Word: bobbed
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...more than it wants to fully understand it. The jealous girlfriend business doesn't go anywhere beyond the conventional, but the affair with the married woman does have some traction, in that Toni Mannix - played with lusty high spirits by Diane Lane - was the wife of Eddie Mannix (Bob Hoskins), who was Louis B. Mayer's enforcer at M-G-M, the man who knew all the studio's secrets, scandalous and otherwise, and made sure they stayed secret. He was one tough guy, with connections to all the right cops and crooks (though, curiously, there were people in Hollywood...
...patient Bob has a "bone-on-bone" knee - no cartilage at all between his femur (thigh bone) and his tibia (leg bone). Common arthritis looks white on an on X-ray; Bob's X-ray is a snowstorm. He's as bow-legged as a cowboy, the inside of his bones have ground each other down. Although his cartilage is all gone, there's something even more important missing in his case. He has no pain. Bob, 70, actually comes in this time because he has pulled a muscle. When I examine him, I'm careful...
...What a contrast to my next patient. Sean is half Bob's age. He weighs less, isn't as active, and has nice straight legs. Barely a trace of arthritis on X-ray and nothing except "minimal arthritic changes" on his MRI. He has taken Advil, Naprosyn, Voltaren, Celebrex with minimal help. Injections into his knees of hyaluronic acid (a component of joint fluid) and corticosteroids provided only a few weeks of relief. Physical therapy, braces, acupuncture, yoga all failed. He couldn't get out of chairs, couldn't climb stairs because of the pain. There was one thing left...
...next? Here is the greatest mystery of my profession. As doctors, especially in my field of orthopedic surgery, we like to act as if we understand things like this - but we don't. It's a really interesting question because whoever answers it can turn a Sean into a Bob - getting the pain to go away without doing the operation - and this would be a minor miracle. We do have some tantalizing tips, though, about what makes things hurt...
...American Veterinary Medical Association has come out against the ban, fearing rescue shelters would be swamped with hundreds of thousands of unwanted horses while others would be sold to unregulated slaughterhouses overseas and brutalized even more. The U.S. ban "does not solve problems, it creates problems," complains Rep. Bob Goodlatte, chairman of the House Agriculture Committee, which is almost unanimously opposed to the measure...