Extreme Medicine (31 page)

kidney transplants, 53, 61

Korean War, 96

Ko San, 198, 199

lactic acid, 119

Laika (dog in space), 254

Larrey, Dominique-Jean, 95–97, 111

larynx, 156

Lassen, Henry Cai Alexander, 129

lens system, 220

life, edge of, 115

life expectancy, 245, 250

life-support systems:

in space, 186, 191, 193

and trauma, 111, 115

for trip to Mars, 229–31

when to stop, 120

Light, John, 115–16

Li Moon Ki, 121

Lindfield, Henry, 244–45

lithium hydroxide, 226

Liu Jianlun, 139–40

liver transplants, 61

lungs:

and aging, 247

air in, 154, 157, 169

and breathing, 156, 161

and buoyancy, 157

carbon dioxide expelled from, 132, 133

in diving, 167

inflating, 184

and rupture of alveoli, 169

TB in, 241

transplants, 61

water in, 158

Magellan, Ferdinand, 255–56

Malenchenko, Yuri, 201, 202–3, 206

Mamanuca islands, 171

Manish (resident), 69–70

marker proteins, 56

Mars, 211–14

getting to, 224–27, 232, 234

gravity of, 235

life support for trip to, 229–31

long-stay architecture, 225, 226

orbit of, 225

resupply for, 226

short-stay architecture, 225–26

MASH units, 96

masks, high-filtration,
118
, 144–45

Mauritius, 121–23

polio epidemic on, 122–23, 127

maxillofacial surgery, 47, 246

McIndoe, Archibald, 43, 44–48, 54, 56, 65, 256

medicine, frontiers of, 72–73

mercury, 164–65

microsurgery, 49–50

Middlesex Hospital, 97–98, 100–102

Mifsud, Stéphane, 166

Mir,
229

mitochondria, 124, 156

mitral valve, 85–87, 88–90

Moon:

astronauts on, 253

as destination, 212, 213, 232, 236, 255

studies of, 253–54

Moore, Nick, 116

motor cortex, 123, 124–25

mountaineers, 182–83

Mount Everest, 182–83, 185, 190

Mount Vernon Hospital, 240–42, 244

MRI (magnetic resonance imaging), 60

muscle contraction, 125

muscles:

aging, 246–48

wasting away, 218, 221–22

Næsheim, Torvind, 15–18, 29

Napoleonic Wars, 97, 111

narcotic effects (“narcs”), in diving, 170, 171

NASA, 181–82, 187, 191, 195–96

Apollo space program, 213, 215

Artificial Gravity Pilot Project, 233–36

author's internship with, 181–82

budget cuts in, 236

Challenger,
186, 190, 205

Columbia,
186, 190, 205

Enterprise,
180
, 195

Kennedy Space Center, 187, 191–92

and Mars, 211–14

and space shuttle, 187, 191

training aircraft,
210
, 215–17

X-38, 195–96

negative buoyancy, 155, 158

nervous system, cells of, 125–26

neurons, 124–26

neutrality, 10

Nimrod,
27

nitrogen, 170–71, 175–76

Nitsch, Herbert, 166

non-heart-beating organ donation, 53–54

noradrenaline, 143

nuclear arms race, 254

Oberth, Hermann, 230, 231

orange angels, 215–17

orbit, use of term, 190

orbits, of Earth and Mars, 225

organelles, 124

organ transplants, 52–53

and immune system, 55–56

matching donor and recipient, 56

non-heart-beating donation, 53–54

order of retrieval for, 61

Orpington General Hospital, England, 42–43

otoliths, 218, 219

oxygen:

absence of, 177

in air, 170, 183–84

in the blood, 142, 163

and breathing, 156, 184

in diving, 166

supplemental, 182–83

supply of, 165–66

under pressure, 170, 184

ozone hole, 28

Paget, Stephen,
Surgery of the Chest,
73

parabolic flight, 216

parafoil, 196

Parkland Memorial Hospital, Dallas, 57

pearl divers, 162

Peiris, Malik, 147

penicillin, discovery of, 85

photosynthesis, 226–27

plasticity, 48–49

plastic surgery, 44–48, 58, 257

poliomyelitis, 126

and anesthesia, 130–35

infantile paralysis as, 127

and intensive care, 130–31, 135, 148, 256

and iron lungs, 131, 132–33, 256

polio epidemic in Copenhagen, 127, 129–35, 148, 256

polio epidemic on Mauritius, 122–23, 127

polio virus, 125, 127

vaccination against, 148, 256

Polyakov, Valeri, 229

Pomahač, Bohdan, 54–55, 56, 58–64

Ponting, Herbert, photo by,
8

pregnancy, 86

pressure:

air, 168–69, 170–71

at altitude, 183

at sea level, 170

water, 169

wound of, 170

pressure cookers, 185

pressurization, of airline cabin, 183

priority, ABC, 99–100, 105, 109, 110

proteins:

and burns, 42

matching, 56

public health, 147–48

pulmonary artery, 76

Qalito, 171–77

quadriceps, 218

Queen Victoria Hospital, England,
30

and McIndoe, 46

Ward 3 in, 43–48

radiation hazards, 227, 228

radiology, 87

reconstructive surgery, 257

redundancy, 192

respiration, anaerobic, 166

resuscitation:

and hemorrhage, 113

intraoperative, 82–83

key to, 19

and survival, 257

retina, 219–20

return to landing site (RTLS), 192–94

rheumatic fever, 86, 89

ribosomes, 124

ribs, 156, 158

risk, 92, 252–53, 254

rocket science, 190–91, 205

Ross Ice Shelf, 9, 12, 27

Royal Air Force (RAF), 38–41

Russian Progress vehicle, 226

SARS, 139–48

contagiousness in, 146

declining number of cases, 146–47

and Gomersall, 142–46

how it works, 140–41

and intensive care, 148

and Liu, 139–40

and masks,
118
, 144–45

SARS-CoV, 147

survival, 148

science fiction, 193–94

Scott, Robert Falcon:

death of, 14, 15, 26, 253–54

and hypothermia, 9, 12–14, 26

legacy of, 27–29, 72, 207

ship of,
8
, 27

SCUBA (self-contained underwater breathing apparatus), 167–68

scuba diving,
152

seasickness, 220–21

semicircular canals, 233

Shackleton, Ernest, 27

shock caused by hemorrhage, 83, 84

Siebe Gorman diving gear, 167

Singstad, Ketil, 17

sinking, 155

skin, 32–36

aging cells, 246

and blood supply vs. beauty, 45–46, 50, 64

bridged to face,
30

burned, 32, 36

cold receptors in, 161, 164

dermis, 35

epidermis, 34–35

as essential organ, 37

free flap of, 50, 58

grafted, 56

microsurgery on, 49–50

new cell growth, 36–37, 126

and plastic surgery, 44–48

reconstruction of, 46, 50

remapping the circulation of, 50

sensory array of, 35–36

strata of, 34–35

vapor barrier, 37

vascular anatomy of, 50–51, 60

waltzing, 45–46, 48–49, 256

skin diving, 162–63

Smithy, Horace, 87

sodium thiopental, 134

solar flares, 227–29

solid rocket boosters (SRBs), 188

South Pole, 9, 27–29

Soyuz space vehicle, 196

on reentry, 204–7

TMA-12, 200–202

space:

and Armstrong line, 184–86

artificial life support in, 186, 191, 193

Assured Crew Return Vehicle, 196

deep-space maneuvers, 225

Enterprise,
180
, 195

exploration of, 207

frontier of, 186–90

Mars,
see
Mars

medical emergency in, 194–95, 196

mishaps in, 207

and NASA training,
210
, 215–17

and nuclear arms race, 254

orbital flight, 207, 212–13

radiation hazards in, 227, 228

and return to Earth, 205–7, 208, 223–24

solar flares, 227–29

X-38, 195–96

spacefall, 224

spaceflight:

consequences of, 230

use of term, 224

space shuttle, 187, 191–94, 196, 208

space vehicles, 204–5

Spanish flu, 240

spinal column:

and erector spinae, 217

in trauma cases, 99–100

spleen, 165

Sputnik, 254

Starr, Harold Morley, 39

Statti, Giorgios Haggi, 162–63, 167

stem cells, 34, 240

stroke, 125

Styner, James K., 105–9, 113

suction, 156

supernova,
238

survivability, limits of, 5

synapse, 125

syphilis, 135

Taylor, Ian, 50–51

Terra Nova,
8
, 27

testosterone, 247

thermal shield, 205

thermal tolerance, 42

thoracic aorta, aneurysm of, 23

thoracic surgery, 80, 81, 84

thoracotomy, 71

Torquemada, Tomás de, 234

trachea, 156

tracheostomy, 133–34

transatlantic abort (TA), 193

transfusion medicine, 87–88

transplant medicine, 52–54

transplants:

full face, 52, 54, 55, 58–64, 257

and immune system, 55–56

trauma, 243

ABC priority in, 99–100, 105, 109, 110

Advanced Trauma Life Support protocol, 100, 105, 109, 111, 113

and airplane crash, 105–9

barotrauma, 170

body's response to, 113–14

and bombing incident, 102–5, 109–11, 115

derivation of word, 98–99

and hemorrhage, 110, 113

and immune system, 114–15

and intensive care, 115

protocols in, 104–5, 108–9, 111–12

spinal column in, 99–100

Tromsø University Hospital, Norway, 19–23, 29, 257

tuberculosis, 241

Tudor Edwards, Arthur, 79–80, 81

unconsciousness, of anesthesia, 128–29, 134

underwater exploration, 177–78

Urbani, Carlo, 135–38, 139, 147

U.S. Army hospital, England, 82

vapor barrier, 37

vena cava, 76

ventilators, 128, 135

iron lungs, 131, 132–33, 256

and SARS, 142–43

vestibular system, 233

Victoria,
255–56

Vietnam War,
94
, 96

viral pandemics, 126, 135, 147–48, 240

viruses, 126

atypical pneumonia in China, 136–40

containing outbreaks of, 147

coronavirus, 147

move from animals to humans, 140

polio, 125, 127

SARS, 139–48

visual cortex, 210

vocal cords, 247

voluntary movement, 123

von Braun, Wernher, 211–12

von Kármán line, 186

Vostok I,
208

waltzing the skin, 45–46, 48–49, 256

Ward, Claire, 89–90, 92

water:

boiling point of, 185

covering the Earth, 177–78

density of, 168

pressure of, 169

Waterloo, Battle of, 95

weightlessness,
210
, 214, 216, 221, 232

Wellington, Arthur Wellesley, Duke of, 95

Whipple, Allen, 80

white blood cells, 55, 114, 165

Whitson, Peggy, 200, 201, 203

Wiens, Dallas, 56–65, 257

Wilson, Edward, 27

World Health Organization (WHO), 136–38, 139

World War I, 73–76

in France,
66

gunshot wound to the heart, 74–76

Hudson in, 239–40, 245–46

X-rays in, 75

World War II:

and acceptable risk, 92

antibiotics in, 85

Battle of Britain, 38–41, 256

bomber crews in, 184

burn victims,
30

cardiac surgery in, 87

D-Day, 82

helicopter evacuations in, 96

mechanization of combat in, 79

skin grafts in, 56

Wright brothers, 6

X-38, 195–96

X-rays, 75, 228

Yang Tin Ying, 121

Yi Soyeon, 197–203, 208

going to Moscow, 198–99

and reentry, 202–3, 205–7

on space station, 200–201

zero-G, 214