Otitis media secretions from the nasopharynx into the normally sterile middle-ear space, the fluid may then become infected — usually with bacteria. The virus that caused the initial URI (upper respiratory infection) can itself be identified as the pathogen causing the infection. As its typical symptoms overlap with other conditions, such as acute external otitis, clinical history alone is not sufficient to predict whether acute otitis media is present; it has to be complemented by visualization of the tympanic membrane. Examiners use a pneumatic otoscope with a rubber bulb attached to assess the mobility of the tympanic membrane. In more severe cases,
What Is the What writes: "Over the course of many years, Dave and I have collaborated to tell my story... I told [him] what I knew and what I could remember, and from that material he created this work of art." The book is typical of Eggers' style: blending non-fictional and fictional elements into a non-fiction novel or memoir. By classifying the book a novel, Eggers says, he freed himself to re-create conversations, streamline complex relationships, add relevant detail and manipulate time and space in helpful ways—all while maintaining the essential truthfulness of the storytelling. However, not all critics were impressed. Lee Siegel sees