Author Archives: Giancarlo Buonomo

Why does rubbing salt in a wound hurt so much? As a metaphor, “rubbing salt in a wound” means to make an already-bad situation worse for someone, especially in an unnecessary or gratuitous way. One hears the phrase constantly, about everything from taxes to sports. Perhaps one reason it’s so common is that, even ifContinue reading “Episode 110 – Salt in the Wound”

Why don’t we all get heparin-induced thrombocytopenia? Way back in episode 59, we discussed why heparin, a commonly-used anticoagulant in the hospital, can cause mild hyperkalemia. The more widely-known side effect of heparin, though, is heparin-induced thrombocytopenia (HIT), of which there are two types: Type 1 (non-immune mediated) and Type 2 (immune-mediated). If a hospitalizedContinue reading “Episode 109 – The HITS Keep Coming”

How could alpha-gal be used to treat cancer? In episode 61 of The Curious Clinicians, we explored a rather odd complication of tick bites: “Alpha-Gal Syndrome ,” or an allergy to red meat. The culprit was galactose-α-1,3-galactose (alpha-gal), a carbohydrate which many mammals (and ticks) make but humans do not. The alpha-gal in tick salivaContinue reading “Episode 108 – Alpha Gal Again”

Why do humans have such a sensitive smell for rain? If other animals ever praised humans, they’d probably laud our brainpower, our bipedalism, and perhaps the invention of the air fryer. They’re probably not raving about our sense of smell, but they really should. Not only is the human sense of smell far keener thanContinue reading “Episode 107- The Smell of the Rain”

Why do patients with methemoglobinemia have an oxygen saturation fixed at 85%? Here’s a case for you: an older patient with lung cancer undergoes an awake intubation with benzocaine. They then experience hypoxemia which stays fixed at 85% despite receiving 100% FiO2 oxygen. The care team does an ABG, which yields chocolate-colored blood with aContinue reading “Episode 106- Pulse Check: Methemoglobin”