OK, so I\’ve done this thing called Ask Dr. Rob, in which I answer questions that my readers have regarding health, tacos, webkins, fetuses driving speed boats, the end times, baby spit, the dangers of kumquats, and other crucial issues. But there is a big problem: nobody ever asks me questions anymore.
So I asked myself: why is this? Why don\’t people ask me questions?
Then I answered myself: well, you just asked me a question!
Then I said back: Yeah… but I am me, and that shouldn\’t count, should it?
To which I answered (in a very snarky tone): There you go again! You keep asking questions! Aren\’t you good enough for you (or me)?
I pounced on this: Hah! Now you are asking me questions! Caught you!
Then I stormed out and left myself alone. I still haven\’t seen me, but it did start me pondering the fact that I could ask myself questions. I did this without asking a direct question (so as to not raise a ruckus), but wondered this:
I think a question I would ask myself (If I would do such a thing) would be about the coldness of doctors hands and if there was a reason for it. I think that this would, hypothetically, be a good question to answer (as it were) on the \”Ask Dr. Rob\” segment.
Then my doctor increased my dose of medication and everything got better.
But hey, why not answer the mystery of doctor\’s cold hands? These hands of mine cause babies to cry when touched; they take away my patients\’ ability to breathe for several minutes, and cause asystole at least once a week. My hands get so cold at times that I was contacted by Al Gore to see if they could be used to combat global warming.
I am considering it.
In the mean time, let me explain to you (and me, if I ever come back) the science behind cold hands. Yes, it is science,not magic. It does not involve he-who-must-not-be-named or horacruxes (though my patients may disagree with that). It is science because it relies on the basic laws of nature, namely: the laws of thermodynamics, which include the following:
- If you have no energy, you won\’t get it; and if you have energy, it will changed from one kind to another (probably making you feel like you have none).
- Heat will move from the hotter thingy to the colder one until they are both the same temperature. The colder one won\’t make the hotter one even hotter, which is too bad because my air conditioning bills would be a lot less if it could.
- The colder things get, the less they move, and if things get really, really cold, they give up even trying to move.
Now, some idiot scientist got all smarty-pants and said \”Well, actually there has to be another law before the first one\”, and so instead of shifting everyone back in line, they made it the zeroth law. I think they did this to insult that scientist. This law states:
- If two thingies (let\’s say they are gerbils) are just as cold as another thing (let\’s say it\’s a wrench), then the gerbils are just as cold as each other (although one will invariably complain more).
They didn\’t talk about gerbils and wrenches in the law when they made it, but it does make it more interesting.
Much more interesting.
In truth, these laws are pretty obvious, and many people don\’t understand why they were made in the first place. The laws were actually voted on during the presidency of Millard Fillmore, who wanted to make the youths think he was a cool dude. He figured that kids liked physics, as Albert Einstein was all the rage at the parties, he wanted to jump on the \”hip physicist\” bandwagon. Nobody was fooled, though, and he was never invited to the cool parties.
Despite this, the laws still stand, even the one before the first law.
The Application of the Science
So, you may ask (because I wouldn\’t dare), what does this have to do with doctors\’ cold hands?
1. The Conservation of Energy
Certain patients come to the office constantly complaining that they have \”no energy.\” These patients are wrong about this, they actually have energy and consume huge quantities of it. They actually are energy magnets, drawing all energy from their environment and storing it in their thymus gland. You may have met this kind of person before; they often attend office parties.
This is what is known as the conservation of energy, which is the first law of thermodynamics. Why does it conserve energy? The reason is that these patients never use the energy they store in their thymus gland. The heat energy in the hands of the doctors is removed by these patients, and not wasted on the comfort of the other patients.
Some scientists are looking into ways to tap this abundant store of energy in the thymus glands of these patients. Unfortunately the scientists themselves don\’t have the energy to complete these experiments.
The second law states the obvious fact that cold things don\’t make warm things warmer, If someone sticks an ice cube in your pants, it doesn\’t feel warm.
At first glance, this doesn\’t seem to have to do much with doctors\’ cold hands (unless they are the ones who put an ice cube in your pants), but a central concept to this law is the principle of entropy. Entropy is the tendency of things to get disordered over time, the mortal enemy of people with Obsessive Compulsive Disorder. It turns out that things that are cold are less disorderly than warm things, or conversely, warm things have higher entropy.
There are many examples of entropy in the day-to-day world of a doctor:
- The state of the insurance industry – creates chaos and disorder in the lives of medical professionals.
- The medical record – disorganized and incomplete. Attempting to keep order in this realm is a battle against chaos.
- Doctors\’ handwriting – nothing more need be said.
So you see, each of these chaotic things in the day of a doctor requires heat to cause such disorder. This heat is sucked out of the hands. If enough heat is removed, it will cause permanent freezing to the heart.
3. Absolutely Freezing
The third law states that cold things don\’t move as much as hot things, and really, really cold things stop moving altogether. While this law does not explain the coldness of a doctor\’s hands, it does explain a troublesome phenomenon. Why do doctors run late? Simple: their hands are cold, which causes them to slow down progressively more throughout the day.
In response to this, doctors have turned the temperature of the exam rooms, attempting to accomplish two things:
- Slow the patients down so that the relative perspective of the patient is that the doctor is operating at normal speed.
- Some theorize that lowering the temperature enough will even cause time to slow down, creating a eddy in the time/space continuum where the patient sees less time pass relative to normal time.
This theory explains why doctors are slow to adopt computerized records, as the extremely low temperatures in doctors\’ offices has caused the slower passage of time. One office in our city is actually still in 1964.
So there you have it. As you see, an understanding of science allows complex problems to be simplified. It\’s not magic, it\’s science!
Me: Wait! You forgot to explain the application of the zeroth law!
Myself: So you\’ve finally decided to come back, have you?
Me: I was over at Kevin MD\’s blog, but I could hear through the walls. It sounds like decent science, but what about the Zeroth law?
Myself: The one with the gerbils and the wrench?
Me: Yeah, that one.
Myself: It actually has no place in medicine. The law is restricted to the plumbing industry.
Me: And the Gerbils?
Myself: They turned out to be horacruxes and had to be destroyed.
9 thoughts on “Ask Dr. Rob: The Hand that Freezes”
OK, so why do my feet get so cold that they suck all the heat out of my calves and shins?
Ok. That is the best thing I have read all week. And the science is impeccable!!! Thank you. I can’t stop laughing.
You are such a good doctor because you are always concerned that people understand the “why” Thank you for taking the extra step as always and providing good humor along with it.
Funny _and_ good science. You gotta love it!
I once saw the laws of thermodynamics paraphrased as: “You can’t win, you can’t break even, and you can’t get out of the game.”
You do know you’re crazy, don’t you?;)
Okay, here’s a question: When is the last time you cleaned the earpieces of your stethoscope?
Ok, I thought it was because you always wash your hands between patients, and you are so speedy about it that you don’t wait for the water to warm up. Thereby, you are constantly washing your hands in cold water and your hands get colder and colder!I do think the coldness is slowing down time though!
As a PT student I told my patient yesterday that my cold hands were simply bonus cryotherapy. That’s a legit therapeutic intervention for sure!
Now, when is the last time you cleaned the diaphragm of your ‘scope?
I actually put hand sanitizer on my stethoscope numerous times per day. The washing of hands, by the way, doesn’t cause hands to be cold, nor does the hand sanitizer. My hands get cold independent of my hygiene.
Brilliant! Why wasn’t this part of my Physics 105 class back in college?
Also- a question for Ask Dr. Rob: My grandfather was a doctor (of the old-school type) and he LOVED draining things, cutting things, doing surgery, etc. He even ate lunch while watching a video of his own eye surgery! Is this normal for a doctor? Do they test for this type of un-squeamishness on the MCAT?