The 2013 IgNobel prizes were awarded last night in a ceremony that was typical of the IgNobel prizes, which is to say: hilarious, fun, and highly educational. It is my opinion that no awards show or conference would be complete without naked silver painted humans serving as spotlights, custom operas, and my personal favorite, Miss Sweetiepoo, a charming 8 year old who recites "please stop, I'm bored. Please stop, I'm bored" when you go over your allotted speaking time (every talk EVER should have this. No joke).
But really, it's the science we're here for, right? The science that makes you laugh, sure. But it also makes you think. While all of the science was hilarious, it also all had a POINT. Sometimes that point wasn't...immediately obvious. But if you dig far enough, you'll find it (most of the time. No excuse for the peace prize this year).
And that's why I'm not only live tweeting the ceremony and announcing the winners and live streaming the show, I'm also going to blog in depth about each and every one of the winners (ok, except for the couple that are posthumously given, where it's often hard to get the information. Those will be shorter).
So today I present to you the FIRST of this year's Ignobel prizes. It was actually presented last, but I wanted to do this one first. To get it out of the way. Why? Because it's a bit of a painful subject, and somewhat close to home for about 50% of the population. Not to mention any ducks in the audience.
Presenting...the IgNobel Prize in Public Health!
Bhanganada et al. "Surgical Management of an Epidemic of Penile Amputations In Siam" The American Journal of Surgery, 1983.
(Oh sure. It looks innocent. Til it eats your penis. Source)
This is one of the ones for the IgNobels that really is only funny because, well, it's about penises. Getting eaten by ducks sometimes. But otherwise, it's actually quite a serious subject, and the paper itself has important implications for surgery in...delicate areas.
It turns out, during the 1970s, Thailand had an epidemic. Not an epidemic of cholera or polio or something (though it may have had those, too). No, this was an epidemic of revenge. A particular type of revenge, by women on their philandering husbands.
This type of revenge stemmed from (or so the authors' hypothesize), the Thai concept of a "cool heart," to suppress anger and avoid confrontation. This apparently work pretty well some of the time, but has its limits, when wives, confronted with cheating spouses, come up while they are sleeping...and cut off their penises.
This is where we get to the ducks. A traditional home is Thailand is elevated on pilings. This mean you get some airflow under the house, some relief from the heat, and being higher off the ground a little relief from bugs. But it also means that the under area beneath the house becomes the evening resting place for all your domesticated animals, like ducks and chickens, etc. So this means, and I quote:
Thus, it is quite usual that an amputated penis is tossed out of an open window, where it may be captured by a duck.
There is even a Thai saying, “I better get home or the ducks will have something to eat," The Thai equivalent of "I better get home or the wife will eat me alive", except in this case...she'll cut off your penis in a fit of rage and accidentally feed it to the ducks.
And there was an epidemic of these incidents in the 1970s, fueled by several high profile Thai women saying in the media that they thought this was a totally acceptable revenge. In 7 years, there were over 100 dick choppings. That's pretty incredible.
And of course, this means surgery. On the off chance that the penis is NOT eaten by ducks, obviously it needs to be reattached, and soon. It's a difficult prospect. There are lots of blood vessels to reattach, muscles, etc. Often there's infection of the wound, infection of the chopped off penis (which sometimes arrived wrapped in newspaper, handkerchiefs, or even a banana leaf), the whole thing has to be shortened just to get it back on, and very low odds that the penis will end up functional. The best bet was microsurgical techniques, for which you need a procedure.
Warning: the diagrams below are not for the faint of heart. You can't unsee a carefully drawn flayed-open penis. You've been warned.
What you can see above were the best practices developed after a total of 18 case studies. The extra skin up around the head of the penis (present in non-circumcised men), could be opened and used to help re-attach. You have you re-attach the veins at the top and the bottom of the penis, but even so, skin necrosis (tissue death), often set in and had to be cut our and grafts put on.
In more severe cases, where the whole base of the penis was amputated and part of the scrotum as well, they used a "burrowing" technique, where they re-attached the penis where they could, cut a hole in the scrotum, brought the penis down through the hole, and used that skin to graft on to the penis. The penis could pee, but it could no longer become erect. It was embedded fully in the scrotum. After healing for a while, they could then do another surgery, and bring the penis back out, this time covered in testicle skin rather than penis skin.
Yeah, I'm wincing too.
In some cases, they were able to get partial erection:
When they came back for followup (some did, but most didn't), some were able to feel pressure when the penis was squeezed, but many were numb. Several, though, described this as a GOOD thing...because they could have sex longer (so I guess they were achieving at least something of an erection).
Let's admit it, this is gross. And it's sad that people would resort to this kind of violence. But it's also useful to know how to do this. Accidents (or on purpose events) do happen, and it's good to know how reattachment could work. It can also inform doctors on procedures for things like operations on transgender individuals. So that's good.
And on the whole, the doctors were very bright about the prognosis. And of course there were the funny bits:
We believe that penile reimplantation
should be successful regardless of the
method of anastomosis, provided that the amputated
part is not mutilated, decomposed, or partially
eaten by a duck.
(It should be noted that in two cases, the penis had to be fished out of a septic tank. It was still good.)
C'mon, you included THAT sentence in there and you thought you wouldn't win an IgNobel??? Please.
So the moral of this story? Well...don't cut your penis off. If you do, there's a good method for re-attachment. Just don't let the duck get to it first.