Three Things

[dr_pretentious]

First, a writing research question:

Let us begin by imagining a character who is, to her surprise, growing gills. The skin over the new structures will, left to itself, rip over the all ten of the gill slits. It's already ripped over two. Ripping is messy, unpleasant, likely to result in infection, etc. Suppose this character decides not to go to the ER, but rather to show up on the doorstep of her trusted friend, a professional body modification artist, and say to him, in effect, "Do something!" I have imagined that the body modification artist, after protesting to no avail that the ER really is the better option, eventually agrees to open up the gill slits that haven't already torn open on their own.

Does he use a self-cauterizing scalpel? My internet searches, so far, are inconclusive. Body modification artists who do scarification work do sometimes use scalpels, and artists who do scarification generally also do branding, but I haven't yet found any reference to self-cauterizing scalpels on relevant sites. My current guess is, since opening the gills means, in effect, opening the airway, a self-cauterizing scalpel would be desirable, to prevent her from aspirating blood. But what do I know about surgery, or body modification, really? Also, I haven't yet figured out whether a self-cauterizing scalpel is something this character would plausibly have in his studio. (writersweekend, I think you're the only person on my flist who's been in the body modification business. Do you know offhand? jeneralist, would it be difficult for someone without a medical degree or affiliation with a medical establishment to get this piece of equipment? And what would a doctor do with such a patient, if she ended up in the ER instead? Anyone? Anyone?) I may yet phone up the local tattoo parlor, but I'd rather sound like an idiot here than there.

Second, a bit of social calendar stuff:

I had slated the annual Bad Poetry Party for 21 January, but then, just about when I should have been posting invitations, I had a miscarriage. Nothing like one for forcibly reprioritizing your To Do list for a week. Now that life goes on again, more or less, I'm looking at the catalog of things I didn't get to during those very unpleasant days, trying to catch up. (And thank you, to all the folks who said kind things when I keenly needed kind things to be said.)

So, if you're someone to whom I casually mentioned saving the date, back when I thought I knew what January would entail, please note that a new date will be chosen Very Soon. Some of the folks I asked to save the date were thinking of traveling Great Distances to come for the occasion, so I feel kind of bad about having to reschedule. Sorry. Sometimes things just happen.

All-Around Smart You are all-around smart. Essentially, that means that you are a good combination of your own knowledge and experience, along with having learned through instruction - and you are equally as good with theoretical things as you are with real-world, applied things. You have a well-rounded brain. 0% applied intelligence 0% learned intelligence

Take this quiz at QuizGalaxy.com

I don't take a whole lot of these quizzes, but I take enough to find it odd that I land right smack in the middle. It's not often I'm right in the middle of anything.

It also seems odd because I think of myself as a sort of credentialed ignoramus. So I've read pretty much everything H.D. ever wrote, including several unpublished (and possibly unpublishable) novel manuscripts locked away in Yale's archive--so what? Grad school is especially brutal to generalists, so I decided not to be one until I got out. Which meant that, eventually, I did get out--but, see, now I don't actually know anything. How did a skewed brain like mine end up in the middle of this person's schema? Dubious quiz design.

Comments

[vgnwtch.livejournal.com]

Why the hell are you apologising, woman? Stop it immediately.

[jeneralist.livejournal.com]

Probably the tattoo shop wouldn't have a self-cauterizing scalpel handy, but they might have a scalpel (or other blade) and an electrocautery/electrosurgery machine, sometimes called a "Bovie" (presumably for the same reason that vacuum cleaners are called "Hoovers"). Bovies can cut or cauterized, depending on how they're adjusted. I've never seen one used for a skin incision, but that might be because they tend to scar or otherwise not heal well. They do cut through fascia pretty well.

A few seconds of research reveals that Bovies are available on Ebay to the sufficiently interested.

Why would a character have one lying around? You're asking this of a woman with a Vandegraff generator in the garage -- someone who uses liquid nitrogen for desserts -- and who ignited a perfectly harmless fruitcake at your very home?

OK, why would a plausible character have one handy? They're great gadgets for controlling bleeding, if you don't mind the scar and the barbecue smell. Find a "little bleeder" on someone undergoing a scarification cut? Just zap it. Maybe someone had frequent nosebleeds (although you would need a special tip to be able to reach).

But when you mention that it's about to open over "all ten of the gill slits" -- which gill slits did you have in mind? Are the ones your character is developing lined up with the ones that appear in embryonic development. For her sake, I hope they don't all wind up in her face and throat....

And as for what a doctor would do if that showed up in my ER: it starts with a whole lotta tests. Skin spontaneously ripping, and I can see something like mucous membrane on what should be skin and muscle tissue? Imaging studies to see what's going on (I'd go for the MRI rather than CT, since I'm trying to understand soft tissue, not bone); blood tests with an emphasis on rheumatology and immunology; a very detailed medical history ("so, you and your buddies have been doing skin grafts for fun, huh?"); and probably some antibiotics "just in case," because otherwise the doc (ER docs tend to be pro-intervention) wouldn't feel that he was doing anything.

[puckmls.livejournal.com]

{{{ Hugs }}} to you -- sending wishes for utter wellness and a complete recovery your way. (Mama Cat, on my lap, sends purrs.)

[padmaclynne.livejournal.com]

shouldn't gills not aspirate at all? any blood would just clot, and obstruct "breathing" if the character enters water without washing her gills out (with water. maybe saline.) and rinsing the gills should be possible with a mouthwash (of saline!) kind of swallowed out the sides, the way breathing action is with gills, splashing salt water and blood on her shoulders, so doing it in the shower is a good idea.

[newroticgirl.livejournal.com]

my brother is a bodypiercer, and i'm pretty sure he doesn't have a self-cauterizing thingy... but then again, he's also given emergency stitches to a friend who nearly severed his ear but didn't want to go to the ER.

if you want to discuss with him (he's always glad to talk to folks!) I can give you the shop phone #.

[kistha.livejournal.com]

For all the medical tech questions I go with jeneralist I had scarification done by scalpel, and it bled a lot. Of course mine was close to the scalp so that's no surprise.

Much love to you, with hugs, comfort and warm fuzzies. And if you want I can send a couple of related prayers your way.

Loves

[writersweekend.livejournal.com]

The only scarification I've done is with needles or scalpels. We have used branding to cause what I remember we called keloid or something like that (scar tissue) to be bigger and more pronounced.

You are the writer, you have the imagination. You can totally make up a machine/technology that a scarification/body modifier person would have on hand as part of their bag of tricks. One guy I know (okay, he was a neurologist) had all kinds of crazy electronics he used to drag to parties and zap people with. Lots of 'players' use violet wands (they use them in hair salons to straighten kinky hair) to zap people (when it hits the mucuous membrane, it feels just like it would if you'd taped the open end of a wire from an electric train transformer to your hand and then licked your lips). I've seen people take joy sticks from video games and adapt them to other uses...so, you could make up a machine that cauterizes and cuts at the same time. For people who want delicate scarification, not huge ridges of scar tissue. Maybe it tattoos simultaneously, for a tribal look?

[shakti-lemaris.livejournal.com]

I dated a guy who wanted to be a body mod specialist. We spent a lot of time around folks who were. What they have in common is that outside of their licensed professions many have a tendency to, um...experiment. That's why you have folks with spikes sticking out of their foreheads and guys with little stainless steel ball bearings under the skins of their penii. No one gets a license to do *that.*

It would not be out of the question for your body mod guy to have some contraband medical equiptment and the ability to do some wild stuff to the human body that he might not neccesarily do in the shop.

[shakti-lemaris.livejournal.com]

Are you saying that you are not a plausible character?
:-D

[twoeleven.livejournal.com]

And what would a doctor do with such a patient, if she ended up in the ER instead?

i conducted a brief study using a modified bogsatt (n=2, blind), and happy doctor friend and i think:

it depends. :) for starters, an er is for assessing, stabilizing, and (sometimes) treating patients with acute conditions. she ain't got one. as hdf says, "yeah, what's her complaint?". if the gills are causing her trouble breathing air, they can deal with that. if the gills are causing her whacky blood chemistry (from the new gas exchange locus), they can deal with that. if she's just worried, they can't do anything with that. so, how do we get to that conclusion?

one possibility is that she presents as a alert, oriented patient who calmly gives a history along the lines of "i've started to develop gills, and the slits are tearing when they open. they bleed, and do other icky things, and i'm worried that they'll get infected w/o care." the doctor will probly verify this history, examine the gills, and frantically run every test they can think of, as jeneralist suggests. but development of (vestigial) gills isn't a medical problem per se. the doctor may refer her to outpatient counseling (psych, genetic testing, etc) or attempt to get her to check in (at the hospital's expense) with visions of nobel prizes dancing in his head.

diagnosis: benign idiopathic development of gills.
disposition: discharge to home care, follow-up on outpatient basis; return to er or primary care doctor if infection develops and over-the-counter treatment fails.

another possibility is that she presents as hysterical, delirious, or otherwise out of it. the er team will probly panic, suspecting severe lacerations (knife fight, unfortunate encounter with a window, or botched amateur surgery (body mods or weirder)) complicated by shock and/or heroic drug abuse. they'll probly get a bunch of stat blood work (looking for shock or whatever she's flying on, and blood typing) and start rounding up surgeons. nothing will make sense, tho. blood panels come back normal; she's not bleeding out despite normal carotid and radial pulse and pressure; examination of the "wounds" reveals healthy if bizarrely vascularized tissue. they'll run lots of tests in utter pandemonium. it'll be a while before they'll let her out of the hospital. they may even attempt surgery on the gills before they conclude they're harmless. eventually, they'll come around to nobel prizes, diagnosis, etc.

[dr-pretentious.livejournal.com]

An odd memory:

When we lived in Japan, my mother used to teach American business etiquette and conversational English to Japanese businessmen who needed to be able to handle business trips in the U.S. She once had a student who apologized compulsively, and then would apologize for apologizing. Not a winning social habit for the American business scene. Her solution: To roll up a newspaper and hit him on the head with it anytime he apologized unnecessarily. After a few weeks of cascading apologies for apologizing interspersed with thwacks of the newspaper, he did eventually get over his problem.

[dr-pretentious.livejournal.com]

Thank you! The Bovie is just what he needs.

The gills are on the throat, but not the face. Five on each side, starting just below the ears. With turtleneck sweaters and opaque scarves, she can pass if she wants to.

It's the medical history she'd balk at giving. She's got her reasons.

I've got the antibiotics covered, in this draft. When you say "just in case," does that mean the antibiotics might actually be unnecesary. I'd been assuming she would be in deep trouble without them.

[dr-pretentious.livejournal.com]

Clearly, I need to look more into the mechanics of the gills themselves. I've been so focused on the character dynamics and the stuff of their daily lives, I've neglected my McGuffin.

[dr-pretentious.livejournal.com]

A body piercer with a sister who writes fantasy might be less fazed by my odd questions than would the luckless guys I would otherwise ambush at the tattoo parlor on Main Street. I would be most grateful for his number, if you can let him know I might be calling. You can find me at savery at rci dot rutgers dot edu.

[dr-pretentious.livejournal.com]

Prayers are always welcome. Dan and I have been trying, off and on, to reproduce since 1998. Of course, there was a dissertation to finish in the middle of that, and a thesis, and a 70 hr/week teaching job, and and and. Too much and. Now we've got less and.

At least I conceived. Didn't know I could do that.

Anyhow.

What does a person think while awaiting the scalpel? I know the sorts of things a person thinks before getting a tattoo, and I imagine the motivations for scarification are a lot like that. But the thoughts the moment before the first cut might be different from the thoughts the moment before the first dot.

[dr-pretentious.livejournal.com]

I've felt free (maybe too free?) to imagine the gills in a way that's convenient for the story, since most readers won't have sprouted gills of their own. But plenty of people get their bodies modified, so I want to be reasonably plausible about the artist and his studio. (He's got a hifalutin clientele in a seaside town that imagines itself to be chic and edgy. Dear, pretentious Red Bank.)

Yes, you have just the right idea about what kind of thing that character's up to when he's not bailing out his hippy coven sister.

[padmaclynne.livejournal.com]

i'm pretty sure that's how gills work, but i would check.

[dr-pretentious.livejournal.com]

Intriguing. Now I have to decide how far out there he is, when he's working on himself. The guy fetishizes his professionalism, but it sounds like that's an attitude that would not be incompatible with the kind of experimentation you're talking about.

[dr-pretentious.livejournal.com]

Okay. If the latter scenario is plausible, then Sophie is justified in hesitating to go to the ER. If the former scenario is plausible, then I'm justified in giving her a fairly straightforward recovery at home, with antibiotics and meticulous attention to her dressings. Just what I was hoping. A cast of six is as big as the story can sustain. Adding doctors, just in the moment when the plot's nearly played out, would have unbalanced the structure altogether. (Structure, she said of her first draft. Ha! Structure, such as it is.)

Many thanks to you and the HDF. Now that spring's not so far off, and you won't have to travel to Maryland so often, and my foot injury's resolved, we should start looking at the calendar for hiking days again. It's been too long since we saw the HDF&Co.

[jeneralist.livejournal.com]

I've got the antibiotics covered, in this draft. When you say "just in case," does that mean the antibiotics might actually be unnecesary. I'd been assuming she would be in deep trouble without them.

Well, I don't know if she'd need them or not. It depends, I suspect, on how well-developed the new tissue (gills?) underneath those openings is.

For the sake of comparison, let's say that I spontaneously developed a third nostril. If the nostril develops completely first, with a nice smooth mucus membrane, well-supplied with natural defenses (mucus, cilia, a good blood supply with lots of white blood cells), the day the skin covering it finally opens I might have potentially serious bacteria growing on the new surface, but that's not the same as being infected.

If, instead, it was a cut-up inner surface with a deep rip in the skin and overlying tissue, I'd be a lot more nervous about infection. Keflex, 500mg four times a day for ten days (assuming she's not allergic to penicillin or cephalosporins) to treat skin infections; maybe Zithromax to treat -- would you call it respiratory? -- bugs as well.

Is there pus? bleeding? red streaking or other signs of infection?

And I hope that this happens during humid weather! You know how you feel in the winter when it's so dry, everything in your nose turns to concrete (and stops working as an infection control mechanism)? I can only imagine how much fluid she'd lose with that much surface area, even if she's keeping them covered most of the time.

She may, eventually, want to check out a product more generally targeted to summertime motorcycle riders. You take a water bag (camelbak or platypus are representative brands) and put it alongside your chest, held in place with a strap around the opposite shoulder. the outlet of the bag, instead of being a tube into your mount, is a tube that goes up and wraps around your neck. At neck level, it has several small holes in it. When you get too hot and you're not sweating enough to cool off, pull your arm in toward the chest, compressing the bag. Water is forced up the tube and into a fine spray onto your neck and T-shirt, where it can evaporate and cool you down. A similar mechanism might be used to keep gills moist, should it present a problem....

[twoeleven.livejournal.com]

the only question we had is: why do you want the gill slits to tear as they open? if the gills are at all acting like normal tissue development, the "unneeded tissue" will simply atrophy (by apoptosis), and gill opening won't be any messier than when a kitten opens its eyes for the first time. probably not any bleeding, and likely nothing else unpleasant.

[kistha.livejournal.com]

Hmm, I probably wasn't thinking much of what an 'average' person might feel about getting cut with a scalpel. I was in the middle of my dedication/initiation (pick the word that least offends :>) as a priestess, so I was flying pretty high on the magic of the moment, and the almost indescribable openness. I also had planed the whole thing out, and had picked the one person I knew who could do it, since I didn't know any professionals that were Pagan friendly that I would even begin to trust with my neck.

I was a little nervous, and wondered how bad it would hurt, and if I'd be able to stand through the whole thing, but it was mostly vague voices in the back of my brain. (For proper reference I was standing at night, on a beach, buck naked, drenched in salt water from the Pacific in September, since as you know context is everything.)It hurt, but not as bad as I anticipated, and when I had them dump the rubbing alcohol on it, it was just cold. That I expected to burn much like fire. I thank the Her regularly that only the cuts had to hurt. :)Of course after the ritual was over and I tried the alcohol again, I nearly puked from the pain. Don't go there, trust me.

Ironically I'm terrified of getting a tattoo, because I think it will hurt to badly. Most tattoo artists have stared in abject disbelief after they hear that story and find out I'm afraid of a 'simple' tattoo. Go figure.

Now branding? That's insane. Not much that hurts worse than a burn.

I'll send prayers your way then to wish you much luck on the fertility angle. It's my goddess' specialty, that and all aspects of child bearing. :>

[dragonlaire.livejournal.com]

I'm very sorry to learn of your misfortune, but, as you say, at least you've discovered that conception is possible, and I know a few people for whom it is not and witnessed the unhappiness that knowledge has brought them.

I'm not a religious person at all, nor even a superstitious one, but it often seems that things occur, if not for a purpose, then perhaps during times when the results eventually prove themselves fortuitous.

If you wish children to be part of your future, then I'm certain that someone as nice and thoughtful as you will receive those rewards.

[jeneralist.livejournal.com]

I had a patient who apologized for bleeding on the hospital linens...

[newroticgirl.livejournal.com]

I just sent you an email with Mike's number... he says you can call anytime. *grin* He's used to weird questions from all sorts of people.

[reynaud.livejournal.com]

I think she was more concerned with what would happen during the opening of the gills rather than after. (Right, Dr.?)

[vgnwtch.livejournal.com]

I apologised to the nurse when I threw up and crapped myself in hospital while suffering from a nasty gastroenteritis. I think it's kind of normal. You're so fucking ill, and someone else has to clean up after you in the most intimate way, and you're sort of removed from your body at the time. Very weird.

To roll up a newspaper and hit him on the head with it anytime he apologized unnecessarily.

I think this may be why sabrinamari stopped wearing her baseball hat so much - when one of your friends just snatches it off your head and whacks you with it when you make pointless apologies, it probably seems safer to leave it at home.

Don't get me wrong - I think that there's a good and honourable place for apology. But apologising because you had a miscarriage that whacked out your social calendar? Don't make me buy you a baseball hat, alright?

[vgnwtch.livejournal.com]

It's her very plausibility that makes her dangerous.

[dr-pretentious.livejournal.com]

There are people (like Brina) who look really cute in baseball hats. Then, there are people (like me) who just plain don't. Even if you weren't planning on whacking me on the head with it, please don't buy me a baseball hat. If my excessive apology problem continues, I'm confident we can negotiate about alternative headgear. : )

[dr-pretentious.livejournal.com]

In my first draft of this scene, there was no pus, and the bleeding was only from the torn skin over the surface. No red streaking, but I had imagined inflammation. Should I ditch the inflammation?

[dr-pretentious.livejournal.com]

For the scene I was concerned about here, I wanted to get the opening of the gills right, but I haven't yet decided how much to show about the gills at work, since they're more the McGuffin than the point of the story. If the character's breathing with them on stage, as it were, I ought to get it right enough that nobody stops believing in the characters just because the gills are impossible.

There's plausible impossibility, and then there's implausible impossibility.

[dr-pretentious.livejournal.com]

Why do I want them to tear? Um, good question...

Very early on, when I was in the list-making, pre-zero-draft stage, I was making a list of cool things that might happen. I had my cast, I had my starting incident, I had my setting, and a general idea of what I wanted the story to be about, but I didn't have my incidents yet. "Gills tear open?" is on that page, along with lots of other things I didn't use. The gills are tearing open, not because of any sort of biological process I had in mind, but because of a sibling dynamic that needed to explode.

But there are plenty of ways to detonate a sibling dynamic.

[jeneralist.livejournal.com]

So, it sounds like it's happening pretty atraumatically. The inflammation might be coming from the torn skin getting snagged on clothing or necklaces. I don't think you need to get rid of it.

nursing student

[tracyandrook.livejournal.com]

ROFLMAO
You may think this perverse, but I kinda get a kick out of cleaning somebody up. They are so human. Plus, it gives me something to do that requires absolutely no decisions. Gotta be done.

butting in

[tracyandrook.livejournal.com]

To me it sounds like a trach, but what are we doing with the rest of the neck physiology?
Carotid/jugular anastomosis/capillary beds in the gills i picture.

if you need another contact

[tracyandrook.livejournal.com]

who would understand your question, try Xuk (pronounced "chuck" at Sparks salon in New Brunswick. Friends you know have patronized his services. He's highly on the up-n-up.

Re: nursing student

[dr-pretentious.livejournal.com]

I wasn't raised on the lives of the saints, but the little bit I know about the tradition of hagiography is full of moments when female saints roll up their sleeves to do what needs to be done, in precisely that way, and find Illumination in that. And why not?

Re: butting in

[dr-pretentious.livejournal.com]

Yeah, I'd wondered about the rest of the structures in the neck, too. Your answer sounds much more coherent than mine.

If I were writing hard science fiction, in which the whole story hinged on the functionality of the gills, I'd be sunk by my ignorance.

Fortunately, the story that came to me to be written is more like Gabriel Garcia Marquez's "A Very Old Man With Enormous Wings," as it might have been imagined by Kevin Smith, if Kevin Smith were a Wiccan priestess. Nope, definitely not hard sf.

Re: nursing student

[tracyandrook.livejournal.com]

Why not? When I'm cleaning somebody up, they are in total humiliation (generally) and I'm in a position of benevolent authority. It is only by my good graces that they are reassured of their worth as a human being. It takes a really strong person to think of complaining to management when they are getting their butt wiped.

Re: butting in

[tracyandrook.livejournal.com]

I tried to respond to this the other day, it didn't take, i think. I think lungs are a little like gills turned inside out. Or vice versa. But lungs are more complicated. In lungs, the air is just air, and the diffusion surface is held open by surface tension. In gills, air is dissolved in the water and diffuses across a thin membrane. So this girl is a fish out of water, maybe. If her lungs are still funcitonal, then it only matters to keep the gills moist. I imagine they ache and she uses ice packs stuffed inside an orthopedic neck ring. But her sweater is always wet. There may be some mathematical relationship between the amount of o2 the person needs, and the surface area of the gills, that would make me wonder if the neck were too small, and should she have grown them on her chest instead. (she could retract them between her intercostals for safety, once the lungs started to shrink in size, but that may be too gross and your story is just about done right?)

that quiz

[tracyandrook.livejournal.com]

I dunno. I ended up in the middle too. But, I am "paranoid" in the other quiz. Yikes

Re: nursing student

[tracyandrook.livejournal.com]

Ugh, gods, I bothered and upset about this all weekend. I didn't mean it. Please ignore.

Re: nursing student

[dr-pretentious.livejournal.com]

No worries. I find it kind of reassuring to hear medical people talk about the emotional side of their jobs, even if they end up saying things that aren't pretty, or that they don't think all the time, or that they felt one time but don't believe is right. It suggests that people in the medical professions can be self-aware about that kind of thing, and a person who's self-aware is a lot less likely to be insensitive to a patient than is a person who believes s/he is capable of doing the job without feeling things.

It didn't occur to me to be alarmed.