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Who Says There’s Safety in Numbers?

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Ever since NASA’s $125-million Mars Climate Orbiter went AWOL--because some scientists were using English system of measurements instead of metric--we’ve wondered if similar snafus could happen in medicine. After all, a lot of us are foggy in this area: I personally think of boiling and freezing in centigrade, the local weather in Fahrenheit and human body temperature in both (my mom took my temperature in Fahrenheit, but I know from working in labs that the human gut dweller, E. coli, likes to grow at 37 degrees C). So we investigated.

We learned of one incident from a retired bioengineer, David Auth, who lives near Seattle: A heart machine blew up after a U.S. doctor visiting France assumed that the machine was calibrated in pounds per square inch when it was actually calibrated in bars, a metric unit of pressure. Wow.

Neither the U.S. Metric Assn. (a metric enthusiasts’ society formed in 1916) nor the Metric Program at the National Institute of Standards and Technology (which works to promote metrics) had anything dire to report. Medicine is pretty much metrified, if that’s the proper way to say it.

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Hospitals, for instance, weigh and measure babies in kilos and centimeters but also in pounds and inches for parents, says Dr. Harold Bass, a clinical geneticist at Kaiser Permanente Medical Center in Panorama City and a clinical professor at UCLA, who helped Kaiser go metric. And drugs are measured metrically too, though the doses are often given in teaspoons.

Old-fashioned apothecary measurements known as “grains” and “drams” have largely gone, though doctors still scribble a symbol for a “dram”--kind of a backward “Z”--on prescriptions. (A dram is a teaspoon, and the pharmacists translate.) Aspirin used to be made in 5-grain adult doses and 1 1/4-grain doses for kids, and still is: A grain is 0.065 of a gram, don’t you know, and 1 1/4 grains, or 81 milligrams, is the strength of kids’ aspirin.

Got that?

The Beat Goes On in the Operating Room

Recently, we received: two packages of pills guaranteed to stop snoring; perfume from Bijan inscribed with “DNA: Fragrance for Men” and an assurance that the perfume doesn’t contain DNA; and a CD of Flamenco music by an artist named Armik, which certain surgeons like to listen to while they work in the operating room, Armik’s publicists inform us.

This inspired us to ask local surgeons what music they favor. Here’s some of what they said:

* Dr. Ronald Busuttil, chief of UCLA’s liver transplant program: Elvis, the Beatles, Ricky Martin, Julio Iglesias, and classical music for the wee hours. “Most of the time we want to keep the operation moving at a pretty good pace, so we play music with a beat,” he says. Humming and singing are strictly forbidden, though.

* Dr. Keith Black, director of the neurosurgical institute at Cedars-Sinai Medical Center: no music. He finds it distracting. “When I walk into the operating room, the first thing I do is turn the music off--I like the whole team to be focused on the operation.” (Cedars chief of surgery Dr. Achilles Demetriou and UCLA neurosurgeon Dr. Neil Martin also prefer a quietOR.)

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* Dr. Susan Downey, reconstructive plastic surgeon at USC Medical Center: classic rock. “I find classical music distracting, because it gets real loud and real quiet at different places.”

* Dr. Rick Selby, who runs the abdominal organ transplant program at USC Medical Center: “We play a lot of ranchera music--a lot of our patients and the people who work with me are Hispanic,” he says. It depends on the stage of the operation, though. Say he’s transplanting a liver. He’ll have ranchera during the easier parts, such as making incisions and sewing up at the end.

At moments of intermediate difficulty, such as preparing to take the old liver out, he’ll go for more sedate sounds. When the old liver’s being removed, and the new liver attached--the trickiest part--he won’t play any music.

Music helping operations is one thing. But operations inspiring music? In 1725, the French composer Marin Marais wrote a piece for an early string instrument, the viol--”Tableau de l’operation de la taille”--about the removal of a stone from a bladder, believed to be his own. What can it possibly sound like?

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