A stay in medical Antarctica

Yesterday’s medical adventure, set off by my shortness of breath during exertion, especially in hot weather (which we’ve been having a lot of; my symptoms became worrisome on a weekend in May when the temperature in Palo Alto reached 107 F). I was referred to a cardiologist; alarmed, she set up yesterday’s myocardial perfusion imaging (MPI) test, specifically via single photon emission computed tomography (SPECT). Details to follow.

The test involved hours at Palo Alto Medical Foundation, much of it sitting around between its parts. The actual imaging parts of the test took place in astonishingly icy rooms — which I came to refer to as medical Antarctica — so that I was shivering with cold when I left after 5 hours.

In the sitting-around parts of the event, I read through most of the latest (August 7th and 14th) issue of the New Yorker. To leaven the stark medical details, I’ll report on one of the pieces (Lauren Collins’s “Identity crisis: Notes from a names obsessive”), one of the cartoons (by Joe Dator), and a set of “spots”, small illustrations by Nishant Choksi sprinkled throughout the issue.

Medical background. When the shortness of breath became an issue, my family doctor referred me to a cardiologist, who ordered the MPI; altered my medication significantly (doubling the heart medications, replacing one diuretic by a much stronger one, and adding baby aspirin); told me to go on a very low-salt diet; recommended that I continue my senior fitness classes at the Y but at a reduced level of exertion (in particular, doing all the exercises in a chair, rather than moving around on my feet); and told me not to schedule cataract surgery until after my cardiac situation was clarified (at my age, you accumulate medical conditions, and the treatments often compete with one another).

The fitness classes have been very satisfying. My arms and legs are stronger, my disabled right arm moves more easily, and my balance improved so much that six weeks ago I was able to give up using a cane (on the street) and a walker (in exercise class). The instructors and the other participants are supportive and encouraging; we buoy each other up.

But on hot days my face flushed in exertion and I panted for breath. Not good. (The sort-of-good news is that I haven’t had any chest pain.) In any case, both the insertion of stents in one or more of my coronary arteries — there are three of them — and bypass surgery were mentioned. Frankly, terrifying.

Break: Lauren Collins on selecting a baby name. The New Yorker piece is entitled “Identity crisis: Notes from a names obsessive” in print, “Notes from a baby-name obsessive: My son was almost due. What would I call him?” on-line.

Collins, an American, and her French husband Olivier are wrestling with a name for their impending son (they already have two daughters). They’re trying to find a name that will work with both sides of the family and won’t subject their son to ridicule. Not an easy task.

On the American side, there are many naming patterns that strike Europeans (including the Britons as well as the French) as peculiar or absurd. On the French side, naming patterns have gone through several convulsions, including (until fairly recently) a period in which only the names of Roman Catholic saints could be registered legally. Collins writes:

Today, a registrar is required to accept any name, except one he deems not in a child’s best interest, in which case he will refer the matter to a judge. In recent years, French courts have rejected such names as Nutella, Prince-William, and, for a pair of twins, Joyeux (Happy) and Patriste (a phonetic take on Not Sad [pas triste]). “The names of ‘Joyeux’ and ‘Patriste’ are of a nature, because of their fanciful, even ridiculous, character, to create difficulties and embarrassment for the child,” the opinion read. “It is therefore necessary to confirm the judgment taken with regard to the suppression of these two names, which must be replaced by the first names of ‘Roger’ and ‘Raymond.’ ”

We wanted something squarely French, but not, as John F. Kennedy once warned Jackie in advance of a state dinner, “too Frenchy.”

As the due date loomed,

Olivier, who tends to take a rational approach to problem-solving, came home … with a spreadsheet. He had input the top two hundred and fifty Parisian boys’ names for 2016, the number of births corresponding to each, and his comments on the entries. Sacha: “Too Russian?” Neil: “Ask Lauren.” Leonardo: “Too DiCaprio.” Ferdinand: “1st World War.” Aurèle: “J’aime bien.” Charlie: “Charlie Hebdo.” Sure enough, next to Kevin he’d written, “Silly.” [In France, it seems to be seen as a name for an idiot.]

We went through the list together, filling in the missing cells.

“Timothée,” I read out.

“Timothée douche,” Olivier said.

“What’s Timothée douche?”

“A bath gel.”

No. 90 was Lenny, one of a number of English names that have recently gained traction with French parents.

“You put ‘Why not?’ next to Lenny?” I said. “Have you ever heard of a book called ‘Of Mice and Men’?”

Eventually, they settle on Louis.

Funny and charming, with light digressions into the history of naming practices, nominal determinism, and the like.

Medical moment: the MPI test. (MPI is always going to call up the Max-Planck Institutes for me, especially the Max-Planck Institut für Psycholinguistik in Nijmegen, the Netherlands. But for present purposes, it’s all about myocardial perfusion imaging.) From the American Heart Association on MPI, “What is a myocardial perfusion imaging test?”:

Myocardial perfusion imaging (MPI) is a non-invasive imaging test that shows how well blood flows through (perfuses) your heart muscle. It can show areas of the heart muscle that aren’t getting enough blood flow. This test is often called a nuclear stress test. It can also show how well the heart muscle is pumping.

There are 2 techniques for MPI: single photon emission computed tomography (SPECT) and positron emission tomography (PET).

MPI is useful in patients with chest discomfort to see if the discomfort comes from lack of blood flow to the heart muscle caused by narrowed or blocked heart arteries (angina). Myocardial perfusion imaging doesn’t show the heart arteries themselves, but can tell your doctor with good certainty if any heart arteries are blocked and how many. MPI can also show if you’ve previously had a heart attack.

My SPECT in outline: injection of a radiopharmaceutical, rest, and then 15 minutes of imaging; 2 hrs. rest, then stressing (often on a treadmill but in my case, via a drug that increases blood flow to the heart and makes it beat faster), another shot of the radiopharmaceutical; rest, and another 15 minutes of imaging.

For drug-induced stressing, the radiologist administers the drug and then sticks around talking to you and encouraging you to report the sensations you’re undergoing — usually, a big physical rush associated with suddenly expanded coronary arteries. I was one of a minority — about 10%, apparently — of patients who experience nothing at all. So the radiologist, the nurse, Kim Darnell, and I engaged in banter about language, our academic degrees, and undergraduate education at Stanford (a bit of this was Kim and the radiologist chatting in Japanese).

Break: Joe Dator. In the midst of all this, I laughed out loud at this Joe Dator cartoon (the artist now has his own Page on this blog):

(#1) “You weren’t supposed to see this.”

Not especially language-related, but a great pleasure during a difficult day.

Medical moment: what now? So now I wait for messages about the MPI test. Meanwhile, lipid test results have come back with continued splendid good cholesterol/bad cholesterol ratios; my blood sugar levels continue to be good (I have type 2 diabetes, under control); and an earlier echo cardiogram showed that my heart valves are in good shape, so I try to be hopeful.

Final New Yorker flourish. Though I’ve been staying away from material on Squire Grabpussy, the latest New Yorker (in print and on-line) has a series of hilarious small illustrations by Nishant Choksi poking pointedly at the Squire, and I just can’t resist. Choksi describes himself, laconically, on his website:

Nishant Choksi is an illustrator based in the UK. He regularly contributes to many publications including The New Yorker, The Atlantic and The Wall Street Journal as well as working with advertising agencies and publishers.

[Correction 8/18/17: the original version of this posting had an image here of a Der Spiegel cover that I misattributed to Choksi. It was instead the work of illustrator Edel Rodriguez, and will be included in a posting on Rodriguez.]

Five of the New Yorker illustrations, with commentary (and my titles):

(#3) All hat and no cattle/cowboy

My favorite of the set. From Wiktionary:

all hat and no cattle: (US, idiomatic) Full of big talk but lacking action, power, or substance; pretentious.

A few cites from Wiktionary:

1980, Patricia Calvert, The Snowbird: A fortune can be made on the prairie, and that’s what me and Mr. B aim to do. Don’t aim to be all hat and no cattle forever, let me tell you!

1998, Buffy the Vampire Slayer, “I Only Have Eyes for You”:

Drusilla: It’s time, Angel. She’s ready for you now, she’s dancing, dancing with death.

Spike: Big deal, he won’t do anything. Our man Angel here likes to talk, but he’s not much for action. All hat and no cattle.

1999, Randy Newman, “Big Hat, No Cattle”, from the album Bad Love, refrain:

“Big Hat, no cattle / Big head, no brain / Big snake, no rattle”.


an epithet said to have been applied by then-governor Ann Richards to [George W.] Bush in an effort to classify him as a pretend cowboy who dresses and talks the part, but is pretending to be what he isn’t (link)

I’m partial to the (also well-attested) variant all hat and no cowboy. On a shirt:


(#5) Loose cannon

noun loose cannon: an unpredictable or uncontrolled person who is likely to cause unintentional damage. (NOAD2)

(#6) Kremlin President / The Russian Connection

noun onion dome: a dome that bulges in the middle and rises to a point, used especially in Russian church architecture. (NOAD2)

(#7) The Kremlin Palace in Moscow, with onion domes

(#8) Gasbag

noun gasbag: 1 informal a person who talks too much, typically about unimportant things. 2 the container holding the gas in a balloon or airship. (NOAD2)

(#9) Grabpussy in Lilliput

(#10) On the island of Lilliput: a color print from an 1860s edition of Jonathan Swift’s Gulliver’s Travels

4 Responses to “A stay in medical Antarctica”

  1. Kim Darnell Says:

    I first saw the Kremlin President one as a take off of Ursula, the evil sea witch from The Little Mermaid (http://disney.wikia.com/wiki/Ursula). Of course, I now see that your interpretation is the intended one, but Trump is rather tentacley, manipulative, and dream-crushing, so I think it still kinda works.

  2. Moxie Supper Says:

    Reblogged this on moxie supper and commented:
    Sums it up well. Now for some Russian beluga and caviar,

  3. Robert Coren Says:

    Just so you know, I too laughed aloud on seeing the Dator cartoon (here; I’m a couple of issues behind on my New Yorker reading, as usual).

  4. Bigmacbear Says:

    In my current position I had occasion to work with Alcatel Lucent fairly often (past tense because the company has since been absorbed by Nokia). Im not sure whether it’s good or bad that I never got the chance to use the horrible pun that came to mind: “Alcatel and no hat”.

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