The Seattle Intensivist’s Blog
Spherical Sanitarium: What can a 900 ton steel sphere teach us about bad medicine
In 1928, the residents of Cleveland, Ohio watched in wonder as a unique structure was erected along the shores of Lake Erie. Over months a huge steel ball took shape, some 64 feet in diameter containing five stories. When it was completed it held 38 rooms, 350 portholes to provide natural light, an elevator, and an ornate recreation room replete with crystal chandeliers. This strange spherical building was the first - and only - of its kind in the world: a hospital pressurized to 60 PSI that promised a panacea for its patients, able to cure a broad range of ailments ranging from diabetes to pernicious anemia to cancer. This was Dr. Orval Cunningham's Sanatorium, or “Timken's Tank,” after its benefactor, the “Baron of bearings” tycoon Henry H. Timken who bankrolled the $1,000,000 to build it. This unusual sphere was both an early hyperbaric hospital and a 900 ton monument to the dangers of unscientific medicine.
Tactile Fremitus: Lost in Translation
Mark Twain said “Be careful reading medical texts, you may die of a misprint” Perhaps he should have also warned about mis-translations too.
One conspicuous example of a mistranslation turned myth is when students are instructed to have a patient repeat “ninety nine” while feeling for tactile fremitus.
Dissipating The Myth of Shoe Covers
If you work in a hospital chances are you've put on shoes covers. This is a well intentioned practice largely predicated on a misunderstanding about the history of medicine. Originally, shoe covers were about preventing operating room fires not infections.
Is Critical Care becoming a Cargo Cult of Vitamin C?
Dozens of institutions have embraced the “metabolic cure” based upon evidence far flimsier than would be required for any “non-natural” medicine. Non-falsifiable theories ("this patient was saved by vitamin C”) are proffered as fact.
Whether the “metabolic cure” is truly a panacea or not remains to be rigorously tested. Whatever the outcome, the rituals practiced by the cargo cult of critical care must be questioned. Surely, if a plane did land on an Atoll, it was not brought there by magic.