Lost: the Afterbirth

(spoiler alert)

It has happened. After years of resistance, of living in the dark, of isolating myself socially and culturally, of misunderstanding my peers, I am finally allowing myself to embark on the spiritual journey that so many before me have undertaken.

I am finally watching Lost.

Right now I am still living in the innocent world of the first season, where polar bears and crazy french ladies and mysterious numbers and terrifyingly creepy people named Ethan live somewhere out in the jungle. The world where the ladies still wears clean clothes. And as much as I am enthralled by the mysteries of the island, I find myself annoyed by the actions of the main characters, who are apparently the only people who know how to do anything, and yet seem to feel the need to do everything in secret. With all of the perpetual character development that is going on, you'd think some of the characters would actually explain some of their actions to other people before they go storming off into the jungle.

But, non-suspension of disbelief aside, what I find most interesting is the medicine of Lost. The good Dr. Jack Shepard, spinal surgeon, has my undivided attention. I just watched the episode where he gives a blood transfusion to a crushed comrade using a sea urchin spine after performing a decompressive needle thoracostomy with a metal spike and instructing the heroin addict on how to instruct someone else on how to deliver a baby and, of course, after curing his arch enemy's headaches. I won't dwell on the fact that he jammed the spike through the chestwall too low (ok, maybe I will... its supposed to go up at the second intercostal space along the midclavicular line so as not to risk puncturing the heart), because what I find more interesting is the role of The Doctor in this little marooned microcosm of society.

The second the plane crash-landed, Dr. Jack emerged as the natural leader of the group. People looked to him for guidance, for answers, for decisions. He seemed, at least for a while, to be the only one who had any rational ideas or actions. Why is that? Is it because doctors traditionally hold a place of power and esteem in our society? Because there is an assumption of trustworthiness based on his profession? Or the idea that doctors are inherently good? [i can tell you right now that this is not true] Or maybe it is because there seems to be a bit of magic involved in knowing how to save a life, and knowing how to heal, and more importantly, knowing how to predict what will happen (prognosis: pro- gnosis, to fore-know or foresee: this was one of Hippocrates' major contributions to medicine). Personally, I think it was because Jack was attractive and manly with well-defined musculature.

I wonder sometimes, whether if I survived a plane crash on a mysterious tropical island, I would be able help people. Sometimes i think that I might have the capacity for leadership, but then I remember how long it took me to decide on what to eat at Typhoon the other night and I am not so sure. I suppose that is why I should probably finish medical school and then go to an emergency medicine residency. To be more like Jack Shepard on Lost. Ha! If only I could have brought this up in my interviews - that really would have wowed 'em.

Over the episodes, there have been many little medical events that have piqued my interest. Like the Post-crash Peritonitis, the Asthma Exacerbation, the Stab Wound, the Poisoning, and the combination of heatstroke, delirium, fatigue, and post-traumatic stress that causes everyone to either charge blindly into the jungle or pull a gun on someone else. But the Delivery of the Baby... this was the impetus for me writing this entry. Not to mention the fact that no-one had once discussed a birth plan with the cute little 9 month pregnant australian girl, or that perhaps she should avoid wandering off alone in the jungle (remember what happened last time?), or the fact that it is apparently possible to deliver a baby without getting a single drop of blood on your clothes... I want to know why television births always ignore the thing that happens right after the baby comes out.

Because there's something else in there that has to come out. What does everyone think the cord is attached to? The placenta! The placenta has to be delivered as well, and this is also accompanied by contractions and sometimes the need to push. It is the 3rd stage of labor, the stage where most complications occur, and the stage that all tv births fail to progress to. Probably because it is very anticlimactic, pretty gross, and raises all sorts of questions like how do you clamp and cut the cord in the middle of the jungle? Dr. Jack neglected to instruct the heroin addict to instruct the murderous bankrobber to clamp the cord after delivery, an action that is important in preventing the flow of deoxygenated blood to the baby from the detaching placenta and in aiding the newborn's circulation to reset itself to get its oxygen from the lungs. Since I'm pretty certain that most people get all of their medical knowledge from television and movies, I'm beginning to wonder if anyone in our society remembers that the placenta even exists.

This is perhaps a minor point in the setting of the beautiful symbolism of new life on the island, and my new life as a member of the Lost-obsessed. But what would be the fun of watching the show that everyone else has already watched without dissecting it a bit? Just don't get me started on House MD.