#HematologyTweetstory #6: the ‘pawn ball megakaryocyte’. We’ll revisit Dr. Frankenstein from Tweetstory #1, discover the origin of Santa Claus, and travel from Boston to Las Vegas – a flight the clever guys from the MIT Blackjack Team used to make every Friday. #hematopathology/1 
‘Pawn ball’ megakaryocytes have 3 distinct nuclear lobes; this is abnormal. The first reference I’ve found that uses this term is a 1984 @BloodJournal paper by David Rosenthal & William C. Moloney (1907-1991). Dr Rosenthal @DanaFarber led @Harvard Health Services until 2011/2
Moloney, who became the champion of the 'pawn ball meg.' concept, came from @TuftsMedicalCtr & the old Boston City Hospital to become hematology chief at Peter Bent Brigham Hospital (now @BrighamWomens) in 1966. He continued to work until he turned 90 in 1997. @BrighamHeme /3
The ancient symbol of pawnbroking is 3 balls. This symbol is less commonly used on advertising or signs today. When I lived in Rochester, Minnesota, I had to drive all the way up to St Paul to find a pawnshop that still used the 3 balls that I could photograph. This was it./4
William Hogarth’s 1751 engraving 'Gin Lane' highlights the dangers of excess drink & shows a pawn ball symbol. The message: if you drink too much, you’ll have to pawn/sell everything to support your habit. For a mostly illiterate population, these trade symbols were essential./5
Back in college, one of my roommates picked up this 1970s vinyl album by folk singer #JoeHickerson at a pawn shop, which including a song, “Shingling the Rum-Seller’s Roof.” Lyrics: “While your own house decays, are you spending your days just shingling the rum-sellers roof?”/6
Pawn shops have experienced something of a renaissance - or at least a publicity bonanza - in recent years with the binge-worthy @HISTORY show, “Pawn Stars” @pawnstars (Alas, it is one of the few programs on that network nowadays that is not about silly ancient alien stuff.)/7
Rick Harrison of @GoldSilverPawn wrote a highly readable book in 2011, “License to Pawn“. I learned several useful things from it – including always getting the other guy to name a price first, and never being afraid to walk away from a deal that doesn’t feel or seem right./8
While some folks love Chumlee, my favorite recurring @PawnStars character is book expert @rebeccaromney, who doesn’t miss a thing when it comes to appraising old books. I met her briefly at @BostonBookFair some years ago; her depth of knowledge is real, not just for the show./9
My other fav is Mark “Beard Of Knowledge” Hall-Patton, @KnowledgeBeard director of @CCHMuseum. I love this guy – not only will he never stoop to crassly putting a $ figure on a cool historical object 😉, he seems to know a bit about *everything* (Image from his Twitter acct) /10
I'm no Mark Hall-Patton, but have always had, erm, a less-focused mind. When I took an aptitude test in school to see what career might be best, top score was “Miscellaneous" & suggested careers were limited to shepherd, forester, bus driver. Has guidance counseling improved?/11
So: where did the traditional pawn ball symbol come from? A pawnbroker I spoke to circa 2002 told me the 3 balls stand for “Buy, Sell, Lend”, which are the 3 main things pawnbrokers do. There are two leading hypotheses for why these balls became the pawnbroking symbol./12
Hypothesis 1: it was the #Medici family, the most famous moneylenders of the early Medieval period (four popes were Medici family members). Their family coat of arms – depicted here on a building in Italy – includes a series of orbs, albeit usually more than 3 orbs. /12
The “Medic” name suggests that some of the family may originally have been apothecaries or physicians, and the orbs may represent pills. (There are alternate theories.) Regardless, they became known as moneylenders at a time when lending was considered sinful 'usury'. /13
For hypothesis #2, we must go to 4th c. Italy and the town of Bari, where the local bishop was extremely popular. You may know him as #SaintNicholas, or "Nicholas the Wonderworker" because so many miracles are attributed to him. Notice what he has on the plate he's carrying?/14
An iconic St. Nick story: 3 young girls from a poor family had no money for a dowry, so were going to become prostitutes. Nicholas came in the middle of the night and gave them money. Here he's painted throwing golden bags through a window. Gotta love the NBA-worthy jump shot!/15
Every Christmas, my father-in-law gives everyone in his extended family an orange. This is an old tradition in the US; the oranges look like the bags of gold received by the fortunate 3 girls of Bari, and are an allusion to Saint Nicholas’ gift./16
Because he bailed out a family in tough circumstances, St Nicholas became the patron saint of pawn brokers. As the guy who came in the night to give gifts to children, he inspired contemporary Santa Claus. This 1983 Christmas stamp of #SantaClaus is Scott #2064. @APS_stamps /17
Back to #hematology. More commonly, the ‘dysplastic’ (derived from Greek words meaning “bad" and "formation”) megakaryocytes in #MDS look like this: monolobated – rather more reminiscent of Polyphemus and his Cyclops brethren than the ancient symbol of pawnbroking./18
Here's another bilobed meg - from a 1973 @BloodJournal paper by a @UCSFMedicine group (W Byron Smith et al). I've heard some people call these “Marty Feldman cells”, a reference to the late comedian’s trademark exophthalmos stare, as here in Mel Brooks' "Young Frankenstein". /20
We'll finish now with the 21st tweet in the #tweetstory - fittingly, since books 'Bringing Down the House' & 'Busting Vega$' by @benmezrich about the MIT Blackjack Team mentioned in tweet1 (Vegas is also where @GoldSilverPawn shop is located) were made into a movie: "21". /21End
