Thursday, February 9, 2023

The Counterpuncher

The Grim Reaper is no sap.  He knows better than to go for the first-round knockout against an opponent still quick and cocky, fast on his feet, possessed of infinite stamina.  No, the reaper is a wily boxer; he feints and jabs, dekes and ducks, circles his rival and waits for an opportunity.

The Reaper isn’t a headhunter, he sticks with body blows, attacks and retreats, waits for his prey to lower his hands, slow down, get a little tired.  The shots to the solar plexus get easier by the sixth round, his prey is confused, aching, losing confidence.  By the eighth, his mitts are down, his power lost, he starts thinking there might be an easier way out than the constant pummeling.

In the ninth, the weary underdog goes down hard and thinks seriously about not getting up.  He rises, shaky, not sure what he’s doing here, looks to the first row of fans for a friendly face.  It all comes down to courage---does he have it or does he not?  Will his career end this day, his body slumped on the canvas of a soiled boxing ring or will he find a way to go on?

The beaten fighter backs up, circles, fends off punches the best he can, adopts a strictly defensive posture.  He ties up The Reaper in the corners, traps his muscled arms, refuses the referee’s commands to break.  He knows the best he can do this day is to run out the clock, refuse his enemy the satisfaction of a knockout, perhaps come back another day.

In the tenth, the verdict is sealed, as it always has been.  But for one brief instant near the end, the ragged boxer gets his second wind, steps up and delivers a hard shot to The Reaper’s jaw.  Surprised, the winner takes a step back, smiles almost imperceptibly and decides “I’ll let this one go for awhile.”  He knows he’ll always be the winner and still champion.

Alyssa the Miracle Girl

Shelter From The Storm

The trouble with these damn human bodies is that they wear out.  If a fortunate septuagenarian makes it through the minefields of cancer, heart disease, Alzheimer’s and Interstate 75, he finds himself in the geriatric ward with crumbling discs, rampant arthritis, disintegrating intestines and/or the heartbreak of psoriasis.  What’s a guy to do when the spirit is willing but the flesh is weak?  How do you live to 110 when your physical apparatus wants to throw in the towel at 85?  The answer, of course, is the same one Sister Louise Clara gave you in sixth grade---one step at a time.  The good news is that medical research, goosed on by Artificial Intelligence, is progressing by leaps and bounds.  Results which seem impossible now may be just around that elusive corner.

In May of 2021, a 13-year-old girl named Alyssa from Leicester, England was diagnosed with T-cell leukemia, a disease which has offed two of our close friends and been considered incurable.  After undergoing all the conventional forms of treatment to no avail, Alyssa was entered into a clinical trial administered by the Great Ormond Hospital for Children (GOSH) in May, 2022 and became the first person in the world to receive base-edited CAR T-cells which originally came from a healthy donor.  Less than a month after the procedure, Alyssa was in remission.  A second bone marrow transplant was then performed to restore her immune system.  In December, she was at home in recovery.  Doctors expect a complete cure.  True, Alyssa had the many benefits of youth on her side but the point is that a disease once considered unbeatable was finally conquered.  Somewhere in the dark night, the Grim Reaper winced and threw his bloody gloves to the floor. 

Brain-Eating Amoeba News

Dress ‘em up, can’t take ‘em anywhere, or that’s what they say about those unruly brain-eating amoebas who keep showing up uninvited and wearing inappropriate clothes.  One of the critters turned up at 12-year-old Kali Hardig’s house the other day and they had to call the cops.

The day before, Kali was giddily playing King of the Hill with friends at a water park near Benton, Arkansas, which is likely where the rowdy amoebas first noticed her.  Impolite as they are, the little rascals are prone to swim into an unsuspecting victim’s nose, travel along her olfactory nerve and into her brain, where all the good eats are waiting.  The doctors have a nice medical way of putting it---primary amoebic meningoencephalitis---but the amoebas call it “lunch.”  And, as you might suspect, it’s 99% fatal.  Only two lucky people in North America have ever survived the banquet.  Over in the Deathcave, the Grim Reaper smiled and put a large X next to Kali Hardig’s name.

“We told her parents Kali probably had 48 hours, tops,” said Matt Linam, MD, the infectious disease specialist who treated the girl.  “Those amoebas have ravenous appetites.”  Nonetheless, Linam and his amoeba posse at Arkansas Children’s Hospital jumped into action, pumping Kali’s body full of antifungals and antibiotics, then added a new rare and unapproved German drug they got from the Centers for Disease Control.  They lowered the girl’s body temperature to 93 degrees, putting her into a medically-induced coma in an attempt to reduce brain swelling, then hooked her up to a ventilator and finally to a dialysis machine for her failed kidneys.

Kali Harwig, to everyone’s surprise, did not die in 48 hours or 96 hours or a week.  For two weeks, her medical team worked round the clock to keep her alive, balancing the complex job of preventing low blood pressure and stopping episodes of high blood pressure that worsened her brain swelling.  “It was hour to hour,” said Linam.  “We just didn’t know.”

Slowly, very slowly, the young girl’s brain swelling stabilized.  The doctor’s reduced her sedation and gradually increased her body temperature, unsure whether she would even be the same girl if and when she woke up.  “Two days later, Kali gave them a thumbs-up and her parents knew she was still in there, smiled Linam.

Kali remained in the hospital another eight weeks, relearning the most basic functions, like swallowing.  But for whatever reason, she became survivor number three.  Doctors don’t know why she lived.  A 12-year-old Florida boy, diagnosed days after Kali and given the same German medicine, did not survive.  Linam says “It was countless little things that went her way, tiny miracles which happened every day that made the difference between life and death.  It almost never happens.”

Off in the distance, The Reaper lit up a Newport, glugged down some Everclear and trudged slowly over to his scoreboard, picking up an eraser and wiping out the letter next to Kali Hardig’s name.  “Some days you can’t make a buck,” he grunted.

Michael---Not Dead Yet


Once upon a scary time, Michael Crowe, 23, froze up on his living-room couch, eyes open, staring into space.  He quickly snapped out of it, but when it happened again a few minutes later his mother rushed him to the nearest emergency room.  The doctors looked at one another, turned away from the victim and uttered “Oh, shit.”

Michael was in trouble, I’d say, right here in River City, with a capital T and that rhymes with D and that stands for Dead.  His heart was pumping out blood at just 25%, an alarmingly low rate.  By the time he was transferred to Nebraska Medical Center in Omaha one hour later, it was down to 15%.  Doctors hooked Crowe up to a machine to keep blood pumping through his arteries.  He was suffering from an inflammation of the heart muscle called acute myocarditis, which left the organ barely viable.  “Michael was only alive because the machine was doing the work of his heart,” said Dr. John Um.  “When the heart stops, that’s clinical death.”

Michael Crowe was placed on a transplant list and put into a medically induced coma.  Watching the action from his invisible plane high in the ethers, the Grim Reaper chortled and walked to his wine closet, drawing out a bottle of Dom Perignon.  “I still like the old stuff,” he smirked to no one in particular.  “I like to watch the bubbles break.  It’s an occupational bonus.”

Ah, but not so fast, my friend.  Back at the ranch, a heart was found for the flagging Michael Crowe and overjoyed doctors prepared to perform the transplant.  Outraged, the Reaper countered with a death blow and Michael came down with a blood infection, which meant he would likely not survive the operation.  This is when Catholics start using phrases like “Extreme Unction” and bringing in all the relatives for the grand finale.  People unfamiliar with the genre suddenly resort to things like prayer, lighting candles, leaving their lucky horseshoes at the foot of the bed.  St Peter gets the word, climbs out of bed and dusts off the welcome mat.

It ain’t over til it’s over, according to Yogi Berra, who knows what he’s talking about.  An hour after the medicos put the kibosh on the transplant, Michael Crowe’s blood pressure started to increase ever so slightly, even though his machine was only there to maintain it at a solid level.  Abuzz, the medical team ran tests and discovered the left side of Michael’s heart was pumping blood again.  “The heart was actually beginning to heal itself,” said Dr. Um.  “This never happens.  It’s really a miracle.”

A few days later, Crowe’s heart began to function normally.  An MRI scan found no permanent damage or scarring.  It was as if the death-defying incident had never happened.  Michael was released from the hospital and went about his business with no medical restrictions.  “Another kick in the ass,” sulked the Grim Reaper.  “But at least the champagne was tasty.


1.---In June of 2022, results were published from a drug trial at Memorial Sloan Kettering Cancer Center in New York in which all 18 patients with rectal cancer were cured.  The drug Dostarlimab contains laboratory-produced molecules that act as substitute antibodies in the human body.  All 18 patients were given the drug and at the end of the trial their cancers were undetectable by physical exam, endoscopy, PET scans and MRI scans.  Doctors from the Cancer Center commented, “This is the first time this has happened in the history of cancer.” 

2.---Michael Cassidy is one of those guys who probably grabbed the brass ring on the carousel.  It’s still working.  In March, he was thrown off his motorcycle face-first into an inconvenient fire hydrant, cracking his pelvis wide open like a book, which is why Michelle McNutt, MD, chief of trauma at Memorial Hermann Red Duke Trauma Institute in Texas calls the injury an “open-book fracture.”

When Cassidy arrived at the Center, Dr. McNutt placed a flexible catheter into his femoral artery in the thigh, maneuvering it all the way up into the aorta and inflating a balloon at the end of the catheter.  This stopped the blood flow beyond the balloon and improved Cassidy’s blood pressure, providing a sort of bridge to getting a severely injured person into the operating room in time to save him.  The procedure is called REBOA, or resuscitative endovascular balloon occlusion of the aorta.  “It’s like an internal tourniquet,” explains Laura Moore, MD, an associate professor in the Department of Surgery at the University of Texas McGovern Medical School.  “Michael was extremely lucky to have been where he was when the accident happened or he would never have had access to REBOA.  If you want to call it “cheating death, I wouldn’t argue with you.”

3.---In June of last year, a woman with the unlikely name Jennifer Beaver fell off a golf cart and landed on her head, leading to such a massive brain bleed that doctors were forced to remove half her skull to alleviate pressure.  “To say that her prognosis was grim is a laughable understatement,” reported Colin Looney, MD, the Nashville orthopedic surgeon called in to attempt repairs.  Adding to Looney’s angst was the fact he was a friend of the stricken woman’s family.  “This was my first time operating on a friend who was actually dying,” said the doc.  “I tried to sound positive but I’d seen so few patients survive massive brain trauma that I’m sure it showed on my face.  I didn’t really think she’d ever go home again.”

Just when The Reaper thinks it’s safe to toll the Death Bell, however, Fate occasionally intervenes.  After repairs were made, Mrs. Beaver was brought out of her medically-induced coma, spiffed up and allowed to return to her lodge.  She’s back at work building dams and suffering no significant deficits.  Her new golf cart has sidebars and helmets.

A Retrospective

The hefty, helmeted, golden-haired Brunhilde slowly marches onto the stage, spear in hand.  She has greased her throat with honey and slippery elm, sprayed with pharyngeal moisturizers, polished her weapon with the finest urine-soaked sand.  But incredibly, she opens her mouth and nothing comes out.  The actors stare in disbelief.  The audience gapes in awe.  The producers are catatonic.  Time stands still.  Not a sound rises in the opera hall.  Against all odds, beyond all explanation, a mystery no one can answer.  Sometimes, for reasons known only to the spiraling vapors of the universe, the fat lady does not sing.

That’s all, folks….