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For more than two centuries, the New England Journal of Medicine has been the destination of choice for successful pharmaceutical trials, health policy debates and medical discoveries that are changing the practice.
The venerable publication has sometimes become viral because of medical images such as those discussed by its main writers earlier this year, in preparation for future print issues and its website.
"Wow, it's weird."
"It's really weird."
"If someone walked with that, it would not be your first diagnosis."
"It's too extreme."
"Following."
At the newspaper's headquarters, at the top of the Harvard Medical Library near Boston, editors meet every two weeks to select the finalists from hundreds of submissions from around the world. Medical mystery, partial curiosity, most doctors may never see, or particularly compelling images of the ones they see every day.
There was the boy with the mysterious wheezing cough, who had swallowed a real whistle that had lodged in his lungs. ("It happens all the time," said Jeffrey Drazen, editor-in-chief of the newspaper.)
There is a patient who has inhaled barium during a medical procedure, instead of swallowing it. The liquid smeared the delicate branches of his lungs, illuminating an x-ray like a Christmas tree. ("It's just beautiful," said Chana Sacks, the newspaper's image editor.)
A motorcycle accident, where the top of the victim's femur broke and was moved kinetically into his scrotum. ("You have to relearn the anatomy of the hip joint connection," said Sacks.This article has become the most-viewed image of the review of all time.)
"There was one we published a year or two ago, an area in which they get rid of a worm. And the worm is literally across the room, what is the size of this tapeworm. It makes everyone creak, "said Sacks. "That said, there is an interesting point of teaching, do you need to take it out all the time?" (Please, yes.)
The snake bite
The journal has several ways to be published, a nonprofit organization with an acceptance rate similar to that of Harvard University. For most physicians and researchers, a scientific breakthrough or historical medical trial is needed that will be closely examined by physicians and investors. Being accepted can mark the culmination of a university career.
The images section offers doctors a different way to sign up. Some photos are gorgeous. Gross suits, whether it's educational or at least interesting. No one needs to see another really big tumor.
"This section deals with what you see and a good doctor should be a good observer," said Drazen, who wore a bowtie adorned with the newspaper's red and white seal. "It's all part of this education: what are the normal variants of the body and which are the ones that teach you more?"
And then, of course, there is perhaps the most legendary image of the magazine.
The photo was titled "A Viper's Bite" and there is no way to describe it delicately. The photo was submitted by Tajamul Hussain, an Indian doctor. His patient, a 46-year-old farmer, was in a field when he had to relieve himself. Unbeknownst to the farmer, a viper from the Levant, Macrovipera lebetina, was hiding nearby.
He opened his pants and was – we can badume, depending on the location of the fang marks – on hand, when the snake hit. The newspaper published a photo of the injury.
Farmers The photo infamous.
Chest cough
A large number of photos from the New England Journal are now available online, where they are available for free and reach a much larger audience than 600,000 readers.
Gavitt Woodard, a research scientist in cardiothoracic surgery at the University of California, San Francisco, presented the photo that became the last viral success of the section. One of his patients had coughed a huge blood clot. She unfolded the drop, spread it on a piece of surgical tissue and saw a perfect stream from inside the patient's right lung.
"It's crazy. That's not why I published it, of course, but I probably have 50 media e-mails, "Woodard said on the phone as she was returning home after a day in the operating room. academic documents.
This one, however, occupies a special place.
"At one point," said Woodard, "I will probably frame and put it on the wall."
First publication: January 26, 2019 at 09:19 IST
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