comic for 2/27/13

[d murphy]

ugh.

[Madrian]

I'm sorry to hear that you're feeling poorly. I hope that gets better!

Regarding today's comic: I'm not sure if Mary would know this information, but the docs certainly should:

It appears from how Lindsay is drawn, that she has achondroplasia. While not exactly common in general, this is the most common form of dwarfism, and if Lindsay did wish to get pregnant in the future and carry to term, she can do that safely. Also, while any child she conceived would have a 50% percent chance of having achondroplasia as well, there are other possible outcomes - if the father doesn't have achondroplasia, the chance of the baby having it is 50/50. If the father does have achondroplasia, then the chances are still 25% osteo-typical ("average" height), 50% achondroplasia, and a 25% chance that the baby would inherit the dominant achondroplasia gene from both parents, which would most likely result in a miscarriage or, if carried to term, unlikely to live very long.

It seems, from what the patient has said to Mary, that her GP and/or regular OB have not really discussed this with her, and the patient deserves to be told what her likely outcomes would be if she decides in the future that she does want to have children. How that is done in this context might be touchy, without sounding like an attempt to persuade her to keep the pregnancy she is currently experiencing, of course - but I would expect Dr McGill or Dr Gregory to be able to accomplish it, given the empathy they have shown to other patients.

You may well have been aware of this, but it seemed worth mentioning, since it may impact the Lindsay's feelings of depression and hopeless with regard to reproduction - at least she would know exactly what her risks are.

Thanks, that went on longer that I meant it to!

[d murphy]

none of what you've said is inaccurate, except maybe the gene portion of it. theorhetically, the biological father or herself may have other information increasing the likelihood a pregnancy would suffer from the same disability. i agree that the most likely form of dwarfism lindsay suffers from is achondroplasia, but i'm being specifically vague to both try not to get too bogged down in gene theory and draw a comparison between lindsay's dissatisfaction with her own life and projecting that upon her pregnancy.

most of the other ideas i do intend to at least reference in future comics, so don't get too far ahead of me yet