Tag: jamie fraser

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2024 SiWC Panel with Diana Gabaldon

Greetings Outlander fans! My, I have missed you all… 🤗

This weekend I find myself in beautiful Surrey, British Columbia,  Canada, attending the Surrey International Writers’ Conference, more commonly known as SiWC!

I drove from Oregon to Canada lastThursday. It was a beautiful day but the  normally 5.5 hr drive turned into nearly 7 hours due to two collisions in Washington state.  Yes, it was an inconvenience for those on the freeway, but I was grateful to arrive safely and I hope those involved in the crashes are OK.

Thus far, I have attended several events featuring Diana – she is one busy lass! All were delightful and I will share them with you, but not in chronological order mostly due to the technical issues of posting via  iPad. 😉

Today’s event was titled “Compelling Expositions,” a panel featuring Diana Gabaldon, Michael Slade, Robyn Harding, and Darren Groth (not shown).  K. C. Dyer moderated (also not shown).

Diana looked stunning, layered with in a deep red shawl because the room was freezing! 🥶

Many fruitful topics were covered by the panel. Here are some highlights including Diana’s responses:

  • Question:  Which is your fav scene from your writings? Diana chose the scene from “Outlander” book wherein Jamie rescues Claire from Black Jack Randall’s clutches. They shelter at a tavern –  Jamie tells Claire he is not ready for bed and proceeds to whip her with his sword belt. This set up a major clash between the two characters because each POV was justified from their perspective. Claire was trying to find a way back to Frank but Jamie knew her actions put all of their lives  in danger. I must confess, this choice surprised me. I suppose because Diana has written so many splendid scenes. How would one even choose? 🤔

This is wee bit of the excerpt from the scene (pp. 249-250 “Outlander” Kindle version) that is Diana’s fav!

“Come to bed, Jamie. What are you waiting for?”

He came to stand by the bed, swinging the belt gently back and forth.

“Well, lass, I’m afraid we’ve a matter still to settle between us before we sleep tonight.” I felt a sudden stab of apprehension.

“What is it?” He didn’t answer at once. Deliberately not sitting down on the bed by me, he pulled up a stool and sat facing me instead.… 😯

  • Question: How do you deal with pacing? Diana responded that pacing depends on context. For example, if there is an emergency then the writer wants to keep sentences short and terse. Pacing allows the author to create tension between two elements. A question is raised and then answered to move the story forward. (Psst…. She didn’t mention that sometimes the answers to questions she raises don’t get resolved until two books and ten years later!) 😂
  • Question: How do you deal with slang or dialect? Diana feels dialogue is the most important way to define a character.  An author using another language (e.g. Gaelic) needs to educate themself in the language. She watched films with Scottish characters to hear their spoken English. At conferences, if she heard anyone speaking with a Scottish accent, she invited them for coffee and listened to them speak. Diana also recommended reading books written by someone who speaks the language. She read several Scottish authors to help her get a feel for syntax, cadence, etc. Frankly, her devotion to her craft is a splendid example to all aspiring authors. 🥰
  • Question: Do you plan out a chapter or scene ahead of time? Diana does not. We already know she doesn’t write in a straight line. She also does not tell her characters what to say or do. She waits patiently for them to speak to her.  This being my fourth SiWC, I can tell you hers is a unique approach. Most writers I encounter plan out scenes, many even work from  a classic outline. She also doesn’t know ahead of time how a book will end. I guess the one exception here is that she seems to know how the “Outlander” books will end. Sob! 😢
  • Question: Who is your favorite author. James Clavell, she answered without a moment’s hesitation.  Clavell authored the marvelous, “Shogun,” for those who might not know. Although it has been some time since I read it, it is well worth doing so. 👍🏻

These were highlights of the panel for me.

The full panel discussion can be accessed here:

I hope you enjoyed the panel. Need I say, my fav author for “Compelling Exposition” is none other than Diana Gabaldon? 🤩 🥇 🏆

The deeply grateful,

Outlander Anatomist

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Photo and audio credits: Outlander Anatomy

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Anatomy Lesson: Mandy’s Malady

Welcome all anatomy students! It has been a while since I posted a lesson because, frankly, I have been dealing with my own malady – a shattered left ankle! Six months out and beginning to feel and function better. 🥳

Outlander fans recall that in episode Episode 702, “The Happiest Place on Earth,” Brianna gives birth to her second child, Amanda Hope Claire MacKenzie-Fraser. Dr. Claire is there to reassure Brianna and ease the process. The wee one is adored by all and affectionately nicknamed, Mandy.  Fraser’s Ridge is the happiest place on earth and all is well! 🥰

Young Mandy is quickly introduced to the Ridge’s denizens as Granda’ Jamie takes her on a wee stroll to meet a new foal at the stable. Do you see it, Mandy? It is a cutie-beauty like you! 😍 

Mandy’s doting Granny takes her on a guided tour of Claire’s fav room – the surgery! Mayhap she will follow in Granny’s footsteps? 👩🏻‍⚕️

Claire coos to Mandy, admiring the beautiful, wee lass. Then…. she sees Mandy’s fingernails. A closer look and a startled Claire exclaims: “Bloody hell!”  (Couldn’t have said it better myself)  

Ever observant Claire spies a bluish tinge at the base of Mandy’s wee fingernails (below, red arrows)!

Fun Fact: This is not hyperbole.  Fingernails and toenails give clues to at least a dozen possible medical conditions that require evaluation and followup. And, Mandy is no exception.

A quote from Diana’s 6th big book, “A Breath of Snow and Ashes,” documents the moment Claire observes Mandy’s nail beds: ”

“The minute nails were faintly tinged with blue.” 

Bree senses Claire’s concern and asks what is wrong.  She kens that look on her mother’s face. After Claire explains, Bree reports her own maternal observations: Mandy does not nurse well nor is she gaining weight like Jem. What is wrong? 😯

Claire determines that the wee lass has a heart defect requiring more advanced care than Claire is able to provide in the 1700s. She is clear that Mandy’s Malady is life-threatening and she likely will not survive for long without corrective cardiac surgery. Brianna and Roger decide to return with their children to the 20th century to obtain the necessary care to save Mandy’s life.

Arrangements are made for the MacKenzie family to travel through time at the standing stones on Ocracoke Island. Everyone agrees this is the best course of action, but this time and place is no longer the “happiest place on earth!” Will they ever see Fraser’s Ridge and one another again? 🤷🏻‍♀️

Time to start our lesson….What leads Claire to her startling diagnosis? The following are symptoms and clues that Doctor Claire considered:

    • Lethargy and weakness
    • Fast or labored breathing
    • Tachycardia (a heart rate exceeding the normal resting rate)
    • Cyanosis (blue-ish skin color due to a lack of oxygen), primarily seen in lower extremities
    • Dyspnea (shortness of breath)
    • Poor feeding
    • Failure to thrive
    • Distinctive murmur

Another pithy quote from “A Breath of Snow and Ashes:” 

I moved my stethoscope over the tiny chest, ear pressed to it, listening intently. It was my best stethoscope, a model from the nineteenth century called a Pinard—a bell with a flattened disc at one end, to which I pressed my ear. I had one carved of wood; this one was made of pewter; Brianna had sand-cast it for me.

The following image is a wooden Pinard stethoscope, currently for sale on the Internet for about $180 (there are much less expensive versions)! 💰

Claire placed her ear against the cup shaped disc at the top; the bottom of the tube was placed on Mandy’s chest. The stethoscope amplifies the sounds of blood rushing through the heart and striking its valves.  

What did Claire listen for? she was listening for a distinctive murmur: a soft, continuous shushing sound, particularly audible near the base of the neck. It is usually the first diagnostic sign of a problem with a fetal heart vessel.  

Although Mandy exhibits only some of the above symptoms, Claire diagnoses Mandy’s condition as a Patent Ductus Arteriosus (PDA).  

But, before we can understand PDA, let’s look at normal heart anatomy.

Heart Anatomy: To better understand Mandy’s Malady, let’s consider the normal anatomy of the heart and its great vessels. Now, I kid you not, the heart is a very complex organ, both anatomically (structure) and physiologically (function). We will only cover the basics. Understand that there are many more anatomical details that are beyond the scope of this lesson. But, we fearless folk press onward!

Chambers: The human heart has four chambers (next image). Right atrium and left atrium are thin-walled filling chambers. Right ventricle and left ventricle are thick-walled pumping chambers . The walls are composed of cardiac muscle, a specialized tissue found in the heart. (psst….don’t forget, the patient’s left is your right, and vice versa) 🤓 

Vessels: The heart has eight (!!!) vessels carrying blood to and from its chambers. These are (next image):

    • Superior vena cava – delivers blood from upper body into right atrium
    • Inferior vena cava – delivers blood from lower body into right atrium
    • Pulmonary artery – deliver blood from right ventricle to lungs
    • Four pulmonary veins – deliver blood from lungs to left atrium
    • Aorta – delivers blood from left ventricle to body 

Blood Flow: Next, let’s review the pattern of blood flow through the heart. As you read the details, check with the image below to verify the flow.

    • Deoxygenated blood (low oxygen – O2; high carbon dioxide -CO2) from  superior vena cava and inferior vena cava pours into right atrium and then into right ventricle.
    • Right ventricle contracts and ejects blood into the pulmonary artery which branches to supply left and right lungs. 
    • Blood releases carbon dioxide (CO2) in the lungs which is exhaled and picks up O2 from inhaled air.
    • Oxygenated blood (O2-rich) is carried to left atrium via four pulmonary veins. 
    • Blood pours into the left ventricle which contracts and ejects O2-rich blood into the aorta.
    • Branches of aorta carry blood to all other regions of the body (except lungs).  

OK, students, hang in there! With normal anatomy under our belt, let’s look at the fetal circulation. 

Fetal Circulation: Blood circulation in the fetus is different because the placenta provides the functions of lungs, gastrointestinal tract, and kidneys. Thus, a normal blood supply to these maturing organs is not required.

Ductus Arteriosus: The fetal heart has a vascular bridge between pulmonary artery and aorta that shunts blood exiting the right ventricle into the aorta and bypasses the lungs. This vascular bridge is the muscular ductus arteriosus (aqua arrow – below image). Again, because lungs do not process gasses during intrauterine life, most blood is shunted away from them. 

The ductus arteriorsus is patent (open) throughout fetal life and normally closes within 24 hours after birth as blood flow to the lungs is established. Within 2-3 weeks, it turns into a fibrous band, the ligamentum arteriosum. 

All of this is highly regulated by various chemical and physiological substances including oxygen levels. 

Patent Ductus Arteriosus: If the ductus arteriosus does not close soon after birth but remains patent (open), it is diagnosed as PDA, a congenital heart lesion. PDAs are most common in premature babies but can also occur with full term infants. 

Nowdays, if a ductus arteriosus does not spontaneously close after 8 weeks post-birth, it usually is treated with medications, plugged, or surgically closed. Small PDAs may not be a cause for concern and are often not treated.

Adding a bit of perspective – PDA is not new. It was known as early as 129 A.D. to Galen, a Greek anatomist and physician, although he didn’t understand its significance. It wasn’t until 1938, almost two millennia later, that Dr. Robert E. Gross of Harvard Medical School and Children’s Hospital in Boston, Massachusetts, perform the first successful ligation (closure) of a PDA. This was also the first congenital heart lesion to be successful corrected, surgically.

Now, let’s return to Mandy’s Malady. This was her problem. Mandy’s ductus arteriosus did not close after birth and she exhibited some of the concerning symptoms outlined above.  Blood from her aorta flooded her lungs subjecting fragile lung tissues to excessive blood pressure (hypertension). Allowed to go unchecked, the fragile lungs will be permanently damaged and she  eventually will experience right-sided heart failure.

Diana explains all of this with her usual magical writing skills in this excerpt from “A Breath of Snow and Ashes:” 

The ductus arteriosus is a small blood vessel that in the fetus joins the aorta to the pulmonary artery. Babies have lungs, of course, but prior to birth don’t use them; all their oxygen comes from the placenta, via the umbilical cord. Ergo, no need for blood to be circulated to the lungs, save to nourish the developing tissue—and so the ductus arteriosus bypasses the pulmonary circulation. 

At birth, though, the baby takes its first breath, and oxygen sensors in this small vessel cause it to contract—and close permanently. With the ductus arteriosus closed, blood heads out from the heart to the lungs, picks up oxygen, and comes back to be pumped out to the rest of the body. A neat and elegant system—save that it doesn’t always work properly.

The ductus arteriosus doesn’t always close. If it doesn’t, blood still does go to the lungs, of course—but the bypass is still there. Too much blood goes to the lungs, in some cases, and floods them. The lungs swell, become congested, and with diverted blood flow to the body, there are problems with oxygenation—which can become acute.

Lastly, this is a brief video about PDA which you might find useful. It is easy to understand and accurate: https://youtu.be/7DKaCqubuSg. 🤓

Fast forward! It is clear that the MacKenzies arrived safely in the 20th Century and Mandy received the medical intervention needed for her PDA repair. When we meet her next at Lallybroch, she is a healthy, happy, and feisty wee lass, played by Rosa Morris. 🤗

As William Shakespeare once wrote, “All’s Well That Ends Well!”

(Well, it would end better if they were all together, but we shall see) 🤞🏻

The deeply grateful,

Outlander Anatomist

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Photo creds: Sony/Starz; www.commons.wikimedia.org; www.heart.org; www.kidshealth.com; www.medicalsuppliesgh.com; www.medlineplus.gov; www.outlander.fandom.com; www.theoutlandermuse.com; www.twitter.com (now X)

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2022 Outlandish Vancouver/Outlandish Adventures – Day 3

Day three and we were off and running!

Jamie caught up with us in the vendor room and held us at gunpoint! We surrendered! 😍

Next panel was the guys! Just the guys! And, only the guys! 🤗

They got settled in and the questions began!

Jody stood at the mic and said she had been a teacher for 36 years and wanted to predict the type of student each had been. She Thought Tim and David were quiet. But, likely, Paul got into trouble. Yep, turns out, she was right.

David was studious. Tim also was quiet in school but did use humor to deal with bullying! 😮

And, Paul……  Weil, Paul got into trouble for talking too much! His punishment was to write many time what it was that he did that was bad!

Tim was asked if it was difficult to play Tryon.  His answer was candid, interesting and enlightening. He replied that it helps to understand that the British always think they are right! He said he put himself in that frame of mind when he played the part of Governor Tryon. He added that Tryon felt justified in all the decisions he made even though they were bad for the settlers. He was so good as a baddie!

Then, questions were interrupted for an surprise auction! An Outlander fan who was not named donated a rug to be auctioned  off to benefit the Wounded Warriors project. Koko explained that she goes by the moniker, “The Happy Hooker.” 😊 She is a disabled vet. The rug was made of wool that was hand dyed, hand carded, hand spun, and hand hooked! It really was a splendid piece of work!

Bidding began at $20. For a moment, Tim took over and did a perfect imitation of a bonafide auctioneer!

Bidding moved to $30, then $40, then higher and higher until it sold at $1600 to the highest bidder: Tina from Texas. 👏🏻👏🏻👏🏻

Sadly, time was up and the guys exited. Buh bye, guys! 👋🏻

Then the gals came in. Caitlin and Joanne took their seats and the grilling began anew. People are very curious! 🤔

Asked what male character of Outlander they would like to play, JoAnne wants to play Roger. Caitlin wants to play young Ian! (Psst…..I think she would make a swell young Ian)

Question: “What was filming like?”

Caitlin said, nothing is like what you would expect. Scotland is cold and wet. She was very scared at first. And, most importantly, she made sure she carried Tampons in her purse! 👍🏻

I asked how they liked the corset. Caitlin said not at all! She had trouble getting food through her esophagus into her stomach and it was very hard to use the toilet! They had port-a-potties, which were cramped with dirty floors.

But, JoAnne loved wearing a corset. She said it was the best her figure ever looked!

I have to agree. I wore one while walking the Royal Mile in Edinburg in 2016 and I liked my posture! 😇

Caitlin shared that any stories about how difficult children are on set, are true. She said at the S5 wedding scene , she was supposed to take care of Jemmy, but both twins were terrified of her. She was directed to lay Jem down in the basket but the baby kept standing up! Director, Stephen (Woolfenden), was signing to her to push him down in the basket which she tried to do but after that he screamed whenever she came near him. (moms know this wouldn’t work) 🫣

This is one reason Joanne was given a “plastic” baby to hold for her scenes as Amy.  The camera would cut away to a live baby for close ups. 👍🏻

Asked what was hard for Caitlin to play the role of Lizzy, she was very candid. For her screen test, she was asked to do the bit where she tells Claire about the wee curlies around Jo’s paps! 😜 It was hard to be serious, but then, she took it seriously because she loves Lizzie’s innocence and her wondrous exploration of her sexuality. She also looked forward to playing a polyamorous relationship which is a first for her.

The ladies left and then the whole crew re-emerged for the last panel of the event. And, we were able to posit our final questions.

When you joined Outlander, were you prepared for the fandom?

Caitlin, No!

Paul, No, but he is grateful and appreciative of us!

David, No. These experiences are not available to anyone outside this room (includes entire fandom). He really appreciates hearing and receiving the love of the fans.

Tim, No. At first, he only knew what the director told him. Soon, he learned that the fans know the books forward and backwards. (Of course we do! 😇)

Any fun fan stories?

David said he appreciated the gifts fans give to his son. He is very grateful for their thoughtfulness.

Caitlin was in Glasgow walking down the street with John bell. People would stop them and ask if she would take a pic of them with John! Puir lass! 

Tim said someone gave him a foot spa as a gift! 😁 He wondered if this was OK?

Joanne said someone knitted her a pair of fingerless gloves. One bore a picture of a bear and the other a cluster of grapes. She wondered what that meant! 😉

Last question was did you know about Outlander?

Paul did because he is Scottish and very aware of the influx of tourists. He shared this apocryphal story: Diana was on tour and stopped at a bookstore in a small hamlet. She picked out two books and took them to the counter to pay. The bookstore owner said they were on “the house!” Everyone in Scotland knows about Diana. 🥰

And then it was time to say goodbye for this event! Great time! Great guests! Great fandom!

We exited the event and even said goodbye to our strange security guard. It was asleep at its docking station! 😁


The deeply grateful,

Outlander Anatomist

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Photo and Video Credits: Sony/Starz, Outlander Anatomy, Jody Kawamata-Chang, www.natgeo.com, www.secretseattle.com