Introducing…

Our new collaborators:

Kasey Mackenzie

Kasey Mackenzie is a published author and certified paralegal with over 10 years of experience in the legal field, most recently working for a large, multi-practice law firm in St. Louis, Missouri. She possesses a Master’s Degree in Legal Analysis and does freelance writing for various clients and websites, primarily relating to the legal, marketing, and human resources fields.  Her urban fantasy series, Shades of Fury, is published by Penguin/Ace Books.  Passionate about both writing and the law, she enjoys computer games, knitting, reading, and spending time with her family.  Her website can be found at http://www.kaseymackenzie.com.

Kasey’s latest book, Green Eyed Envy, is available wherever books are sold.

Alba T.

Alba T. is a web developer, native New Yorker, and Mets fan who has worked in theater and fundraising, among other fields.  Oh, and she writes!  She can answer questions about computers, the internet, and everything involved in designing, constructing, and maintaining a website; stage production and all the things that go on behind the scenes in a theater; baseball; New York City; photography and digital cameras/post-production; political philosophy; and a lot of random miscellany.

If you have questions in any of the fields our contributors have graciously agreed to answer, please follow the “Ask your Questions” page instructions.
Posted in General | 1 Comment

Exciting Changes

So I’ve been maintaining this blog as my health and time allow for a couple of years now. I looked back over the statistics and realized that despite my health hiatuses and extended periods of forgetting this place exists over the last year, I’ve had over twenty thousand visitors to this blog. I feel both awestruck by that number and vaguely guilty for not devoting more time and attention to this endeavor. I am also a realist. The time to work on content that meets my expectations for usefulness, accuracy, and entertainment value isn’t going to magically appear (unless one of you readers would like to send me a Harry Potteresque Time Turner watch? No?).

Besides the time factor, there’s the issue of expertise. Questions keep trickling into my inbox. I love answering people’s questions, whether by email or here on the blog. It gives me an opportunity to stretch my research muscles, to learn something new, and to shrink that list of stuff I do not know. A few of the questions I get, though, fall pretty far afield of my own areas of expertise.

Here at Muse Medicine, we (and by that I mean me, since I’m the only one here right now) define an expert as someone who has sufficient specialized knowledge to locate answers, interpret the jargon, and, ideally, translate both into a format that people without that specialized knowledge can understand and use.

I have plenty of expertise in medicine, psychology, childbirth/pregnancy, and lactation, but very little in combat, law, geology, high-tech computer stuff, industrial security, and herbal remedies. Trust me, the list of what I do not know (yet) is practically endless. This is a good thing! More to learn.

So, for those of you who have questions in non-medical fields, or who look forward to shrinking your own “don’t know” lists, I’d like to announce some very exciting news! Over the coming weeks, I’ll be introducing experts in a number of fields who have agreed to answer your questions and do occasional guest posts on topics of interest to writers of all stripes.

Please continue to forward all questions to me via the “Ask Your Questions” page. I’d also love to hear any topics you’d like to see covered from any of the fields we have contributors for. Interested in black holes? Want to know more about Small Pox or the procedures used to set up secured computer facilities? Let me know and I’ll see what I can do.

Please keep in mind that the guiding principles of the site still apply:

The site is free…

…but the time of the volunteer contributors is valuable and given as they see fit. Be polite. Demanding emails or comments are unlikely to generate a lot of enthusiasm.

Realize that your question may not be something they can or will answer. I’ll  make every effort to have someone get back with you if you send me a question, but I don’t have Stephen Hawking on speed dial. Plus, some concepts are just too vast and require too much base knowledge to cover in this format.

Be aware that turn-around time will vary wildly, depending on how busy that contributor is, how many other people are asking questions, and how long it takes me to track somebody down.

The advice is for fiction ONLY

The advice given here, on any topic, should be considered as generalized and for the purposes of fiction writing only. (Notice how that was bold and italicized? Very important, that bit).

No advice here is intended for use on real people or animals, real problems, or real world situations. Legal and medical advice is strictly for fictional use only and not intended for diagnosis, treatment, or as a substitute for legal counsel or medical consultation.

Consider this a place where you can broaden your horizons, deepen your understanding of concepts, get exposed to new ideas that can germinate into stories, and find suggestions for dealing with your own story problems or starting points for doing your own research.

Contributors are human, too

All advice and information, no matter how well intentioned, is generated by human beings. Fallible human beings. That means that while we won’t steer you wrong on purpose, you should use due diligence in fact checking anything you see here if it is pivotal to your story. Ask us, and we’ll point you toward a starting point.

That said, if you see something that you feel might be an error, please let me know in comments. I strive to maintain the accuracy and usefulness of information presented here, whether I write it or not.

Altruism is awesome. So is exchange.

The contributors will be giving their time freely to help you out. This does not obligate you to buy anything, donate to their college funds, or raise their children. That said, it might be nice if you checked out their websites if linked, and/or let them know in comments here or at their main sites that you are reading and appreciate them. It is much easier to maintain interest in an volunteer endeavor if you get feedback from people who benefit from your hard work. Much harder if the words seem to be falling into a void.

One final note: If you are an expert in a field, broad or narrow, and would like to contribute to this blog and/or answer questions from other writers, please contact me. All contributions are accepted, pending editorial review by yours truly and are required to maintain standards of accuracy, usefulness, and readability (ie, tell the truth about stuff people care about without boring them to death).

As always, feedback on this or any other post is very welcome.

Posted in Muse Medicine Updates | Tagged | 3 Comments

Cautery Basics

A question hit my inbox recently regarding cautery.

If you’ve never heard the term before, cautery (aka cauterization) means the intentional burning or scarring of tissue as a means to:

  1. Stop blood loss and seal blood vessels
  2. Sever tissue (for instance during a female sterilization procedure where the tubes allowing the egg to travel to the uterus are severed with electrocautery)
  3. To remove growths (like moles, warts, etc.)

Basically, the purpose of cautery is to destroy tissue. The burns produced are typically second degree (blisters), but if handled clumsily can easily become third degree burns that go clear through the skin.

Surgical cautery is often used in modern settings to seal a single stubborn blood vessel, to carefully pare off or to destroy unwanted tissue as in the case of cancerous cells, moles, or lesions caused by viruses, or to surgically separate tissues with minimal blood loss. The two types of cautery used for modern surgical intervention include electrocautery which uses an electrical instrument (see photo) to generate the burns or chemical cautery which involves the application of acids, freezing chemicals, or other chemical substances that produce a chemical or frost burn.

The old fashioned form of cautery was a little… less refined. A (typically iron) implement was heated to glowing red hot and pressed against or into an open wound, typically deeper wounds like arrow or bullet hole. In most cases, the person would have been better served to apply pressure to stop bleeding and then keep the wound clean with boiled water.

The other historical use for cautery is to seal a field amputation. Amputation is the removal of a whole or partial limb, typically arms, legs, feet, or toes (or more rarely, castration). Prior to modern micro-surgical technique (and especially in battle-field situations where time was limited and patient numbers were overwhelming) amputations were performed by applying a tourniquet above the cut line to prevent massive bleeding, cutting through the tissue to the bone, sawing through the bone, and cutting through the remaining tissue. As you can imagine, this was a very blood procedure. The risks of infection were astronomical, but the risks of bleeding to death when the tourniquet was removed were even higher. Rather than allow their patients to die from blood loss, field surgeons performed cautery to seal the end of the amputation. Keep in mind this was also before the use of anesthesia became widespread. Ye-ouch!

So when is cautery appropriate?

Basically the only times when cautery is really a good idea* is when you’re in a well controlled situation (operating room, hospital ER) or when the risks of not performing cautery outweigh the huge risks of second and third degree burns.

There are a few other instances when a writer might consider the benefits of cautery, though. Historically cautery has been used to brand people (as tribal markings, disfigurement, self-mutilation, or marks of ownership in cases of slavery), as a torture method, or as a means of obscuring distinguishing features (birthmark, scars).

What is cautery like?

The first thing the people who aren’t the one being cauterized will probably notice is the smell. If you’ve never smelled burning human flesh (and often hair)… well, let’s just say you don’t forget it. There will be a small amount of smoke if the cautery involves heat, and possible a chemical smell if a chemical cauterization agent is used.

The person getting this treatment will probably not notice much other than the burning AGONY OH MY GOD THE GOGGLES, THEY DO NOTHING! Screaming. Lots of screaming.

Aftercare

After the fact, treatment consists of keeping it clean (preferably with water boiled for 20 minutes or so), keeping it covered with a clean dressing, and try not to use it more than necessary so the tissue can heal. Don’t poke it or pick at it. Watch for signs of infection – spreading redness, pus, blackening tissue that sloughs off, foul odors.

One small caveat – I noticed that the Wikipedia page lists prevention of infection as one of the reasons for cautery, which always kind of struck me as dumb, considering the fact that you are basically scalding the skin and creating an ideal environment (moist, warm, full of the food of dying tissue) for bacteria to grow. Turns out that cautery done in the old days caused as much infection as it prevented (if not more), so I did not include that in my list of reasons why, though it has reportedly been one of the justifications for this procedure. (edit: I actually submitted a correction to the Wikipedia page, with reference and the page now lists prevention of infection as a historical rational that has no modern day merit)

*Which is not to say that characters can’t have good intentions and still do something incredibly stupid *evil grin*

Posted in infection, Treatments, wounds | Tagged , , , , | 11 Comments