• V/Q scans and PE: Ventilation-perfusion scans involve the administration of a small amount of radioactive material (usually Tc-99) into the bloodstream; the patient is then put into the scanner and the distribution of the material is measured. V/Q scanning can detect occlusions in blood vessels that are smaller than 50 micrometers, so with small blood clots forming up in the lungs, the usefulness of this diagnostic technique is pretty obvious. Unfortunately, as Steve said, it's a really expensive procedure. Carol -- you need to learn to separate your personal life (money, house) from your patients. Blurring that line leads to burnout and ethical problems (like the whole Ricky plotline).

  One of the nice touches featuring Radiologist Steve was the film badge he was wearing -- anyone working in a radiology department at a hospital wears one. Every time I've ever worn one, someone has asked me, "What's that thing?" I say, "It's a device to measure radiation." They back away in fear. I get three extra points on the Nerd Test for that. :)

  For those that were wondering, treatment of pulmonary embolism in stable patients is to anticoagulate the blood (10,000-20,000 U heparin IV bolus) followed by more heparin, either IV or SC. You can also use thrombolytics to do this (things like tPA and streptokinase). The condition can also be treated surgically, although from what I gathered, they were planning on managing this case with heparin.

• Hodgkin's disease: Strauss had Hodgkin's disease, a type of lymphoma that's one of the most easily treatable cancers out there right now. If you watch "Party of Five," you might recognize this as the condition that Charlie suffered from a couple years ago (last year?); I believe that Mario Lemieux suffers from it too, although my knowledge of hockey players is kinda thin. (Flyers? French Canadian? Am I remembering this properly?) The disease has shown up on the show before, too, although I can't remember in what context or when it might have been.

  Lymphomas are tumors affecting the lymphatic system, composed of lymph node tissue (funny how that naming convention works out, huh?) characterized by painless swelling in the lymph nodes, weight loss, night sweats, or fever (oh, great). It affects people in their twenties, and then hits people in their fifties; localized, it can be treated with radiation but for disseminated tumors, combination chemotherapy with ABVD (doxorubicin, bleomycin, vincristine, and dacarbazine). Given Strauss' age and the extent to which the disease had seemed to progress, he'd get the radiation; patients treated this way have an 80% 10-year survival rate -- the prognosis is excellent. As with most cancers, it's important to get it diagnosed early.

  For what it's worth, although I'm not a surgeon or an oncologist, I tend to think women who find malignant lumps in their breasts should go for lumpectomies first, and then if it doesn't work, move to radical mastectomy. It is somewhat more traumatic in terms of what it does to the body, but I think the psychological benefits outweigh the theoretical advantages of radical mastectomies. Having said this, however, I'm not a woman and I don't have breasts, so I don't really feel qualified to comment. People who are female and/or oncologists and/or surgeons, feel free to disagree with me on this.

• ALD: Adrenoleukodystrophy. It's an X-linked genetic disorder with an occurance rate of 1:20,000, affecting males only (not unlike hemophilia). It is a degenerative disease of the myelin sheath surrounding nervous tissue, not unlike multiple sclerosis. I'm afraid I don't know a whole lot about this disease. It was, apparently, the subject of a movie I never saw with Susan Sarandon and Nick Nolte, "Lorenzo's Oil." I'm not sure who Lorenzo was (but I can take a guess) or what the oil is/was (I can guess here too), so you're probably better off to check IMDB for the information you want, or http://www.myelin.org for more information on the foundation started by the people in the movie (thanks to a forgotten poster on the newsgroup for the link)

You'll notice I'm not saying anything about Doug and Ricky -- that's intentional. The issue requires more thought and time than I can give it right now, and this is just to address the most common questions I've been getting so far on this particular episode.