http://save-the-souls.livejournal.com/ ([identity profile] save-the-souls.livejournal.com) wrote in [community profile] paradisalost2011-12-28 06:24 pm
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[Private]

There's no records at all of Timothy or...even the orphanage. It's as though they never existed.

I suppose it was too much to hope for, but...at least I tried.

[a pause]

I hope Father Abel is all right.

[Christmas Filter]

Ah, thank you very much for the gifts! I'm very grateful for all of them!

[/Filter]

[Allen is sitting outside a cafe, about a block away from the hospital he's been volunteering at, enjoying his lunch break with...well, many plates of food. There's a cell phone (that is strangely gold in color..) sitting on the table, in case he receives any calls to head back. Mostly he just seems to be enjoying himself. ]

I wonder how long this world change will last...

[OOC: Open!]

[identity profile] stateofatrophy.livejournal.com 2011-12-30 12:45 pm (UTC)(link)
[Well, maybe you should have picked a career better suited to your limited mental capacity. Like being a doorman.]

Which sound do you hear with the pulse?

[Hint: say S1 and you get a cane to the gut.]

[identity profile] stateofatrophy.livejournal.com 2011-12-30 06:08 pm (UTC)(link)
Remember that. Only way you'll differentiate between S3 and S4. Now find the pulmonic valve. Go the left of the sternum and then up a rib. If you hit the clavicle, you've gone too far.

[identity profile] stateofatrophy.livejournal.com 2011-12-30 07:21 pm (UTC)(link)
Dude. He's in a coma. He doesn't care about what we're doing.

[He waits until Allen's hand alights on the correct spot.] What do you hear?

[identity profile] stateofatrophy.livejournal.com 2011-12-30 07:58 pm (UTC)(link)
[Eye roll.]

Why do you think that is?

[identity profile] stateofatrophy.livejournal.com 2011-12-30 09:38 pm (UTC)(link)
[The iPod suddenly belts a buzzer sound a little too loudly for comfort.]

Wrong. Try again.

[He is glancing pointedly at French Coma Guy's chest. Specifically, its rise and fall.]

[identity profile] stateofatrophy.livejournal.com 2011-12-30 10:57 pm (UTC)(link)
[Because sound effects are indispensable teaching tools. Also they get hilarious reactions.]

Close. It's due to inspiration. Inspiration here meaning inhalation, not something that stimulates you to put in effort. When you inhale, it creates a difference in pressure. I would explain this in greater detail, but I figure your crippled brain needs to take it slow. Like your sex life apparently.

[Yes. He went there. And he continues without giving Allen a chance to respond.]

Blood flow into the lungs is affected so the pulmonic valve closes a little after the aortic. If you hear it on every beat or the gap between the two sounds is wide, that's a problem. Otherwise it's completely normal. Now move your stethoscope down in a straight line until you can't hear anything. And then keep on going down until you do.

[Moving on to the mitral valve and S3 heart sound. You better be paying attention because he is not repeating this lesson.]

[identity profile] stateofatrophy.livejournal.com 2011-12-31 12:24 am (UTC)(link)
[It's not like he'd then post all your secrets in the journal...! No, he'd do that. Just don't share. Never share. Don't do that to yourself.

His tone is almost bored as he recites the conditions mechanically. At least the crazy, unethical doctor knows his stuff?
]

A fixed splitting points to a septal defect, holes in the walls of the heart separating the four inner chambers. Can be atrial or ventricular. Abnormally wide splitting can result from stenosis, the narrowing of openings, like say a pulmonary valve stenosis. The thinner the neck, the longer it takes to empty the bottle, longer it takes to put a lid back on. It can also result from delayed depolarization like in left or right bundle branch block. Bottle metaphor again. If it takes too long to flip it over and pour everything out, it'll take longer to put a lid on it.

[A beat.]

Bottle's no good. The contents need to be under pressure. Picture a fire hose. [You might want to interrupt or you'll get stuck with another metaphor.]

[identity profile] stateofatrophy.livejournal.com 2011-12-31 06:43 pm (UTC)(link)
[The longest pause ever.]

No. And don't ever try to use a metaphor again.

[identity profile] stateofatrophy.livejournal.com 2011-12-31 06:56 pm (UTC)(link)
[USE OF METAPHOR IS AN ART AND YOU BUTCHERED IT. Also you totally didn't understand anything he was talking about, nice to know.]

No, you found the tricuspid valve. Your other hand better not be off French Coma Guy's pulse. [Craning his neck to see what's going on at French Coma Guy's other side.]

[identity profile] stateofatrophy.livejournal.com 2011-12-31 07:23 pm (UTC)(link)
The first and louder one in this case. You should still hear two sounds. Unless his aortic and pulmonic decided to take the day off in the twenty seconds since you stopped listening to them.

[identity profile] stateofatrophy.livejournal.com 2012-01-01 05:38 am (UTC)(link)
Now open your shirt and find your tricuspid valve. Tell me if the beat is the same.