The Last Word on the Last Breath

The patient, only 35, had been in a persistent vegetative state for 15 years. Recently, he had developed septic bedsores and pneumonia. His kidneys were failing, and despite the feeding tube, he was losing weight. Now he was in cardiac arrest. He was dying.

But the young staff doctor had no choice. The patient’s relatives, convinced that the man could communicate, had insisted that all revival efforts be made. So the doctor gave the patient a few mouth-to-mouth breaths, climbed on the bed and began vigorous chest compressions, trying cardiopulmonary resuscitation.

The patient was intubated, shocked with electric paddles and injected with epinephrine. Blood spurted as a central line was inserted into the large vein in his groin to administer medicine and fluids. EKG electrodes were placed on his arms and legs: streams of paper spilled over the floor, as the hospital room filled with people and shouted orders.

After 15 minutes, the doctors called the time of death.

“Kneeling on that bed, doing CPR, felt not only pointless, but like I was administering final blows to someone who had already had a hard enough life,” said the doctor, Daniel Sulmasy, now a New York internist, medical ethicist and Franciscan friar, recalling this experience from his internship. “Why was I forced to crack this person’s ribs? Why couldn’t we have let the patient die in peace?”

Extreme cases like this one are rare. But the question of who has final say over whether CPR should be attempted on a gravely ill patient — the doctor, the patient or the patient’s representative — is live and unsettled in law and medicine.

The Last Word on the Last Breath

Chow Chow

Characteristics
An ancient breed of northern Chinese origin, this all-purpose dog of China was used for hunting, herding, pulling, and protection of the home. While primarily a companion today, his working origin must always be remembered when assessing true Chow type. A powerful, sturdy, squarely built, upstanding dog of Arctic type, medium in size with strong muscular development and heavy bone. The body is compact, short coupled, broad and deep, the tail set high and carried closely to the back, the whole supported by four straight, strong, sound legs. Viewed from the side, the hind legs have little apparent angulation and the hock joint and metatarsals are directly beneath the hip joint. It is this structure which produces the characteristic short, stilted gait unique to the breed. The large head with broad, flat skull and short, broad and deep muzzle is proudly carried and accentuated by a ruff. Elegance and substance must be combined into a well balanced whole, never so massive as to outweigh his ability to be active, alert, and agile. Clothed in a smooth or an offstanding rough double coat, the Chow is a masterpiece of beauty, dignity, and naturalness, unique in his blue-black tongue, scowling expression, and stilted gait.

Owning
The Chow Chow's coat will require at least weekly grooming. The Chow Chow is a possessive dog who endears his family and their possessions to him. The Chow Chow is a wonderful companion for adults who will take the time to care for them properly.

Did You Know?
The Chow Chow is one of the oldest recognizable types of dog, dating back more than 2000 years. The Chow Chow possesses the rare characteristic of having a blue-black tongue. The breed was recognized by the American Kennel Club in 1903. The Chow Chow was used for hunting, herding, pulling, and protection of the home in China. Today, the Chow Chow is primarily a companion dog.

Chow Chow

Their Stamp on History: Jan E. Matzeliger (1852-1889)

Before Jan Matzeliger came along, no one thought it was possible to make shoes entirely by machine. Other inventors had managed to create machines to cut out the different parts of the shoe and to sew together the leather that made up the top, but the last and hardest part still had to be done by hand. Skilled shoemakers would shape the leather upper part of the shoe over a foot-shaped wooden mold called a last and then sew it onto the sole, or bottom, of the shoe. An expert shoe laster could make about fifty pairs of shoes a day. When Matzeliger was thirty years old, he created a machine that could make 150 to 700 pairs a day…that’s fourteen times as many as a skilled person!

Matzeliger was born on September 15, 1852 in Dutch Guiana (now called Suriname). His father was a white Dutchman and his mother was a black Surinamer. As a child, Jan worked in his father’s machine shop and developed an early interest in mechanics.

When he was 19, Jan set off to explore the world as a sailor. After two years, he arrived in the United States and began doing odd jobs in New England. By 1876, Matzeliger had settled in Lynn, Massachusetts and taken a job in a shoe factory. He worked ten-hour days there and spent his free time learning English (he was a native Dutch speaker) and joining in activities with his church.

When Matzeliger learned of the challenge of creating an automatic shoe lasting machine, he set to work on inventing one, using whatever materials came to hand—some wire, pieces of wood, and cigar boxes. His early mechanical experience and his observations in the shoe factory served him well. By 1883, he was the owner of a patent crediting him with the invention.

Matzeliger’s shoe-lasting machine was so efficient that it cut the price of shoes in half after it went into production in 1885. Thanks to him, new shoes became much more affordable for average Americans.

The success of his invention came at a price to Jan Matzeliger. Weakened by long working hours, he contracted tuberculosis and died when he was only 37 years old.

Their Stamp on History: Jan E. Matzeliger (1852-1889)

Python Eats Pregnant Sheep

A fresh lamb dinner might sound like a manageable meal for an 18-foot-long (5.5-meter-long) python. But maybe the hungry snake should have waited for the lamb to be born.

Last week firefighters in the Malaysian village of Kampung Jabor were called in to remove the bloated snake (pictured) from a roadway. The reptile had swallowed an entire pregnant sheep and was too full to slither away and digest its supersize meal.

But the stress of being captured likely triggered the python to purge—it eventually regurgitated the dead ewe.

Pythons are constrictors, meaning they rely on strength, not venom, to kill their prey. About once a week the large snakes ambush a likely meal, grab hold with backward-curving teeth, and wrap around the victim, suffocating it to death. Pythons then open their hinged jaws wide to swallow their prey whole.

Sometimes, though, it seems like the voracious reptiles don't think before they snack. This particular snake isn't the first python to get a tough lesson in the dangers of swallowing oversize prey.

In July a pet Burmese python in Idaho required life-saving surgery to remove a queen-size electric blanket from its digestive tract. And last October a python in the Florida Everglades apparently busted a gut when it tried to make a meal of a 6-foot-long (2-meter-long) American alligator.

Python Eats Pregnant Sheep

Scientists Solve Mystery of Rare Disorder

Two rare and related diseases leave their sufferers with no fingerprints. Now scientists may have cracked the genetic code behind the inherited ailments.

Researchers at the Technion-Israel Institute of Technology in Haifa and Thomas Jefferson University in Philadelphia report that defects in the protein keratin 14 may be responsible for both diseases, known as Naegeli syndrome and dermatopathia pigmentosa reticularis (DPR).The lack of fingerprints can cause vexing social problems, which are magnified because few people have heard of the condition.

Cheryl Maynard of Fairfax, Virginia, is part of the fifth generation of her family to have inherited DPR from her mother's side.

"My father was in the military and he had top-secret clearances," she recalled.

"We moved a lot, and everywhere we went they'd say, What do you mean your wife doesn't have fingerprints? What do you mean that you have kids without fingerprints?"

Maynard has personally experienced many fingerprint-related snafus, often related to employment.

She works as a flight attendant and noted that a standard background check by the U.S. Federal Aviation Administration, which took about 2 weeks for most of her peers, took 14 weeks in her case.

"I applied for work at a jail facility, and they were naturally fingerprinting people who were going to be employees," she said.

"I kept hearing, Of course you have fingerprints. And five or six different technicians were telling one another, You're doing this wrong, let me do this. I have to tell them I was born without them."

"Things like that are a problem," Maynard said. "It has delayed me [from] getting jobs."

Scientists Solve Mystery of Rare Disorder