TESE and religion

I follow the Androlog e-mail list, which sends out Q&A on andrology issues. Most of the time, it is technical information of little interest to me, but I thought the following was interesting on Torah and Testicular Semen Extraction (TESE):
Androlog Mail

{Regarding Allen's query about a young man with a poor EEJ specimen:}

This is unfortunately, not a suggestion for the patient's care. But I was intrigued by the religious objection to TESE, so asked my learned, observant son. I paraphrase his comments as to the possibilities:

The required testis biopsy is surgery that does not benefit the life or health of the patient himself, thus falls under the Torah's prohibition against 'cutting' oneself.
On the other hand (there is always another hand), a positive commandment, e.g. be fruitful and multiply, can outweigh a negative commandment. Furthermore, one could construe a procedure to restore the ability to have a family as part of being a religiously whole man and thus does contribute to the patient's health.

Alas, you can't shop for an opinion. You have to first pick your rabbi and then abide by the opinion you get.

Donna V., MD, PhD

Who Moved My Cheese? book review

For Nur428, we were assigned Who Moved My Cheese? by Spencer Johnson. Here is a modified version of my Amazon review:

Who Moved My Cheese? is a terrible little book that I am embarrassed to say is assigned reading for my nursing management course. You can read a summary of it in my Scribd documents if you want, although I failed to include there the key sentence about Hem in the book: "his complicated brain with its huge belief system took hold".

There are a constellation of belief systems that revolve around the relationship of valuelessness, lack of personal investment, spontaneity, and happiness. These include systems like Buddhism, Jean-Jacques-Rousseauianism, materialist nihilism... Who Moved My Cheese? falls in this constellation. The message of the book is that the only thing in life is following "the cheese," and you'll be happier if you don't get invested in wherever you're currently getting "the cheese," so you can immediately go to where "the cheese" is without looking back.

Of course, we know of another tradition of change, represented by Lot's wife, the Exodus, the diaspora, etc. But that tradition tells us something very different about change, suggests differentiating important from unimportant, and that there are times it is necessary to resist instead of "embracing change."

Nietzsche tells us that Judaism is a "slave religion," but the truth is that "the cheese" philosophy is the true slave religion. It's no mistake that this story takes place in a maze, and the heroes are mice. The message is that life is just a giant maze, we're all no different from mice, and the sooner you accept that, the happier you'll be. This is a book for people who don't believe in self-determination and are just cogs in a giant business machine.

At the end of the book, one of the high school graduates says that his family-owned chain of mom and pop stores should have been sold off so that he could build a giant supermarket department store to compete with the new "mega-store" in town. He rejects the idea that there might have been something worth saving, not to mention the possibility of saving it through ingenuity. His conclusion is to just see which way the wind is blowing and follow along.

Another of the high school graduates says that her son was a star swimming champion but that after the family moved for her husband's work, he learned to enjoy skiing instead and now lives happily in Colorado. But if you want to know what the "embracing change" and "enjoying new cheese" philosophy has done to families, you should read GenerationMe, by Jean Twenge.

The phrase The Writing On The Wall comes from the story of King Belshazzar in the Book of Daniel, chapter 5. King Belshazzar took sacred cups from the Temple in Jerusalem and used them to drink in honor of the gods of gold and silver. A ghostly hand appeared in front of him and wrote on the wall "מנא מנא תקל ופרסין׃," meaning that Belshazzar's kingdom would come to an end. That night, Belshazzar was killed.

The author, Spencer Johnson, seems to think that The Writing On The Wall means we should all just go along with whatever life brings, but there are really two other meanings to the story. First, would Belshazzar have been killed if his people had decided not to believe the writing on the wall? Second, there some things in life more important than gold, silver, or cheese. To this book I say "תקל Thou art weighed in the balances, and art found wanting."

Men's night & beard

Tonight, I went over to the house of a male RN co-worker along with a couple other male RN's. The evening consisted of red meat and cigars on the porch. I enjoy being included in this group quite a lot. It's flattering since I'm not yet an RN, although, to be honest, it is quite intimidating. There is banter in this group about the competency of certain other RN's, and I am still feeling quite inadequate about my ability to step on the floor and start providing care next June. So much to learn, still, and my mind is really not oriented well for nursing.

Also, I've been sporting a beard lately. Actually, I grew it out this summer. Since I don't really feel I can have a large beard as an RN and since--I assumed--I couldn't have one in nursing school, I thought this summer was my last chance to grow one. As a matter of fact, no one in school has said anything yet, and as my only clinicals this semester are psyche and management, I think they may not. That leaves me with the difficult decision whether or not to cut it off now or keep letting it grow...

My hospital has CNS's

"Duck Pond" Bob Collins with (l,r) med-surg and critical care CNS's

Your hospital probably already has Clinical Nurse Specialists, but we haven't until recently. I think our geographic area is low in advanced practice nurses and nurses with professional certifications because we are a long ways from centers of higher ed for nursing. Anyhow, we have two CNS's now, for med-surg (Carrie Howard-Canning, CNS) and critical care (Kathleen Carey, CNS). They've been working for maybe a year or so now, but our local newspaper is just getting around to recognizing them in today's edition...
Howard-Canning and Carey are the first inpatient clinical nurse specialists at CVPH and in northern New York. Elli Collins of the hospital's FitzPatrick Cancer Center has practiced as an outpatient clinical nurse specialist for about a decade.

There are approximately 67,000 clinical nurse specialists across the nation, but the specially trained RNs are scarce in the North Country.

The concept is relatively common in metropolitan settings but is only now catching on in more rural areas, she noted.

"We have five nurses currently enrolled in advanced nursing programs."

Both nurses credit associate vice president of Patient Services Julie Brunell for their decision to continue their education; she recently earned her Ph.D. in nursing.

As clinical nurse specialists, Howard-Canning and Carey spend a great deal of their day on the patient floors, sharing their knowledge with nurses and working with the patient-care team to provide treatment methods based on proven techniques.


Fall '08 - first day done

Finished the first day of the fall '08 semester.

Boot Camp Psychiatric Nursing
Started out at 0800 with Nur435 psychiatric nursing. This should be an interesting class, although I have reservations. This is the same instructor as the signature incident, and she has already said that night clinicals are part of the program regardless of whether you work or not. Well, no they're not. We don't sign away (literally, we don't) our lives on entering the nursing program. Last semester, the instructors were extremely accommodating in scheduling for day clinicals people who worked. They also made a point to try to get you out of clinicals in time for any afternoon classes you might want to take, whereas this instructor has said we should expect clinicals to run to 1530 or 1600 during days. That seems unreasonable to me. For the first week of classes, she scheduled a short clinical-orientation period for 1300-1600, which means it interferes with both potential day and evening shifts. This instructor knows her material and teaches well, but she is an example of what I am starting to think of as the "olde-fashioned boot camp mentality" of nursing school. It needs to go, especially in a contemporary social structure where there are many non-traditional students trying to raise families and/or work their way through college.

Anyhow, for this course, we have to attend a meeting of a 12-step program. I'd like to attend a sexual addiction program meeting as it is more closely related to my interest in men's health. Unfortunately, we don't have any in my town, so I'm going to have to expand to "the milieu." In accordance, I made a map of the all the sexual addiction services I could find in upstate NY, VT, and southern Quebec. Use and link to if you find useful...
Nursing Research
The afternoon saw nursing research course. This has the potential to be extremely interesting, and I would like to work on something to publish, but you never know how it might turn out. It meets in a too-small classroom, and the other students aren't interested in research, so who knows...
Or maybe I just live in the wrong part of the country (yes, I digg the henna)...

More of what you're missing

Tomorrow is the first day of the fall '08 semester, and in honor of that, here is more of what you're missing by not being in medical school, courtesy of pathologist euthman on Flickr...

and for the ladies...

Mysteries of Montreal

I was browsing for material on embryology the other day when I came across the section of the RG's devoted to midwifery. My eye caught a book entitled The Mysteries of Montreal: Memoirs of a Midwife by Charlotte Führer. There aren't a lot of historical books on nursing, and I thought this one looked interesting since it dealt with Montreal, Quebec, which is in my milieu. Haven't read it, though. I probably won't for time constraints. But if you like, you can read it and let me know what's of interest.

Some lite reading on transmissible cancer

School starts up again next week. To get ready, here's some lite reading on transmissible cancer from Harper's. Bet you thought cancer wasn't communicable, didn't you?
The phenomenon of transmissible tumors isn’t confined to canines, Tasmanian devils, and Syrian hamsters. There have been human cases, too...

Low immune response also figures in two other situations in which tumor transmission is known to occur: pregnancy and organ transplant. A mother sometimes passes cancer cells to her fetus in the womb. And a transplanted organ sometimes carries tiny tumors into the recipient, vitiating the benefits of receiving a life-saving liver or kidney from someone else. Cases of both kinds are very rare...

Other cases are less easily explained. In 1986, two researchers from the National Institutes of Health reported that a laboratory worker, a healthy nineteen-year-old woman, had accidentally jabbed herself with a syringe carrying colon-cancer cells; a colonic tumor grew in her hand, but she was rescued by surgery. More recently, a fifty-three-year-old surgeon cut his left palm while removing a malignancy from a patient’s abdomen, and five months later he found himself with a palm tumor, one that genetically matched the patient’s tumor. His immune system responded, creating an inflammation around the tumor, but the response was insufficient and the tumor kept growing. Why? How? It wasn’t supposed to be able to do that. Again, though, surgery delivered a full cure. And then there’s Henri Vadon. He was a medical student in the 1920s who poked his left hand with a syringe after drawing liquid from the mastectomy wound of a woman being treated for breast cancer. Vadon, too, developed a hand tumor. Three years later, he died of metastasized cancer because neither the surgical techniques of his era nor his own immune system could save him.
via BoingBoing

Vacation for three days

If all goes as planned, the fam should be leaving in a couple hours for Long Sands near York Beach on the Maine coast, an area probably most famous for the Nubble Light House. We used to camp at the Eaton camp ground in a tent every year for 3 nights, but lately have switched over to the Anchorage Inn, a touristy but very convenient and adequate beach-side hotel, for 2 nights.

The agenda for the stay is quite straightforward:
  • breakfast
  • walk on beach
  • lunch on fried clams
  • lounge on beach with book
  • dine on lobster
  • shop in Kittery
  • dessert at Brown's
  • sleep
  • repeat
I will enjoy myself, but this marks the end of summer for me...

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Cardiac cath lab observation

One of the more embarrassing moments I've had in nursing school was taking the gross anatomy portion of the cardiac unit exam in A&P. I didn't study much (i.e., at all), and when it came time to name the arteries, I drew a complete blank. All of a sudden the surface of the heart model appeared to be just a confusing jumble of serpentine lines. I made up some names like "posterior cardiac artery," but they weren't up to the job.

That was a very shame-faced experience for someone who had been working in a cardiac/progressive unit, even as a ward clerk. Ever since then, in my mind, the heart has been a complexity too much for me. So I was very surprised when I reviewed the arteries this morning to find how straight-forward it all seemed. In a few moments, I had identified and memorized almost all the vessels in my current anatomy book (I borrowed a text for A&P).

The review was in preparation for observing a cardiac catheterization today. I requested an opportunity to see the entire interventional procedure, including the pre- and post-procedure nursing care. The interventionalists were very accommodating, but unfortunately there was only one case today and no opportunity to see stenting. All in all, a rather unimpressive time. Frankly, I don't see why an MD is needed for a diagnostic cath. I, myself, was able to identify the blockages. I think the procedure could be performed adequately by people with master's degrees (and I bet they will be in the future). I can't speak to the stenting, though.

Corpus obscurum on nursing

Citypages.com had for one year an excellent blog of obituaries of little known people who made significant contributions. While it was in existence (2006-07), it was one of the most interesting blogs around, and it remains as an example of what blogging can be, disseminating relevant, interesting and (semi-) original material.

Anyhow, its one-year anniversary passed in late July, so I thought I'd look up whether it had ever covered nurses. Two.
One of the "Angels of Bataan" dead at 88

Jean Kennedy Schmidt died Saturday, March 3, at her La Canada Flintridge, California, home from complications of a fall, her daughter, Susan Johnson of Bemidji, said last Friday. Schmidt received her nursing degree in 1941, then enlisted in the Army. She was stationed in the Philippines in 1942 when the Japanese attacked. Schmidt and other medical personnel treated the wounded in open-air field hospitals on the Bataan Peninsula. When the Philippines fell, Schmidt and 76 other nurses were held prisoner in Manila for nearly three years, treating military and civilian prisoners, sometimes eating weeds to stave off starvation. In 1945, a U.S. tank crashed through the gates freeing the prisoners. Schmidt later married a fellow prisoner, Richard Schmidt, and they settled in California. Only three "Angels of Bataan" are now believed to be living. Schmidt was 88.

Only Chinese nurse who cared for the famous "Flying Tigers" dead at 95

Rita Wong died Tuesday, June 5, in Kunming in the southwestern Yunnan province of China. Wong was born in Guangdong in southern China and attended the University of Hong Kong. She graduated in 1941 with a nursing degree. Wong began an internship at Hong Kong hospital when Japanese troops attacked and took over on Christmas Day, 1941. The Japanese declared no doctor or nurse was to leave Hong Kong, lest they be captured and killed. Wong and her brother escaped one night by floating away on a sampan. The brother and sister traveled 600 miles from Macau to Chongqing where Wong applied to the headquarters of Allied Forces, who were seeking English-speaking nurses. Stationed at the hospital of the U.S. 14th Air Force in Kunming, Wong cared for the "Flying Tigers," U.S. airmen who defended the Burma supply line to China over the Himalayas during World War II. Wong wrote in her diary that the flights were so dangerous that there were plane crashes every day, with many servicemen never found. During Wong's later years, she visited former Flying Tigers and their descendents in the United States. Wong was 95.

Teddy bear anatomy

Stephanie Metz is an artist who produces felt sculptures, especially of teddy bear skulls...

Although a staple of American childhood now, the teddy bear did not appear until the early 20th century:
The name Teddy Bear comes from one of American President Theodore Roosevelt's hunting trips to Mississippi... A suite of Roosevelt's attendants, led by Holt Collier, cornered, clubbed, and tied to a willow tree an American Black Bear after a long exhausting chase with hounds. They called Roosevelt to the site and suggested he shoot it. He refused to shoot the bear himself, deeming this unsportsmanlike, but instructed that the bear be killed to put it out of its misery, and it became the topic of a political cartoon by Clifford Berryman in The Washington Post on November 16, 1902...
A Brooklyn store owner, Morris Michtom, saw the drawing of Roosevelt and the bear cub and was inspired to create a new toy. He created a little stuffed bear cub and put it in his shop window with a sign that read "Teddy's bear." The toys were an immediate success...
Metz has a decided highfalutin take on her sculptures:
...Like designer dog breeds, the teddy bear is a creature whose shape is dictated by social trends and the changing definition of ‘cute.’
Genus Ursulus: Teddy Skulls is a pseudo-scientific study of the morphology of skulls of teddy bears... Using a variety of store-bought teddy bears as ‘species’ source material, I am reverse-engineering what their skulls look like and the differences and similarities between ‘breeds.’ My approach is to make up evidence and document, present, and interpret that evidence in a formal manner.
I consider the skull to be an elegant structural armature for life, something that reveals historical clues and hints at individual stories that may never be told...
More photos here.

9 months from nirvana

9 Months from Nirvana blog follows the reflections of a man whose wife has became pregnant.

Margot Quan Knight photography

Margot Quan Knight is a surrealistic photographer who has done a few anatomical and medically-related photos:

Aftermath Two

Sweater (veins series)



There is a new search engine out there called cuil, created by engineers who left Google. It claims to search more webpages than Google and analyze the pages to create results (instead of basing search results on web user link preferences, like Google). It also has a different layout and design and a quirky "you might be interested in these searchs, too" box. And it advertises that it won't record any personal information about you (which Google does every time you search).

I tried searching for the term "cardiac arrhythmia" and then the term "critical care nursing" on both. In general, I would say that Google performed better. cuil's layout makes it easier to see every entry at a glance, but it isn't that big an advantage over scrolling since you have to read each entry anyhow. cuil's quirky box was useless. It also returned more business- and organization- related websites. For example, Wild Iris Medical Education came up on cuil's first page of "critical care nursing" results, whereas it was on the third page in Google. And there's a reason it's on the third page in Google, which is that "who cares" factor. cuil also returned a place where I can buy software for a PDA on the first page. When I search for critical care nursing, I want information about critical care nursing, not just places where I can spend more money.

The only interesting/useful advantage to cuil was that it returned information on British and European critical care nursing organizations that didn't show up on Google even after 5 pages of results. That makes me wonder if part of what's meant by (1) searching more pages and (2) analyzing page content instead of user links is that cuil tries to "level the playing field" with regard to the US dominance of world Internet usage.

The privacy issue is an advantage for cuil, too, but I don't see that it has much relevance to nursing--at least until your Google search for "how to cover up Heparin overdose" starts being admissible in civil actions.

For the time being, I'm going to stick with Google for most of my searching but I'll keep returning to cuil to see how it's doing, 'cause gosh don't they have a nice color scheme?

Richard Brookhiser on nursing

The last issue of National Review (LX 15) contained an essay on nurses in Richard Brookhiser's column "City Desk." Venturing out of his New York City apartment, he passes an outpatient KDU and takes a moment to reflect on the young people working there. Having suffered through testicular cancer, he is familiar with their work, and writes in conservative hagiography:
We are all good these days (haven't you heard?). Starlets cruise the plague and combat zones of the world for orphans of color. We are commanded to worry about polar bears and the ice-cap shortage. Habeas corpus will be extended to al-Qaeda and apes. But in the daily churn of ordinary life, these young men and women are committing more than their share of goodness.
He does well by male nurses, avoiding cliches about female nursing, although he does essentially refer to nurses as people who have just escaped welfare. This is a class matter. Nurses today are very touchy on this point, but there is no escaping that nursing still bears the marks of little white caps and skirts. Paul Fussell, in Class, A Guide Through the American Status System, calls nursing a job for female proles. Essentially any job, he says, in which you wear a uniform to work marks you as a prole. I find it hard to disagree with him. The years intervening 1983 and 2008 have served more to drag down medicine than to elevate nursing. The youngest doctors I work with seem almost wholly uneducated outside medicine and have poor command of language. As hospitalists, many of them are working for the man just as much as nurses and can be seen wearing around scrubs. Nurse practitioners often pointedly leave behind their scrubs for clothes sometimes dressier than the doctors, but still few are educated outside nursing and medicine. To my mind, among the youngest set in the hospital, the Physician Assistants tend to have the widest-ranging minds.

I'm sure most nurses today would take great offense at the suggestion that they are "working class," as we are all professionals now, as even Richard Brookhiser insists. But I'm afraid that's a sign that nursing still has a big inferiority complex.

Ian Fleming, RIP & heart disease

If you follow with any attention at all the James Bond movies, you are probably aware that they are based on books, which were written by the late Ian Fleming, a British journalist who served in naval intelligence during WWII. He was born in 1908, so this year marks the centenary of his birth. As part of the centenary activities, the British Heart Foundation is trying to raise awareness (and money) to combat heart disease. The rationale is that Fleming died of a heart attack. Although he was athletic as a youth, never obese, and kept active throughout his life with activities like snorkeling at his villa in Oracabessa, Jamaica, he was an avid smoker and drinker. His first biographer John Pearson records in Alias James Bond-The Life of Ian Fleming this medical assessment by a "New York heart specialist whom Fleming, unbeknownst to his friends, visited in the autumn of 1946":
The patient admits to smoking seventy cigarettes a day and drinking at least a quarter bottle of gin. He is not seriously ill but during the last two months has complained of a pain in the heart. He has slightly low blood pressure, the cardiograph shows an inverted T wave, but there are no important clinical symptoms of heart weakness. The above symptoms could all be the result of nicotine poisoning. I instructed the patient that the situation could not be improved by medication--only by will power.
This write-up was 18 years(!) before his death by heart attack on today's date, August 12, 1964. At 56 years old, Fleming was quite young, even for a time when people had shorter life expectancies. He left behind a wife who divorced her husband to be with him and a 12-year-old son.

R-3: why I haven't moved

Although I'm not sure the PostSecret website is all authentic, they occasionally have pieces that strike home anyhow. I've had several opportunities to move to better jobs in my hospital--in particular, an EMT position that I really should have taken, from a career, and possibly even ethical, perspective--but I've stayed put, apropos of this recent PostSecret...

Drug preferences by medical specialty

When I took an EMT-B class a while back, I noticed that there were a fair number of people in the class who were most worked up over the possibility of seeing car accidents and most engaged by the instructors' stories of having to hold in the intestines of an eviscerated patient. "This is what people want who go into emergency medicine," I thought. So, it comes as no surprise when Mindhacks reports that drug use is most high among doctors in nurses in emergency and critical care and lowest in surgery. Psychiatry also ranks highly, although with different classes of drugs. In nursing, but not in medicine, oncology also ranks highly. It doesn't surprise me to learn that oncology nurses use drugs, but I was surprised to learn that oncology nursing ranks with emergency and critical care nursing for binge drinking...


Graham was featured in some news mag article on medical bloggers a while back and became, I suppose, one of the most famous bloggers on the Internet. He's finished blogging for now as he graduated from med school.

Project N fail

I think one of the best nursing blogs out there is impactEDnurse (note: not ImpactedNurse). I don't follow it regularly, but recently Ian wrote that Project N, his and his readers' attempt to get textbooks to a Nigerian nursing school, seemed to have not come off well.

Of course, when I read this, my first thought was, don't they have the Internet? The obvious solution to continuously outdated textbooks is to create a digital, collaborative, open access textbook and try to get as many laptops to third world nursing schools as possible. In the short term, that takes a much larger capital investment, but I suspect it would save in the long term. Of course, the biggest problem is that the OLPC laptop is so constricted in its target audience. I don't understand why MIT didn't just create a laptop for third world nations in general instead of targeting children. Do the advantages of their ideas cease once you get beyond childhood or get out from total poverty into significant poverty?

There are other possibilities like the Koolu Works Everywhere Appliance, although at $299 + monitor, it is not really a substitute. Again, why there isn't something like a cross between OLPC and the WEA is beyond me, since the advantages of both are so great, but !!

Anyhow, a second thought I had was for nursing schools in first-world nations to adopt those in third-world nations. It could actually be made into a nice international relations/networking program. Say one nursing school each in Germany, UK, Australia, Japan, and the US collaborated on a school in Africa. You couldn't help very many schools this way, but you could help a few and it might be fun!

Geum japonicum for muscle recovery

I was cleaning today and came across two abstracts I pulled off MDConsult last year. Both deal with the effects of Geum japonicum, an herbal, on muscle recovery. In the first, an extract from the plant was found to promote muscle regeneration following "severe injury." In the second, an extract was found to be effective in promoting recovery from heart attack. Results of the study found a 35-45% reduction in size of infarct. That seems like a pretty big improvement to me. I think it's a shame that there isn't a little more leeway for using these things in the medical community. As far as I can tell, Geum japonicum is used in some bodybuilding products but isn't available as an herbal supplement by itself.

  1. Cheng L, Gu X, Sanderson JE, Wang X, Lee K, Yao X, Liu H, Cheung WL, Li M. (2006). A new function of a previously isolated compound that stimulates activation and differentiation of myogenic precursor cells leading to efficient myofiber regeneration and muscle repair. International Journal of Biochemistry and Cell Biology, 38(7), 1123-1133.
  2. Li M, Yu CM, Cheng L, Wang M, Gu X, Lee KH, Wang T, Sung YT, Sanderson JE. (2006). Repair of infarcted myocardium by an extract of Geum japonicum with dual effects on angiogenesis and myogenesis. Clinical Chemistry, 52(8), 1460-1468.

RN radio

If there were a radio station that nurses were going to listen to, wouldn't it make sense for it to be called "RN"? Does such a radio station exist? Actually, yes.

Australian Broadcasting Corporation (Autralia's BBC, I guess) provides Radio National (RN) for Australian listeners. Although not all the programs are related to nursing, a surprising number could be interesting/educational for student nurses or registered nurses. Of particular interest are shows called All in the Mind about psychology/psychiatry and Health Report. Also Ockham's Razor, about science, and Philosopher's Zone, about miscellaneous topics, have quite a few shows that touch on nursing themes. Right now, a sampling of ABC RN radio podcasts available for download includes:

The stomachs of champion eaters

Neurocritic writes about research on the physiology of being a champion eater. One paper in the American Journal of Roentgenology describes the physical differences between a champion eater and a normal person:
The regular guy went first, and stopped after seven dogs... Using fluoroscopy, an x-ray that gives a real-time view of what’s going on inside the body, the doctors saw what you’d expect: His stomach was indeed full of hot dogs and hadn’t stretched much from its original size.

Then they looked at the competitive eater. First, they noticed that his empty stomach showed virtually no peristalsis, the normal squeezing motion that helps the stomach break down food. He started eating hot dogs and his stomach got bigger and bigger. Ten minutes in, he’d eaten 36 dogs. He said he didn’t feel full, but the researchers told him they’d seen enough.

“His stomach now appeared as a massively distended, foodfilled sac occupying most of the upper abdomen, with little or no gastric peristalsis,” they wrote in their paper. Levine said the stomach was like no healthy stomach he’d seen in his 30-year career. He compared it to a “giant balloon that looks like it has no limit.” The eater’s previously flat belly swelled out as if he were pregnant.