Why Do Men Have Nipples? Hundreds of Questions You'd Only Ask a Doctor After Your Third Martini

CHAPTER 2. BODY ODDITIES

I amable to finally escape from the torture of Jeremy’s food inquisition, and I look around and can’t find Leyner anywhere. The bottle of Don Julio is missing and there is a trail of shrimp tails that leads to the elevator. I find him sitting in the hallway, playing Chutes and Ladders with the neighbor’s children, and devouring cocktail sauce with a straw. I try to get him back inside and he snarls, “Are you out of your mind? I’m down a hundred and fifty bucks.” His bark is heard inside and several revelers come outside to watch the action. A crowd has formed around the game and Mark is becoming surly with the children as his losses mount. It doesn’t help that the children are mocking him by singing “The Gambler” by Kenny Rogers. The tides turn and Leyner has soon wrestled the weekly allowances and the school lunch money from the kids, who disperse crestfallen while muttering to themselves. Triumphantly, Leyner rises and shouts, “Punk-ass suckers go crying to your mommy. We’re going to bring this party back inside and play some strip Candyland.” He pockets his winnings, swigs the Don Julio, and we are off.

Back inside, Wendy Thurston, a senior editor at Half-a-Dozen Ponds Press, has fallen victim to Leyner’s shrewd, merciless gamesmanship. She is down to her bra, thong, and socks. As Leyner wins another point, she removes her left sock, revealing the most beautiful alabaster-hued foot and immaculately pedicured webbed toes. Teary-eyed, Leyner turns to me and in a choir boy’s piping, soprano weeps, “I have found my Cinderella!”

This romantic outburst leaves the party in stunned silence, and then I’m again besieged by a slew of body-related questions. What is it about sideshow body oddities that awakens our most primal desires and curiosities?

As I, Billy, was sitting on the beach, relaxing and leafing through an old copy of theJournal of Manipulative and Physiological Therapeutics, I came across the answer to this age-old question. I also wish my father had known this, because maybe he would have yelled at my brother less. Cracking your knuckles is not as bad as people think. The usual argument is that knuckle popping causes arthritis. This does not happen. Chronic knuckle cracking may cause other types of damage, including stretching of the surrounding ligaments and a decrease in grip strength, but not arthritis.

So what causes the pop? The sound is produced in the joint when bubbles burst in the synovial fluid surrounding the joint. Really interesting, huh?

I didn’t have the answer to this question until I delivered my first baby. I always believed that you had an “innie” if the doctor tied a good knot, and if he didn’t, you were cursed with that funny-looking “outie.” Well, there is no knot tying at all. We just put on a clip, cut, and wait for the umbilical cord to dry up and fall off. It is all random.

Sometimes someone can develop an “outie” because they have a hernia at this site. This also has nothing to do with the doctor’s Boy Scout skills. I have recently heard of plastic surgeons removing an “outie” for belly beauty. How sad.

One question that cannot be answered, however, is why some belly buttons collect so much lint.

In Australia, the “poo fairy” comes at night to take a dump in your mouth. In England, they say a long night at the pub leaves your breath “tasting like the vulture’s dinner.” And a Scottish friend with a new Hawaiian bride reports that a late-night fridge-binge of haggis and poi will leave you with the worst morning breath of your life.

So, given all these tales, we should probably start with the anaerobic bacteria, the xerostomia (a fancy word for dry mouth), or the volatile sulfur compounds (which are actually waste products from the bacteria). All these combine to give you that wonderful get-up-in-the-morning feeling of garbage mouth.

Other things also contribute to this oral smorgasbord: medications, alcohol, sugar, smoking, caffeine, and dairy products.

But don’t run off and have your tongue sandblasted; there are simple things that you can do to fight morning breath. Brush regularly (don’t forget the tongue), floss, and drink plenty of water.

Gberg: I was just thinking that the more chaotic this is, the harder it is for Carrie to edit. It might even induce a seizure.

Leyner: That’s funny!! I think tormenting her is always a good sort of compass for us when we’re lost and floundering.

Leyner: What is a seizure, actually?

Gberg: Is that the way it usually works in the creative process? Is your genius always fueled by torment?

Gberg: Abnormal electrical activity in the brain, why?

Leyner: My creative process is fueled by a sense of Nietzschean aristocracy and a simultaneous feeling that I’m an abject fraud.

Gberg: I think everyone feels like a fraud. What about me, trying to answer these unanswerable questions?

Leyner: Coupled with torment and an overwhelming need to be loved and liked (even) AND horniness AND creditors calling ALL THE FUCKING DAY LONG. Didn’t you go to medical school in Ingushetia? You are a fraud.

Gberg: Where the hell is Ingushetia?

Leyner: Directly east of Chechnya. Check MapQuest.

Gberg: Enough of your Chechen obsession. Let’s talk about the book.

Leyner: I told you… with the amount of money we’re getting paid for this book, Mercedes and I are getting a time-share summer dacha in Chechnya.

Here are several things we can be thankful arenot contagious:

drooling

nosebleeds

itching

seizures

farting

That said, there are several theories for what causes yawns and why they are contagious. It was originally thought that people yawned to get more oxygen, but this appears not to be true.

The most common theory is behavioral. In an article examining contagious yawns, Dr. Steven M. Platek and others state, “Contagious yawning may be associated with empathic aspects of mental state attribution and are negatively affected by increases in schizotypal personality traits much like other self-processing related tasks.”

Huh? I find myself yawning right now.

What they mean is that people are unconsciously imitating others when they yawn. Humans are not the only species that yawn. Yawning is seen in many animals, including cats, fish, and birds, although we don’t know what a yawning fish looks like either.

Since our editor thought this question made the best title for this book, we racked our brains to come up with a hilarious, witty, and informative answer to this question. Our attempts proved futile, so, in order to finish this book so another brilliant title wouldn’t go to waste, we went for the boring, straight scientific response. Sorry.

We are mammals and blessed with body hair, three middle ear bones, and the ability to nourish our young with milk that females produce in modified sweat glands called mammary glands. Although females have the mammary glands, we all start out in a similar way in the embryo. During development, the embryo follows a female template until about six weeks, when the male sex chromosome kicks in for a male embryo. The embryo then begins to develop all of its male characteristics. Men are thus left with nipples and also with some breast tissue. Men can even get breast cancer and there are some medical conditions that can cause male breasts to enlarge. Abnormal enlargement of the breasts in a male is known as gynecomastia. Gynecomastia can be caused by using anabolic steroids. So, if Barry Bonds ends up coming to the old-timers game with a pair of sagging 44DD man boobs, then I think we will finally have our answer to the steroid controversy.

It is common for people to come into an emergency room because they can’t find their contact lens. Sometimes it is found folded and tucked beneath the eyelid, but other times it is nowhere to be found. So where is it???

Probably on the bathroom floor at home. A little anatomy lesson: there is nowhere else for it to go.

Other commonly “misplaced” items that lead people to the ER: tampons, condoms, and car keys.

This is a surprisingly frequent question, and often a reason women find themselves in the emergency room. Patients often come in either because they cannot remove the tampon or because it has disappeared and they don’t seem to know where it went.

Time for another anatomy lesson. The vagina is a potential space, not a hole or cavity inside the body. The walls of the vagina are normally in contact with each other unless something is inserted between them. When something enters the vagina, the body makes room for it. At the end of this potential space is the cervix. Therefore, there is no place for the tampon to go. It cannot be lost inside that small area and you should be able to remove it, or it can be easily removed by any doctor. Often we find nothing inside, and that means you probably forgot you removed it. Leaving a tampon inside too long can put you at risk for a serious infection, so don’t be embarrassed to ask for help.

Now, we are sure there are many possibilities as to why someone would need the answer to this question. We never asked our friend who asked this question why this was important, but surely she had her reasons.

Some sources do agree that the tongue is the strongest muscle per size, but the tongue is actually made up of four muscles. The heart has also been mentioned, but since it moves involuntarily and is mainly an endurance muscle, it doesn’t really get to the heart of this question (bad pun intended).

The sartorius, which slants across the thigh to the knee, is the longest muscle in the body. As for the strongest, there are two other candidates, the masseter, used for chewing, and the gluteus maximus. By gluteus! Who knew that our asses were so strong!

Another tidbit for you trivia geeks, here are Billy and Leyner’s two favorite ass-vocabulary words:

callipygian: having beautifully proportioned buttocks

steatopygic: an extreme accumulation of fat on the buttocks

The body usually maintains a constant temperature of 98.6 degrees Fahrenheit. At this temperature the cells of the body work best. If there is any significant change in temperature, it is sensed by an area of the brain called the hypothalamus. When the body gets too cold, this center alerts the rest of the body to begin warming up. Shivering, the rapid movement of the muscles to generate heat, then begins. Teeth chattering represents localized shivering.

The appendix is a small pouch off the large intestine. The wall of the appendix contains lymphatic tissue that is part of the immune system for making antibodies.

Removing the appendix doesn’t cause any harm because there are several other areas in the body that contain similar tissue — the spleen, lymph nodes, and tonsils. The spleen and the tonsils can also be removed.

Gberg: You were going to give me a little something to add to the appendix question, Why do you have one if you can live without it?

Gberg: Some expert Leynerisms on vestigial organs.

Leyner: God put certain internal organs in the human body for purely aesthetic reasons. They just look nice when the forensic pathologist opens you up.

4:05P.M.

Leyner: How do we know yet what all the vestigial organs are? A lot of the organs that seem crucial now may seem vestigial pretty soon.

Gberg: Please explain to me what is so beautiful about the appendix. It looks like a little wet caterpillar.

Leyner: It’s so subjective, though… a little wet caterpillar is beautiful… vulnerable, bespeaking the evanescence of life and the unbearable limpness of it all. I’m sure at some time, somewhere, the appendix had its moment, its evolutionary “15 minutes” of utility.

Gberg: What the hell are you bespeaking of?

Leyner: There was probably some predator that only ate people without an appendix so that gene flourished for a while….

Leyner: Speaking of vestigial.

Leyner: What other supposedly vestigial organs are there?

Gberg: The tail.

4:10P.M.

Leyner: Wouldn’t body hair also be considered vestigial now, since we don’t live naked out on the primeval savannah?

Leyner: I try to live naked on an inner sort of primeval savannah, but you know what I mean. Body hair is surely some sort of atavistic throwback too.

Leyner: What’s the purpose of pubic hair or back hair or even hair on the head?

Gberg: Hold on, I have to look up “atavistic.” I need a freakin’ thesaurus.

Leyner: It’s all economics. There’s not enough of a service industry devoted to the appendix, so it’s anathematized as “vestigial”… hair’s cool, what with the waxing industry and salons and shampoos and conditioners, etc. etc.

Gberg: You know, I love the word “merkin,” but do people really wear those?

Gberg: Why would anyone really want a pubic toupee?

4:15P.M.

Leyner: The whole idea of a merkin is so great! I think this whole culture of plucked women is pretty perverse, actually. It’s sexually infantilizing. Who wants a woman who looks like a six-year-old down there?

Leyner: How big can an appendix get?

Gberg: I know, but by the same token, you don’t want someone who looks like a Yeti.

Gberg: Is that how you spell it?

Leyner: A Yentl?

Leyner: Yentl?

Gberg: No, the abominable snowman.

Gberg: Are you saying that Babs wears a merkin?

Leyner: Well… I know we’re digressing a bit… but rather a Yeti than a glabrous, waxen thing.

Leyner: Streisand is famous for the merkin. Made by the finest Venetian merkin-makers.

Gberg: Let’s not digress. We can get back to the book.

Leyner: From Yak scrotal hair.

Leyner: OK… back to the book.

One of the great secrets of medicine and one of the things that doctors aren’t quick to admit is that we often don’t have all the answers. Canker sores are one of those cases. Canker sores, medically known as recurrent apthous ulcers, are the most common oral disease and something that many of us have experienced. They differ from cold sores in several ways. Canker sores occur inside the mouth while cold sores show up on the lips. Cold sores are caused by the herpes virus and are definitely contagious. The etiology of canker sores is still unknown, although scientists have spent a great deal of time searching for the answer. Studies have suggested that this inflammatory disease is a result of abnormal immune response directed toward the oral membranes. Several bacteria and viruses have also been investigated as the culprit, but none has been found to be responsible.

It’s all about the arrectores pilorum.

What, you say, are arrectores pilorum?

These tiny little hair erector muscles that contract and raise the hair follicles above the skin. These are goose bumps or goose flesh or chicken skin.

What causes them?

They start with a stimulus such as fear, cold, or the sight of yourself in the mirror after a night of vodka-induced debauchery. This causes the sympathetic nervous system to become activated. The sympathetic nervous system is responsible for the body’s “fight or flight” response. This sends a message to the skin and activates those little muscles.

Saturday night palsy is a condition often seen in the emergency room, not a sequel to a John Travolta film. It is caused by the same mechanism that makes your foot fall asleep but is a tad more severe. Saturday night palsy is caused when someone, who is usually really wasted, is unable to move an arm or leg in response to the pins and needles caused when a limb “falls asleep.” It can lead to temporary or even permanent nerve damage.

Here is what happens in normal conditions. When pressure is exerted on part of your leg or arm, several things occur. Arteries can become compressed, making them unable to provide the tissues and nerves with the oxygen and glucose they need to function properly. Nerve pathways can also become blocked, preventing normal transmission of electrochemical impulses to the brain. Some of the nerves stop firing while others fire hyperactively. These signals are sent to the brain, where they are interpreted as burning, prickling, or tingling feelings. It is these sensations, paresthesias, that alert you to move your foot. Shaking your foot releases the pressure and nutrient-rich blood flows back into the area and nerve cells start firing more regularly. The “pins and needles” feeling can intensify until the nerve cells recover. That is why it is painful when you try to “wake up” your sleeping limb.

Persistent numbness or tingling can be a sign of certain medical conditions, and in those cases you should see your doctor.

Feeling exhausted? Wondering why you have bags under your eyes that make you look like Droopy Dog or John Kerry?

Lack of proper restful sleep seems to cause dark rings for reasons not properly understood. The skin around the eye is the thinnest found anywhere on the body, and this thin skin allows dark, venous blood to show through.

Dark rings around the eyes are a common problem. They appear to be genetic and can get worse as you age and your skin gets thinner. Adequate rest, good nutrition, and overall good health tend to make the circles less noticeable. You can also wear sunglasses all the time.

You definitely don’t spend a great deal of time learning about laughter in medical school. I know that doesn’t surprise you since physicians are such serious people. The closest they come to humor is the physiological study of laughter — gelotology. There is even a form of seizures called gelastic seizures that causes sufferers to laugh incessantly.

Laughter is a complex process that requires the coordination of many muscles throughout the body. Laughter also causes an increase in blood pressure and heart rate, breathing changes, reduced levels of certain neurochemicals, and a potential boost to the immune system. So, overall, it is very good for you.

Researchers have attempted to decipher the purpose of laughter and many believe that the reason for laughter is related to making and strengthening human connections, a kind of social signal. Studies have shown that people are thirty times more likely to laugh in social settings than when they are alone. Reports also suggest that the origins of laughter may predate human evolution.

So, what about the connection between tickling and laughing?

Well, this tickling-induced laughter is actually a reflex. Scientists don’t fully understand how this works, but because you cannot tickle yourself, the reflex seems to require an element of surprise.

Have you ever used the expression “sweat like a pig”? Think again. Pigs don’t sweat. Pigs don’t have sweat glands, which explains why they have to wallow in puddles and mud to cool off.

As for us humans, we routinely sweat as a way of eliminating excess heat and maintaining a normal body temperature. The average person has 2.6 million sweat glands distributed over the entire body except for the lips, nipples, and external genitalia. There are two different types of sweat glands, eccrine and apocrine. These glands are different in size and produce different kinds of sweat. Eccrine glands are located all over the body. Apocrine glands are different because they are found mostly in the armpits and groin. They are larger and open into hair follicles. Though sweat is mostly water, it is the small amount of protein and fatty acids in the apocrine sweat glands that gives armpit sweat that wonderful milky or yellow color. It is also what causes it to stain.

Sweat itself is odorless whether it comes from the armpits or other areas of the body. The funk begins when sweat mixes with bacteria that occur naturally on the surface of the skin. This distinctive odor is called bromhidrosis — foul-smelling sweat.

Gberg: I was going to add a New York cab driver joke to the “Why does sweat stink?” question.

Gberg: Any thoughts?

Leyner: What’s the joke?

Leyner: I love jokes.

Leyner: What’s the stinky cabbie joke?

Gberg: I don’t know one, but the scents of a taxi are so rude.

Gberg: It’s either that overwhelming air freshener or wretched body odor.

Leyner: See!! It’s all economics…

cabbies won’t run the AC… so of course they’re gonna stink — especially the ones who wear the Irish fishermen’s sweaters and the Latex underwear in the middle of the summer.

Leyner: Air freshener is, to me, worse than the smell it’s supposed to obscure… it just makes me think of what the person is trying to camouflage, so my mind creates an even greater fetid fiction.

Gberg: I don’t know. It depends what scent you are talking about. The hospital has some particularly vicious scents that need covering, like…

Gberg: Butt pus and

Gberg: bloody stool, which…

Gberg: They both sound like punk bands.

Leyner: Isn’t the smell of sweat supposed to produce certain subconscious (or conscious perhaps) sexual responses? And…

Leyner: What the hell is “butt pus”?

Gberg: Like a perirectal abscess or a pilonidal cyst — you drain them and the scent is horrible.

Leyner: Oh… that’s not so bad.

Leyner: I’ve smelled that.

Leyner: I have a pilonidal cyst — a dormant one though.

Gberg: You always were scent obsessed.

Leyner: I met a girl at Brandeis who also had one, and we soaked ours together. That’s true.

Gberg: Sitz baths.

Leyner: Fond memories of her.

Gberg: A sitz schvitz.

Leyner: Yes… sitz baths — we were young and idealistic.

Leyner: Isn’t a pilonidal cyst somehow related to a vestigial tail?

Gberg: I don’t know.

Leyner: That’s a fucking simple medical question, and your answer is “I don’t know”!!!!!!!!!!

Gberg: It brings back the original point of this book. They never teach you the obscure stuff that people actually ask.

4:30P.M.

Leyner: My grandfather used to go to Hot Springs, Arkansas, for “baths.” Or so he told my grandmother.

Gberg: I can describe in detail the technique for draining a pilonidal cyst or talk about marsupialization, when you sew down the sides.

Gberg: Nobody wants to know that.

Gberg: And then I get mocked by some pumped-up little writer who couldn’t marsupialize his way out of a peper bag.

Gberg: Not a pepper bag but a paper bag.

Leyner: Do people ask you strange questions in the ER? Or are they too freaked out by having meat cleavers embedded in their heads to make small talk with you?

Leyner: You gotta explain that, dude!!

Gberg: Explain what?

Leyner: What’s marsupialization?

Gberg: You cut open the cyst and sew down both sides so it doesn’t come back. You create a little pouch.

Leyner: Maybe I’ll get that! I’ll have the ass of a kangaroo!

Phlegm, snot, spit, boogers, sputum — all different varieties of the same thing. These terms are used to describe different forms of mucus, a slimy material that lines various membranes in the body (called, of course, mucus membranes). Mucus is composed chiefly of mucins (lubricating proteins) and inorganic salts suspended in water. Mucus aids in the protection of the lungs by trapping foreign particles that enter the nose during normal breathing. Mucus also makes swallowing easier and prevents stomach acid from harming your stomach wall.

As for the different varieties, phlegm is one type of mucus. By definition phlegm is limited to the mucus produced by the respiratory system, excluding that from the nasal passages (that is what we refer to as snot), and that which is expelled by coughing (sputum). In medieval medicine, phlegm was counted as one of the four bodily humors, possessing cold and wet properties. Phlegm was thought responsible for apathetic and sluggish behavior, which is how we get the wordphlegmatic. Boogers are less historical, a slang word for dried nasal mucus or snot.

The presence of mucus in the nose and throat is normal. When you are sick the mucus can become thicker and change colors. Color is not a clear indication of a bacterial infection, but persistent rust-colored or green mucus tends to indicate a more serious condition.

For those do-it-yourself types, there are many ways to make home mucus to prepare yourself for a career in medicine:

RECIPES

Ingredients

1/2–1 pound fresh okra

1–2 cups water (the less water you add, the thicker your mucus will be)

Instructions

1. Chop the okra into large pieces and place them in a saucepan with a tight-fitting lid.

2. Add water to cover and boil the okra, about 10 to 15 minutes, until it is a dark grayish green and very soft.

3. Turn off the stove and remove the lid. Let your slimy substance cool.

4. Strain the slimy mess into a bowl and discard the okra.

Or

1. Stir 1/8 cup borax into 500 ml (2 cups) warm water. It’s okay if some borax remains undissolved. Allow solution to cool to room temperature.

2. In a separate container, stir 2 spoonfuls of glue (Elmer’s) into 3 spoonfuls of water.

3. Stir a couple drops of food coloring into the glue mixture.

4. Add a spoonful of the borax solution to the glue mixture. Stir (if in a bowl) or squish (if in a Baggie).

To answer this question we called one of my smartest friends, an Ivy League — educated ophthalmologist who is a retina surgeon at a prestigious university hospital. He’s the kind of guy who sends me Proust as a birthday gift. Doesn’t watch TV. Listens to NPR. So, we go to him for the answer….

Nothing. He tells me he will look it up. This just goes to show you that medical school sometimes misses the really simple stuff.

So, who has the answer? Honorary physician and expert on medical oddities Mark Leyner wrote about this malady inMaximum Golf magazine. Here, one pseudoschizophrenic golfer hears two golf announcers having the following discussion in his head:

Announcer B: Michael’s a bit off center — I’d say less than a foot from the left edge of the mattress and maybe a good foot and a half from the right rim. He’s got his left arm tucked under the pillow—

Announcer A: Which looks to me like a 245-thread-count cotton-twill shell filled with a 95-percent-Canadian-feather-and-5-percent-down blend.

Announcer B: What’s that in the corner of his left eye? A small emerald green particle. Can you make that out?

Announcer A: That’s the mucopolysaccharide secretion from the lachrymal gland that’s accumulated and crystalized overnight, Bobby.

Announcer B: Eye gunk. My mama used to call that a “sleeper.”

Announcer A: Well, we’ve got a lovely aerial view of Michael’s sleeper from the MetLife blimp,Snoopy Two, cruising at thirty-five miles per hour at an altitude of twelve hundred feet. Our thanks to Captain William Schmickling and his crew for that shot. Absolutely splendid.

Announcer B: Chris, he’s gotta get that outta there. What would you do in this situation?

Announcer A: There’s the very slightest breeze coming through the open window, but not sufficiently gusty to warrant any sort of major tactical adjustment. I’d use an index finger here, position it on the corner of the eye, precisely there at the lachrymal duct, and just ever so gently, ever so deftly, roll the particle out.

Announcer B: You can’t try to do too much here.

Announcer A: Just get it out, actually — that’s a job well done.

Announcer B: Reminds me of when Ernie Els got an eyeful of sandpiper guano at the ATT Pebble Beach National Pro-Am in ’95. Played the back nine basically half-blind. One of the most courageous exhibitions I’ve ever witnessed.

This eye gunk is nothing serious. While you sleep, a mixture of oil, sweat, and tears collects near the corners of your eyes. As the tears dry up you get left with a nice little bit of crust.

The pale half-moon shape at the base of each nail is called the lunule. It shows where the hardening process is not yet complete.

The American Academy of Dermatology provided these nail facts:

Nails grow about 0.1 mm (or about.004 inch) per day.

Fingernails tend to grow a little faster than toenails.

Toenails are approximately twice as thick as fingernails.

In general, nails tend to grow faster in summer than they do in winter.

Men’s nails usually grow faster than women’s nails.

Nails on your dominant hand tend to grow faster.