol causes intoxication, so the more you drink, the sicker you
get. It doesn’t have anything to do with the order in which you tend to chug your
beer or wine.
As for the dreaded hangover that follows, it is caused mainly by dehydration
and interrupted sleep. The sleep and water that will ultimately cure you are not as
interesting as some of these famous hangover cures:
1. The Prairie Oyster (olive oil, tablespoon of tomato ketchup, one egg yolk, salt
and pepper, Tabasco, Worcestershire sauce, vinegar or lemon juice)
2. Cold pizza
3. IV fluids (helps to date an M.D. or paramedic)
4. The hair of the dog that bit you (i.e., the blessed Bloody Mary)
5. Vitamins B and C
6. And the most effective, and most expensive, kidney dialysis
If it’s the Jewish holiday Purim and you plan on competing in the Olympics, you
may want to think twice before gorging on poppy seed hamantaschen. Eating
enough poppy seeds can cause your urine to test positive for opiates. It is difficult
to say how many poppy seeds you need to eat to fail your drug test, but some
reports have stated that three poppy seed bagels, for example, could generate a
positive test result. Pastries and cookies that contain heavy amounts of poppy
seeds, like hamantaschen, could also lead to a positive test. There is an
additional test that looks for certain chemicals present in heroin that are not
present in poppy seeds. So, your athletic future really will depend on the exact
test you are taking.
What is the poppy seed–heroin connection? Cultivated poppies are the
source of opium, from which morphine and heroin are produced.
Answer: To keep Domino’s and Frito-Lay in business.
Marijuana is the most commonly used illicit drug in the United States. The
main active chemical in marijuana is THC (delta-9-tetrahydrocannabinol), or The
High Causer. THC falls in the category of chemicals called cannabinoids.
A study in the April 2001 issue of Nature helps us to better understand how
marijuana causes users to have an increased appetite, the famous “munchies.”
Molecules called endocannabinoids, marijuanalike chemicals present in our own
brain, bind with receptors in the brain and activate hunger. These
endocannabinoids in the hypothalamus of the brain then activate cannabinoid
receptors that are responsible for maintaining food intake. The chemicals from
marijuana bind to these cannabinoid receptors and cause the munchies. Sound
complicated? Maybe you’re too stoned to understand. Go eat some cookie
Hold the Rogaine. If you are bald, there may be another advantage besides the
cost savings on hair products. You won’t have any hair to offer for your drug test.
As drugs are ingested into the body, they circulate in a person’s bloodstream.
Trace amounts of these drugs or the drug metabolites are deposited in the hair
follicle. As the hair grows, they remain stored in the core of the hair shaft.
When a person is tested, samples are taken at various levels in the hair shaft
so that a reasonably accurate approximation can be made of how long ago a
particular drug was used. Drugs or drug metabolites cannot be washed,
bleached, or flushed out of the hair follicle.
The major practical advantage of hair testing compared with urine testing for
drugs is that it can show that drug use occurred in the past weeks to months,
depending on the length of the hair shaft, versus within only the past two to four
days for other tests. Hair analysis is the least invasive of the testing methods but
might not reveal recent use. Blood analysis is the most accurate but definitely
invasive. Urine analysis is typically the least expensive and can detect infrequent
or a recent single use. Urine analysis is the most commonly used form of drug
So, if you constantly hit the bong, you might want to consider shaving your
There has been much discussion and research over the years on the health
benefits of alcohol. In the 1920s the “Guinness Is Good for You” campaign in the
United Kingdom made people believe that this famous Irish stout had health
properties. The slogan stemmed from intense scientific market research: people
told the company that they felt good after a pint, and the slogan was born.
Echinacea, vitamin C, zinc, and chicken soup, as well as a stiff belt, have all
been postulated to prevent or cure the common cold. Unfortunately, there is no
strong evidence for any of these choices. There are many other home remedies,
several of which include brandy or whiskey. A friend has her own recipe,
combining vodka and orange juice into a screwdriver, as her own special cold
cure. Most likely the buzz just helps you forget how bad you feel.
Alcohol is the most common drug that leads people to throw their friends in the
shower or force-feed them coffee. Time is the only thing that will sober up a
drunk person. Coffee, showers, exercise, sweating it out, fresh air, or any other
method will not increase the rate at which alcohol is eliminated from the body.
The liver just needs the time to metabolize the alcohol.
As for other, more hardcore drugs, the coffee won’t help, but keeping
someone awake until help arrives could be a lifesaver. Heroin and other opiates
cause you to stop breathing, and this leads to cardiac arrest. Remember, coffee
is only a temporary measure and medical help should be sought for any drug
overdose. If someone stops breathing, you should begin CPR. The shower is
probably unnecessary, and a big waste of precious time.
Vomiting from excessive drinking is simply your body’s way of getting rid of the
toxins in alcohol quickly. Vomiting is not a bad thing in this case, but repeated
hurling can lead to potentially life-threatening dehydration and electrolyte
imbalances. There is also the danger of choking on vomit, like the guy from Led
The urge to vomit comes from two anatomically and functionally separate
units—a vomiting center and a chemoreceptor trigger zone. The vomiting center,
which has overall control of vomiting, is located in the part of the brain called the
medulla. The chemoreceptor trigger zone, which sends signals to the vomiting
center, is found in the fourth ventricle of the brain. The ventricles are a system of
four communicating cavities in the brain that are filled with cerebrospinal fluid.
Alcohol probably acts on the chemoreceptor trigger zone.
In the hospital vomiting is referred to as emesis, but many doctors prefer
these more colorful terms:
blow chow
ride the porcelain bus
pray to the porcelain god
technicolor yawn
toss your cookies
lose your lunch
feed the fish
spill the groceries
This is a question that gets asked a lot, both because of the increasing popularity
of Ecstasy and the fact that people keep forgetting that they asked in the first
place. So, yes, Ecstasy probably does cause memory loss. Ecstasy,or MDMA
(34methylenedioxymethamphetamine), is a synthetic psychoactive drug
chemically similar to the stimulant methamphetamine and the hallucinogen
mescaline. Some refer to it as a “designer amphetamine.” One of the major
results from the use of Ecstasy is that both in short-term and long-term use it
could have serious effects on brain cells. Specifically, Ecstasy harms neurons
that release serotonin, a brain chemical thought to play an important role in
regulating memory and other important functions. Case reports and interviews
with Ecstasy users report memory loss, depression, alterations in sleep, and
anxiety. Memory deficits seem to persist even after stopping the use of Ecstasy.
In the process of researching this book, the authors had a working dinner, and in
the course of our hard work, we consumed large quantities of beer, wine, and
tequila. As we stumbled down the street, Mark insisted that he was fine to take
the train home. Better judgment prevailed, and I wrestled him into a cab. The cab
drove away and I started to walk home. A block later, I came upon the cab and
found Mark fumbling with his empty wallet in the backseat. I opened the door.
Mark, with no memory of our evening, said, “What are you doing here?” Alcohol
surely kills brain cells.
To properly answer this question we must separate light to moderate drinking
from heavy drinking. We also need to separate temporary from permanent
In general, alcohol doesn’t specifically kill brain cells but alcohol damages the
dendrites, the small branches that extend from the cells and receive information.
The mechanism of action for intoxication is multifaceted but the end result is the
slurred speech, clumsiness, slow reflexes, and loss of inhibition that we
associate with being drunk. This damage isn’t permanent in light to moderate
usage. This means you can have one to seven drinks a week and be just fine.
Heavy alcohol use does clearly cause neurological damage. CT scans of
chronic alcoholics can show brain atrophy and studies have shown that heavy
use damages retrospective memory. Alcoholism can produce WernickeKorsakoff syndrome, which is caused by deficiency of the B-vitamin thiamine;
alcohol decreases the absorption of this vitamin, and alcoholics also don’t have
the healthiest diets. Patients with this condition have symptoms such as
confusion, delirium, disorientation, inattention, memory loss, and drowsiness. If
thiamine is not given promptly, the syndrome may progress to stupor, coma, and
Nothing is worse than the moment when you hit the sheets and the room starts to
spin. Trying to explain why this happens causes almost as much dizziness.
The vestibular system is a complicated network of passageways and
chambers within the inner ear, all of which work together to control equilibrium
and balance. Inside there are tubes and sacs that contain different fluids, each of
which has a different composition. When you are healthy, and both sides of your
vestibular system are functioning properly, both sides send symmetrical impulses
to the brain. When someone gets very intoxicated, the alcohol changes the
density of the blood and this affects the intricate system of balance. That is when
the spinning starts. This is very similar to the condition called vertigo.
There is a common serenade in any emergency room. The coarse snore of the
regular alcoholic fills the air. Normally, we just ignore it. But sometimes, too much
alcohol actually impedes the breathing process. We fix this easily with a short
small rubber tube in the nose, an aptly named nasal trumpet. Alcohol increases
snoring by relaxing the muscles that hold the throat open, allowing the soft palate
tissue and uvula to flutter more as air passes.
Finally, some good news.
Historically there has been a belief that wine has medicinal properties.
Hippocrates and Thomas Jefferson both considered wine an important part of
their health regimens. Louis Pasteur, the famous French biologist, said, “Wine is
the most healthful and hygienic of beverages.”
There now is an enormous amount of research about what has been called
“the French Paradox,” that despite a diet rich in fats there is a lower-thanexpected prevalence of cardiovascular disease among the Gauls.
Scientific studies have linked this surprising fact to the moderate consumption
of alcohol, specifically red wine. Red wine has also been linked to a reduced risk
of some cancers, atherosclerosis, heart disease, and even the common cold.
So drink a whole bottle tonight. Your bed will spin but you probably won’t
have a heart attack.
There are some important medical uses for marijuana, and some of these lead to
solid arguments for legalization. However, the use of marijuana for glaucoma
does not appear to have any benefit over available medications.
Marijuana does reduce pressure in the eye, but in order to sustain this
reduction you would have to smoke about ten to twelve joints a day. Your eye
pressure might be lower but you will be too stoned to get anything else
accomplished except naked guitar playing, gluttonous pork rind consumption, or
deriving profound meaning from Rob Schneider films.
The arrival of the Saint Bernard with the little cask around its neck is a
heartwarming image but drinking alcohol to warm yourself or prevent frostbite
doesn’t make any medical sense, we’re sorry to report. Alcohol consumption
actually can be dangerous in these conditions as it decreases blood circulation
and thus can enhance heat loss and impair shivering.
Poor, sad toads. They always seem to take a backseat to the frogs. Frogs get
kissed and turn into princes, and toads just get to cause warts. Well, here is
some good news for toads. Toads do not cause warts. Toads do, however,
produce a protective substance in the parotid gland behind the eyes. This toxin
can make animals, such as dogs, very sick and can be irritating to the human
eye. But some people go way beyond touching toads and actually lick them in an
attempt to get high from a “psychedelic” substance supposedly found on its skin.
The species known as the Bufo toad does have a psychedelic substance on
its skin. This substance is similar to serotonin and LSD and can cause
hallucinations. Be careful when trying this method because some people have
been arrested for toad licking.
Straight from the Department of Psychology at the University of Glasgow, a
paper entitled “Alcohol Consumption Increases Attractiveness Ratings of
Opposite-Sex Faces: A Possible Third Route to Risky Sex,” thus proving that
beer goggles do exist. Feel free to use this paper to excuse your bad behavior.
seems to have rebounded from his brief period of remorse and
sorrow, and is now back to his crazed ways. Tequila in hand, he is delivering a rambling
quasi-coherent lecture about cultural differences in post-defecation hygiene. The
audience is appalled, yet raptly entranced by his scholarly scatological soliloquy. As
Leyner continues, a hand pops up in the back of the room. The hand belongs to Joel
Blake, a celebrity orthodontist, who starts to ask a question but begins to stammer as tears
well up in his eyes.
Leyner moves through the crowd with the style and empathic grace of Oprah
Winfrey, grabs his hand, and says, “It’s okay Joel, you can tell us, you are among
“I wipe standing up!” Joel blurts out.
There is a cackle from the gallery but Leyner silences the offender with an icy stare.
“We need to honor everyone’s Way of Wiping,” Leyner says serenely, as he hugs
The bathroom and all that occurs behind closed doors may be the final taboo. Yet
when placed in a comforting environment or in a locker room, people will share their
secrets often to unfortunate results.
Thanks to our wonderful democratic society, you can do whatever you want. The
better question is, Why would you want to drink your own piss?
Drinking small amounts of your own urine is probably safe. It is made up of 95
percent water, 2.5 percent urea, and 2.5 percent salt, other minerals, hormones,
and enzymes. Actually, some folks consider it to have therapeutic properties. Ask
the Chinese Association of Urine Therapy. They say urine is sterile, antiseptic,
and nontoxic.
For serious yoga practitioners, drinking one’s urine is called amaroli. One of
the most famous users of urine therapy was the prime minister of India from 1977
to 1979, Morarji Desai. At the celebration of his ninety-ninth birthday, Desai
attributed his longevity to drinking urine on a daily basis. But, we plan on sticking
to morning coffee, a good glass of Cabernet, and an occasional Yoo-hoo, even if
it knocks a year or two off our life spans.
• An average fart is composed of about 59 percent nitrogen, 21 percent
hydrogen, 9 percent carbon dioxide, 7 percent methane, and 4 percent
oxygen. Less than 1 percent of its makeup is what makes a fart stink.
• The temperature of a fart at its time of creation is 98.6 degrees Fahrenheit.
• Farts have been clocked at a speed of ten feet per second.
• A person produces about half a liter of farts a day.
• Women fart as much as men.
• The gas that makes your farts stink is the hydrogen sulfide gas. This gas
contains sulfur, which is the smelly component. The more sulfur-rich your
diet, the more your farts will stink. Some foods that cause really smelly farts
include beans, cabbage, cheese, and eggs. Also soda.
• Most people pass gas about fourteen times a day.
All are important facts, but back to the question: Is it really possible to ignite
The answer to that is yes!
The flammable character of farts is due to hydrogen and methane. The
proportions of these gases depend largely on the bacteria that live in the human
colon that digest, or ferment, food that has not been absorbed by the
gastrointestinal tract before reaching the colon.
There is some danger associated with igniting flatulence. Fraternity guys don’t
seem to care.
There is nothing like a long soak in a bath to relax your soul. The problem is that
you have to deal with the ghastly sight of your hands and feet after exiting. The
simple answer for why this occurs is that our outer layer of skin (the epidermis)
absorbs a little bit of water when we soak too long in the tub. Voilá! Old lady
The skin on the feet and hands is thicker than the skin on the rest of the body
and therefore makes any changes more noticeable. As the epidermis expands,
the layer below it, the dermis, does not swell, so the epidermis buckles in areas.
Lovely, right?
There is no specific course in medical school to deal with all the secretions that
you find yourself faced with as a doctor. It is definitely a rude awakening to find
yourself being coughed on, spit on, and even urinated on. All doctors have been
doused in a variety of bodily fluids.
One wonderful evening in the ER, I heard a nurse screaming. I found her
desperately trying to keep a drunk patient who had passed out from hitting the
floor. He was not a small man, and the dead weight was too much to manage.
The only way I could get him back on the stretcher was to grab him from behind
and throw myself on the stretcher with the patient on top of me. Simple. I could
then just roll him over. I unfortunately didn’t plan on him using me as a bedpan
the instant we hit the bed.
This is disgusting, of course, but when faced with the option of being urinated
on or spat on, I would choose urine. No, this is not a fetish. Normal urine is
sterile. It contains fluids, salts, and waste products, but it is free of bacteria,
viruses, and fungi. It is not always fragrant, but is certainly cleaner than spit. Spit
contains large amounts of bacteria and thus is filthy.
It is unbelievable how much information there is available about farts. Flatulence
is the subject of numerous medical studies, books, and CDs. One company even
makes a fart filter and underpants designed to absorb odor. But among all this
gaseous information it always comes back to the bean, the most famous farting
Beans contain high percentages of sugars (oligosaccharides) that our bodies
are unable to digest. When these sugars make it to our intestines, bacteria go to
work and start producing large amounts of gas. We also form gas from other
sources, including the air we swallow, gas that seeps into our intestines from the
bloodstream, and carbon dioxide formed from saliva reacting with stomach acid.
There is some help available for those who can’t handle their beans. A
product called Beano is readily available. Beano contains a food enzyme
extracted from mold, one alpha-galactosidase, that helps to break down the
complex sugars in gassy foods. Another method is to soak beans before you
cook them, as this cuts down on their gas-producing power if you then discard
the water. Unfortunately, you also lose some water-soluble vitamins by doing
Other flatugenic foods are broccoli, brussels sprouts, cooked cabbage, raw
apples, radishes, onions, cucumbers, melons, coffee, peanuts, eggs, oranges,
tomatoes, strawberries, milk, and raisins.
Notice the abundance of vegetables on the fart-producing list. That is why
those vegetarians are always passing wind in yoga class as they contort
themselves into weird positions.
There is a psychiatric illness called coprophagia, the eating of one’s own feces. It
is an uncommonly reported symptom that can be seen in patients with
schizophrenia, alcoholism, dementia, depression, Kluver-Bucy syndrome (ask
Mark), and obsessive-compulsive disorder. Scatolia, the smearing of feces, is
often seen in psychiatric hospitals. High-functioning individuals may sometimes
exhibit coprophagia as part of a paraphilia or abnormal sexual arousal disorder.
There are even some claims that Eva Braun urinated and defecated on Adolf
Hitler. Sexy!
You can get very sick by eating feces. It shouldn’t be fatal, but complications
from snacking on shit include hepatitis, oral infection, abscess, and a variety of
other infectious diseases. Besides that, think of the morning breath.
Leyner:Be right there...
Gberg:OK, I gotta run to the bathroom.
Gberg:I have returned.
Leyner:Did you wipe standing up?
Leyner:Some people do, I’ve heard...
Gberg:Stop mocking me. You know I am sensitive about being
a stander.
Leyner:I’m sorry...you know sometimes I pee sitting
down...out of pure laziness.
Gberg:That is what they should teach you in school.
Gberg:Bathroom etiquette.
Leyner:They should teach boys that they don’t HAVE to stand
up...that it’s an option.
Leyner:When my niece was a little girl she said a great
thing once on the way back from a little skiing excursion
in Lenox, Massachusetts.
Gberg:And...what were these words of wisdom?
Leyner:It was quiet in the car and all of a sudden she
piped up, “I didn’t fart...but I’d open a window if I were
Gberg:With all the new technology, they should make an
automatic sensor that senses the gas and opens the window.
Leyner:I hate going into a bathroom in a fancy restaurant
where they have an attendant in there.
Leyner:A men’s room seems to be the one place on earth
where Emersonian self-reliance should be the rule.
Gberg:I know, I don’t really need assistance getting the
paper towel out of the dispenser.
Leyner:There’s really nothing that goes on in a men’s room
that I can’t handle myself.
Gberg:You end up feeling so guilty that you have to give
the poor bastard a tip.
Leyner:You know that expression for waiters and cooks—when
they spend their day off at the place they work?
Leyner:Bellman’s holiday or something?
Leyner:Wonder if there’s an equivalent for men’s room
Leyner:Look that expression up online, will you...bellman’s
Gberg:They probably can’t urinate or defecate at home
because it reminds them of work.
Leyner:What about the people who check stool samples all
day, like at that place Jetti Katz, you know that lab?
Gberg:What the hell are you talking about?
Leyner:There’s a lab I went to once when my cousin, my
gastroenterologist, thought I might have picked up some
exotic parasite in Tierra del Fuego.
Gberg:Jetti Katz sounds like a performer in the Catskills.
Leyner:So he sent me to this lab that specializes in
analyzing stool for parasite eggs...Jetti Katz or Jeddi
Cats or something like that...some place in upper Manhattan.
Gberg:The Jeddi Cats sound like a band.
Gberg:I love their music.
Leyner:Anyway...they have these women who work there, and
what they do all day is handle hot, steaming fresh stool
samples. The whole experience is indelible in my brain.
Gberg:Indelible or inedible?
Leyner:First you down some...What’s that laxative they give
you?... It has a catchy name.
Leyner:Works mighty fast.
Leyner:Know what I’m talking about?
Gberg:Nothing light about it.
Leyner:What’s it called? Help me out here.
Gberg:Not Go-lytely?
Gberg:Lactulose, sorbitol, milk of magnesia, cascara,
Leyner:Dulcolax...I think.
Gberg:Magnesium citrate.
Gberg:Dulcolax, “the Duke.”
Leyner:DULCOLAX, yes!!!!!! Anyway, they make you drink
that...then, a dozen or so people vie for three bathrooms.
It’s like some debased Japanese game show.
Gberg:We could be huge in Japan.
Leyner:We already are.
Gberg:Did your books sell internationally?
Leyner:That’s the strange thing about Japan. You can be
famous there, have malls named after you, etc., etc., and
NEVER know it.
Gberg:I am pretty sure there is no Billy Goldberg mall in
Leyner:One of my books has been published in Japan, and all
of them in Great Britain, Italy, and France...and Chechnya,
I think. I’m like the Dr. Seuss of Chechnya.
We have no pretensions about this book, and we expect it to be found in that
precious spot right next to the toilet. For that reason, we fear we need to warn
you that sitting too long on the throne may cause hemorrhoids. Unfortunately,
this one’s not an old wives’ tale.
Hemorrhoids, or piles, are abnormally swollen veins in the rectum and anus.
They are similar to the varicose veins you might see on a person’s legs at the
beach. It’s estimated that about one hundred million Americans are currently
suffering from hemorrhoids. More than half of the U.S. population develops
hemorrhoids by age fifty. The most frequent causes of hemorrhoids are constant
sitting, straining with bowel movements (from constipation or hard stools),
prolonged sitting on the toilet, severe coughing, giving birth, and heavy lifting. It
has also been suggested that the Western diet, which is rich in processed food
and lacking in fiber, contributes to hemorrhoids.
Sitting on the toilet too long is problematic because this is the only time that
the anus truly relaxes, allowing the veins down there to fill completely with blood.
To prevent this problem, you should move your bowels as soon as possible after
the urge occurs. If you cannot go right away, pick up our book (we expect it to be
toilet reading) but read as you walk. You can always return to finish the job.
We don’t want to create any cultural stereotypes here, but most of the bathroom
questions came from folks from Down Under. Yes, two Aussie friends seem to
ask many questions about their bowels.
Everything that happens in the intestine seems to have something to do with
the production of gases and sulfur compounds. The bacteria inside feces is what
makes it smell so bad. Specifically, the bacteria produce various compounds and
gases that lead to the wonderful smell of a bus station bathroom. The smell of
your stool can be affected by medical conditions or your diet. Fatty stools and
bloody stools are known to be particularly malodorous. In the hospital, a large,
ripe poo is known as a code brown. How’s that for real insider knowledge?
Some people seem to be obsessed with the creation of the perfect poo. My
brother even called me in to examine his works of art, a true bonding moment for
young boys. Another friend described his perfect moment for us when he
produced the cobra—one that coiled around and poked its head out of the bowl.
There is something about “dropping the kids off at the pool” that makes us all
smile. So, laugh if you must, but we’re sure you’ve wondered why some poos are
It is gas that makes poo float. Increased levels of air and gas make it less
dense and therefore cause it to float.
It is very common to have people ask about the color of their stool to figure out
how it relates to disease. There are definitely some color changes that can be
cause for concern, but in general assessing stool color is no exact science.
Feces are mostly shades of brown or yellow because of the presence of an
orange-yellow substance called bilirubin. Bilirubin combines with iron in the
intestine to give the combo a beautiful brown color.
Poo does, however, have a rainbow of possibilities:
• Black:A black stool (melena) can mean that blood is coming from the upper
part of the gastrointestinal tract, the esophagus, stomach, or first part of the
small intestine. Other things that can cause black stool are black licorice,
lead, iron pills, Pepto-Bismol, or blueberries.
• Green:Green, leafy vegetables contain chlorophyll, which can color the stool
green. Green feces can also occur with diarrhea if bile passes through the
intestine unchanged. In breast-fed babies, green stool is a normal
occurrence, especially right after delivery.
• Red:Maroon stool or bright red blood in poo usually suggests that the blood
is coming from the lower part of the GI tract. Hemorrhoids and diverticulitis
are the most common causes of red blood in the stool. Beets and tomatoes
can also make stools appear reddish.
• Gray:Diseases of the liver, pancreas, and gallbladder can cause pale or gray
• Yellow:One condition that can cause yellow stool is a parasitic infection
known as giardia. Giardia also causes significant diarrhea. Another cause of
yellow poo is a condition known as Gilbert’s syndrome. This is a fairly
common genetic disorder that causes an increase in your level of bilirubin.
Gilbert’s syndrome is rarely dangerous.
Some people like to think of their lower gastrointestinal tract as a one-way street.
One time during a rectal examination during a trauma, a frightened young man
screamed out as the doctor was placing his finger in the man’s rectum, “Whoa,
that’s an exit!”
Flatulence follows that same rule. Gas goes out or it simply goes away.
Seawater is more than three times as concentrated as blood. Humans shouldn’t
drink salt water because it forces your body to deal with a solution that is more
concentrated than its own fluids. In order to get rid of the excess salt, your body
must excrete it through the kidneys as urine. The kidneys can only make urine
that is less salty than salt water, so if you drink seawater, you’ll be peeing a lot
and losing an excess of water. This would cause your body to become
dehydrated, leaving an excess of sodium in your bloodstream. Water would then
leave all your other cells to enter the bloodstream. This would cause the cells to
shrink and malfunction. As a result, muscles would become weak and ache, the
heart would beat irregularly, you would become confused, and ultimately you
would die.
Drinking urine is probably safer than seawater, but the catch-22 is that if you
don’t have any water to drink, you will become dehydrated and not produce any
urine. The best bet is to not get shipwrecked and if you do, hope for rain.
By doing research we found reports of gonorrhea, toilet-seat dermatitis
(infragluteal eczema), ascaris lumbricoides (roundworm), and enterobius
vermicularis (pinworm). We know what you are thinking. After carefully washing
our hands, we went back to our computers and came across more information.
Yes, occasionally you can catch something from a public toilet seat but this
isn’t all that common. Work, on the other hand, may be worse for your health
than toilet seats. A microbiologist at the University of Arizona, Charles Gerba,
found that the typical office desk harbors around four hundred times more
disease-causing bacteria than the average toilet seat. Here is the bacteria count:
telephone: 3,894 germs per square centimeter
keyboard: 511 germs per square centimeter
computer mouse: 260 germs per square centimeter
toilet seat: priceless
In our house, we call it the coffee alarm. Nothing is more reliable.
Coffee is definitely known to have a laxative effect. The caffeine in coffee
speeds up every system in the body including the bowels. But when used
excessively, caffeine can interfere with the bowels’ normal contractions and lead
to constipation. Decaffeinated coffee does away with the caffeine but it still acts
as a bowel irritant.
There is nothing better, for some, than the morning cup of joe and a cigarette,
followed by the “morning constitutional.” Caffeinated drinks and nicotine have a
laxative effect probably because they stimulate nerves that increase intestinal
contraction, so if you had a block of cheese for dinner, this is a wonderful
If you want to have a cigarette and coffee for breakfast, make sure that you
have a clean toilet nearby.
Sorry, pal, sometimes there just aren’t medical explanations for things. Nobody in
medical school explained why you get the urge to urinate when you pour gas into
the generator.
Going to bed at camp always felt like a risky time. The fear of having someone
dip your hand in warm water and waking in a puddle was terrifying. There is no
clear medical proof to this camp myth but there may be some science behind it. It
is known that when someone has trouble urinating, a warm bath can sometimes
make it easier to go, perhaps because of a reduction of pressure in the urethra
with the increased body temperature during a bath. A study from Egypt called
“Role of Warm Water Bath in Inducing Micturition in Postoperative Urinary
Retention After Anorectal Operations” described this so-called thermo-sphincter
reflex in 1993. We still don’t know if the hand dip works the same way, but it sure
would be funny to picture an Egypitian in the laboratory sneaking up on sleeping
volunteers to try to get them to wet their beds.
My junior high school biology teacher instilled fear in our young hearts when he
told us that if we got into a car accident with a full bladder, the bladder could
rupture. He was right. In general, a full bladder ruptures more easily than an
empty bladder.
This doesn’t mean that your bladder will explode if you hold in your urine
because your dad, husband, or brother won’t make a pit stop.
Our bodies have a nonvoluntary reflex mechanism to prevent our bladder
from getting too distended, called the micturition reflex. When our bladder gets
distended, there are stretch receptors in the bladder wall that let us know that it is
time to go. As we all know, this is not the most comfortable sensation (if you wait
too long). These sensory neurons cause contractions that can become strong
enough to overcome the muscle tone holding the urethra shut and release all that
Borborygmi:bor•bo•ryg•mi; noun, plural : rumbling sounds caused by gas
moving through the intestines.
Certainly not a word learned in medical school, or that can be easily used in a
These rumbling sounds are a normal part of digestion. They are generated
from muscular activity in the stomach and small intestine as the food, gas, and
fluids are mixed together and pushed through the intestine. This squeezing of the
muscular walls is called peristalsis. Many people associate these sounds with
hunger because they are louder and echo more when the intestine is empty.
Gberg:Good morning.
Leyner:All the best to you and yours...give me one moment,
just finishing an e-mail...
Gberg:I’m just making a coffee.
Gberg:Coffee and pizza for breakfast.
Leyner:I had a Slim Jim and a fermented mare’s milk.
Gberg:It’s hard to find good fermented mare’s milk these
Leyner:People should drink the milk of as varied a
miscellany of mammals as possible.
Gberg:Did you ever sample human breast milk back in the day?
Leyner:All those diverse antibodies are good for getting an
immune system ready for the coming apocalyptic flu pandemic.
Gberg:I live in fear of the avian flu.
Leyner:No...never sample that mamma milk...I’ve tried to
keep the birthing process and my sex life as far apart as
Leyner:The whole avian flu thing seems like some Hollywood
pitch...like Hitchcock’sThe Birds and...
Gberg:So, my brother, we need to finish this bitch and move
on to bigger and better things.
Leyner:What was that epidemic movie?
Gberg:Outbreakwith Dustin Hoffman.
Leyner:What are doing right now...are we IMing about
something we need to be IMing about?
Gberg:Not yet, really just getting loose.
Leyner:Tomorrow seems not so good to work...is Thursday any
Gberg:I am doing stretches at the same time.
Leyner:Tell me about Thursday.
Gberg:Can’t do Thursday. Working.
Leyner:One of those six-pack ab cover mags...that men
should do the recumbent bike in the gym and not the regular
one that puts pressure on the cajones and the tender
Gberg:There is something about bike riding that can damage
the pudendal nerve and affect your front end lifter.
Gberg:The tender perineum—who wrote that? Fitzgerald?
Leyner:I love when you conflate urology and heavy machinery.
Leyner:“The Tender Perineum”...yes, yes...the unfinished F.
Scott masterpiece...
Gberg:I never knew I could conflate.
Leyner:Poor slob never had the chance to work out the
Leyner:I heard some woman talking about morning erections
the other day...
Gberg:Did you just spontaneously spell denouement correctly?
Leyner:At a supermarket in L.A.
Gberg:I was wondering where you heard that?
Leyner:Yes, I spontaneously spelled it correctly...it’s the
Gberg:I didn’t know that people actually spoke in L.A.
Leyner:This woman...enormous plastic L.A. tits and the face
of a wizened gargoyle...said she won’t touch a morning
erection...because it’s not “for me” (she said)...it’s just
a “reflex.”
Leyner:I guess people want to feel they’ve “earned” a
change in some other human’s physiognomy.
Gberg:L.A. is such a bizarre place. New Yorkers would take
advantage of any erection. Why waste a good thing?
Leyner:You know those commercials for that new
Viagra...whatever it’s called?
Gberg:Cialis. Damn, those people seem relaxed and happy.
Gberg:We should start our own pharmaceutical company.
Leyner:Why do they say—at the end of that ad—that you
should report erections that last over four hours to your
Leyner:Maybe you should report them to the police?
Leyner:What’s the danger of a four-hour erection anyway?
Gberg:Priapism, my friend, priapism.
Gberg:Very painful and can cause permanent damage to the
Leyner:Can you get a permanent erection?
Gberg:Me, personally?
Leyner:That’s funny.
Leyner:Porn stars are said to be able to get their
erections back quickly...it’s a vocational skill in high
demand in the industry...
Leyner:What accounts for the difference in the refractory
time for various men?
Leyner:Is that what that’s called?
Gberg:It sounds so scientific.
Leyner:That’s the right term! I just looked it up. I’m so
smart...Don’t you think?
Gberg:You could write a scientific
article, “The Refractory Erectile Period in the Porn
Gberg:Just as important as making it go up is making it go
down. For those embarrassing public moments.
Leyner:Speaking of porn.
Leyner:Did we ask this in the book: Can women ejaculate?
Gberg:All we are doing is speaking of poop, porn, and
Gberg:So sophomoric.
Gberg:Yes, and they can.
Leyner:...that we’re hard-wired to launch our genes into
the future before we decay in a puddle of excrement and
Leyner:You think THAT’s sophomoric?
Leyner:That’s the whole comic tragedy of life!
Leyner:And the central thesis of our book, yo.
Gberg:What is the thesis of our book?
Leyner:The intertwining cosmic threads of poop and porn.
Leyner:That’s string theory, ever hear of it?
Gberg:I am very slow on the keyboard this a.m.
Gberg:I think my head is going to explode.
Leyner:That we valiantly attempt to create poetry and
architecture and pass along culture and bequeath our
genetic heritage, ALL in the face of certain decrepitude
and the abject indignities of old age and DEATH.
Leyner:It’s a grim struggle each and every day to maintain
my dinginity in the face of “reading glasses.”
Leyner:I misspelled in my passion.
Gberg:Hold on 1 sec.
You left the chat by logging out or being disconnected.
flurry of bathroom talk was cathartic, leaving everyone feeling purged and
invigorated. Joel, with a newly found confidence, is leading a small group in a game of
charades. Leyner, with the nearly empty tequila bottle in one hand and a fat Cohiba in the
other, is gesturing madly and attempting to act out a scene from Gone With the Wind . I
mistake Leyner’s gesticulations for a focal seizure and I run across the room to
administer first aid. The group assumes that this is all part of the clue giving and
continues to shout out movie titles. Leyner’s face is contorted in a bizarre grimace as I
assist him to the ground and protect his airway with a head tilt and jaw thrust. Leyner is
now scowling and I realize this is not a seizure as Cinderella incorrectly guesses
Spartacus .
Joel shouts out,“Vision Quest!”
And Jeremy quickly replies, “Dude, they’re not wrestling, I think they are in love.”
Joel quickly responds,“The Birdcage!”
And Cinderella guesses,“Willy Wonka and the Chocolate Factory.”
Jeremy turns to me and blurts out, “Are Oompa Loompas orange from eating too
many carrots or are those little bastards just using too much self-tanner?”
Before I can respond, Eloise saunters over and—astonishingly—says in a slow,
wistful drawl, “It’s got to be Gone With the Wind . I’d have a fit too if my ten-milliondollar Charleston bungalow burned to a crisp. Oh poor beautiful Tara.”
People often leave the movie theater filled with questions about what they’ve seen on
the screen. After a thrilling episode of ER, I can always expect to get a call.
Accurate:ac•cu•rate; adjective.
1. Correct in all details.
2. Free of mistakes or errors.
Of course it’s not completely accurate! It’s TV.
But the writing staff does capture the general controlled chaos of an ER. They
deal with real medical cases but their medical depictions are always embellished
to add a little extra Hollywood flair.
I did my residency in emergency medicine in Los Angeles, when ER was just
starting and the writers often came by our hospital looking for new ideas. One
patient I saw there was portrayed in an early episode, and highlights the writers’
taste for the dramatic. One day, a baby was playing with a coat hanger and the
tip of the hanger got stuck in the back of his throat. The paramedics carefully
brought the baby in to our ER with the hanger dangling from his mouth. This was,
of course, very dramatic looking, and we all rushed over immediately. The child
was scared but was breathing fine and my fellow doctors and I did our best to
just leave him alone and keep him calm. (Rule #1 of medicine: do no harm.) An X
ray showed that the tip of the hanger was superficially caught up on the back of
the child’s throat. Now...for the big dramatic ending: we simply reached inside
and removed it. Case over!
On ER, however, when the glamorous doctors tried to remove the hanger
from the child’s throat, the baby started to bleed profusely. After an emergency
tracheotomy, some miraculous bedside surgery, and a little on-screen romance,
this child was just barely saved.
Amnesia seems to be one of the favored topics of screenwriters for an easy plot
twist. The list of “amnesia movies” can go on and on:The Bourne Identity, 50
First Dates, Desperately Seeking Susan, Eternal Sunshine of the Spotless Mind,
Overboard, Spellbound, Total Recall, to name just a few.
The amnesia that doctors see is very different than the big-screen version.
Amnesia is best defined as a failure to retrieve information or to place
information in an appropriate context. Amnesia rarely erases memory of all past
events. No one suffering from amnesia actually goes through the rest of his or
her life without an identity or any knowledge of the past. Memory loss is usually
temporary and only involves a short time span of the person’s life.
Types of Amnesia
•anterograde amnesia: Inability to remember ongoing events after the
incidence of trauma or the onset of the disease that caused the amnesia.
Anterograde amnesia often occurs following an acute event such as a
trauma, a heart attack, oxygen deprivation, or an epileptic attack.
•retrograde amnesia: Inability to remember events that occurred before the
incidence of trauma or the onset of the disease that caused the amnesia.
Retrograde amnesia is often associated with neurodegenerative pathologies
such as senile dementia and Alzheimer’s disease.
•emotional/hysterical amnesia (fugue amnesia): Memory loss caused by
psychological trauma such as a car crash or sexual abuse. Usually it’s a
temporary condition.
•lacunar amnesia: Inability to remember a specific event.
•Korsakoff syndrome: Memory loss caused by chronic alcoholism.
•posthypnotic amnesia: Memory loss sustained from hypnosis. Can include
inability to recall events that occurred during hypnosis or information stored
in long-term memory.
•transient global amnesia: Spontaneous memory loss that can last from
minutes to several hours and is usually seen in middle-aged to elderly
Here are some movies that Hollywood executives would like to forget:Gigli,
Ishtar, Howard the Duck, The Postman, and The Adventures of Pluto Nash .
“No, you don’t gotta fucking stab her three times! You gotta stab her once, but
it’s gotta be hard enough to break through her breastbone into her heart, and
then once you do that, you press down on the plunger.”
—Lance (Eric Stoltz),Pulp Fiction
No, intracardiac injection is not recommended for routine use during CPR.
Translation: ER docs don’t ever inject anything directly into people’s hearts.
There is an uncommon procedure called a pericardiocentesis when a needle is
inserted under the breastbone and into the sac around the heart to remove
excess fluid. This is done when fluid or blood surrounding the heart is restricting
its function. This is only done in serious emergencies.
In Pulp Fiction, John Travolta and Samuel L. Jackson are trying to save Uma
Thurman from a drug overdose by injecting her with adrenaline. Instead, they
should have given her an injection of a medication called Narcan to reverse the
effect of the heroin. Adrenaline (epinephrine) is often given during cardiac arrest
but only through a vein. Sorry, not as dramatic but definitely less painful.
In the movies and in the dictionary, “shock” can mean to strike with great surprise
and emotional disturbance. In medicine, “shock” is a major medical emergency.
When doctors talk about shock we are referring to the failure of the circulatory
system to maintain adequate blood flow. This requires rapid treatment, otherwise
it can lead to death.
There are a number of different causes of medical shock, including bleeding
(hypovolemic shock), inability of the heart to pump enough blood (cardiogenic
shock), severe infection (septic shock), and life-threatening allergic reactions
(anaphylactic shock). People suffering from shock have low blood pressure,
difficulty breathing, a weak rapid pulse, cold and clammy skin, decreased
urination, and confusion.
So, the shock that we so often see on-screen should be more appropriately
called freaked out.
If real life were a soap opera, then the answer to this question would always be
yes. Unfortunately, coma is a very serious problem and although people do wake
up, the longer they remain in this state, the less likely they are to return to
consciousness. This is a very delicate question because doctors can’t really
predict which patients will wake up and which will not.
If you look carefully in the original movie Coma, you will see Tom Selleck,
that’s right, Magnum, P.I., in a state of suspended animation. Recent movies like
While You Were Sleeping, Kill Bill, and Talk to Her also used coma in their
stories. The medical story of coma isn’t as glamorous as Hollywood portrays.
To begin, there are several different categories of coma, or disorder of
consciousness. Consciousness can generally be divided into two main
components, arousal and awareness. Coma is defined as a state of
unresponsiveness from which an individual has not yet been aroused. Patients in
a coma are neither awake nor aware of their surroundings. On average, coma
doesn’t usually last very long. After several weeks, most patients either regain
some level of consciousness and if not are classified as being in a persistent
vegetative state. Persistent vegetative state is characterized by complete lack of
awareness of self or one’s environment. These patients can appear awake and
even have their eyes open but are totally unaware of their surroundings.
Another category of consciousness is the minimally conscious state, an
intermediate stage of consciousness, which indicates that a patient is
somewhere in between a persistent vegetative state and normal consciousness.
These patients can show intermittent signs of awareness.
The “locked-in” syndrome is a rare condition that must be distinguished from
disorders of consciousness. It is characterized by complete paralysis of the
voluntary muscles in all parts of the body except for those that control eye
movement. These patients can think and reason but are unable to speak or
It certainly would be dramatic if we had our gunshot trauma patients take a swig
of whiskey and bite on their belt as we removed the bullet with a knife that had
been sterilized by heating over a fire. I also would love to ride a white horse to
work every day but that doesn’t happen either.
In old Westerns, there is an urgency involved with removing a bullet, as if this
is the life-saving maneuver. In reality, doctors are not concerned with the
presence of the bullet but rather the damage that it does on its way in or out. We
often see patients who get an X ray for another reason only to find a bullet from a
previous injury.
There are some special situations when we worry about leaving a bullet in a
person’s body. When bullets or fragments are near large blood vessels, nerves
(especially the spinal cord), or in a joint, then they can migrate and cause
damage. In these cases, bullets are usually removed.
People have also asked whether or not you can get lead poisoning from
bullets that are left in the body. In general, lead fragments in soft tissue become
surrounded by fibrous tissue and are therefore essentially inert. If a bullet is in a
joint, there can be a problem with lead poisoning. A study in Los Angeles in 2002
looked at more than four hundred patients who had bullets retained in their
bodies. They found increased levels of lead in a small percentage of patients.
Bullets or shotgun pellets are 50 to 100 percent lead and people are more likely
to have problems with lead poisoning if there are multiple bullets or multiple
fragments in the body. Sorry to disappoint you spaghetti Western aficionados,
but the old whiskey-and-leather routine is just for show.
Action heroes like Arnold Schwarzenegger often find themselves faced with an
interrogator who uses a truth serum to get the hero to reveal his secrets. In the
movies, our heroes are able to resist these potions and hide the truth. Hiding the
truth seems to also prepare action heroes for a successful career in politics.
They seem pure fiction, but truth serums do exist. Barbiturates such as
sodium amytal and sodium pentothal were first used as truth serums in the early
twentieth century. These drugs inhibit control of the central nervous system and
were used by physicians to help patients recover forgotten memories or
repressed feelings. They are also used for patients with suspected conversion
disorder, a condition in which psychological problems produce physical
An “amytal interview” is performed by administering a small amount of this
drug intravenously. The drug produces a state of drowsiness, slurred speech,
and relaxation. This condition makes patients more susceptible to suggestion,
allowing the potential to uncover repressed feelings or memories.
Today these interviews are seldom performed. The “truth serum” will not
necessarily make you tell the truth. Patients may lose inhibition but will not lose
all self-control. Therefore, they are still able to control their behavior and lie.
Studies have shown that during these “amytal interviews,” patients often
demonstrate a distorted sense of time, show memory disturbances, and have
difficulty distinguishing between reality and fantasy, so the line between fact and
fiction becomes even more blurred.
We’ve all seen it in the movies. The bad guy grabs someone from behind, places
a rag over the victim’s nose and mouth, and instantly the person slumps to the
This isn’t exactly how anesthesia is administered in a hospital, but many
people wonder if this rag trick is possible, and if so, what is the chemical on the
Chloroform and ether are the two possibilities. In the mid-1800s, both of these
chemicals were being used as anesthetics. Chloroform is the more common
substance discussed in these cinematic knockouts but actually doesn’t work as
swiftly as portrayed. It usually takes several minutes to induce a state of
unconsciousness with chloroform. Chloroform also causes a lot of side effects
including nausea, vomiting, and skin irritation.
Ether was discovered in the 1500s and later used as an anesthetic. It was
also used to treat respiratory ailments such as asthma. Ether became popular
and turned into an early party drug that people used to get high. Unfortunately,
ether can’t deliver that dramatic takedown either.
Another option for the quick movie knockout involves secretly dissolving a pill
in a drink. This is often referred to as “slipping a mickey” or a Mickey Finn.
Spiked drinks in this sense contain Chloral hydrate dissolved in alcohol. Chloral
hydrate is a sedative that is used in hospitals today, often to sedate children prior
to procedures. Other modern movie knockout options are the so-called date rape
drugs: GHB, Rohypnol, and ketamine.
In the movieSpinal Tap, Eric “Stumpy Joe” Childs, the second drummer in the
eponymous band, died in 1974 from choking on vomit. As the movie reveals,
“The official cause of death is he died of choking on vomit. It wasn’t his own
vomit. He choked on somebody else’s vomit.”
This event is said to have been inspired by the death of John Bonham, the
drummer of Led Zeppelin. In 1980, Bonham was found dead after a drinking
binge. He apparently had passed out and choked on his own vomit.
This is a true and potentially dangerous possibility with excessive alcohol
intake. Death from alcohol abuse most often occurs from aspiration. Aspiration is
defined as breathing the vomit into the lungs, which causes the victim to
essentially drown.
The 1976 TV movieSybil was based on a book of the same name written by
Flora Rheta Schreiber. Both of these accounts were based on a real-life patient
and psychiatrist but recently there has been controversy over whether the real
Sybil actually had multiple personalities at all. Other movies likeThe Three Faces
of Eve, Psycho, andMe, Myself & Irene have also dealt with multiple personality.
Once this disorder was popularized in the movies, the number of diagnosed
cases increased dramatically.
Multiple personality disorder is no longer the term used to refer to this
disease. It is now referred to as Dissociative Identity Disorder (DID). DID is
defined as a disorder where two or more distinct personality states or identities
alternately control or take over a person’s mind. This disorder is a result of many
factors, most commonly severe emotional stress.
You can scare the pants off someone or be scared shitless, scared stiff, or
scared out of your wits. But is it really possible to be scared to death?
There is significant evidence that psychological and emotional stress can
increase the likelihood of a heart attack. So it makes perfect sense that the stress
of fear could lead to sudden death.
InThe Hound of the Baskervilles, a famous Sherlock Holmes story that has
been adapted into film several times, Sir Charles Baskerville dies of a heart
attack after being frightened by a ferocious dog. An article from theBritish
Medical Journal in 2001 entitled “The Hound of the BaskervillesEffect: A Natural
Experiment on the Influence of Psychological Stress on the Timing of Death”
examines whether this phenomenon is actually true. These researchers wanted
to show that people are more likely to die of a heart attack when they suffer
extreme emotional stress, so they focused on the death rate on the fourth day of
the month. In Japanese and Chinese cultures, the number four is associated with
death and is feared and avoided. This is not true in other cultures.
When the death rates between Japanese and Chinese Americans and white
Americans were compared on the fourth of the month, the researchers found that
death rates on this day peaked in the Japanese and Chinese but not in other
groups. So it seems as though you can be scared to death—by the number four
at least.
Even if you don’t end up choking on your own vomit, alcohol is still pretty
dangerous. The consumption of even small quantities of some types of alcohol,
such as methanol or rubbing alcohol, can be fatal.
With ethanol, the alcohol that is found in vodka and wine, for example, too
much can certainly lead you to the pearly gates. People often wonder how much
alcohol can be life threatening. In medicine, we use the term LD 50to describe the
dosage or amount of alcohol that causes death in half of the population. The
LD50for alcohol is equal to a blood-alcohol concentration of 0.4 to 0.5 percent.
That would be about four to five times the amount required to make you legally
To give an example of how much drinking this means, a hundred-pound
person would need to drink about ten drinks in an hour to threaten his or her life.
Our bodies tend to protect us from alcohol-related death by vomiting or passing
out. The danger occurs when you puke and faint at the same time. If you are
brought to the hospital, we will protect your breathing and wait for the alcohol to
move out of your system. Stomach pumping for alcohol abuse is a myth since
you do that yourself when you puke. Oh, and occasionally when it is a slow night
in the ER, the staff will bet on who can guess your blood-alcohol level, just to
pass the time. . . .
On an episode ofKing of the Hill, Hank accidentally sees his mother in bed with
her new boyfriend and suddenly loses his vision. In the movieHollywood Ending,
Woody Allen’s character has the same problem because he is so nervous about
the film he has to direct. So, does this sudden blindness really happen outside of
the movies and TV?
The answer is definitely yes. And it is not unusual to see these patients in the
ER. Hysterical blindness can occur as a result of a psychological stress (a
conversion disorder) or someone can intentionally fake blindness for some
secondary gain (malingering)—a prisoner who says he can’t see in order to try to
avoid going directly to jail. It is not difficult to figure out when patients say they
are blind but can actually see. We have a simple test that lets us determine
whether the eyes are functioning. Using a rotating striped drum, we test for
something called optokinetic nystagmus. As the drum spins, normal eyes will be
seen moving back and forth.
If a striped rotating drum is not available, you can always use a picture of J.
Lo’s rear. Move it back and forth, and any normal eyes will follow.
Leyner:So . . .
Gberg:Just sent you the blindness question.
Leyner:Okay . . . just got the e-mail . . . I’m reading it
now . . . hold on (to something of your own choosing).
Gberg:Just hold on to what you’ve got. You’ve got a lot
girl, you’ve got a lot. Got a lo-ovely feelin’. Hang on,
hang on to what you’ve got. I may have left out a “hang on”
in that musical interlude. Singing doesn’t really work on
Leyner:I think we need to explain just what that test is,
then maybe make some joke about something visual that would
be almost impossible not to react to, like some starlet’s
muff for instance, then . . . maybe a joke about what might
cause hysterical deafness.
Gberg:Very good. Will do. Let’s focus on the intros.
Leyner:Okay . . . let me read through the intro again. . . .
We’re not sure that we can answer this one with any scientific references, and
there probably isn’t a hospital that would allow you to study the consequences of
leaving movie candy inside a patient during surgery. This is not to say that
surgeons don’t occasionally leave things behind. Surgical sponges and
instruments are the most common items left behind, and believe us, it has
In theSeinfeld episode, the patient makes a miraculous recovery and it is
implied that the mint may have prevented infection. Although there are some
reports about using granulated sugar and honey on wounds, having a Junior Mint
inside your body is more likely to cause an infection. So, remember to always ask
your surgeon to step out of the operating room if he or she needs a snack.
One of Mark Leyner’s favorite recent news stories is that of Armin Meiwes, a
German computer technician who was convicted of murdering someone for
sexual pleasure and then eating him over the next several months. Mr. Meiwes
had advertised on the Internet for “well-built young men aged eighteen to thirty to
Mr. Meiwes in interviews with court psychiatrists said that his fantasies of
cannabilism began as a child from watching horror films. For those film buffs who
are looking for a viewing list, these movies all involve cannibalism:Alive; Eating
Raoul; The Silence of the Lambs; Hannibal; The Cook, the Thief, His Wife, and
Her Lover; andNight of the Living Dead .
So, is it dangerous to eat another human being? I am sad to report that it
really isn’t that dangerous. Human flesh holds much nutritional value and will
keep you alive if your plane goes down and all you have are your fellow, more
unfortunate, passengers. Unless you are eating the brain.
A rare disease called Kuru can occur from eating human brains, which killed
about 10 percent of the Fore, a New Guinea tribe of cannibals. The Fore would
honor their dead by eating them. The brain was reserved for the female relatives
and children. Whole villages were wiped out by this rare neurodegenerative
Kuru manifests with muscle weakness and trouble walking. The Fore would
then have trouble talking and could no longer stand, sit, or even hold their heads
up. Death ultimately resulted from starvation or an infection that developed when
they became so sick. Researchers were very interested in this disease because
it is very similar to mad cow disease.
Gberg:Time really flies when you are typing away at this IM
Leyner:Are you being sarcastic?
Gberg:How was the lamb your mother-in-law made last night?
Leyner:The goat you mean.
Leyner:It was great.
Leyner:I love goat and all things goat.
Gberg:I made a mean beef tenderloin last night.
Leyner:Meat, cheese, milk, etc.
Leyner:How’d you make it?
Gberg:In a red wine sauce, tender and delicious.
Gberg:Did I tell you that I added in your favorite story of
that German cannibal?
Leyner:That sounds great.
Leyner:I saw that . . . that’s essential and indispensable
for this book.
Gberg:What an insane story.
Leyner:It’s a lot more common than you think. Families tend
to keep cannibalism hushed up . . . I had an uncle . . .
Gberg:I will never come to your family’s for Thanksgiving.
Leyner:Never mind.
Leyner:I was looking up satyriasis.
Leyner:Speaking of goats.
Gberg:What is satyriasis?
Leyner:It comes from the word “satyr,” meaning part man,
part goat (fond of Dionysian revelry).
Leyner:Satyriasis: abnormal sexual craving in the male.
Gberg:Says on the Internet that it is caused by extreme
Leyner:Really . . . I’m in the high-risk category then.
Leyner:I can spend all day just staring at a single vein on
my left bicep.
Gberg:There are treatment options available, medication
or . . . I assume that castration is not an option.
Leyner:I’m not taking some horse suppository, son.
Gberg:Maybe some very tight underwear?
At the end ofScarface, Tony Montana gets shot many times but doesn’t lose his
ability to spew obscenities. In the hospital we believe that an innocent person will
get killed by a single gunshot but the meanest, guiltiest thug can survive multiple
gunshots and simply get up, curse at the doctors, and walk out.
The truth is that it really depends on where the bullet hits you.
It happened inAn American Werewolf in London, and who can forget Michael J.
Fox asTeen Wolf ? Lyncanthropy refers to the delusion that one is a wolf. This
can definitely be seen in psychiatric illness, but it may be that in some cases this
is not a delusion at all. The werewolf legend may have originated out of two
medical conditions.
Porphyria is a rare hereditary blood disease. There are two types of
porphyria. In one type, cutaneous porphyria, the symptoms can resemble the
characteristics of a werewolf. These patients become extremely sensitive to
sunlight, grow excessive amounts of hair, and develop sores, scars, and
discolored skin. Porphyria also leads to tightening of the skin around the lips and
gums, and can make the incisors stand out (think fangs).
Another disease that may have contributed to the werewolf myth is congenital
hypertrichosis universalis, sometimes known as human werewolf syndrome. This
is another rare genetic disorder that is characterized by excessive hair growth
over the whole body, including the face. If you travel to Austria, you can see
portraits of the first family discovered with this condition in Ambras Castle near
So, there isn’t really such a thing as a werewolf, but there is a possible
medical explanation of how the stories began. Sorry, we don’t have a medical
explanation for Dracula, Frankenstein, or the Abominable Snowman, but we’ll do
some research and include it in our next book,Why Are Women Smarter?
InMonty Python’s The Meaning of Life, a man eats a massive feast, but one
wafer-thin dinner mint puts him over the edge. He explodes all over the
restaurant. With the obesity epidemic in our country, we have a great deal to
worry about, but don’t expect to see people exploding at McDonald’s. People
won’t explode from overeating, but if you eat too many Big Macs, you can rupture
your stomach.
Stomach rupture, or gastrorrhexis, is a rare condition, although it has been
reported to occur from eating too much. In a 2003 issue ofLegal Medicine,
Japanese scientists Ishikawa et alia, reported the case of a forty-nine-year-old
man who was found dead in a public restroom after his stomach exploded from
eating too much. There is no mention of what his last supper was, and therefore
no reason to suspect Pop Rocks and Coke (see chapter 8, page 192).
Does anyone else remember the Man from Atlantis? Patrick Duffy (Bobby Ewing
fromDallas ) played the last man from the legendary underwater city of Atlantis.
He had webbed feet and hands and gills instead of lungs. This fantastic show
only lasted for one season, but it inspired a TV junkie to ask if people could really
have webbed hands and feet.
The answer is yes! People can have webbed hands and feet. Actually, it is
more common than you may think, occurring anywhere from one in one thousand
to one in two thousand births. There are two types of webbing: syndactyly is
when two fingers or toes are fused or webbed; polydactyly involves the webbing
of more than two fingers or toes. We all start life with hands and feet that
resemble a duck, and between the sixth and eighth week of development, our
fingers and toes separate. The failure of this separation is what leaves you
looking like the Man from Atlantis.
It always happened to Wile E. Coyote. The Road Runner drops an anvil on his
head and then the poor coyote sees stars circling his head. Not only does this
happen in cartoons but it is actually a sign of a concussion. A concussion is
simply when an injury to the head causes your brain to move around inside your
As for the stars, what probably happens is that the portion of your brain that is
responsible for visual information, the occipital lobe, bangs up against the side of
the skull.
In 1976, one year before John Travolta was dancing his way throughSaturday
Night Fever, he was inThe Boy in the Plastic Bubble. The film was based on a
true story of a boy suffering from a rare inherited disease called Severe
Combined Immunodeficiency Disease (SCID). SCID is now often referred to as
“bubble boy” disease, thanks to this cinematic tour de force.
Severe Combined Immunodeficiency is a life-threatening syndrome in which
there is a defect in the white blood cells that protect us from infection. This lack of
a functioning immune system leads to frequent severe infections. Patients are
usually diagnosed before they are three months old and if untreated the
syndrome can be fatal. New treatments such as stem cell or bone marrow
transplantation can save many patients. Gene therapy now also shows promise
as a treatment for one type of this syndrome.
After some of his more recent movies, John Travolta has been rumored to be
photographed by paparazzi attempting to re-enter the bubble. Good idea.
now 4A.M. and people are drunk, bloated, and exhausted. Leyner is recovering
from his Academy Award performance and has his tongue inside the tequila bottle, trying
to extract every last drop. He removes his mouth from the bottle and says, “The tongue is
God’s gift to the human race . . . the ultimate organ of poetry and pleasuring.”
Leyner goes on to say, “The lingua, blessed instrument of storytelling that allows me
to continue the tradition of the oral urban legend.”
Jeremy, still stinging from his loss in charades, confronts Leyner and says, “I’m so
sick of all your stories, my tongue tells me that you should kiss my ass.”
Although it’s late for most, nothing motivates Leyner more than verbal provocation.
He responds with glee. “Ah Jeremy, in medieval times, kissing the ass of a fool’s sister
was said to cure acne. Have you noticed how clear my skin is lately? Thank your sister
for me.”
Jeremy leaps at Leyner and the two of them tumble around the floor in a grunting,
adolescent flurry of fists and fury. They roll toward the living room and Leyner, although
in a seemingly suffocating headlock, is still able to continue his grand historical survey of
old wives’ tales. “The Visigoths believed that eating juniper berries would make them
strong for battle.”
Jeremy tries to silence Leyner with a jab to the throat, but in a hoarse voice Leyner
adds, “All it did was cause excessive flatulence.”
Urban legends and folklore can be the cause of tremendous uncertainty. People often
desperately want the record set straight on some of these common myths. So, here you
As a child, no time seemed longer than the time spent waiting to jump back in the
water after a meal. This half hour in hell is not based on science but rather on the
minds of nervous parents. There is absolutely no medical evidence that supports
waiting thirty minutes before getting back in the pool. Digestion begins
immediately when you put food in your mouth, but once the food arrives in your
stomach it takes about four hours to process there completely. Food then passes
into the small intestine, where it spends another two hours, and then on to the
large intestine for another fourteen. These times vary widely depending on what
you eat, so don’t set your watch by it.
This doesn’t mean that it is safe to eat twelve hamburgers and then try to
swim the English Channel. Use your head and listen to signals from your body. If
you feel pain, cramping, or severe fatigue when swimming, get out, and please
don’t puke in the pool.
Things to avoid staring at:
a woman’s cleavage
a large facial mole
a couple making out in public
the sun
The answer to this question is that you probably will not go blind, but staring
at an eclipse can indeed cause harm.
The eclipse of the sun on August 11, 1999, put many people at risk of solar
retinopathy. Solar retinopathy is the fancy name for damage to the back of the
eye caused when radiation from the sun is concentrated by the lens onto the
retina. This radiation causes a burn. Solar retinopathy has been studied in
medical literature, and surprisingly the damage it causes is not as severe as
previously thought. A group of researchers in the United Kingdom studied forty
people who experienced eye problems after the August 11, 1999, solar eclipse. It
was found that only half suffered from eye discomfort. Only 20 percent of the
group of forty reported some damage seven months after the eclipse. These
were people who looked directly at the eclipse. It is unclear if these same
patients were also staring at cleavage, moles, or amorous couples.
Or is it feed a fever and starve a cold? Or should you just curl up on the couch,
whine like a baby, and call your mommy?
Either way, the answer is no, but there may be some science behind this old
wives’ tale.
In a study inClinical and Diagnostic Laboratory Immunology, cell biologists in
the Netherlands found that starving and feeding affect the immune system in
different ways. Scientists looked at healthy volunteers and measured certain
chemical messengers in their blood. After a meal, the average level of the
chemical that stimulates the body’s defense against infections increased by 450
percent. So you should feed a cold and a fever, right?
Not so fast.
Other volunteers, after starving, had high concentrations of another chemical,
one that is also associated with the production of antibodies. So the answer is
confusing, because it seems as though both starving and feeding a cold or fever
can help the immune system.
Like many areas of science, there is no absolutely clear answer here. Our
recommendation is that whether you have a cold or a fever, your body needs
fluid, rest, and nourishment. If you’ve lost your appetite, try to drink plenty of
fluids and eat whatever healthy food appeals to you and, if in doubt, whine like a
baby and call your mommy.
A friend once called to ask if she could have caught a cold from touching a goat
at a petting zoo. This is not a common question, but many people do ask if any of
the following things can cause a cold:
sleeping in front of an open window
getting a chill
sleeping in front of a fan
getting caught in the rain
sleeping with a wet goat in front of a fan in the rain
The answer is no. Cold or wet weather does not cause a cold, but nobody
seems to want to accept this.
The common cold is caused by a virus. These viruses are everywhere and it
is difficult to avoid them. When you are exposed to someone who has a cold, you
are more likely to get ill yourself, so be careful about close contact and definitely
wash your hands. Not getting enough sleep or eating poorly can also reduce your
resistance to infection. Remember that antibiotics won’t fight your everyday cold.
Antibiotics work only against bacteria.
To take care of a cold, rest, eat well, and a little chicken soup couldn’t
hurt. . . .
From penicillin to Post-its, accidental discoveries have led to many of our most
important products. That is how we’ve come to have Pop Rocks.
Pop Rocks were accidentally invented in 1975 by William Mitchell, a scientist
at General Foods. Mitchell was trying to design an instant soft drink when he
mixed sugar flavoring and carbon dioxide in his mouth. His startling discovery
may or may not have led to the demise of Mikey, the boy from the Life cereal
commercials, who as the urban legend goes, liked mixing Coke and Pop Rocks.
Supposedly, this deadly mix caused his stomach to rupture.
In 1983, Pop Rocks were taken off the market but recently have come back
into fashion like Razzles, Sugar Babies, Charleston Chews, and other retro
candy. You should have no problem finding Pop Rocks for your home science
experiments. You will surely find that there is no danger in the delicious
combination of soda and Pop Rocks.
As for Mikey, he is alive and well and living in post–child star obscurity. As for
other child stars, we offer these dramatic gastrointestinally induced death rumors:
1. Gary Coleman (Diff’rent Strokes) from snorting Lik-M-Aid and drinking fizzies.
2. Danny Bonaduce (The Partridge Family) from ingesting the marshmallows
from thirty boxes of Lucky Charms.
3. Erin Moran (Happy Days) from choking on Razzles while intoxicated from
drinking excessive amounts of Clamato.
When you search the Internet these days, you realize that some people have far
too much time on their hands. Conspiracy theorists seem to have it out for many
commercial products. Websites claim that lip balm manufacturers lace their
products with addictive substances, and lip balm companies use the Internet to
refute these claims.
Lip balms may be habit forming, but they certainly aren’t addictive. Carmex,
which has been accused of containing acid and ground-up fiberglass, contains
salicylic acid, which is closely related to aspirin. The salicylic acid works as a
pain reliever and as a drying agent but is not addictive. Chap Stick contains white
petrolatum (petroleum jelly), lanolin (a wool grease), and padimate O
(sunscreen). Nothing addictive there either.
First we must state that we are right-handed. Second, Billy’s wife is left-handed.
Mark’s wife is ambidexterous and must use both hands to keep him in line.
Medical literature is filled with studies on the effect of right- or left-handedness
on oral hygiene, depression, immune function, schizophrenia, enuresis (bedwetting), longevity, language, asthma, allergies, and injury.
The list continues but none of the evidence is very clear.
In general, the right side of our brain receives input from and controls the left
side of our body, and vice versa. Therefore, right-handed people are usually said
to be left-brain dominant and left-handers, right-brain dominant. Each brain
hemisphere is known to have specialized abilities. The right brain is responsible
for visual and spatial skills while the left controls language and speech. Again this
does not always hold true. Neuropsychologists have tried to test for intelligence
differences between lefties and righties but have found no significant results.
Males are about one and a half to two times more likely to be left-handed than
evidence about why this occurs but Mark postulates an evolutionary explanation.
Males have developed their left hands to accommodate ambidextrous
Unless you are sleeping beneath an industrial fan that causes your head to
wiggle like a bobblehead doll, there should be no problem. This old wives’ tale
has no scientific basis.
This morning I microwaved the milk for my coffee, and a few hours later I heated
up some lasagna for lunch. If what you read on the Internet is true, I should have
about twelve more hours to live.
But no studies have proven modern microwave usage to be harmful. Much of
the fear about the cancer-causing agents of microwaves has to do with radiation.
Basically anything that moves is radiation, including visible light, ultraviolet rays,
X rays, and microwaves. Ionizing radiation, such as X rays, have enough
localized energy to do chemical damage to the molecules they hit. Nonionizing
radiation, such as microwaves, do not damage molecules.
One possible danger with microwaves is that heated products can explode
even after they are removed from the microwave. Exploding eggs are specifically
dangerous. Many injuries have been reported and some doctors in the United
Kingdom have even pressed for warning labels.
Wireless phones (including cell phones) use radiofrequency energy, also known
as radio waves. It is not believed that wireless phones are harmful, but the
research in this arena has only been conducted recently, so the real negative
effects of cell phone usage remain unknown for now.
This question makes me think of the scene fromHigh Anxiety when Mel Brooks,
playing Dr. Richard Thorndyke, passes through airport security with a gun. As the
metal detector beeps, he bursts out, “Is this a game show? What did I win, a
Pinto? I beeped! Take me away! Take me back to Russia! I beeped! The mad
beeper is loose!”
If you have a titanium plate in your head, a pacemaker, plates and screws for
a broken bone, or an artificial implant, this too could happen to you. The size of
the implant and the sensitivity of the device will determine whether you are
turned into the mad beeper. Don’t worry, the metal detector won’t hurt you.
The old wives’ tale warns us that if you hold in a sneeze, your head might
explode. That won’t happen, but you can do yourself some harm.
A sneeze is a very complicated thing that involves many areas of the brain. A
sneeze is a reflex triggered by sensory stimulation of the membranes in the nose,
resulting in a coordinated and forceful expulsion of air through the mouth and
nose.The Guinness Book of World Records reports the longest sneezing bout
ever recorded was that of a schoolgirl from the United Kingdom. She started
sneezing on January 13, 1981, and didn’t stop sneezing for 978 days.
The air expelled by sneezes is said to travel up to one hundred miles per
hour, and an unimpeded sneeze sends two to five thousand bacteria-filled
droplets into the air. Holding in a sneeze potentially can cause fractures in the
nasal cartilage, nosebleeds, burst eardrums, hearing loss, vertigo, detached
retinas, or temporary swelling called facial emphysema. Therefore it is best to let
your sneeze fly, but please cover your nose and mouth.
Several years ago at the Columbus Circle entrance to Central Park, I came upon
someone having a seizure in the street. As I attempted to help the patient,
someone from the crowd reached into the nearby garbage can and insisted that I
stick the dirty spoon he had found into the person’s mouth to keep him from
swallowing his tongue. The guy with the spoon didn’t seem to be impressed with
my medical degree and “politely” told me that I didn’t know what the (insert vulgar
NY expression here:___) I was talking about.
This is not an uncommon belief, but it is not possible to swallow your tongue.
The tonguecan block the opening of the airway and one of the first things that
you are taught in basic life support is that if someone is having difficulty
breathing, you should tilt his or her head and lift the chin. This helps to remove
the tongue as an obstruction. If you do come upon someone who is having a
seizure, just make sure that he is safe and won’t hurt himself. Do not put a
bacteria-covered spoon in the mouth. Call for help and before you know it, the
seizure will probably stop on its own.
I can’t
believe it’s not over yet. I feel as though this evening has taken years
off my life. Leyner and Jeremy have been separated, and there are only a few stragglers
left picking at the remnants of Eloise’s glorious buffet.
Even Leyner seems beaten down from a combination of toxic tequila, amorous
adventures, and verbal violence. He is leaning on the credenza and says to me as he
agonizingly stretches his neck, “I used to be able to drink, womanize, and brawl and
come out of it all as fresh as a daisy. Now I feel limp and shriveled like a rotting clump of
Leyner stands and arches his back uncomfortably. “Did I mention my prostate feels a
little swollen?”
With that, I turn and exit the party.
There are many advantages to getting older—early bird specials, senior citizen
discounts, the fact that people don’t ask you to help move a sofa up a flight of stairs, and
getting away with saying whatever the hell pops into your head. But there are some
perplexing changes ahead for all of us. . . .
Leyner:Hey you . . . give me five minutes (at
most) . . . go get something . . . then we’ll work.
Leyner:You there?
Gberg:Yes, sir.
Leyner:What should we do?
Gberg:Light this piece of shit on fire and go drink
ourselves silly.
Leyner:Brilliant idea.
Gberg:Or we can talk about the health alert that I just
received about mycobacterium bovis in U.S.-born children.
Leyner:What the hell is that?
Gberg:You are so filled with all of this medical knowledge,
I was hoping you could fill me in.
Gberg:I am waiting.
Leyner:What is it? Some mushroom thing, some fungal thing?
Leyner:Some fungal cow thing.
Gberg:You are getting warm with the cow.
Gberg:Sounds perverse.
Gberg:Give up?
Leyner:I give up.
Gberg:Similar to TB (mycobacterium tuberculosis).
Leyner:Duh . . . should have known that.
Gberg:Infection that you can get from the milk of infected
Gberg:Unpasteurized cheese and stuff.
Leyner:People should just drink cow’s blood . . . like the
Masai . . . that would solve the problem of mycobacterium
and lactose intolerance.
Gberg:You should run the Department of Health.
Leyner:Thank you.
Gberg:And Homeland Security.
Leyner:Homeland Senility.
Gberg:We have to finish this book first.
You finally have time and money to relax, travel, and have a good meal. The bad
news is you probably can barely taste this meal.
Starting at age forty-five, tastebuds begin to lose much of their sensitivity.
Older people often lose their ability to sense bitter or salty flavors altogether. You
start your life with about nine thousand tastebuds and in old age you have less
than half of that.
You want some more bad news? Aging also causes decreased hearing, sight,
smell, and touch.
All the hairs on our head contain pigment cells that contain melanin. Pigment
cells in our hair follicles gradually die as we age. The decrease in melanin
causes the hair to become a more transparent color like gray, silver, or white.
Premature gray hair is hereditary, but it has also been associated with
smoking and vitamin deficiencies. Early onset of gray hair (from birth to puberty)
can be associated with medical syndromes including dyslexia.
A more interesting question is why old ladies insist on trying to cover up their
gray hair with bright blue hair dye.
Some of us don’t have a lot of inches to lose. In height, that is.
Unfortunately, we all will get a little shorter as we age. This takes place over
many years, and ultimately we all lose an inch or so. Gravity is responsible for
some of this height loss. You lose muscle and fat as you age and gravity weighs
down especially on the bones in your spine and may cause compression. This
explains why all those senior drivers in Florida can barely see over the
The easy answer would be to work in a carnival, but it is actually not that simple.
At menopause, the ratio of male hormones, or androgens, to estrogen begins
to change. This can produce mild increases in facial hair. The amount or
thickness of facial hair is hereditary and how thickly hair follicles are distributed
throughout the skin is determined at birth. Some ethnic groups or nationalities
are more likely to develop facial hair than others.
Some medical conditions can cause excessive hair growth, so it is always
wise to check with your doctor especially if you are a woman experiencing five
o’clock shadow.
Prince Charles may worry about this very question.
There are definitely some changes in the face that occur with aging. First
some facial muscle tone is lost, causing that saggy look. Then you get the
dreaded double chin. The nose can also lengthen a bit, and the skin on the face
becomes thin, dry, and wrinkled. Then there are longer, thicker eyebrows and
gray hair. We haven’t even mentioned droopy eyes, receding gums, missing
teeth, and last but not least—bigger ears. Yes, your ears do continue to grow as
you age, but only slightly. This is probably due to cartilage growth.
What a list of wonderful things to look forward to as we enter our golden
Actually, you do not need less sleep as you get older.
The body’s sleep requirements remain constant throughout our lives. The
average total sleep time, however, actually increases slightly after age sixty-five.
This sounds like something to be excited about, but not really. The problem is
that as you age, you have more difficulty falling asleep. Sleep for the elderly is
also interrupted by such factors as leg cramps, sleep apnea, and medical or
psychiatric illness.
Normal sleep consists of two major states: REM (rapid eye movement) sleep
and NREM (non-REM) sleep. NREM sleep is divided further into four sleep
stages. A healthy night’s rest is generally comprised of 20 percent REM and 80
percent NREM. As you age, this distribution is changed.
You lose the hair where you want it, and gain it in all those other unsightly
places. Bushy eyebrows, excessive nasal hair, and hairy ears certainly don’t
make you anxious to get older, do they?
Sometimes the excessive growth of hair on the ears is genetic and is linked to
the Y chromosome, the sex chromosome found only in males, which explains
why you don’t see many hairy-eared females, except inThe Lord of the Rings
And what would this excess hair growth be without a competition?
TheGuinness Book of World Records record for the longest ear hair was broken
again in 2002. A seventy-year-old from Tamil Nadu state in India, Anthony Victor,
broke the record with his ear hair measuring 11.5 centimeters.
Human nails and hair do not grow after death. The fact of the matter is that after
you die, your body starts to dry out, creating the illusion that your hair and nails
are still growing as the rest of you shrivels up.
Age spots are also known as sunspots or lentigines. They are flat, brown
discolorations of the skin that usually occur on the back of the hands, neck, and
face of people older than forty years of age.
Age spots are caused by an increased number of pigment-producing cells in
the skin. As our skin becomes thinner with age, it also becomes more
translucent, which makes these spots more obvious. Age spots are caused by
the skin being exposed to the sun over many years and are a sign of sun
damage. They are not harmful and do not represent skin cancer.
How we age as individuals is a complex interaction of genetic and environmental
factors. There have been many studies that try to assess how much of our
longevity is determined by our genes. Scientists have known for several years
that people who live the longest often have children who also have long life
spans. The life spans of adoptees seem to be more closely correlated to those of
their birth parents than to those of their adoptive parents. One study of twins
reared apart suggests about a 30 percent role for heredity in life span, but others
say the influence is even smaller. Recent research seems to indicate that the
process of aging and life span may be determined by your mother’s X
chromosome. Incessant maternal nagging, however, could reverse any beneficial
Leyner:I spoke to my grandmother last night . . . but she
thought I was her son, my uncle.
Leyner:So I had the conversation with her as my uncle.
Gberg:Deceptive but useful.
Leyner:It was simpler than disabusing her of the mistaken
Gberg:How old is she now?
Leyner:I’m going to be 49 on Tuesday.
Gberg:I can’t imagine you as a 96-year-old.
Leyner:Feels like I’m teetering on the precipice of
something major.
Gberg:What, the publication of this masterpiece?
Gberg:Do you have plans for Tuesday?
Leyner:Yes! We should start writing Nobel acceptance
speeches now. I just booked a ticket for Stockholm on
Travelocity. This book will do for us what “The Little Red
Book” did for Mao.
Leyner:Speaking of not going gently into that good
night . . . Mao is my model for groovy aging.
Gberg:That’s the first time I’ve heard Mao and groovy in
the same sentence.
Leyner:Smoked five packs a day . . . never brushed his
teeth (just rinsed with green tea) . . . AND cavorted every
night with three or four young Red Guard hoochie girls.
Gberg:I never knew he was such a player. He probably would
have loved to party with Kim Jong-il.
Leyner:Mao got more action in a week than Kim Jong-il will
have in a lifetime.
Gberg:Those were the days, my friend.
Leyner:Our next book should be “The Sex Lives of Asian
Gberg:We need a catchy title, like . . .
Gberg:. . . “Despots and Sexpots.”
Leyner:That’s pretty good—maybe we should just call this
book “Despots and Sexpots.”
Dr. Linus Pauling, a two-time Nobel Prize winner, took high doses of vitamin C
for almost forty years and died at the ripe old age of ninety-three. He believed
that his life was prolonged for twenty years because of his high vitamin C intake.
Sounds great, and Pauling certainly makes a valid argument but unfortunately
there isn’t any strong evidence to support this claim.
Vitamin C and vitamin E, often referred to as antioxidant vitamins, have been
suggested to prevent cell damage in humans, thereby lowering the risk of certain
chronic diseases including high blood pressure, stroke, and asthma. Many
studies have tried to prove this, but with no obvious results.
Very few side effects exist with vitamin C, so there is no major downside to
adding a vitamin C supplement to your daily regimen, though occasional reports
of nausea, heartburn, gas, or diarrhea are noted with higher doses. A more
prudent approach is to eat a balanced diet including fruits and vegetables and
avoid dangerous activities like smoking.
The concept of male menopause and the need for hormone replacement therapy
as a treatment is a highly controversial topic. The many names that are used to
describe these changes in an aging male include andropause, viropause, male
climacteric, ADAM (Androgen Decline in the Aging Male) syndrome, Aging Male
Syndrome (AMS), or late-onset hypogonadism. Some wives prefer to call it a
midlife crisis. Even though we don’t like to admit it, they may be right.
Male menopause is thought to be due to a decrease in testosterone. In
contrast to the female menopause, the process in men is characterized by slow
onset and slow progression. There is a progressive reduction in testicular
function in men between the ages of twenty-five and seventy-five. During this
time, the amount of available testosterone can fall by almost 50 percent. This is
not a fixed number and there is a great deal of variation among individual men.
The symptoms of this syndrome are lethargy, or fatigue, depression,
increased irritability, mood swings, decrease in lean muscle, increase in fat,
decreased libido, and difficulty in attaining and sustaining erections. Many men
now receive treatment with testosterone, and report improved symptoms. There
is a downside to this treatment as it can increase the risk of prostate cancer and
Many experts believe that this syndrome is more likely to be the result of
nonhormonal explanations or the normal aging process. Lifestyle factors such as
alcohol and drug use, medications, marital problems, financial problems, and
stress in general all may have a role. Doesn’t sound much different than a midlife
Leyner:I’m going to give my daughter some Benadryl and I’ll
be right there.
Leyner:Be right back.
Gberg:So, you medicate your daughter in order to get work
Leyner:How dare you suggest such a thing—pharmaco-parenting!
Gberg:A little Benadryl beats a little Ritalin.
Gberg:What, are you too offended to respond?
Leyner:I’m stretching to gear up for this session. . . .
Gberg:I am having a cup of coffee and trying to jump-start
my lethargic body.
Gberg:I can’t believe I have to work 4–12.
Leyner:How are you feeling? Any better?
Gberg:Tired, didn’t sleep all that much.
Gberg:Just getting old, I guess.
Gberg:Male menopause.
Leyner:Shouldn’t old people sleep better, sort of like dry
runs for death?
Leyner:I think I’m getting younger from the neck down and
rapidly achieving senescence from the neck up.
Gberg:Please just stay above the waist—it’s too early to
hear anything more.
Leyner:How come lawyers never use male menopause as a
mitigating defense?
Gberg:What, a hot flash causing road rage?
Leyner:A hot flash causing an otherwise rational person to
decide that murder makes more practical sense than
divorce . . .
Leyner:Aren’t we entering into a world in which old-age
homes will be populated with withered hags with enormous
perfect boobs and hunched drooling men struggling to haul
their pec implants around the joint?
Gberg:Both covered in faded tattoos that now resemble
ancient cave paintings.
Gberg:But at least the blue hair will seem somewhat funky
rather than freaky . . .
Gberg:Or maybe not.
Our population is aging. Persons sixty-five and older now represent about 12
percent of the total U.S. population. In 2050 there should be about 86.7 million
seniors in the United States, comprising 21 percent of the total population. I hope
that they aren’t driving in front of me. Wait a minute . . . that is going to beme !
It is true that older drivers are more likely to get in multiple vehicle accidents,
more likely to get traffic citations, and more likely to get seriously injured in a
crash than younger drivers. One theory is that they tend to overestimate their
abilities and are less able to compensate for their mistakes.
There are also some medical reasons that older drivers are less adept behind
the wheel. First, seniors need to contend with common vision problems. Loss of
visual acuity (especially night vision) is a problem and even when corrected there
is usually still a loss of peripheral vision, contrast vision, and depth perception.
Hearing loss makes drivers less likely to hear important cues such as sirens,
horns, or screeching tires, too. Restricted mobility, weakness, and decreased
reaction time also contribute to driving problems.
The only way to prevent wrinkles is to avoid aging or to freeze yourself like Austin
Powers. Otherwise, you will have to stick with sunscreen and moisturizers. To
reduce or improve wrinkles there are several options.
Tretinoin (Retin-A) is the only topical medication that has been clearly proven
to improve wrinkles in controlled clinical studies. It is also the only FDA-approved
medical treatment for this purpose. Tretinoin increases sensitivity to sunlight,
therefore sun avoidance, protective clothing, and sunscreen are recommended
when used. Side effects include peeling, dry skin, burning, itching, and redness.
Hydroxy acids are also present in many over-the-counter creams and there is
some evidence that they may help with minor wrinkles. There is great variability
in the amount and type of hydroxy acid in different products and therefore
variable efficacy.
Other more drastic treatments include chemical peels and laser resurfacing.
The short answer, though, is not really.
If aluminum caused Alzheimer’s, wouldn’t the Tin Man have needed a brain
rather than a heart?
Aluminum intake is unavoidable. It comes primarily from food, drinking water,
and pharmaceuticals, like antacids. It occurs both naturally and as an additive. It
also can leach into food from the pans we use. Aluminum has been linked with
Alzheimer’s disease since the 1960s. For almost every study in favor of a
connection, there has been a study against it. Like many scientific theories, there
remain many unanswered questions. The majority of scientists now believe that if
aluminum plays any role in Alzheimer’s at all, it is very small.
What does this mean for us? It means we can relax. Aluminum is the third
most common element in our world after oxygen and silicon, so it would be
extremely difficult to entirely avoid aluminum. If you do choose to try and avoid
aluminum, you can drink filtered water, avoid aluminum-containing
antiperspirants, and be careful when cooking acidic or basic foods in aluminumcontaining cookware.
If you are going to be an anti-aluminum crusader, we hope that you will be
consistent. There is nothing more annoying than people preaching to you about
eating organic while they are smoking cigarettes.
Gberg:Are you there?
Gberg:Shall we call it quits?
Leyner:When I get sufficiently old and incontinent, I want
to be taken to the doctor in one of those pet-carrying
cases . . . like a cat . . . and left there.
Leyner:Then I want to be boiled down and canned.
Leyner:My version of a pharonic memorial . . . instead of
mummification . . . canning . . .
Gberg:And then your entire family can keep a can of you on
a back shelf next to the Spam.
Leyner:Exactly . . . a fitting tribute.
Leyner:That seems to wrap all this up: aging, family,
cannibalism, and the pursuit of health . . .
Gberg:We have come full circle.

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