With the imminent release of Iron Man on DVD next week, the mainstream public is more aware of the saga of Tony Stark than ever before. When my in-laws start asking me about how accurate the movie was to the comics (because I’m “that” relative who still reads funny books), you know it’s become part of the cultural landscape.

While talking about the movie with my old college roommate, I remembered something. He’s a doctor! The goofy guy I watched The Simpsons with, shot with paintballs, and took to his first strip club went on to become a respectable member of society. So I asked him how medically sound is the story of Tony Stark suffering a coronary injury due to his own weapons and becoming Iron Man to atone for his sins. Specifically, the Iron Man movie.

Dr. Ken Nizza is a board-certified internist in the state of Pennsylvania. He doesn’t read as many comics as your average ComicMix reader, but he had an unofficial education in college when I stuck issues in his text books. He would also like to note that he has more foreign policy experience then Sarah Palin.

ComicMix: Is shrapnel lodged in your chest getting closer to your heart exist a possible medical condition?

Dr. Nizza: I could definitely classify having large pieces of metal lodged in one’s chest as being a "medical condition". If they were moving towards the heart ("embolizing", in the biz), I would even go so far as to call this a "worsening medical condition".

CMix: Would you recommend a powerful magnet to keep it from getting closer as a treatment option?

Dr. N: Well, assuming that one had a powerful enough magnet, the shrapnel was not in the proximity of any vital organs, and the patient had good enough insurance… then no, this is still a really stupid idea. To illustrate this point, let’s imagine actual magnets as used in medical diagnosis: the MRI machine. An MRI has in it a large electromagnet that is powerful enough to align all the hydrogen in the water molecules of the body.

If one were to pass a patient with some sort of metal through an MRI machine, the metal in question would rocket out of the patient’s body like a bullet towards the machine’s magnet, leading to a) a very unhappy/broken multimillion dollar piece of medical instrumentation, b) a very unhappy hospital administrator and c) a very unhappy/dead patient. Keep a mop handy.

It would be easier to have a cardiothoracic surgical team perform an exploratory thoracotomy. And yes, this is the only time an "exploratory thoracotomy" can be considered the easier option.

CMix: Would it be possible to have a metal tube big enough to fit Gwenyth Paltrow’s entire hand directly in your chest?

Dr. N: For one to breath, the chest cavity has to be completely airtight. When you inhale, the diaphragm flattens and the space inside the chest expands. Because of the vacuum generated ("negative pressure" in the biz), the lungs are stretched and, in turn air is pulled down to fill the space. To exhale, the diaphragm relaxes, the lungs snap back into place, and air is expelled. With a large, gaping hole in the middle of the chest that’s exposed to the outside world, this entire process is somewhat less effective in that it doesn’t work at all even a little bit. Think "sucking chest wound". (more…)