Slim Novel 15 - http://adventuresofkimi.blogspot.com - See Homepage
13. Tricks a Medical Student Learns
Danny is just back from a 2-week study-stay under the great cardiologist Paul Dudley White at Harvard. It is early AM in library and he is sitting with Eddie. He has a blood pressure machine in hand. Also a stethoscope to listen to heartbeat.
"I learned a lotta tricks from old Dudley-White," Danny quips in his wise guy way.
"Fuddy Duddy, as the students call him behind his back, don't consider what he is teaching might fool insurance companies and Army induction draft boards." Danny laughs. Eddy thinks Danny as usual! Always fooling somebody! He says nothing and Danny continues.
"First, I learned how to make my blood pressure high and my pulse race like I am having a heart attack. Ever heard Mueller Experiment?"
Eddie shakes head No.
"Here it is." Danny makes an effort like he is taking a breath in. But instead of inhaling, he closes his windpipe 30 seconds and then breathes normally.
Turning head to Eddie, he says "I was seeming to take a big breath in. As you see, it can be done in a way no one would notice."
"So why call it Mueller experiment?" Eddie asks.
"Because some damn kraut named Mueller studied it as experiment to see what it does to the blood pressure and pulse."
"Well, what?"
"Let's do it. Wrap this cuff around my right arm and, first off, take my blood pressure and pulse when I am not trying any special breathing, just my normal resting."
Eddie does it and announces. "BP 135 systolic over 80 diastolic and 72 beats a minute."
"Danny smiles, "If you were an examiner from my draft board checking to see I am healthy for the Army, that would be a good BP to send me to get killed, right?"
"Right, so what else is new?"
Danny laughs. "OK, now Mueller experiment. I close-off my windpipe like making a breath-in so you don't notice. And I time it to coincide with your taking my blood pressure and pulse. Go ahead."
Eddie inflates the cuff again. Meanwhile Danny is making like he is breathing-in while actually no air is going in. He cunningly times it so the point where Eddie is letting air out of the cuff - the point where Danny's BP is being measured, coincides with his expansion of chest from the attempt to breathe-in against closed windpipe.
Eddie takes the BP and heart rate, In a surprise he says "165 systolic, 95 diastolic and 92 beats a minute!"
Danny now allows himself to breath normally and sings in parody "I won't be in the Army now, not with that hypertension and that rapid heart rate."
Eddie is impressed. Something else is new, he thinks. "Your Mueller is OK for avoiding draft into the Army but it certainly wouldn't help me pass a life insurance policy exam. In fact it would change my normal BP into hypertension and my normal pulse into tachycardia.
Danny gives his characteristic wise guy look. "Of course it would; it's a trick but only for avoiding the draft. I learned another trick up at Harvard. Ever heard Valsalva?
"Sure, it's what we all do every day sitting on toilet to take a shit. Women birthing a baby do it when pushing."
Danny goes into his explanation mode.
"The Mueller experiment raises blood pressure because when we make an inhaling with a closed-off windpipe, we don't expand our lungs but our chest expands and it makes a vacuum in the chest cavity that surrounds the big veins that feed blood to the heart. And this vacuum pulls on the veins and expands them and this sucks blood faster into the heart and the extra blood going into the heart gives a much bigger cardiac output of blood into the aorta and the arteries, and that gives the high BP that in a potential army inductee can be mistaken for hypertension and the rapid pulse that can be mistaken for a tachycardia.
The Valsalva is opposite. I close off windpipe and make the motions of trying to breathe out. And this sharply raises the pressure in the chest cavity and on the big veins and stops blood returning to heart, and the BP drops and pulse rate slows. So for an insurance exam when you have hypertension and you wanna leave a big bundle of money to your widow, you Valsalva as the insurance examiner is checking your BP and pulse. And then a high BP will become a normal BP for the minutes it takes the examiner to measure it."
Danny stops just as Nina comes from downstairs. He winks at Eddie. "We don't wanna teach lay persons our wise doc tricks do we?" Then looking at Nina with sex in his eyes he adds. But we do wanna lay particular persons.
Thus Eddie learns why medical students and doctors have higher draft deferment rates and leave more and larger life insurance pay offs to their heirs.
For next, click 15.14 Scenes from Death & Dying for a Medical Stud...
No comments:
Post a Comment