"The world’s most experienced penis reattachment surgeons can be found in Thailand..."

"... where, during the 1970s, an estimated one hundred vengeful Thai wives, spurred by media coverage of a prominent 1973 case, sliced off the penises of their adulterous husbands as they slept. When a suitably equipped microsurgeon was on hand to reattach the errant appendage, the men were able to resume philandering within a matter of months. Though probably with reduced success: The penises, though operative, were shorter, numb, and often only partway erectable. The most serious complication, in the Thai attacks, was infection. Two of the wives flushed the penises down the toilet, forcing their husbands to grope for their lost manhood inside the septic tank. (Incredibly, both were found, cleaned, cleaned some more, and reattached.) More commonly, the women would hurl the penis out the window. In the cases described in 'Surgical Management of an Epidemic of Penile Amputations in Siam,' all the recovered penises were 'grossly contaminated.' Better that than eaten by livestock. Many rural Thai homes are elevated on pilings, with the family’s pigs, chickens, and ducks tending to mill about seeking shade in the space underneath. It is not, oddly, the pigs, but rather the ducks, that the castrated Thai must worry about. The paper does not provide the exact number of penises eaten by ducks, but the author says there have been enough over the years to prompt the coining of a popular saying: 'I better get home or the ducks will have something to eat.'"

I'm reading "Bonk: The Curious Coupling of Science and Sex," by Mary Roach.

Arms transplanted.

To an Iraq War veteran who lost both arms and both legs.

Brendan Marrocco is the first Iraq War veteran to survive losing all four limbs in a bombing

His chief surgeon, Dr. W.P. Andrew Lee, said Marrocco’s operation was “the most expensive and complicated arm transplant surgery ever performed."

"To begin Aspiration Therapy, a specially designed tube, known as the A-Tube™, is placed in the stomach."

"The A-Tube is a thin silicone rubber tube that connects the inside of the stomach directly to a discreet, poker-chip sized Skin-Port on the outside of the abdomen. The Skin-Port has a valve that can be opened or closed to control the flow of stomach contents. The patient empties a portion of stomach contents into the toilet after each meal through this tube by connecting a small, handheld device to the Skin-Port. The emptying process is called 'aspiration.'"

If bulimia is somehow wrong, how can this be a legitimate medical treatment?

Via Metafilter, where somebody penned the slogan: "When one anus isn't enough."

Al Roker: "I pooped my pants" at the White House.

Something to think about before you spring for that gastric bypass surgery.

In discussing what makes a job the "least stressful"...

... consider that, in this context, the opposite of stress is control.

Is that true? For some, I would think, too much control would lead to stress. Let's say much was expected of you. You were supposed to be brilliant, high-achieving, and productive. But it was your responsibility to define your tasks, to figure out how to accomplish them, to set your own standards about what constitutes excellence, and to put time — any time, whenever you want, night or day, weekdays or weekends — into doing what you've decided is appropriate to do.

There is some reason to think that people feel best when they are in the psychological state called "flow," which is defined as having 8 components:

First, the experience usually occurs when we confront tasks we have a chance of completing. Second, we must be able to concentrate on what we are doing. Third and fourth, the concentration is usually possible because the task undertaken has clear goals and immediate feedback. Fifth, one acts with a deep but effortless involvement that removes from awareness the worries and frustrations of everyday life. Sixth, enjoyable experiences allow people to exercise a sense of control over their actions. Seventh, concern for the self disappears, yet paradoxically the sense of self emerges stronger after the flow experience is over. Finally, the sense of the duration of time is altered; hours pass by in minutes, and minutes can stretch out to seem like hours. The combination of all these elements causes a sense of deep enjoyment that is so rewarding people feel that expending a great deal of energy is worthwhile simply to be able to feel it.

Can you get there within the "least stressful" job, university professor? Of course. But you'd better be good at defining realistic tasks that will look accomplished when they are accomplished. You'd better be able to get into the zone where you feel a sense of effortless expertise.

Mihaly Csikszentmihaly's book "Flow" identifies surgery and rock climbing as 2 activities that produce flow for the people who have the appropriate expertise. There, the tasks are specific, and the feedback about whether you are doing them right is clear. Compare a scholarly book project, which might take years, where you might wonder whether what you are writing is too dull or too controversial or unsupported by the data you're trying to use or who knows what your colleagues — your rivals? — will say about it at some unknown point in the future if you ever get this damned thing done?

"I want to become a doctor... because I want to save people."

"And when I do, I won't take any money from them."

Best face transplant ever.

Look at the pictures of Richard Lee Norris before and after his horrible gunshot injury and then 7 months after he got a new face, teeth, tongue and jaw. Incredibly, this 37-year-old man looks better than he did before the accident. I'd like to see a picture of the donor. Did he look like Jean-Paul Belmondo?

How do you live without your stomach?

I was wondering, after reading about this poor young woman who had her stomach removed to save her life after she drank a cocktail that contained liquid nitrogen:

"This girl is the victim of an irresponsible alcohol industry that's now competing on gimmicks. People should not be playing chemistry in public houses. This is a very, very cold substance and it is similar to subjecting your oesophagus and stomach to frost bite."...

[L]iquid nitrogen - which vapourises at -196C - has been increasingly used in recent years in the preparation of drinks. It is used to chill glasses and is a crowd-pleaser thanks to the dramatic-looking water vapour it releases at room temperature.

I found this article "Life without my stomach" about a women who, at the age of 27, opted to have her stomach removed because she had the gene for a form of stomach cancer that would kill her if she waited for it actually to develop, which was 90% likely, given the gene. So, then, how do you eat?

As my stomach had been cut out, part of my small intestine was joined directly to my stomach in what is called a Roux-en-Y reconstruction. Without a stomach, my food passed directly from my oesophagus into my small intestine.

With time, I was told, the body would adapt; the small intestine would make a small pouch where food could be stored a little longer (mimicking the stomach), before it continued on its way. It is one of the human body's remarkable survival mechanisms.

Weighing about eight stone, I could not afford to lose much weight. The doctors were concerned about this, so I went home with a feeding tube inserted into my bowel. It was attached to my body just above, and to the left, of my belly button with three little stitches and a plastic triangle. I was to hook it up to a machine each night, which would drip food into my bowel, bypassing the area on which I was operated. I never liked feeding that way because I always woke up feeling really full.

But I didn't have to rely on this for long. Soon, I was also managing to eat small amounts, which meant that I had to eat often. After experimenting, I found I could eat whatever I wanted, and it didn't seem as if there were any particular foods that were going to upset me. I have always enjoyed eating healthily, so I was happy I could still take pleasure in a bowl of fruit and yogurt in the morning.

Given that I was eating so well, it was not long before my feeding tube was removed. To this day, I am really lucky in that I can eat any foods I want. The only difference now is that I eat slightly smaller portions....

Sometimes adhesions cause intense pain and she has to stop eating and drinking and take painkillers and, if the pain doesn't end, go to the hospital. "I can't say this doesn't worry me; I really don't want to be a sick person." She's not yet able to live independently, and she wonders about having children, but only because the condition is genetic. "And, in response to the question as to whether I regret my decision to have my stomach removed, my answer is simple – no way."

"I expect that later this century we'll see a growing trend around the world of many couples deciding in advance to simply not have children."

"Hopefully this will occur via mutual agreement for the man to have a vasectomy early on."

Not everyone has to agonize over choosing life priorities, and I think it's likely more and more will choose to skip mom-ism altogether,... maybe for economic reasons, and maybe because we'll have more talk about women asking themselves, "Do I really want to raise kids?".  "If I love kids, would I rather free myself to work with lots of them in other settings?"  

Oh, what could go wrong?!

That's one of the early comments on an article over at The Nation, by Jessica Valenti, "I'm Not a 'Mother First,'" which begins:

Last week, Republican presidential hopeful Mitt Romney said it was better for children to have a parent at home. “To have one parent to stay closely connected and at home during those early years of education can be very very important,” he said. It’s not hard to imagine which parent he’s talking about.

Romney’s statement didn’t elicit much in the way of outrage, a sign that American women have one more hurdle to overcome on the way to equality: the sexism of mom-ism. It’s no longer enough that women love their children. To be a truly committed parent, women are expected to be mothers above all else—we’re “moms first.”

To make her point, Valenti must reject Romney's use of the sex-neutral word "parent." Why not take it seriously? What does she do when her standard template doesn't fit? Just force it on anyway. Why weren't American women outraged at the sexism of Romney's statement? Because it wasn't sexist! It was putting children first.

And let's get some respect for the men who take the role of at-home spouse in the single-earner family (or who modify their work life to be the parent spending the most time "closely connected and at home"). Valenti mentions fathers in only one paragraph:

Fathers are never expected to subsume their identity into parenthood the way that mothers are. If President Obama were to tell us that he is 'father-in-chief' first, America would balk. How could a man be an effective president if he put the needs of his children above the needs of his country?

Women aren't expected to subsume their identity into parenthood anymore either. It is a choice, and a woman who makes that choice is at least as likely to be disrespected as to be praised.

And maybe President Obama should have waited until his girls were older before he immersed himself in the overwhelming duties of running for and serving as President. For some reason he had to jump in when he did, despite his and his daughters' youth. We were just about to get the first woman President, so the time was ripe.

ADDED: Hillary Clinton would have been a better President. Where's the outrage about that?

"Surgeons removed the rear quarter of Jamie Hilton's skull and placed in her abdomen..."

"... so that the bone would remain sterile and nourished as her brain swelling subsided."

The movement of his eyes back and forth sounded like sandpaper on wood.

He heard his heart pounding, all the sounds of his own body. It tormented him for 10 years, but it was caused by something specific, and there was a surgical treatment.

Summer camp for "kids who don’t fit into society, gender-wise."

Founded by Nick Teich, identified by the Boston Globe as "a social worker who is pursuing a doctorate in social policy from Brandeis."

“Before camp, I was really shy and not confident,” said Gabriel, 15, who has attended camp all three sessions it has been open. “Now, I feel less alone and way more confident.... Here, I realized there isn’t anything wrong with me and there were people like me,” he said. In fact, transgender topics don’t come up all that often at camp, he said. “It’s like it’s not even there, but if we want to talk, we feel totally safe talking to each other.”...

Damien Gabriel, like some of the others, had been on hormone blockers to keep the estrogen at bay and last year started taking testosterone. Two months ago, he had chest surgery to remove breast tissue; he also had a hysterectomy, “which really hurt.”...

The girls tend to wear bikini tops with shorts or little skirts, while the boys wear knee-length swim trunks but leave their T-shirts on. Some, Teich said, wear a binder to flatten their chests. The few who have had chest surgery display bare chests — with horizontal scars.

A WaPo writer "searching for the 'authentic America'" is delighted to travel to Madison, Wisconsin.

"We’d always heard about that mythically quirky place called Madison, a free-spirited land with far fewer chain stores and BlackBerry addicts than Washington," enthuses Emily Wax. Man, living in Washington, D.C. really lowers your standards of authenticity.

Influenced by the 2011 documentary “Wisconsin Supper Clubs: An Old-Fashioned Experience,” Wax goes to the restaurant called Old Fashioned, which is fairly new, and not one of the funky old places I think of as "supper clubs." She eats some fried cheese curds and says she has no idea how to tell whether cheese curds are especially good. (Answer: They squeak. Except they don't squeak if they're fried.)

She drinks the cocktail called an Old Fashioned, and then on another day she has another Old Fashioned and proclaims "How Madison!" On another day, "my husband and I headed for a romantic dinner at the sexy, dimly lit Tornado Steakhouse," which supposedly "has a wonderful menu."

And so did she achieve it, that sense of authenticity infusing the city, of delight with mythical quirkiness all around her, of free-spirited energy rushing through everything alive? Myself, I'm over-indulging in deep-fried prose tonight and wondering if I need to see a surgeon to get my neural pathways reconnected. I'm losing it somehow, as I gaze out on the treetops of Madison.

"To my astonishment and dismay, while my orgasms were as strong and pleasurable as ever, something very different was happening after sex, to my mind."

Said feminist attention-seeker and erstwhile Al-Gore-adviser Naomi Wolf.

"I realised one day, as I gazed out on the treetops outside the bedroom of our little cottage, that the usual post-coital rush of a sense of vitality infusing the world, of delight with myself and with all around me, and of creative energy rushing through everything alive, was no longer following the physical pleasure."

Something is infusing my world right now, I'll tell you that.

"I felt I was losing somehow, what made me a woman, and that I could not face living in this condition for the rest of my life."

May I suggest wearing earth-toned clothing? Oh... no... I see... you found the solution in surgery.

[New York gynaecologist Dr Deborah] Coady told her it could be a problem with the pelvic nerve - her area of expertise - being compressed and [causing] numbness....

She was referred to Dr Jeffrey Cole, an expert in muscular-skeletal medicine who x-rayed her back and found a crumbling of her vertebrae, even though she had never experienced pain or back problems....

Dr Cole told her: ‘All women’s wiring is different. That’s the reason women respond so differently from one another sexually. The pelvic nerve branches in very individual ways for every woman. These differences are physical’.

He added that men’s sexual wiring is much more uniform.

Yes, once again we learn that we women are so fabulously multidimensional and men are so simple. So let me tell it to you straight: Cough up the tax money to pay for the fancy diagnostics of our neural misalignments and the surgery to reconnect us so we can have  "the ‘blended’ clitoral and vaginal orgasms" that will return women to "the sense of deep emotional union, of post-coital creative euphoria, of joy with oneself and one’s lover… and the sense that all was well in some existential way, that [Naomi Wolf] thought [she] had lost for ever." And don't be raising any of your war-on-women objections. 

Of course, she has a new book. It's called "Vagina: A New Biography."

Is it really the story of her vagina? Seems more like the story of a few of her vertebrae. But it's all connected. Elaborately. Complexly. Mysteriously. Now, shut up while I gaze upon the treetops outside the bedroom of my little cottage and contemplate the extent of my euphoria.

ADDED: She's writing the kind of claptrap that feminists used to quote for the purpose of mockery.

IN THE COMMENTS: In Wolf's cogitations, Scott Bradford hears something familiar: "I first became aware of it, Mandrake during the physical act of love.... Yes, a profound sense of fatigue, a feeling of emptiness followed. Luckily, I was able to interpret these feelings correctly."

"At the end of the day, the biggest impact you can make in anything is through kids."

Said the children's surgeon, who died yesterday in Lake Michigan, saving children.

"I had my tonsils out and was in the Evelyn Nursing Home feeling sorry for myself. Wittgenstein called."

Wrote Fania Pascal, back in the 1930:

I croaked: “I feel just like a dog that has been run over.” He was disgusted: “You don’t know what a dog that has been run over feels like.”

That's quoted in Harry G. Frankfurt's book "On Bullshit." Frankfurt aptly wonders if that really happened like that:

It seems extraordinary, almost unbelievable, that anyone could object seriously to what Pascal reports herself as having said. That characterization of her feelings — so innocently close to the utterly commonplace “sick as a dog” — is simply not provocative enough to arouse any response as lively or intense as disgust. If Pascal’s simile is offensive, then what figurative or allusive uses of language would not be?

So perhaps it did not really happen quite as Pascal says. Perhaps Wittgenstein was trying to make a small joke, and it misfired. He was only pretending to bawl Pascal out, just for the fun of a little hyperbole; and she got the tone and the intention wrong. She thought he was disgusted by her remark, when in fact he was only trying to cheer her up with some playfully exaggerated mock criticism or joshing. In that case the incident is not incredible or bizarre after all. 

Pascal needs to be more appreciative of having a friend like Wittgenstein. I'd say. But Frankfurt credits her with having this friendship and therefore with an aptitude for discerning whether Wittgenstein is cranky or nice. He decides to take her report as "sufficiently true to her idea of Wittgenstein to have made sense to her" and to "accept Pascal’s report at face value, supposing that when it came to the use of allusive or figurative language, Wittgenstein was indeed as preposterous as she makes him out to be." That is, Pascal — who might lack a sense of humor — now gets credit for having portrayed Wittgenstein as ridiculous, as if she'd made a joke rather than not getting the joke.

But Frankfurt's agenda is talking about bullshit, not analyzing the quality of a joke. She was bullshitting about how she felt by carelessly likening it to something overly specific — how a run-over dog feels. So Wittgenstein was essentially saying: That's bullshit. The key point — for "On Bullshit" purposes — is that Pascal doesn't care about the truth with respect to how the dog feels. So then Wittgenstein could be disgusted because of the way she didn't care about how the dog felt.

But it's not as though there were any real dog that had been run over. Pascal wasn't being callous toward an actual suffering being. The suffering being was Pascal, and the callousness, if any, was Wittgenstein's. On this theory, which hurt Pascal's feelings, he was saying, essentially, let's not talk about your mundane little tonsil surgery and its predictable after-effects. Let's talk about something philosophical, and the first thing that springs to mind is that dog you just mentioned. And he introduces the new topic. Ironically, the distraction into the random issue of animal feelings was much more likely to alleviate Pascal's pain that going on about the details of the surgery.

In Frankfurt's view — the context of bullshit — Wittgenstein is disgusted by bullshit, the laxity about what is true. I sidetracked the discussion into the question of concern about suffering. But the original topic — and the theme of the day here on the blog — is joking.

Joking has a lax connection to truth and to suffering.

"I got the idea spontaneously.... I'm a man of science, I have a very high IQ."

"I thought, I'll get rid of it.... I have the ability to solve problems in a second."

Said the professor, explaining his thinking after he cut off his wife's lip, when he realized doctors might be able to sew it back on. She'd told him she wanted a divorce. He ate the lip.

Post-gastric-bypass surgery, prisoner needed much more time to eat and now he's suing for $80 million.

At Rikers Island, they only give you 4 minutes to eat, but in his condition, Michael Isola needed to chew and swallow slowly. Speed-eating led to vomiting and — he says — the separation of his stomach from his intestine. And extreme weight loss.

"By 5 o'clock today, you're going to have a Republican liver!"

"You're going to love Ann Coulter! You're going to love Glenn Beck!"

"No way!" protested Tim, a staunch Democrat. He swore that even with a chunk of his Republican brother-in-law's liver inside him, he'd never be conservative. The foursome joked and laughed during the 45-minute drive to Lahey. At the hospital, the sisters kissed their husbands goodbye, and the men were wheeled into operating rooms, where surgeons would remove 60% of Paul's liver and give it to Tim, who suffered from advanced liver disease.

A year later Tim was dead, and Paul died in the operating room that day.

Stomach-stapling surgery as the preferred treatment for diabetes.

"The new studies...  are part of a push by surgeons and obesity experts to establish a role for the operations in treating diabetes, not just obesity...."

The obesity experts with their bariatric surgery are big players in the market in health care. Where will all the money be channeled? I can't help feeling very negative about surgery that simply makes it really hard to eat, but that only produces weight loss because the person is eating less, which could be done without surgery. Just eat less! That would be free. That would save money. But so many people cannot do that.