mrs fitz – Outlander Anatomy

October 15, 2020

A Highland Tea with Diana Gabaldon!

Greetings, dear readers!

Five months have flown by since my last post, Anatomy of an Easter Egg Hunt! 😱

Dealing with summer crops, wildfire evacuation, and COVID have presented been BIG challenges. But, I am back today to share with you a most delightful experience.

On October 3, I was privileged to join author, Diana Gabaldon, and the Northern Arizona Celtic Heritage Society (NACHS) for a virtual highland tea!

Note: The below photos and video were filmed from my iPad screen. Thus, the quality is not the highest. Bear with me, please, because near the end of this blog, I share a link to NACHS full video of this wonderful event!

We gathered via Zoom in the library at Diana’s home in Flagstaff, AZ. The first thing I noticed were book-filled shelves, a must for any library! 😉 Many of these tomes feature her favorite genre – mystery and murder mystery!

Diana was introduced by NACHS’ Mistress-of-Ceremony, Jude McKenzie, who did a splendid job moving things along. Jude explained this is an annual event so every year on this day, they are known as NACHOS: Northern Arizona Celtic Heritage Outlander Society! 😆

Diana has been supporting the NACHOS effort for 20 years! In case you may not know, Diana has supported many good causes over many years.

The Highland Tea is a ticketed event. Jude explained that funds go toward supporting all things Celt-ish! Among its various worthy causes, NACHS supports the Jim Thompson School of Piping and Drumming. To date, they have awarded over $120,000 in scholarships and will consider any proposal promoting Celtic heritage. A record to be proud of!

Diana sipped a blended tea, courtesy of a local Flagstaff specialty shop, Victorian Moon. The tea was served from a beautiful silver tea set which is partly visible in the foreground. Yummy-looking tea treats were made by volunteers.

As you all know, Diana is famous for “talking with her hands,” and this event was no exception. She used them throughout. I enjoy watching her expressive hands “chat” with us. 😜

I always check out Diana’s nail color. 👁 I may be wrong, but I believe she is wearing her favorite green polish.

This is a closeup photo of that luscious green tone taken in October 2018, at the Surry International Writer’s Conference (SiWC) in Surrey, B. C.

Back to teatime!

Diana then consented to read excerpts from her ninth big book, Go Tell the Bees that I am Gone! Because time allowed, she read three!

Psst…..don’t you love her joyful smile!

SPOILER ALERT!!! With NACHS’ permission, this video clip is from the first scene she read. It occurs the morning after the end of Written in My Own Heart’s Blood (MOBY), Diana’s eighth book.

If you don’t want to be exposed to spoilers, you might skip the next paragraph and the film clip! 😱

Jamie and Claire had returned to Fraser’s Ridge just six weeks before this scene occurs. Bree is away on a hunting trip with da. Roger is left to child care at Bobby Higgins’ cabin, which used to belong to Roger and Bree.

It is a wonderful scene starring Roger and Mandy.

Next, Diana read an excerpt about a “lively argument” between Jamie and Claire. The subject: Lord John Grey and his, erm, history with Claire! 😲

The final excerpt describes a shopping trip by Jamie where he provides insight as to why a murdered man is or isn’t Jewish. 😉

Listening to Diana read all three excerpts was an honor and a delight. I hope you enjoyed hearing the first one.

Jude then read a series of questions provided by ticket holders. They were varied, interesting, and from all over the US and beyond. At the outset, Diana took the opportunity to answer an anticipated question: when will the show be filmed and when will book nine be published?

She pointed out that filming the show is postponed not only because of local COVID issues, but until the crew, many of which are Americans, cannot travel to Scotland! Let’s hope this ends soon! 🦠

Diana shared that she has read the first four scripts and verifies that they are good. Yay! 🤗

Then, she carefully explained the process involved in publishing her book and why it takes so long:

She has pretty much finished all of the pieces and is assembling and grooming them.
Once she is finished, the book is sent to three editors: One in US, one in UK, and one in Germany. The editors are encouraged to offer observations and suggestions. She considers input from all three – she may or may not incorporate their suggestions. This can take several weeks.
She sends the edited book to her copy editor (2-3 weeks). She receives feedback about what to keep, what to modify, and what to eliminate. She then decides what to do with these suggestions.
Good news! The cover design is completed and is beautiful!
She then receives galley proofs, meaning a layout that looks like the finished book. Galley proofs take another few weeks
The next step is complicated: “Go Tell the Bees” is a big tome; roughly the same length as Drums of Autumn but slightly shorter than An Echo in the Bone. COVID has affected the printing industry, with several printers either cutting down on the number of books printed or going bankrupt. Currently, there are only TWO companies that can print such big books! They already have books in a waiting cue to be printed. They must prioritize. She does assure us: “They want to sell the book as much as you want to read it!” (Given her passionate fan base, this is a bit hard to believe! 😂)
The last step requires a decision of how many copies to make in the first printing: to do or not to do a full run? A print company doesn’t want to over print and be left with unsold run copies. And, it certainly does not want to under print a likely best seller. The middle of a pandemic make such predictions challenging for these companies. Fingers crossed they make the right decision for all! 🤞🏻

So there you have it! Lots of moving pieces needed to bring this puzzle together as quickly as we all desire. And, hopefully, this helps us be a wee bit more patient with the wait. 🙏🏻

After this Q and A session, Jude moved to an interesting section of the tea – Diana autographed several items for an auction benefitting NACHS. A splendid idea!

The items included:

China tea cup and saucer:

Stained glass sun catcher – Celtic knot design:

Dragonfly stained glass lamp (💓 the green color!):

Then a second round of questions. Diana was asked to repeat her line from Outlander episode 104, The Gathering.

In a brief exchange with Mrs. Fitz (Annette Badland), Diana playing Iona MacTavish, pointedly remarks: “I see you are keeping the place as bright as a penny!” Mrs. F responds with a snide remark about Diana’s gown which, BTW, has a Fraser tartan inset to the bodice.

She recited her line perfectly, complete with Scottish accent. Lovely! 🤗

As always, Diana’s remarks were intelligent, economical, and pithy! Her mind is keen, no? 🥰

The event concluded after more questions from ticket holders. Overall, it lasted about 1 1/2 hours, $25.00 well spent!

If you missed this lovely event, please dinna despair. You can view NACHS’s full recording after making a small donation. Just send an email to the following address: nachs.events@gmail.com. I highly recommend the experience and the cause is worthy!

The deeply grateful,

Outlander Anatomist

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Photo and Video Credits: NACHS; Sony/Starz; Outlander Anatomy

June 6, 2019June 6, 2019

Fun Fact: Inflammation

Anatomy Def: Inflammation is the body’s defensive response to tissue injury.

Outlander Def: Claire’s aching marks after the scourging for witchcraft.

Learn about inflammation in Anatomy Lesson #37, “Outlander Owies, Part 3 – Mars and Scars.”

Inflammation is an important defense mechanism the body employs to combat physical injury. There are two categories of inflammation:

acute inflammation – rapid but brief response to injury
chronic inflammation – prolonged response to injury (numerous types)

Interestingly, acute inflammation is not the same as infection. Inflammation can occur with or without the presence of infectious agents.

Fun Fact: Nearly 2,000 years ago, a Roman encyclopedist named Aulus Cornelius Celsus wrote extensively about medicine, pharmacy, surgery, agriculture, law and military arts. Although not a physician, he was the first to described four cardinal signs of acute inflammation. Rudolf Virchow, father of modern pathology, added a fifth. These signs in Latin, followed by their English equivalents, are:

Rubor = redness
Tumor = swelling
Calor = heat
Dolor = pain
Functio laesa = loss of or disturbance of function

When tissues are injured (e.g. blow, burn, cut, abrasion, infection, etc.) inflammation quickly appears due to dramatic changes in small blood vessels of the injured region. The small vessels dilate and become leaky allowing fluid (plasma) and some types of white blood cells (WBC) to enter the injured tissues. The result:

Increased blood flow causes redness
Leaked plasma causes swelling
escaped WBCs release chemicals inducing more redness, swelling, pain, and heat
Pain causes decreased use (function) of injured area

These responses may seem harmful and sometimes they are, but, overall, are designed to:

eliminate the cause of cell injury
remove damaged cells
pave the way for tissue repair

Try This: Do you have a cut or scratch? If not, the next time one arises, observe the wound. You will likely note redness, swelling and pain. Gently place the wounded area against the skin of face or lip and detect increased temperature (heat). And, likely, you will avoid using that area until it heals (loss of function) because it hurts. The five cardinal signs of inflammation!

Read about inflammation in Outlander book. Yes, it’s there! Claire and Mrs. Fitz share a significant convo over wounded Jamie. Although the word inflame doesn’t appear for another 40 or 50 years (late 1700s), their exchange remains authentic – Mrs. F merely states she “understands” Claire’s “meaning.” So, all is well <G>:

“But he’s hurt. He was shot yesterday and stabbed last night. I bandaged the wound for riding, but I didn’t have time to clean or dress it properly. I must care for it now, before it gets infected.”

“Infected?”

“Yes, that is, I mean, inflamed, you know, with pus and swelling and fever.”

“Oh, aye, I know what ye mean. But do ye mean to say as ye know what to do for that? Are ye a charmer then? A Beaton?”

“Something like that.”

See the striking (no pun intended) marks on Claire’s back courtesy of the strap in Starz ep 111, The Devil’s Mark. Yep, inflammation, for sure! Thankfully, Jamie reassures her with these splendid words:

“It won’t—” he began, then hesitated, “I mean, the cuts are not deep. I—I think you’ll no be … marked.” He spoke gruffly, but his touch was very gentle, and reduced me to tears once more.

Me, too! Sob!

A deeply grateful,

Outlander Anatomist

Photo credit: Starz

December 23, 2014March 30, 2015

Anatomy Lesson 9: “The Gathering” or “Gore by a Boar”

Anatomy Lesson #9: Tibialis Anterior, Femoral Artery and Intestines.

Holiday greetings fledging anatomists! Hope ye have been good since my last post. This lesson follows Starz episode 4, The Gathering. It also contains lots o’ anatomy so let’s begin!

Warning: if ye havna seen episode #4 or are a wee bit squeamish, this post contains a graphic photo of Geordie’s innards; ye’ll get a second warning just before it comes inta view.

Starting off, I nearly choked on me ale when naughty Angus, that shagger of wee beasties, offers Claire a look-see under his kilt! Claire’s no likely to forget that sight! Speaking of kilts, at the end o’ this lesson I’m gonna show ye what is under a Scotsman’s kilt. But, dinna be scrolling to the end just yet! Ye will want ta read through yer anatomy lesson first…

Claire is headed out on the hunt thinking boars are just wee, hairy piggies. Our stylish lassie is outfitted in the latest over-the-shoulder, wicker medical basket wit’ a fine leather strap.

But, her first physicking is fer a young man gored by a boar. Near the knee, a horrific meaty-looking wound gapes the length o’ his right leg (see Anatomy Lesson #7). The gash is huge and Claire applies a nice field dressing while givin’ him holy hell fer messin’ wit’ the pigs. She tells him he will walk with a limp!

Now, let’s puzzle out the anatomy of this wound. Ye may ken from Anatomy Lesson #7 that anatomists divide the lower limb into thigh, leg and foot. Ye also ken that the leg contains two bones (Photo A): the larger, medial tibia and the smaller, lateral fibula. The tibia, or shin bone, has a sharp anterior border and a broad medial surface ye can easily palpate (feel) through yer own skin. Try it. These tibial surfaces are so superficial that they are easily barked on projections such as stair risers.

Photo A

The gash (indicated by the red dashed line in Photo B) runs the length of tibialis anterior (Photo B, black arrow) a fleshy leg muscle just lateral to the anterior tibial border. Test yer own tibialis anterior muscles this way: wit’ the legs side-by-side, stand on yer heels. Ye’ll see fleshy bumps to the side of each tibia – the tibialis anterior muscles. If yers aren’t verra fleshy, read on ta find out how to strengthen them!

Photo B

Tibialis anterior arises (takes origin) from the tibia, turns into tendon, angles across the ankle joint and ends (inserts) on foot bones near the instep (Photo C). It has two major functions: it inverts the ankle (the sole faces the midline) and it lifts the foot at the ankle (dorsiflexion) allowing the toes to be pulled up and held in a locked position. This muscle is critical for walking, running, kicking a ball, or any activity that requires moving the leg or keeping the leg vertical. Now ye ken why Claire warns the young man that he will walk wit’ a limp.

Photo C

Ye can strengthen yer own tibialis anterior using a verra simple exercise (Photo D). Tie an exercise band around an upright, place the loop over the foot (not just the toes) and dorsiflex the foot against tension. Repeat on the other side gradually increasing the number of repetitions over time. Ye can also find tibialis anterior strengthening exercises on YouTube.

Photo D

TAKE NOTE! Flawed running technique, poor athletic shoes, overuse, etc., can cause tibialis anterior muscles to become seriously inflamed (redness, swelling, pain, heat, and loss of function). In Photo E the inflammation is so extensive ye can see the entire course o’ the muscle and its tendon just under the skin!

Photo E

Movin’ on: Claire’s next challenge is puir Geordie whose gory thigh bears multiple lacerations from a boar’s tusk! Claire correctly concludes that the gouges missed his femoral artery because there is no spurt ta the blood flow.

Where is Geordie’s femoral artery? Weel, the (common) femoral artery starts at the inguinal ligament accompanied by a vein and nerve of the same name (Photo F). It bears another name before passing behind the inguinal ligament but it doesn’t concern us just now. Soon, (2-3 inches) it passes behind the sartorius and vastus medialis muscles (see Anatomy lesson #7) too deep fer a boar tusk ta reach.

Photo F

Ready fer a wee bit o’ self-examination? Or, ye can play doctor with a friend!…Snort! Lie on your back and put yer fingers in the groin near the middle of the thigh. Move them up and down. Do ye feel a thick band? This is the inguinal ligament (Photo I – black arrow). Next, place yer middle and ring fingers just below the inguinal ligament and press deep. Ye should feel a strong, even pulse; this is the femoral artery! It lies deep just below the middle o’ the inguinal ligament (Photo G – green arrow). It is often as big as yer thumb because it supplies blood to the entire lower limb (almost).

Hint: ne’er take a pulse with yer thumb or index finger as these vessels have their own pulses that may interfere wit’ yer assessment. The femoral artery is catheterized for diagnostic purposes and medical intervention.

Photo G

Weel, if Geordie’s femoral artery wasna gored, where did all that dark blood come from (ye ken that arterial blood is bright red and venous blood is deep red). It came from tributaries of the great saphenous vein (GSV), the longest vein in the body (Photo H)! Saphenous is from the Greek meaning “to manifest” because often it can be seen through the skin. The GSV begins in the foot and courses up the inside of the leg and thigh ending in the femoral vein. It receives numerous tributaries (dashed oval in Photo H) along its path and these are the sources of Geordie’s blood. Claire stems the bleeding with a tourniquet knowing that she can stitch the lacerations and save his leg.

WARNING: The next image shows Geordie’s gut wound. Scroll past if ye dinna wish to see it!

Photo H

But, sadly, Claire kens puir Geordie’s other wound: a hugh gash through the belly wall exposing globs of yellow fat (green arrows) and loops o’ intestine! This wound will be fatal in the 18^th century and can be today because it exposes a normally sterile space to the outside world wit’ its teeming hordes of bacteria! She canna do anything fer him except take him ta a peaceful place! Kind Claire!

As anatomists, we should learn from Geordie’s wound. The loops shown are o’ small intestine; how do we ken that? Easy! Inspect the loop surfaces and see that they are smooth so this is small intestine; if the loops have pouches (haustra) then it is large intestine (see Photo I – black arrows). The small intestine is divided into duodenum, jejunum and ileum but we see only jejunum and ileum as the duodenum lies too deep.

Photo I

BTW, again verra good special effects because globs of yellow fat show just under Geordie’s belly skin. Anatomists call this layer the superficial fascia of the anterior abdominal wall. But, a shorter name is Camper’s fascia (Photo J). The depth of the fatty layer depends on us. The more belly fat, the thicker Camper’s fascia; the leaner we are, the thinner Camper’s fascia! Clearly, Geordie is a slim-Jim.

Photo J

After Claire telegraphs puir Geordie’s fate, Dougal cradles him gently in his arms (finally a kind deed!) – we hear them reliving fun times together…stealing kine, terrorizing the neighborhood, swiving Geordie’s bonny sister Doreen. What’s a guid friend fer, aye?

Next, Dougal arrives at the shinty field leading a horse carrying puir Geordie wrapped in a plaid death shroud (the great kilt scores again!). A rough but good-spirited game is in progress. Is it Geordie’s death or seein’ his damn nephew playin’? Either way, a black-clad Dougal roars onto the field like an 18^th century Darth Vader (and boy! Isn’t he in braw, shinty-fighting form!)! He is filled wit’ rage and looking fer victims!

OK, time fer an anatomy review pop quiz! So, please git out paper and pencil and keep score…

First, Dougal clips an unwitting player from behind! Dirty pool! (Hey, who’s that running ahead o’ Unca D. and victim #1)? Clipping in the US version of football has been banned for almost 100 years (one type is still permitted in the NFL and CFL). Why is clipping so dangerous? Can ye puzzle it out?

Anatomy quiz question #1: Clipping puts what knee structures at risk?

If ye answered the medial or collateral ligaments and/or the medial or lateral meniscus (see Anatomy Lesson #7) then give yerself 15 points!

A wee aside: why doesn’t Dougal ever wear a kilt? He’s always dressed in breeches. I’d love ta know what the dickens that is all about! Mayhap he gits saddle sore or is jealous of Jamie’s knees? He seems jealous of everythin’ else about the lad!

Next, Dougal shoulders a friend or foe into the fire pit!

Anatomy quiz question #2: What body part(s) does Dougal use to shove the man into a fiery pit?

If ye answered acromion, point of shoulder and/or arm (see Anatomy Lesson #2 and Anatomy Lesson #3) then give yerself another 15 points!

Then, Dougal goes after Jamie big time. Whoa! Watch out Big Red! Yer ever lovin’ uncle is after ye!

Then, Angus (he looks so funny in his poufy kilt) joins the fray ta help Dougal beat up on Jamie. Murtagh, Jamie’s ever watchful god-father, stops Angus in his tracks wit’ a shinty stick to the nether regions! Sorry Angus, but ye shouldna ha’ been so cheeky strutting yer stuff to Mistress Beauchamp!

Anatomy quiz question #3: What body part(s) did Murtagh hurt?

Weel, ye dinna need an anatomy lesson ta’ figure this one out! If ye answered testicles, baws or any of at least 100 other names, then gie yerself 50 points! Yep. Ye ken these parts are super important and worth a whole lot more points! Ouch! Nothin’ does it like a good whack ta the stones – and I don’t even ha’ any! I havena taught an Anatomy Lesson yet on these goodly body parts but I likely will.

Then Dougal and Jamie go at it over the shinty ball followed by a mess o’ blows ta Jamie who remains the high born Scottish gentleman that he is! Finally, Jamie has enough and wit’ a great heave, hoists Dougal o’er his right shoulder!

Anatomy quiz question #4: What body part might Jamie hae damaged wit’ this mightly effort (Dougal is a big man, aye)?

If ye said shoulder joint re-dislocation (see Anatomy Lesson #2) then gie yerself another 20 points!

When I saw Jamie standin’ there nodding to Claire (he always knows right where she is) with his right shoulder droopin’ and his palm turned backwards me thinks, CRAP, he’s done it again!

What do I mean? Weel, once a shoulder has been dislocated, it’s much easier another time. Also, the position of Jamie’s drooping right upper limb is consistent wit’ an anterior dislocation which looks like this (Photo K – ken the black arrow on the acromion?):

Now adding up the points, what was yer final score? Kudos if it was 100%!

Now, I’m done wit’ this anatomy lesson, but I have more ta say about “The Gathering”. I just canna help meself!

I thought Claire is the only time traveler at Castle Leoch, but no, there are two others! First, there’s the lovely Fiona and Mrs. Fitz is sharpenin’ claws on her!

Then, there’s the elegant, hand wavin’, finger pointin’ Moore! He looks mighty dapper!

Next, I love where Murtagh explains the oath takin’ ta Claire. I swear she is the only woman he ever speaks to. Mayhap ‘tis because her smile is as sweet as Jamie’s mother? And, that gown! OMG! Terry and her team work their magic again!

Then, the hilarious scene between Claire and Angus over the “Spanish” sedative. Ha! She even spits her mouthful of port on the floor. Oh yeah, Claire! That is more like it – she an irreverent leddy wit’ a wicked sense of humor! If she and Angus weren’t at such odds, they’d probably be besties!

Next, I must riff on Claire’s cynical horse dung love potion for an unsuspecting Jamie. Handing it to that nasty lassie LogHair, Claire instructs her to scatter it on his threshold, click her heels together three times and recite “There’s no place like love,” “There’s no place like love.” I dinna ken if ye recognize it but this line is straight out of the Wizard of Oz where the Good Witch of the North tells Dorothy to click her heels together three times and repeat “There’s no place like home,” “There’s no place like home!” Since the W of O was released in 1939 Claire could have seen it at a cinema. If ye believe in time travel, then it’s possible!

Finally, I love the intimate scene where Claire stumbles over Jamie in the stables. Fichu and ribbons not-wit’-standing, she left a trail of bread crumbs to mark her escape route? Ha! People, this is verra funny! I live in a forest and bread crumbs willna last more than a few minutes wit’ all the furry, wee beasties around. Would it be different in 18th Century Scotland?

After some difference of opinion, Claire reveals she walloped Dougal over the head with a chair. Jamie rubs the back o’ his heid sayin’ he hopes she left a good mark so Dougal will remember his error in judgment. Mayhap his rubbin’ is in sympathy fer puir Dougal? More likely, he’s feelin’ a 6” scar on the back o’ his own heid left by a wicked Lochaber ax (from the Outlander book) – likely wielded by his connivin’ uncle Dougal!

Here’s what one o’ those wicked 18^th century things looks like:

OK, I’m leavin’ ye wit’ the photo I promised at the start o’ this lesson: what does a Scotsman wears under his kilt? I added the star, ye ken? Back in 2004 when this photo was taken, Queen Elizabeth did indeed visit the 1^st Battalion of Argyll and Sutherland Highlanders. If ye wish ta see the full monty (I’m bettin’ ye do) then search online fer “Scotsman seated next to the Queen” and up, er, pops the whole kilt and kaboodle! Ha! This photo is a bit o’ an urban legend and Snopes rates it as un-determined authenticity. But, the Colonel (Snopes identifies him) sports such a cheeky grin that I canna help thinkin’ the photo is likely real – but, this man is no saying one way or the other!

I do hope ye enjoyed this post. Please tune in 14 days from now for Anatomy Lesson #10, Jamie’s back! Until then, I wish ye the happiest of holiday seasons. Be safe! Take good care of yer amazing bodies!

Be sure to follow me on Facebook and Twitter!

The deeply grateful,

Outlander Anatomist

All photos are credited to Starz,Netter’s Atlas of Human Anatomy 4^th ed., Hollingshead’s Textbook of Anatomy, 5^th ed., www.wikihow.com, www.wikipedia.org, Bodyspace.bodybuilding.com, www.sportsmed.or.nz, www.Radiopaedia.or, www.Wikipedia.org, www.home.southernct.edu, www.williammitchellsstudio.com, www.bodyspace.bodybuilder, www.thesportsphysio.wordpress.com, www.pinterest.com