Oral conception. Impregnation via the proximal gastrointestinal tract in a patient with an aplastic distal vagina. Case report by Douwe A A Verkuyl
img2.tapuz.co.ilToday, as we sat together discussing clinical pearls we have learned from the cases seen in our respective rotations, the conversation veered horribly off course.
What started off as a simple discussion about the ethics of unwanted pregnancies became a discussion about this article from the British Journal of Obstetrics and Gynaecology, September 1988.
What a tangent that was. To discuss it here would be to spoil the strangeness and incredulity of what happens in this case. Read on for more.
Case Study: Evan Osnos of The New Yorker

The Writer: Evan Osnos is a correspondent for The New Yorker in China. Osnos and his wife has lived in Beijing, China since 2005. Other than writing articles for the print magazine, Osnos also blogs about current affairs and culture in China a few times a week. Before becoming a correspondent for The New Yorker, Osnos worked as the Beijing bureau chief of Chicago Tribune.
The story: Evan Osnos travels to Europe with a group of Chinese tourists. During their ten days in Europe, he captures very endearing scenes with some of his fellow Chinese travelers. Some travelers are older and they reflect back on how hard it used to be to travel outside of China. Other travelers are young couples or high school students traveling with their parents, for them, traveling might become a norm while for the older travelers, it’s something they’ve waited for their whole lives.
Sprinkled into the story are precious moments where the tour guide warns the tourists about Gypsies, traveling with knockoff of European goods, and talking to strangers. Traveling to a foreign country for anyone can be a nerve-wrecking experience.
The tour guide then explains cultural practices of Europeans. Osnos’ observations about the concept of someone and something being foreign is really insightful and it’s delivered in such a non-judgmental way.
He ended with some advice: “Let them do things their way, because if we’re rushing then they’ll feel rushed, and that will put them in a bad mood, and then we’ll think that they’re discriminating against us, which is not necessarily the case.”
I asked him about the fine line he treads as a Caucasian writing about China and if its hard to write from that point of view. “It comes from how you feel about the place. I spend a lot of time understanding motivations— its the origins of sympathy. There are times when you have to be judgmental to make a point or to get a reaction. It’s easy to be sensitive. If you study the language and you’re open and friendly, they love telling you stories. You just have to listen.”
I agree. In pieces like this, Osnos’ wonder and admiration for changes in modern China really comes through in his observations. Some traveling writers point out things that are different from what they are used to in his or her homeland. Osnos, on the other hand, points out things that are indicative of a new way of thought that complements the progression of the times.
The Idea and Pitch: Evan Osnos was interested in traveling around China with other Chinese tourists and seeing important historical landmarks through the eyes of Chinese tourists. Before he was able to do this, his editor wanted him to write something for Chinese new year and suggested that he go on a tour to Europe. They scrambled to find a tour close to Chinese New Year, when travelers were most abundant.
He found a tour a couple of days later and he left the next morning. There were really interested in going to Europe because it shows a level of wealth to go to Europe. Mark Twain did it, observing Americans behaving badly. The Chinese tour group, however, did not behave badly, “They behaved in a more courteous manner than my own ancestors did.”
The Reporting: Even though Evan Osnos is beyond proficient in Mandarine Chinese, the tour left from Shanghai, a major city south of Beijing that speaks a different dialect of Chinese called Shanghainese. For a person whose first language is Mandarine, Shanghainese is a little hard to decipher, it was quite a challenge for Osnos at times to understand each traveler.
Osnos recorded as much audio as possible on this trip and later had it transcribed. He also had a notebook on the side and noted important scenes or conversations that drove the plot and would be something he’d want to use in the article.
“You imagine that those ideas will stay in your head and they don’t! You should write it down! Always!” Osnos warned.
When traveling and writing, you always want to get the most amount of material on the first and second days of the trip because “it’ll be the meat of your story,” Osnos replied when I asked him about his note-taking practices. For this story, he told me that the first pages of his notes all referred to his follow travelers by physical description, and later on —after he’s met them and learned their names, he would go back and fill in the notes with their names.
I asked him if he had any expectations about how the story would pan out before starting his trip and he told me that he thought it would be less comfortable. Everyone turned out to be very open and wanted to talk to him for the article. “It was the one of the most satisfying experiences since I’ve been in China.” Osnos reflected on the trip with a sentimental pause. “I expected to be treated like an outsider, and it wasn’t like that at all.”
The point was to capture as many little personal scenes as possible through the eyes of the Chinese tourists.
The writing process: Without fail, Evan Osnos always “gets everything on paper,” before he starts writing. For this story, he had between 100 to 150 pages of notes and transcripts. “I like marinating in the story because it often tells me what the story is about.” Sometimes you’ll get an idea during the middle of the reporting that will reveal to you where the point of the story is, other times you just have to look at everything together at the end and it’ll come to you.
After marinating in his notes, Osnos will start writing one paragraph at a time with an outline in his mind. For some of his other stories, he’ll write around a scene that he really felt was important and then the point of the story comes out after he’d done a bulk of the writing. He is the type of writer who works to journal and log little stories throughout the day. Sometimes while he’s documenting his day, he’ll find an idea or a point that he wants to develop into a story. In this story, after following his own advice of taking the bulk of the notes during the first 2 days of the trip, Osnos let the time frame of the trip lead the narrative of the story.
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Osnos was an absolute joy to talk to. He is such a nice guy. I was a big fan when I chose to interview him and now I’m an even bigger fan.
Visit his blog “Letters from China: The New Yorker”.
Mass communications comprise the institutions and techniques by which specialized groups employ technological devices (press, radio, films,, etc.) to disseminate symbolic content to large heterogeneous and widely dispersed audiences. Janowitz, 1968

The simplest definition of mass communication is “public communication transmitted electronically or mechanically.” In this way, messages are transmitted or sent to large, perhaps millions or billions of people spread across the world. Whenever I heard mass communication, the first thing that gets through my mind is wide. Why wide? As what I have remembered, it covers a very wide range of audience and it uses different forms of media to disseminate its messages. The main functions of mass communication are informing, educating and entertaining even a wide range of people.
There are two forms of media, the Traditional Media and Electronic Media. Traditional media are part of a country’s rich heritage. There are several forms of it like storytelling, folk songs, street theater and puppetry. Right now, when we say traditional media, it points to the foundations or base of the media industry like television, print, photography, radio and film. Electronic media on the other hand are the technologies used nowadays by media practitioners like the online writings, digital media, information technology. These types of media are considered as new media. Television, radio, film, print and photography are also considered as Electronic Media.
There are different institutions that make up the Mass Communication industry. Each institution specialize a specific field. Each specialized field use media technologies depending on their field. Each field has their own way or strategy on how they will transmit the message that they want to convey to their audience. One field may look for the help of the other field in order to make the presentation more attractive and interesting. For example, a TV production may look for a help of a photographer to shoot beautiful angles of pictures which can be use in the television.
An understanding of media richness theory is useful in when examining the impact that different communication media types potentially have on the message. Media richness theory comes primarily from the literature on computer-mediated communications (CMC) and is most often associated with business communication. In this context, media richness theory is used to analyze communication media choices and to help reduce ambiguity of communication through the appropriate selection of communication media.
Media richness is explained by some researchers (Trevino, Lengel et al. 1987) as the ability of a medium to carry information. Sitkin, Sutcliffe, and Barrios-Choplin, (1992) identify two components of a medium’s ability to carry information. These two components are the data carrying capacity and the symbol carrying capacity. Data carrying capacity refers to the medium’s ability to transmit information while symbol carrying capacity refers to the medium’s ability to carry information about the information or about the individuals who are communicating.
Researchers who work with media richness theory often rank communication media on their abilities to carry both information types, but especially the second type, symbolic information. The criteria for ranking a medium’s ability to carry information can be based on the ability of the media to, relay immediate feedback, provide feedback cues such as body language, allow the message to be created or altered specifically for an intended recipient, and transmit the feelings or emotions of the communicators. (Daft and Lengel 1984). In discussing communication in online classes, Newberry (2001) builds on the work of these researchers to construct the following table which attempts to place seven different types of communications media in a three-position matrix (high, medium, and low) expressing the media’s performance or its ability to carry: feedback, multiple cues such as body language, message tailoring, and emotions.
Attempting to rank different media choices does not imply that one is better than the other. Each media type has its own advantages and disadvantages and each is probably more appropriate than the others in different situations. In fact that is the point of much of the media richness research; one should choose the media type that offers the greatest efficiency and the greatest opportunity for the intended message to be conveyed accurately. In educational activities the choice of media can be influenced by many factors. Some of which include, technology availability, time constraints, familiarity with the technology, task appropriateness of the technology and desired outcomes of the learning activity.
Credits :
http://sirmarteliascarlo.tumblr.com/post/13437136724
http://download.nos.org/srsec335new/ch2.pdf
http://learngen.org/Resources/lgend101_norm1/200/210/211_3.html
http://www.google.com.ph/imgres?q=media+clipart&hl=en&gbv=2&biw=1366&bih=705&tbm=isch&tbnid=ZI7VceK2uDnqcM:&imgrefurl=http://photoshop.backata.com/2010/08/page/2/&docid=yyzUBQC732DB8M&imgurl=http://photoshop.backata.com/uploads/posts/2010-08/1283202277_91.media-business-icons.jpg&w=1000&h=667&ei=99vkTq_WFuepiAfAx7i3BQ&zoom=1
Report of Dr. Charles A. Leale. April 15, 1865
Thought to have been lost for nearly 150 years, the Abraham Lincoln Presidential Library and Museum has recently discovered the 21-page report written by Dr. Charles A. Leale. A young army surgeon on leave the evening of April 15th, 1865, he was the first physician to attend to the fatally wounded president. At the age of 23 and only 6 weeks into his practice, this rediscovered report details the deterioration of Abraham Lincoln and the procedures they used in an attempt to save his life.
Here it is in its entirety.