Standard operating practice dictates that a sneezing surgeon face the patient so that expelled droplets escape backward via the sides of the doctor's surgical mask. Remarkably, however, there seems to be no medical literature that actually supports this practice.

So a couple of plastic surgeons in England set about determining whether it was really a smart thing for an operating doctor in a surgical mask to sneeze facing a patient's open wound.

J. Granville-Chapman and R.L. Dunne placed a mask-wearing surgeon in front of high-speed cameras and asked him to hold a small amount of water in his mouth to boost and improve the appearance of droplets in the photographs. Then the surgeon inhaled finely ground pepper.

The resulting images of the surgeon sneezing show droplets escaping from the sides of the mask and a few downward onto the surgeon's chest. None of the photos showed substantial numbers of droplets passing behind the head of the surgeon.

Granville-Chapman and Dunne concluded that the standard practice of facing the patient is, in fact, ineffective. The most worrisome spray is the droplets coming out below the surgeon's mask. Their recommendation, as published in the British Medical Journal:

"We recommend that surgeons should follow their instincts when sneezing during operations."

In other words, turn away. Your patient will thank you - when he regains consciousness.

BODY OF KNOWLEDGE

A one-minute kiss burns 26 calories.

GET ME THAT. STAT!

People living in the upper Great Plains are the healthiest Americans, based upon mortality rates, while those residing along the southern Atlantic coast and the Mississippi River die at a faster rate than the national average, according to a Mississippi State University study.

Incidentally, Southern California residents posted higher-than-average life spans.

NEVER SAY DIET

The world's speed-eating record for grits is 21 pounds in 10 minutes, held by Patrick Bertoletti.

MEDTRONICA

Merck Veterinary Manual

merckvetmanual.com

The Merck Manual is an incredibly comprehensive guide to what ails humans. There's a veterinary version, with equally detailed descriptions of most known animal diseases, their symptoms and known treatments.

STORIES FOR THE WAITING ROOM

In 1869, the "Guide Board to Health, Peace and Competence or the Road to a Happy Old Age" offered this bit of advice: "Have you a family? If you have not, you need not take any exercise, and you can eat and stuff and guzzle all day, for you are of no account and the sooner you die off and make room for a better man, the better for society at large."

Clearly the authors preferred no single men on the "road to a happy old age."

DOC TALK

404 moment - The point in a medical consultation when, despite searches of notes or electronic records, a result cannot be found. The phrase refers to the Internet error message: "404 - document not found."

PHOBIA OF THE WEEK

gamophobia - fear of marriage

BEST MEDICINE

A little girl told her mother that a boy in class asked her to "play doctor."

"Oh, dear," the mother said. "What happened?"

"Nothing," replied the girl. "He made me wait 45 minutes and then double-billed the insurance company."

OBSERVATION

The only difference between alternative medicine and an HMO is that more doctors believe HMOs don't work.

- Comedian Wally Wang

CURTAIN CALLS

The English author-playwright George Bernard Shaw died after falling out of an apple tree he was pruning. He was 94.