explain xkcd - User contributions [en]

1756: I'm With Her

2017-10-05T16:04:45Z

Drake: /* Focus Knob */

{{comic
| number = 1756
| date = November 7, 2016
| title = I'm With Her
| image = im_with_her.png
| titletext = We can do this.
}}
{{TOC}}
==Explanation==
In this serious, ''no joke'', comic released the day before the {{w|2016 United States presidential election}} (which was more contentious than most, due in part to many people finding both candidates unusually distasteful), [[Randall]] urged his American viewership to vote, and showed his {{w|Political endorsement|endorsement}} for {{w|Hillary Clinton}}, the {{w|US Democratic Party|Democratic}} nominee in the election. She was up against the {{w|US Republican Party|Republican}} nominee {{w|Donald Trump}}, who ended up winning. For the sake of completeness, it should be mentioned that there were also nominees from other parties, including {{w|Green Party of the United States|Green Party}} nominee {{w|Jill Stein}}, and {{w|Libertarian Party (United States)|Libertarian}} nominee {{w|Gary Johnson}}. Neither hoped to garner enough votes to become president, but there was a chance {{w|spoiler candidate|they could affect the result}} in some states (no third-party candidate has ''won'' a state since {{w|United_States_presidential_election,_1968|1968}} - and it did not occur this time either - the closest any came in 2016 was independent candidate {{w|Evan McMullin}} in Utah.)

It was the second time Randall referred to this election, the first being [[1748: Future Archaeology]] three weeks before the election, but here it was just a wish to know the result using time travel (of course he did not learn the result back then…).

The "H" with an arrow was {{w|Hillary Clinton presidential campaign, 2016|Clinton's campaign}} logo, and '''I'm with her''' an official slogan that was widely used by her supporters, hence the title. Randall then lists tips to help you cast your vote ([[#How to help|see table below]]) suggesting a personal investment in the election. Clinton herself may be represented by [[Blondie]] sitting on top of the H looking out at the reader as the only of the 11 characters. The only type of joke in the comic is the chosen characters. Two with weapons flank the left and right side looking out ready to defend against Trump. Both are from earlier comic. Especially [[Ponytail]] with a ray gun (the one she also wielded in [[322: Pix Plz]]). The gun is for melting computers of persons that make snide remarks at women, clearly a reference to {{w|Donald_Trump_sexual_misconduct_allegations|Donald Trump's sexual harassment of women}} in general and especially to his ''grab them by the pussy'' {{w|Donald Trump and Billy Bush recording|comment}}. [[Cueball]] with his weapon is from [[303: Compiling]]. See more details in the [[#Character gallery|character gallery]] below.

This is the first time Randall has used a comic to directly support a presidential campaign, although he did [https://blog.xkcd.com/2008/01/28/obama/ endorse] {{w|Barack Obama}} in 2008 on his [[Blag]]. He wrote himself later that it was very controversial when he endorsed Obama, but that it was not the most [[388:_Fuck_Grapefruit#Controversy|controversial comic he had published]] at that time. This comic might take that prize now, given that this was one of the most discussed elections up to its time. This is particularly noteworthy outside the US - for example, some European leaders openly opposed Trump, while others supported him. There were also reports of Russian hackers attempting to influence the election.

Randall's support for Hillary Clinton may have been due in part to Donald Trump {{w|Donald_Trump#Healthcare.2C_education_and_environment|being a prominent}} {{w|climate change denier}}. Randall has published comics opposing climate change denial such as this: [[1732: Earth Temperature Timeline]], published less than two month before the election, as well as several other [[:Category:Climate change|comics on climate change]]. Also Trump beating Clinton made Randall's [[1313: Regex Golf|regex that matches the last names of elected US presidents but not their opponents]] impossible to update.

All the information on the bottom half of the comic includes sites, numbers, info, etc., current as of 2016, that are intended to help US voters to vote, regardless of whom they vote for. Including this information can assist voters who don't understand the process, don't feel that it's worth it, or feel intimidated or threatened. In general, these sites and numbers were likely included to help boost voter turnout.

The title text, which states that "We can do this" refers to Randall's desire to unite Democratic voters and elect Hillary Clinton to the White House instead of Trump. It is possible to [https://www.lookhuman.com/design/86542-hillary-clinton-we-can-do-it/tshirt buy t-shirts] with the famed {{w|We Can Do It!}} logo from the "Rosie the Riveter" wartime poster, but with Hillary Clinton in the famed position. However this is not quite the same "We can do this" sentence that Randall uses. "We can do this" (or in German, "[https://www.dict.cc/?s=Wir+schaffen+das+%5BAngela+Merkel%5D Wir schaffen das]") was also the catchphrase of the German Chancellor {{w|Angela Merkel}} during the recent influx of refugees from the Syrian War — like Clinton, Merkel was fighting against {{w|Pegida|a populist nativist movement}} that wanted to close the country's borders.

Unfortunately for Randall, these efforts were in vain, as {{w|Donald Trump}} (another populist nativist who wants to close the country's borders) was elected on Tuesday, November 8, falsifying the title-text. This result became a fact less than two week before the first ([[1761: Blame]]) of [[#Sad comics|several sad comics]] that all seemed related to the election of Donal Trump.

===How to help===
The list of things that can help is all about getting people to vote. While Randall is likely to have wanted to boost voter turnout regardless of political leanings, it's clear from his endorsement of Clinton that he believed increased turnout would have helped her win the race. There is general evidence that certain more heavily Democratic-leaning demographics are less likely to vote, and in this election in particular, the various political issues that had been raised against Hillary (such as the {{w|Federal Bureau of Investigation|FBI's}} public disclosures of its investigation into her use of a private email server) were shown to have reduced enthusiasm among Democrats. But all these issues aside, both Republicans and Democrats alike agree on encouraging everyone to vote, and Randall is likely to have agreed with that sentiment as well.

Here is Randall's list of suggestions for how to help Hillary Clinton win the election:
{|class="wikitable"
!What to do
!How to do it
!Explanation
|-
|Vote
|[https://iwillvote.com/ iwillvote.com]
|A site to look up polling locations, ID requirements, etc.
|-
|Get a ride to the polls:
|[http://www.drive2vote.org/ drive2vote.org]
|For voters in Douglas and Sarpy County, Nebraska, who needed a ride to the polls from {{w|Warren Buffett}} or his friends.
|-
|If you're having problems voting
|[http://www.866ourvote.org/ 866-OUR-VOTE]
|Racism or other biases on the part of people running polling places is a real issue for minorities. Though it is illegal, people may lie or deny rights to would-be-voters who they believe will not vote for the candidate they agree with. In some instances, voters may require backup from someone with legal understanding to get to vote, which is a service this phone number provides. Since Donald Trump has suggested that unofficial {{w|poll watchers}} should patrol voting stations - which has been described as potential [https://www.theguardian.com/us-news/2016/nov/05/election-day-violence-donald-trump-poll-watchers voter intimidation] - this has been an especially widely discussed topic in this election. The phone number written out as numbers is (866) 687-8683
|-
|Experimental social turnout project
|[http://www.civicinnovation.com/ civicinnovation.com] App Store: VoteWithMe
|An app which "gives you a list of the top 10 highest-impact potential voters in your address book to get in touch with -- based on the likelihood that they support progressive candidates, and that they live in states with the most competitive races". This app is for Android and iOS, with the App Store ID as "VoteWithMe". The "VoteWithMe" app is created by Civic Innovation Works and "uses publicly available voter records to predict which of your contacts are likely to support Democratic candidates, but might not have a plan to vote", as it says on its [https://itunes.apple.com/us/app/votewithme/id1170104517/ App Store Page].
|-
|Reminder:
|If you're in line when the polls close, they have to let you vote.
|This is correct, as is printed on most election pamphlets as part of the ''Voters' Bill of Rights'', as well as being cited on numerous sources online (eg [http://votersedge.kqed.org/en/ca/ballot/election/area/42/section/voting-info?id=statewide-42-ca#section-my-rights-as-a-voter here].) Being turned down for trying to vote after the polling place is officially closed (if you were already in line ''when'' the polls closed) might be an instance where you want to use the phone number mentioned above.
|}

===Character gallery===
The comic shows a gallery of 11 xkcd characters including all the main characters from xkcd (except [[Hairy]]), which stand united behind Randall and Clinton despite their lack of agreement in many other comics.

*From left to right on the left side of the H are: 
**[[Ponytail]] with a ray gun (the one she also wielded in [[322: Pix Plz]], a comic where she was named Joanna). The gun it for melting computers of persons that make snide remarks at women, clearly a reference to {{w|Donald_Trump_sexual_misconduct_allegations|Donald Trump's sexual harassment of women}} in general and especially to his Grab Pussy comment.
**[[Black Hat]] (who was the one introducing Joanna/Ponytail in the mentioned comic)
**[[Danish]] (Black Hat's girlfriend setting up a kite for him, although it could be Megan, but she is also shown later with her regular shorter hair). However it has mainly been Megan in comics with kites, like [[235: Kite]] and [[1614: Kites]]. Kites are a [[:Category:Kites|recurring theme]] on xkcd.
**[[White Hat]] looking at the kite.
*On top of the H are:
**[[Blondie]] (looking out at us, maybe representing Clinton herself)
**[[Megan]] (next to Cueball)
**[[Cueball]] (forming the standard couple in xkcd with Megan)
**[[Hairbun]] with glasses (so specifically not the one from the previous comic [[1755: Old Days]], but rather like in [[1637: Salt Mine]]).
*On the right side of the H are:
**[[Science Girl]] (The adult version of her, is holding her hand out towards a cute squirrel. Of course she could also be the girl from [[635: Locke and Demosthenes]] where the squirrel is poisoned...)
**[[Beret Guy]] is holding a squirrel out towards Science Girl. (The first time squirrels was mentioned was actually when Beret Guy found them in a tree in [[167: Nihilism]] and since then they have become a [[:Category:Squirrels|recurring theme]] on xkcd and a similar squirrel can for instance be seen in [[1503: Squirrel Plan]]. Beret Guy has not been seen together with a squirrel before, but has been shown to care for animals, for instance in [[614: Woodpecker]]).
**[[:Category:Multiple Cueballs|Another Cueball]] is standing on an office chair wielding a sword as he was shown in [[303: Compiling]]. (Interestingly enough the previous comic [[1755: Old Days]] was about Cueball asking Hairbun about {{w|compiling}} in the old days. Seems realistic that Randall has this comic ready for this Monday before the election for some time, and when finding this 9 year old version of Cueball in the old comics, he may have gotten inspired to make a comic about compiling in the old days).

Note that the two characters at either side of the comic wields weapons pointing out defending the other nine. Those next to the characters with weapons are doing recreational things like kiting and admiring adorable squirrels, both are recurring subjects in xkcd.

==Transcript==
:[Eleven characters are drawn left, right and on top of a huge H with an arrow as the horizontal bar connecting the two vertical towers. The arrow breaks the right part of the H. It represents the logo from Hillary Clinton's presidential campaign for 2016. From left to right on the left side of the H are Ponytail with an exotic looking futuristic ray gun like weapon looking to the left away from the H and the others. Behind her is Black Hat who looks at a girl that might be Danish or Megan (but with longer hair than Megan typically has). She is setting up a kite that flies above the first two characters. Behind her and looking up at the kite is White Hat. The H is right behind him, and on top of the left tower of the H sits Blondie looking straight out at the reader with her legs dangling over the edge and her arms resting on her knees. On the arrow between the two H towers sits Megan leaning against the left H tower, also dangling her legs over the edge and arms resting on her knees. Cueball is standing to her right, just left of the right H tower. On top of the right H towers sits Hairbun with glasses looking straight right with her legs dangling over the edge one arm resting on a knee and leaning back on the other arm. On the right side of the H is an adult version of Science Girl holding a hand out towards the squirrel which Beret Guy is holding out in both arms towards her. Behind them is another Cueball standing on an office chair holding a sword high up in front of him to the right away from the others. He keeps his balance by holding his other arm out behind him. Below the H there is a large caption.]
:<big><big><big>H</big></big></big>
: <big><big>I'm with her.</big></big>

:[Below the panel there are several lines of text. The first header line refers to the next four lines with solutions to problems, title/problem on one side then a long dash and the web-link or other information on the right side of that. Below those there is a reminder.]
:<big>How to help</big>
:Vote - iwillvote.com
:Get a ride to the polls - drive2vote.org
:If you're having problems voting - 866-OUR-VOTE
:Experimental social turnout project - civicinnovation.com App Store: VoteWithMe

:<big>Reminder:</big>
:If you're in line when the polls close, they have to let you vote.

==Trivia==
*Despite securing more votes, Hillary Clinton lost the election in the {{w|Electoral college (United States)|electoral college}}.
**She did win in {{w|Massachusetts}} (Randall's home state), but that was never really in any doubt.
*The fact that Trump was elected instead is likely the reason for several comics with a bad mood released after this and until at least just past the day Trump was inaugurated. See [[#Sad comics|below]].

===Sad comics===
{{incomplete|It is debated wether this section is irrelevant to this comic! Should it have its own page, since it is clearly a trend that Randall posts sad/negative or even "scared" comics. And there should be a place for this list.}}



*After this comic there have been a clear trend that '''[[Randall]] has had sad thoughts''' after the {{w|United States presidential election, 2016|election}} of Trump.
**Over the next few months after the election (at least up till just after Donald Trump’s {{w|Inauguration of Donald Trump|inauguration}}) Randall has posted (at least) five comics that could be interpreted as him being sad/angry or that people around him are acting in such a way.
*Not since Randall's wife's [[:Category:Cancer|cancer diagnosis]] has there been so many sad/negative or depressing comics.
**During a two year span there where only five decidedly sad Cancer comics.
**There has now been more "sad" comics in a little more than three months (November 18th 2016 to February 24th 2017), and they continued longer.
***As a comparison the year before the first sad comic there where no really sad, and only one (for real) scary comic: [[1732: Earth Temperature Timeline]].
***That comic has just been made more scary as it now seems the doing nothing is no longer the worst case scenario given That Randall did not expect Trump to win. And his policy of denying climate change, will probably make it even worse than if we did nothing.
***So this is another good reason why Randall would begin to post sad comics after the election. He is likely really scared the climate will be beyond saving once Trump leaves office. And it may be for a good reason. See about the comic [[#Sad|Sad]] below from after Trump became president.
**Hopefully Randall is not so depressed for real as the comics below could suggest.
*Note that none of these sad comics, also including this one, directly mentions Trump at all.
**But this comic indirectly references him as the opponent of the one Randall is with, and all the other comics could be interpreted as being about something that could have come about because of this election result.
**But the connection is not only inferred from the mood. Three comics where released close to some important day on Donald Trump's way to becoming president and another was the New Year comic, thus representing going into the year where Trump actually becomes president. And the fifth was during the days when the first executive order of Trump was overruled (see more below under [[#Focus Knob|Focus Knob]])).
*If more related comics appears they can be listed here below. Then update the above section regarding dates and number of comics.
**They are collected here since these comics are not easily collected under a specific category.
**Also since the connection to Trump and the election is circumstantial in the sad comics, this trivia has been put on this comics page. Though this is not in it self one of the really sad comics, this comic definitely relates to Trump and Randall's stance regarding him becoming president.
**After April there seem to be now more sad comics related to the election. But in August a week before the solar Eclipse the election was mentioned in [[1876: Eclipse Searches]]. This comic has been included here to mark the what seems to be the ending of references to the election and Trumps actions.
*Here below follows a list of the comics related to these sad comics.
**Relations (if any) between the release day and the comics will also be listed.
**The links points here below to an explanation why each comic is listed here:
*[[#I'm With Her|I'm With Her]] (not one of the sad, thus not numbered)
#[[#Blame|Blame]]
#[[#Negativity|Negativity]]
#[[#2017|2017]]
#[[#Sad|Sad]]
#[[#Focus Knob|Focus Knob]]
#[[#Phone|Phone]]
#[[#Location Reviews|Location Reviews]]
#[[#Vomiting Emoji|Vomiting Emoji]]
#[[#Flag|Flag]]
#[[#Security Advice|Security Advice]]
#[[#Identification Chart|Identification Chart]]
#[[#Eclipse Searches|Eclipse Searches]]
#[[#October 2017|October 2017]]

====I'm With Her====
*[[1756: I'm With Her]] (This comic)
**2016-11-07: The day before the election:
***It all began when Randall urged his American viewership to vote in the election the day after this comic was released.
***Here he clearly showed his {{w|Political endorsement|endorsement}} for {{w|Hillary Clinton}}, the {{w|US Democratic Party|Democratic}} nominee in the election.
***Although this is not directly sad, he included two weapon carrying defenders on either side of the comic.
***One of these was [[Ponytail]] with a ray gun (the one she also wielded in [[322: Pix Plz]]). The gun is for melting computers of persons that make snide remarks at women, clearly a reference to {{w|Donald_Trump_sexual_misconduct_allegations|Donald Trump's sexual harassment of women}} in general and especially to his ''grab them by the pussy'' {{w|Donald Trump and Billy Bush recording|comment}}.
***Randall has often made comics against women harassment before (see for a great example in [[1027: Pickup Artist]]).

====Blame====
*[[1761: Blame]]
**2016-11-18: Ten days after the election.
***This is the first really sad comic in which [[Cueball]] actually begins by stating that: ''I feel sad!'' a clear relation to [[1790: Sad]] (the fourth sad comic after I'm With Her, see below).
***This is likely due to all the angry and scared comments of Cueball’s Facebook friends, and he thus decides to blame them rather than what they are angry about.
***It took some days before Randall posted anything that could be said to have relation to the election, but the defeat of Hillary may have taken some time to digest.
***Also the reactions to Trump’s victory on Facebook needed to build up over time before this comic.
***Furthermore there was also some uncertainty to begin with if some states would call for a re-vote etc.
***Still it was only the fifth comic after his campaign for Hillary failed.

====Negativity====
*[[1773: Negativity]]
**2016-12-16: Three days before the {{w|U.S. Electoral College}} voted for {{w|Donald Trump}} to become the 45th president of the United States.
***The first comic with a really negative title. (Like ''Sad'' (see below), although ''Blame'' is of course a negatively loaded word, the comic did not need to be so sad as it was).
***This comic and ''Blame'' could be seen as a small series as Cueball blames his friends on Facebook in the first comic, and then goes outside to avoid all the negativity online in the second, probably worsened for him after he blamed his Facebook friends because: ''Bad thing are happening''.
***Only it does not work because even the grass is after him.
***At the time of the comics release there was still some rumors/hopes that the {{w|Faithless electors in the United States presidential election, 2016|some of the electors would not vote for Trump}}. (But only two changed away from Trump!)

====2017====
*[[1779: 2017]]
**2016-12-30: The [[:Category:New Year|New Year comic]] – a transition to the year when Donald Trump would become president.
***Even the comic "celebrating" New Year was depressive and it was the first time that a New Year comic had such a depressive mood.
***Cueball and [[Megan]] discuss if 2016 could end up as having been better than 2017 since all the bad thing happening in 2016 would first really take effect in 2017.
***The biggest of these would be Trump becoming president, but also {{w|Brexit}} and a lot of {{w|2016#Deaths|dead famous people}} would be troublesome. None of these events (or any other specifically bad event of 2016 are cited in the comic).
***Randall tries to make a happy twist by saying that maybe some unexpected good would come in 2017 as most of the sad events (just mentioned) was not expected to happen.
***But hopping for this in the face of what awaits is difficult so he retorts to just hoping ''they'' won’t cancel the {{w|Solar eclipse of August 21, 2017|2017 solar eclipse}}.
***Fearing (for real) that astronomical events like this being canceled would call for you to be very depressed. Of course Randall doesn’t fear for this in real life, but it puts a perspective on the other parts of the comic.
***Although the eclipse will certainly happen on August 21st 2017 Randall may still miss it, even if he is in the right place, as the weather could always be overcast and then ruin the experience.
***So the worry that he will miss it is real and had also been mentioned three years earlier in [[1302: Year in Review]].

====Sad====
*[[1790: Sad]]
**2017-01-25: Five days after Donald Trump’s {{w|Inauguration of Donald Trump|inauguration}}.
***This was the comic that sparked this section, with the title really being ''[[#Sad comics|Sad]]''.
***The title "Sad" is a common interjection in Trump's tweets. The time-frame of "the past few months" from the first panel is consistent with this, as the election was on November 8, 2016, and the comic was posted on January 25, 2017 four days after Donald Trump's inauguration as 45th president of the United States on January 20, 2017.
***This was only the second comic released after the inauguration the Friday before this comics Wednesday release.
***Although it could be said that Trump first took office Monday (before this Wednesday comic) he already began signing {{w|Decree|decrees}} (or {{w|Executive order|executive orders}}) on Friday January 20th {{w|First_100_days_of_Donald_Trump's_presidency#Immediate_regulatory_freeze_pending_review|within a few hours}} after becoming president.
****{{w|First_100_days_of_Donald_Trump's_presidency#Policy|Most of these}} would make it even worse for those already sad about him becoming president, because they could now see that he really meant all the things he promised (which is not always the case in politics!)
****Up to the day this comic was released (January 25th) it would already be drastic things like the {{w|First_100_days_of_Donald_Trump's_presidency#Mexican_border_wall|Mexican border wall}} (on the day of the comics release), the {{w|First_100_days_of_Donald_Trump's_presidency#Withdrawal_of_Affordable_Care_Act|withdrawal of Affordable Care Act}}, the approval of the {{w|First_100_days_of_Donald_Trump's_presidency#Dakota_Access_and_the_Keystone_XL_pipelines|Dakota Access and the Keystone XL pipelines}} (which would be troublesome for an [[:Category:Climate change|environmentalist]] as Randall as {{w|Dakota_Access_Pipeline#Environmental_concerns|both}} {{w|Pipeline_transport#Oil_and_natural_gas|oil pipes}} {{w|Keystone_Pipeline#Environmental_issues|have}} environmental issues) and the {{w|First_100_days_of_Donald_Trump's_presidency#Mexico_City_Policy|Mexico City Policy}} regarding stopping any help to poor women abroad with regards to information or any other way helping with {{w|abortion}}.
***The actual reasons for Ponytail's frustrations and depression aren't dwelt on and the focus is on her retreat into video games and the damage it's doing to her work projects.
****The video game she plays is referenced again only seven comics later in [[1797: Stardew Valley]], thus showing this game is on Randall's mind, and that he might be using this to avoid thinking of the things that makes him sad.
****This fits with the [[#Focus Knob|next sad comic]] mentioned below, coming out just before ''Stardew Valley'', where Randall focuses on his e-mail settings rather than the big picture.
***It might appear to be non-political, the reference to {{w|PolitiFact.com|PolitiFact}}, however, makes it clear that she is thinking on politics, and the fact checking of most of Trump's claims
****This is another indication that one of her troubles is Trump's leniency with the truth in both election campaign and after, to the point where lies are now on a daily basis just called {{w|alternative facts}} or {{w|Post-truth_politics#United_States|post-truth}}.
****His statements would often turns out to be ''Pants on Fire!'' on the PolitiFact scale.
****See more on Politifact.com the earlier comic [[1712: Politifact]] from during the election campaign
*****By the way apart from the ''Politifact'' comic and ''I’m with Her'' then the only other direct reference to the election during the {{w|United_States_presidential_election,_2016#General_election_campaign|election campaign}} was in [[1748: Future Archaeology]], where Randall expressed interest in knowing the result of the election in advance.
***Seeing that this comic is about Ponytail being sad, the woman who in the first comic on this list was standing with a weapon to defend herself against condescending men (like Trump) and that one of the first decrees Trump signed, was regarding removal of support for abortion abroad, she can see that she still have good reason (especially as a woman) to being sad as she has been these past few months.

====Focus Knob====
*[[1796: Focus Knob]]
**2017-02-08: Less than three weeks after Donald Trump’s inauguration, only six comics after the previous Sad comic.
***Although this comic may look like an easy joke, there is ''panic and existential paralysis'' if you turn your focus more than two thirds towards the big picture (of the world).
****For instance during the days just before this comics release an {{w|Legal_challenges_to_Executive_Order_13769#State_of_Washington_v._Trump|American judge}} (February 3rd) and two days later {{w|Legal_challenges_to_Executive_Order_13769#Proceedings in the Ninth Circuit|several big companies}} went against {{w|Executive Order 13769|Trump's decision}} of banning people from seven countries from entering USA.
****There have thus been many reasons to panic since his inauguration if one follows the news in any way.
***In the comic the detail oriented side is indicated to be a focus on his e-mail settings. But as it was shown already in the next comic [[1797: Stardew Valley]], there are also video games that can help you take your mind off the real world.
****This also relates back to [[#Sad|Sad]] where the same game was mentioned a week before.

====Phone====
*[[1802: Phone]]
**2017-02-22: During the days before this comic, Trump has promised to make a {{w|Executive_Order_13769#Proposed_related_Executive_Order|related Executive Order}} regarding the banning of people from the same seven countries from entering USA, as was ruled illegal around the time of the [[#Focus Knob|last]] of these comics.
***The sadness is not so clear in this comic, but the conclusion in the title text that it is both bad to hear all the scary news and to disconnect in order avoid them seems rather sad. It is a lose/lose situation.
****This also seems related to the problem of finding the right balance mentioned in [[#Focus Knob|Focus Knob]].
***The idea of going for a walk with the phone, thus not avoiding the news feed, is the exact opposite idea of [[#Negativity|Negativity]], where going outside was to avoid the negativity on the internet. Neither of the idea seems to work.

====Location Reviews====
*[[1803: Location Reviews]]
**2017-02-24: Second comic in a row, this one could be a reaction to the cold relationship between Russia and the United States, that became worse a few weeks before this comic.
***Two weeks prior to this comics release [https://www.nytimes.com/2017/02/14/world/europe/russia-cruise-missile-arms-control-treaty.html?_r=0 Russia Deploys Missile, Violating Treaty and Challenging Trump].
***In this comic a Nuclear Launch Facility is reviewed on a Google Map and the last of the reviewers pleads ''Please don't launch these''. Another notices the lack of security as there is a hole in the fence. (See more in the [[1803:_Location_Reviews#Reviews|reviews explanation]] and [[1803:_Location_Reviews#Politics|here]]).

====Vomiting Emoji====
*[[1813: Vomiting Emoji]]
**2017-03-20: The day of this comics release [https://www.nytimes.com/2017/01/20/public-editor/trump-russia-fbi-liz-spayd-public-editor.html?_r=0 stories] about Trump's connection with Russia and the word treason was mentioned, and the stories got [https://www.nytimes.com/2017/03/23/opinion/theres-a-smell-of-treason-in-the-air.html worse] during the week that followed.
***In this comic six vomiting emoji has been created. Most of them can be connected to the situation in USA.
***A vomiting cowboy, could represents the Americans that votes for Trump but now has regretted it.
***Vomiting Statue of Liberty speaks for it self...
***Vomiting peace dove a clear reference to the fear of Nuclear War, as is the rocket below
***Vomiting Moon, the only one that is not clearly connected in any way with this situation. Although Randall has expressed fear that the moon will be gone before the Eclipse this summer, see [[#2017|above]].
***Vomiting rocket ship, see peace dove above.
***Vomiting Hand, could be a reference to the way Trump always holds up his hand in a special way, which is likely to cause nausea in those that really detest what he stands for.

====Flag====
*[[1815: Flag]]
**2017-03-24: On this day {{w|Patient_Protection_and_Affordable_Care_Act#2017|Trump failed}} to get a vote through for removing/changing {{w|Patient Protection and Affordable Care Act|Obamacare}} which was expected. But had it succeeded Randall might have wished for a departure from Trumps states (see below).
***The comic depicts a flag similar in style to the {{w|Flag of the United States|Stars and Stripes}}, and explains he was asked to create it for a new country.
***This seems like a reference to the fact that some have talked about states leaving the USA due to the election of Trump ({{w|California}} for [http://www.yescalifornia.org/ instance]).
***This flag with three stars could thus be Randall's thoughts on this, maybe the three small states in New England; {{w|Massachusetts}}, where he lives, {{w|Connecticut}} and {{w|Rhode Island}} could break free and form their own small state union.

====Security Advice====
*[[1820: Security Advice]]
**2017-04-05: No special event seems related.
***There are two references to what to do when crossing a border, and especially that last tip could be related to the increasing border control caused by Donald Trump's election:
***''If a border guard asks to examine your laptop, you have a legal right to challenge them to a chess game for your soul.''

====Identification Chart====
*[[1824: Identification Chart]]
**2017-04-17: No special event seems related.
***Once again reference to the military like in [[#Location Reviews|Location Reviews]].
***In the title text hostility between fighter-plane like birds that are territorial are mentioned.

====Eclipse Searches====
*[[1876: Eclipse Searches]]
**2017-08-14: A week before the total {{w|solar eclipse}} occurring on Monday, {{w|Solar eclipse of August 21, 2017|August 21, 2017}}.
***This is not a sad comic, but it refers directly to the election day regarding media interest and searches on Google, which makes it the first in almost four month referring back to the election or the result of said election.
***For that reason alone it is included here. It seems that Randall has stopped focusing on Trump and his actions.

====October 2017====
*[[1898: October 2017]]
**2017-10-04: A month before the similar titles comic [[1757: November 2016]], released the day after the election, both of which had the subject [[:Category:Comics to make one feel old|to make one feel old]].
***The comic mentions a movie that is already 7 years old, to make one feel old.
***But in the title text it refers directly to the election stating that so much has happened (because of this) that it is hard to believe that not even a year has passed.
***It thus still seems that Randall can be sad about the election results, although it was only the second reference to it in almost half a year.

{{comic discussion}}

[[Category:Comics featuring Ponytail]]
[[Category:Comics featuring Black Hat]]
[[Category:Comics featuring Danish]]
[[Category:Comics featuring White Hat]]
[[Category:Comics featuring Blondie]]
[[Category:Comics featuring Megan]]
[[Category:Comics featuring Cueball]]
[[Category:Comics featuring Hairbun]]
[[Category:Comics featuring Science Girl]]
[[Category:Comics featuring Beret Guy]]
[[Category:Comics featuring politicians]] 
[[Category:Multiple Cueballs]]
[[Category:Politics]]
[[Category:Kites]]
[[Category:Squirrels]]

1619: Watson Medical Algorithm

2015-12-21T16:56:05Z

Drake: /* Explanation */

{{comic
| number = 1619
| date = December 21, 2015
| title = Watson Medical Algorithm
| image = watson_medical_algorithm.png
| titletext = Due to a minor glitch, 'discharge patient' does not cause the algorithm to exit, but instead leads back to 'hunt down and capture patient'.
}}

==Explanation==
{{incomplete|much more on the different procedures etc.}}

IBM's {{w|Watson_(computer)|Watson}} is a natural language system designed to answer questions posed by humans. Recently, IBM has extended Watson to act as a {{w|clinical decision support system}}, using image analytics to aid physicians in medical decision making. In this comic, Randall shows a {{w|Flowchart|flowchart}} representing a possible algorithm for Watson, including bizarre techniques including surgical alteration of a patient to match a height and weight chart and squeezing the patient to remove yellow fluids. Like [[416: Zealous Autoconfig]], this comic pokes fun at a rigid, poorly-designed setup that ends up potentially doing more harm than good.

Modern medicine involves both standard processes and clinical judgement based around years of advanced training. An algorithm like this would have to be incredibly complicated in order to simulate the clinical judgement of a good doctor.

The algorithm depicted treats a patient as more of a machine or mechanical system than a living being, especially through decisions such as:

* Injecting oxygen into patients with low oxygen saturation, rather than treating the root cause
* Removing and inspecting a skeleton, then diagnosing the patient's condition with a bone count
* Dissecting a doctor "for parts" after consulting him or her for advice
* Removing extra limbs from a patient if the count is less than 100
* Determining whether the "build environment" of the patient is sane. This is most probably a reference to the configure script used in the {{w|GNU_build_system|GNU build system}}, which emits "checking whether build environment is sane" as one of its status messages.
* Rinsing the whole patient with a saline solution
* Removing organs from a patient regardless of response to an organ donation request

Other decisions appear to be entirely unrelated to the conditions upon which they are predicated:

* If the patient doesn't rate their pain on a scale from 0-10, sequence their genome, apply a {{w|tourniquet}}, and perform an {{w|autopsy}}
* If the patient's phone's battery is low, defibrillate until the battery is charged, sync photos, then administer general anesthesia
* If the patient is successfully comforted after an oxygen injection, check their medical history and apply skin grafts
* If green fluid is released from the patient, begin to cauterize
* If the patient has 100+ limbs, check their Vitamin D level

The title text implies that, if the patient is so lucky to ever reach one of the two places with the option "discharge patient," a minor glitch will cause to program to go back to the ''hunt down and capture patient'' option which thus force the patient and the program to repeat the process again in an infinite cycle, that will only end once the patient give another rating of their pain level than on the 0-10 scale. Then the program will start to sequence their genome then apply a tourniquet and finally perform an autopsy, on what will in the end for certain be a deceased patient, but maybe not when the autopsy began. This will finally cause the patient to leave the cycle... as a corpse!

This is one of many comics with [[:Category:Flowcharts|flowcharts]], amongst other a recent comic with that very name: [[1488: Flowcharts]].

This is the second comic in a row about health issues with the last comic being [[1618: Cold Medicine]].

==Transcript and Discussion of Medical Appropriateness==
{{incomplete transcript}}
{| border=1
| | Step
| | Medically valid?
| | Conditions and following step
|-
| |
Draw Blood
| background-color:green |
Phlebotomy is a normal early step in the diagnostic process, but not as first and unconditional step
| |
Record patient’s name
|-
| |
Record patient’s name
| background-color:green |

OK
| |
Measure Patient’s height and Weight
|-
| |
Measure Patient’s height and Weight
| |
OK
| |
Consult Standard height/weight chart
|-
| |
Consult Standard height/weight chart
| |
OK
| |
Surgically adjust patient to match
|-
| |
Surgically adjust patient to match
| |
May be considered ethically dubious unless there are [http://www.gosh.nhs.uk/medical-information/procedures-and-treatments/limb-length-difference-and-limb-lengthening sound medical reasons] for doing so. Could be an allusion to [https://en.wikipedia.org/wiki/Procrustes Procrustes].
| |
Is patient coughing up blood?
|-
| width="33%" rowspan=2 |
Is patient coughing up blood?
| width="33%" rowspan=2 |
OK, coughing up blood is generally a sign that there is something wrong. Typical causes are respiratory tract infections (e.g. tuberculosis), lung trauma or pulmonary embolism.
| |
Yes: Gather blood and return it to body
|-
| |
No: Is patient still here?
|-
| width="33%" rowspan=2 |
Is patient still here?
| width="33%" rowspan=2 |
Not usually considered a step, but missing patients are a problem in some fields, psychiatry or intensive care for example.
| |
Yes: Record pulse rate
|-
| |
No: Hunt down and capture patient
|-
| |
Hunt down and capture patient
| |
Valid if patient should not have left the bed/unit, but the wording is possibly dubious.
| |
Is patient still here?
|-
| |
Gather blood and return it to body
| |
Dangerous idea in this case due to likelihood of contamination, although if safely done autotransfusion is an accepted medical technique to ensure a matching blood supply prior to a major operation, or to enhance stamina (blood doping)
| |
Record pulse rate
|-
| |
Record pulse rate
| |
OK, but maybe a little late.
| |
Is patient screaming?
|-
| width="33%" rowspan=2 |
Is patient screaming?
| width="33%" rowspan=2 |
Very important question, indicating patient is conscious, in pain, and aware pain is bad. First attenders can use it in classifying priorities (quiet patients may be more severely injured). Generally useful in assessing nerve damage, pain relief, etc.
| |
Yes: Ignore
|-
| |
No: Check blood O2 saturation
|-
|-
| width="33%" rowspan=2 ` |
Check blood O2 saturation
| width="33%" rowspan=2 |
Only really indicated if the patient is in danger of hypoxia. Generally normal people should have a SpO2 of 98-100%, but in chronic lung disease this can fall as low to 80%, and in premature babies a SpO2 of 90% is usually targeted to avoid problems with retinopathy. If the SpO2 were to fall as low as 50%, the patient would definitely be dead or unconscious.
| |
>50%: Remove and inspect skeleton
|-
| |
<50%: Inject oxygen
|-
| width="33%" rowspan=2 |
Remove and inspect skeleton
| width="33%" rowspan=2 |
Fatal if patient is still alive when beginning. Also not a valid medical procedure in any way as it is impossible to remove most of the long bones of the body without destroying all surrounding tissue.
| |
Too many bones: Is fluid coming out of patient?
|-
| |
Too few bones: Request consult with human doctor
|-
| |
Request consult with human doctor
| |
Medically valid in the context of obtaining an opinion from a doctor in a different speciality who is better suited to treating the patient.
| |
Dissect doctor for parts
|-
| |
Dissect doctor for parts
| | This may be considered ethically dubious. Possible
reference to the Doctor Who episode “{{w|The girl in the fireplace}}”
| |
Discharge patient
|-
Acceptable, but patient would generally be dead by then.
| |
Discharge patient
| |
| |
END STATE (before you read the title text)
|-
| |
Is fluid coming out of patient
| |
Unintended fluid release is always a problem. How significant a problem depends on where the fluid came from and if it is supposed to be coming from there. Red generally is due to blood, yellow is due to pus/tissue fluid/lymph and green signifies bacterial infection or bile salts (biliverdin). Could also relate to normal fluids being lost (e.g. urine, saliva, sweat)
| |
|-
| |
Squeeze patient
| |
Could be in the medical context is in providing external ventilation (see iron lung) or other means of removing fluid (e.g. squeezing pus from a boil).
| |
|-
| |
What colour?
| |
Never underestimate the number of different types of fluid the body can produce.
| |
|-
| |
Activate sprinklers
| |
Not medically valid. Presumably a reference to how much cleaning up will be required by this stage.
|-
| |
Subdue patient
| |
Potentially very important if patient is behaving dangerously to themselves and others around them (due to mental health issues eg psychosis or drugs) and/or is moving too much to be given treatment.
| |
|-
| |
Apply cream
| |
Medically valid as a form of barrier dressing to improve wound healing.
| |
|-
| |
Ask patient to rate pain level
| |
Useful in the sense that it provides the doctor with the means to ensure that the patient is receiving adequate analgesia during conditions of chronic and acute pain.
| |
|-
| |
Massage scalp
| |
This would belong more to the domain of palliative care and reflexology rather than being an accepted medical treatment.
| |
|-
| |
Patient is healthy
| |
A subjective assessment of the health patient is often helpful in ruling out certain diagnoses. For example, one is less likely to suspect cancer in a fit, healthy 30 year old than a thin, lethargic 50 year old.
| |
|-
| |
Admit for observation
| |
Useful in the context of 'watchful waiting', in which the doctor may be unsure if the patient actually has a condition that they suspect that the patient has. By keeping the patient on the ward for a few days, the clinician can monitor the progression of symptoms and rapidly initiate adequate treatment if medically warranted.
| |
|-
| |
Laser eye removal
| |
This is not a standard medical procedure. This could be a pun on laser eye surgery, where a laser is used to correct visual problems (e.g. short-sightedness).
| |
|-
| |
Sequence genome
| |
Useful in the association of extremely rare point mutations with an organic illness. See for instance the Genome 10K Project or the Cancer Genome Atlas. Or in diagnosing extremely rare mutations that are not picked up by most commercial DNA screening tests (eg kidney failure due to INF2 mutation).
| |
|-
| |
Apply tourniquet
| |
Useful to stop acute bleeding from an injured extremity, but if it is drawn too tightly it can cause neuromuscular damage.
| |
|-
| |
Perform autopsy
| | Fatal if patient is still alive when beginning.
| | END STATE (taking the title text into account, the only possible one)
|-
| |
Inject oxygen
| |
May be fatal as injecting gases directly to the blood vessels can cause a serious embolism if it blocks blood flow to the brain or coronary arteries. However, if the oxygen is injected slowly into the venous circulation, it may be survivable as the bubbles may simply collect in the lungs where the oxygen is then slowly resorbed into the blood.
| |
|-
| |
Comfort patient
| |
Psychological support to the patient and relatives is often useful after breaking news of a poor prognosis. It may also be useful in subduing the agitated or psychotic patient.
| |
|-
| |
Review medical history
| |
Important early step, rather too late and conditional.
| |
|-
| |
Skin grafts
| |
Only indicated if massive areas of the skin are damaged (typically due to burns)
| |
|-
| |
Count number of limbs
| |
Not really relevant in medicine, but may be of use to know the reason behind any missing or extra limbs on seeing the patient though a through review of the medical history will render this point moot. Probably a little late to be noticing this now.
| |
|-
| |
Remove extra limbs
| |
Medically indicated in cases of polymelia either due to cosmetic purposes or because the extra limbs pose a direct threat to the health of the baby.
| |
|-
| |
Measure vitamin D
| |
Valid in diagnosis of bone related issues, for example if multiple or comminuted fractures were being counted as additional limbs/bones.
| |
|-
| |
Check whether build environment is sane
| |
Could be technical reference to the installation of the algorithm in the robot, or could relate to the sanity of:
* The robot doctor
* The patient undergoing this procedure (before or after reaching this part of the process)
* The person who programmed the robot to perform this flowchart
* The person who allowed this state of affairs to occur (I'm looking at you [[Black-Hat]]

NB: Whether the build environment is sane is irrelevant to the flowchart.
| |
|-
| |
Rinse patient with saline solution
| |
Tepid sponging may be indicated if the patient has a high fever. Could refer to internally rinsing patient with saline solution i.e. providing intravenous sodium chloride to boost circulating volume.
| |
|-
| |
Is patient phone battery low?
| |
Invalid in medical terminology, could be a technological metaphor for the patient's consciousness or stamina. "Your life-force is running out"
| |
|-
| |
Defibrillate
| |
Indicated in cases where there is ventricular fibrillation, and to a lesser extent in atrial fibrillation (chemical cardioversion with adenosine is usually preferred)
| |
|-
| |
Sync photos from camera
| |
Definitely invalid. Could refer to the robot attempting to backup photos from a camera before attempting to repair it/attempting to back-up patient's consciousness.
| |
|-
| |
Administer general anaesthesia
| |
Valid, but not at this stage. Only used when the procedure will invoke unnecessary distress or pain to the patient if they were to be awake beforehand.
| |
|-
| |
Blood loss?
| |
Useful. Patient may die if this clinical sign is missed.
| |
|-
| |
Patient address changed?
| |
Useful to ensure that the organisation has current contact details for the patient in the event that they may need to contact the patient (eg to arrange further appointments)
| |
|-
| |
Request organ donation
| |
Generally done prior to registering an individual for a driving licence or to a medical practice, or to the relatives of the deceased if consent had not been acquired beforehand.
| |
|Remove organs
|-
| |
Remove organs
| |
The only organs which can be safely removed from a living person without resulting in serious, chronic medical issues are the kidneys/lungs (only one can be removed), spleen, part of the liver (as long as one lobe is left it can regrow to its original size) and colon (usually consisting of the appendix only). With some serious lifestyle modifications, the pancreas, pituitary gland, frontal lobe of brain, half of the brain, adrenal glands, bladder and most of the gut can be removed. The heart can be removed from the body and replaced with an artificial pump for a few months at the most. However, such organ removals are only indicated if there is a genuine clinical need to do so due to the non-negligible risk of death associated with these operations.
| Discharge patient
|-
| |
Discharge patient
| |
| END STATE (before you read the title text)

|}

{{comic discussion}}

[[Category:Artificial Intelligence]]
[[Category:Flowcharts]]

1619: Watson Medical Algorithm

2015-12-21T16:55:18Z

Drake: There's a reason. (This also reveals an escape technique.)

{{comic
| number = 1619
| date = December 21, 2015
| title = Watson Medical Algorithm
| image = watson_medical_algorithm.png
| titletext = Due to a minor glitch, 'discharge patient' does not cause the algorithm to exit, but instead leads back to 'hunt down and capture patient'.
}}

==Explanation==
{{incomplete|much more on the different procedures etc.}}

IBM's {{w|Watson_(computer)|Watson}} is a natural language system designed to answer questions posed by humans. Recently, IBM has extended Watson to act as a {{w|clinical decision support system}}, using image analytics to aid physicians in medical decision making. In this comic, Randall shows a {{w|Flowchart|flowchart}} representing a possible algorithm for Watson, including bizarre techniques including surgical alteration of a patient to match a height and weight chart and squeezing the patient to remove yellow fluids. Like [[416: Zealous Autoconfig]], this comic pokes fun at a rigid, poorly-designed setup that ends up potentially doing more harm than good.

Modern medicine involves both standard processes and clinical judgement based around years of advanced training. An algorithm like this would have to be incredibly complicated in order to simulate the clinical judgement of a good doctor.

The algorithm depicted treats a patient as more of a machine or mechanical system than a living being, especially through decisions such as:

* Injecting oxygen into patients with low oxygen saturation, rather than treating the root cause
* Removing and inspecting a skeleton, then diagnosing the patient's condition with a bone count
* Dissecting a doctor "for parts" after consulting him or her for advice
* Removing extra limbs from a patient if the count is less than 100
* Determining whether the "build environment" of the patient is sane. This is most probably a reference to the configure script used in the {{w|GNU_build_system|GNU build system}}, which emits "checking whether build environment is sane" as one of its status messages.
* Rinsing the whole patient with a saline solution
* Removing organs from a patient regardless of response to an organ donation request

Other decisions appear to be entirely unrelated to the conditions upon which they are predicated:

* If the patient doesn't rate their pain on a scale from 0-10, sequence their genome, apply a {{w|tourniquet}}, and perform an {{w|autopsy}}
* If the patient's phones battery is low, defibrillate until the battery is charged, sync photos, then administer general anesthesia
* If the patient is successfully comforted after an oxygen injection, check their medical history and apply skin grafts
* If green fluid is released from the patient, begin to cauterize
* If the patient has 100+ limbs, check their Vitamin D level

The title text implies that, if the patient is so lucky to ever reach one of the two places with the option "discharge patient," a minor glitch will cause to program to go back to the ''hunt down and capture patient'' option which thus force the patient and the program to repeat the process again in an infinite cycle, that will only end once the patient give another rating of their pain level than on the 0-10 scale. Then the program will start to sequence their genome then apply a tourniquet and finally perform an autopsy, on what will in the end for certain be a deceased patient, but maybe not when the autopsy began. This will finally cause the patient to leave the cycle... as a corpse!

This is one of many comics with [[:Category:Flowcharts|flowcharts]], amongst other a recent comic with that very name: [[1488: Flowcharts]].

This is the second comic in a row about health issues with the last comic being [[1618: Cold Medicine]].

==Transcript and Discussion of Medical Appropriateness==
{{incomplete transcript}}
{| border=1
| | Step
| | Medically valid?
| | Conditions and following step
|-
| |
Draw Blood
| background-color:green |
Phlebotomy is a normal early step in the diagnostic process, but not as first and unconditional step
| |
Record patient’s name
|-
| |
Record patient’s name
| background-color:green |

OK
| |
Measure Patient’s height and Weight
|-
| |
Measure Patient’s height and Weight
| |
OK
| |
Consult Standard height/weight chart
|-
| |
Consult Standard height/weight chart
| |
OK
| |
Surgically adjust patient to match
|-
| |
Surgically adjust patient to match
| |
May be considered ethically dubious unless there are [http://www.gosh.nhs.uk/medical-information/procedures-and-treatments/limb-length-difference-and-limb-lengthening sound medical reasons] for doing so. Could be an allusion to [https://en.wikipedia.org/wiki/Procrustes Procrustes].
| |
Is patient coughing up blood?
|-
| width="33%" rowspan=2 |
Is patient coughing up blood?
| width="33%" rowspan=2 |
OK, coughing up blood is generally a sign that there is something wrong. Typical causes are respiratory tract infections (e.g. tuberculosis), lung trauma or pulmonary embolism.
| |
Yes: Gather blood and return it to body
|-
| |
No: Is patient still here?
|-
| width="33%" rowspan=2 |
Is patient still here?
| width="33%" rowspan=2 |
Not usually considered a step, but missing patients are a problem in some fields, psychiatry or intensive care for example.
| |
Yes: Record pulse rate
|-
| |
No: Hunt down and capture patient
|-
| |
Hunt down and capture patient
| |
Valid if patient should not have left the bed/unit, but the wording is possibly dubious.
| |
Is patient still here?
|-
| |
Gather blood and return it to body
| |
Dangerous idea in this case due to likelihood of contamination, although if safely done autotransfusion is an accepted medical technique to ensure a matching blood supply prior to a major operation, or to enhance stamina (blood doping)
| |
Record pulse rate
|-
| |
Record pulse rate
| |
OK, but maybe a little late.
| |
Is patient screaming?
|-
| width="33%" rowspan=2 |
Is patient screaming?
| width="33%" rowspan=2 |
Very important question, indicating patient is conscious, in pain, and aware pain is bad. First attenders can use it in classifying priorities (quiet patients may be more severely injured). Generally useful in assessing nerve damage, pain relief, etc.
| |
Yes: Ignore
|-
| |
No: Check blood O2 saturation
|-
|-
| width="33%" rowspan=2 ` |
Check blood O2 saturation
| width="33%" rowspan=2 |
Only really indicated if the patient is in danger of hypoxia. Generally normal people should have a SpO2 of 98-100%, but in chronic lung disease this can fall as low to 80%, and in premature babies a SpO2 of 90% is usually targeted to avoid problems with retinopathy. If the SpO2 were to fall as low as 50%, the patient would definitely be dead or unconscious.
| |
>50%: Remove and inspect skeleton
|-
| |
<50%: Inject oxygen
|-
| width="33%" rowspan=2 |
Remove and inspect skeleton
| width="33%" rowspan=2 |
Fatal if patient is still alive when beginning. Also not a valid medical procedure in any way as it is impossible to remove most of the long bones of the body without destroying all surrounding tissue.
| |
Too many bones: Is fluid coming out of patient?
|-
| |
Too few bones: Request consult with human doctor
|-
| |
Request consult with human doctor
| |
Medically valid in the context of obtaining an opinion from a doctor in a different speciality who is better suited to treating the patient.
| |
Dissect doctor for parts
|-
| |
Dissect doctor for parts
| | This may be considered ethically dubious. Possible
reference to the Doctor Who episode “{{w|The girl in the fireplace}}”
| |
Discharge patient
|-
Acceptable, but patient would generally be dead by then.
| |
Discharge patient
| |
| |
END STATE (before you read the title text)
|-
| |
Is fluid coming out of patient
| |
Unintended fluid release is always a problem. How significant a problem depends on where the fluid came from and if it is supposed to be coming from there. Red generally is due to blood, yellow is due to pus/tissue fluid/lymph and green signifies bacterial infection or bile salts (biliverdin). Could also relate to normal fluids being lost (e.g. urine, saliva, sweat)
| |
|-
| |
Squeeze patient
| |
Could be in the medical context is in providing external ventilation (see iron lung) or other means of removing fluid (e.g. squeezing pus from a boil).
| |
|-
| |
What colour?
| |
Never underestimate the number of different types of fluid the body can produce.
| |
|-
| |
Activate sprinklers
| |
Not medically valid. Presumably a reference to how much cleaning up will be required by this stage.
|-
| |
Subdue patient
| |
Potentially very important if patient is behaving dangerously to themselves and others around them (due to mental health issues eg psychosis or drugs) and/or is moving too much to be given treatment.
| |
|-
| |
Apply cream
| |
Medically valid as a form of barrier dressing to improve wound healing.
| |
|-
| |
Ask patient to rate pain level
| |
Useful in the sense that it provides the doctor with the means to ensure that the patient is receiving adequate analgesia during conditions of chronic and acute pain.
| |
|-
| |
Massage scalp
| |
This would belong more to the domain of palliative care and reflexology rather than being an accepted medical treatment.
| |
|-
| |
Patient is healthy
| |
A subjective assessment of the health patient is often helpful in ruling out certain diagnoses. For example, one is less likely to suspect cancer in a fit, healthy 30 year old than a thin, lethargic 50 year old.
| |
|-
| |
Admit for observation
| |
Useful in the context of 'watchful waiting', in which the doctor may be unsure if the patient actually has a condition that they suspect that the patient has. By keeping the patient on the ward for a few days, the clinician can monitor the progression of symptoms and rapidly initiate adequate treatment if medically warranted.
| |
|-
| |
Laser eye removal
| |
This is not a standard medical procedure. This could be a pun on laser eye surgery, where a laser is used to correct visual problems (e.g. short-sightedness).
| |
|-
| |
Sequence genome
| |
Useful in the association of extremely rare point mutations with an organic illness. See for instance the Genome 10K Project or the Cancer Genome Atlas. Or in diagnosing extremely rare mutations that are not picked up by most commercial DNA screening tests (eg kidney failure due to INF2 mutation).
| |
|-
| |
Apply tourniquet
| |
Useful to stop acute bleeding from an injured extremity, but if it is drawn too tightly it can cause neuromuscular damage.
| |
|-
| |
Perform autopsy
| | Fatal if patient is still alive when beginning.
| | END STATE (taking the title text into account, the only possible one)
|-
| |
Inject oxygen
| |
May be fatal as injecting gases directly to the blood vessels can cause a serious embolism if it blocks blood flow to the brain or coronary arteries. However, if the oxygen is injected slowly into the venous circulation, it may be survivable as the bubbles may simply collect in the lungs where the oxygen is then slowly resorbed into the blood.
| |
|-
| |
Comfort patient
| |
Psychological support to the patient and relatives is often useful after breaking news of a poor prognosis. It may also be useful in subduing the agitated or psychotic patient.
| |
|-
| |
Review medical history
| |
Important early step, rather too late and conditional.
| |
|-
| |
Skin grafts
| |
Only indicated if massive areas of the skin are damaged (typically due to burns)
| |
|-
| |
Count number of limbs
| |
Not really relevant in medicine, but may be of use to know the reason behind any missing or extra limbs on seeing the patient though a through review of the medical history will render this point moot. Probably a little late to be noticing this now.
| |
|-
| |
Remove extra limbs
| |
Medically indicated in cases of polymelia either due to cosmetic purposes or because the extra limbs pose a direct threat to the health of the baby.
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Measure vitamin D
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Valid in diagnosis of bone related issues, for example if multiple or comminuted fractures were being counted as additional limbs/bones.
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Check whether build environment is sane
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Could be technical reference to the installation of the algorithm in the robot, or could relate to the sanity of:
* The robot doctor
* The patient undergoing this procedure (before or after reaching this part of the process)
* The person who programmed the robot to perform this flowchart
* The person who allowed this state of affairs to occur (I'm looking at you [[Black-Hat]]

NB: Whether the build environment is sane is irrelevant to the flowchart.
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Rinse patient with saline solution
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Tepid sponging may be indicated if the patient has a high fever. Could refer to internally rinsing patient with saline solution i.e. providing intravenous sodium chloride to boost circulating volume.
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Is patient phone battery low?
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Invalid in medical terminology, could be a technological metaphor for the patient's consciousness or stamina. "Your life-force is running out"
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Defibrillate
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Indicated in cases where there is ventricular fibrillation, and to a lesser extent in atrial fibrillation (chemical cardioversion with adenosine is usually preferred)
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Sync photos from camera
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Definitely invalid. Could refer to the robot attempting to backup photos from a camera before attempting to repair it/attempting to back-up patient's consciousness.
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Administer general anaesthesia
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Valid, but not at this stage. Only used when the procedure will invoke unnecessary distress or pain to the patient if they were to be awake beforehand.
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Blood loss?
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Useful. Patient may die if this clinical sign is missed.
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Patient address changed?
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Useful to ensure that the organisation has current contact details for the patient in the event that they may need to contact the patient (eg to arrange further appointments)
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Request organ donation
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Generally done prior to registering an individual for a driving licence or to a medical practice, or to the relatives of the deceased if consent had not been acquired beforehand.
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|Remove organs
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Remove organs
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The only organs which can be safely removed from a living person without resulting in serious, chronic medical issues are the kidneys/lungs (only one can be removed), spleen, part of the liver (as long as one lobe is left it can regrow to its original size) and colon (usually consisting of the appendix only). With some serious lifestyle modifications, the pancreas, pituitary gland, frontal lobe of brain, half of the brain, adrenal glands, bladder and most of the gut can be removed. The heart can be removed from the body and replaced with an artificial pump for a few months at the most. However, such organ removals are only indicated if there is a genuine clinical need to do so due to the non-negligible risk of death associated with these operations.
| Discharge patient
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Discharge patient
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| END STATE (before you read the title text)

|}

{{comic discussion}}

[[Category:Artificial Intelligence]]
[[Category:Flowcharts]]