RSS

Category Archives: Medical Issues

Q and A: Could Death From Bleeding Be Delayed For Several Days After a Frontier Wagon Wheel Accident?

Q: My story takes place in a wagon train in the late 1800’s. My character is dragged by a horse while crossing a river. He hits rocks and is bounced off the back wheel of a wagon. Of course the horse’s hooves do damage as well. Three days later he dies from massive bleeding from his internal injuries. This three day delay followed by the sudden loss of blood is important to the story’s timing, but is it realistic?

wagon_train-2

A: The answer to your question is yes.

This type of accident could, as you can imagine, result in all types of injuries. Broken bones, skull fractures, neck fractures, cracked ribs, punctured lungs, and intra-abdominal injuries (injuries inside the abdominal cavity). This last type of injury might serve you well.

A ruptured spleen or lacerated liver or fractured kidney would bleed into the abdominal cavity. Death could be quick or take days if the bleed was slow. There would be great pain, especially with movement or breathing, and the abdomen would swell. Also a bluish, bruise like discoloration could appear around the umbilicus (belly button) and along the flanks. This usually takes 24 to 48 hours or more to appear. This occurs as the blood seeps between the “fascial planes.” The fascia are the tough white tissues that separate muscles from one another. The blood seeps along these divisions and reaches the deeper layers of the skin causing the discoloration. But, these injuries wouldn’t lead to external bleeding since the blood has no exit from the abdominal cavity.

However, if the injury was to the bowel, then external bleeding could occur. For blood to pass from the bowel, the bleeding would have to be within the bowel itself and not just in the abdomen somewhere. If the bowel were ruptured or torn so that bleeding occurred within the bowel, the blood would flow out rectally. But, blood in the bowel acts like a laxative so the bleeding would likely occur almost immediately and continue off and on until death, which in this situation would be minutes to hours to a day, two at the most. It would be less realistic for the bleeding to wait three days before appearing in this case. With one exception.

The bowel could bruised and not ruptured or torn, and a hematoma (blood mass or clot) could form in the bowel wall. As the hematoma expanded it could compromise the blood supply to that section of the bowel. Over a day or two the bowel segment might die. We call this an “ischemic bowel.” Ischemia is a term that means interruption of blood flow to an organ. If the bowel segment dies, bleeding would follow. This could allow a 3 day delay in the appearance of blood.

In your scenario, the injuries would likely be multiple and so abdominal swelling, the discolorations I described, great pain, fevers, chills, even delirium toward the end, and finally bleeding could all occur. Not a pleasant way to die, but I would imagine this happened not infrequently in frontier days.

The victim would be placed in the bed of one of the wagons and comforted as best they could. He might be sponged with water to ease his fevers, offered water or soup, which he would likely vomit, and prayers would be said. They could have tincture of opium (a liquid) available and give him some. This would lessen the pain since it is a narcotic and would also slow the motility (movement) of the bowel and thus lessen the pain and maybe the bleeding.

Of course, during the time period of your story, your characters wouldn’t know any of the internal workings of the injury as I have described. They would only know that he was severely injured and in danger of dying. Some members of the wagon train may have seen similar injuries in the past and may know just how serious the victim’s condition is, but they wouldn’t understand the physiology behind it. They might even believe that after he survived the first two days that he was going live and then be very shocked when he eventually bleed to death. Or they might understand that the bouncing of the wagon over the rough terrain was not only painful but also dangerous for someone in his condition. They train may be halted for the three days he lived or several wagons might stay behind to tend to him while the rest of the column moved on.

 

Murder By Meme: Slender Man and the Wakefield Anti-Vaccine Hoax

Slender Man

We all know that viral illnesses can kill. Ebola would be an example. So would small pox and the 1918 Flu.

But can an internet viral hoax kill? An interesting article titled “Murder By Meme: Slender Man and the Wakefield Anti-Vax Hoax” by Travis Langley, Ph.D. in Psychology Today looks at this issue.

In June, 2009, Eric Knudsen (aka Victor Surge) posted a pair of black & white photos of groups of children in which he had inserted a thin figure in a black suit into the background. This was the birth of the Slender Man hysteria. It led to the attempted murder of a 12-year-old girl by two of her classmates, also 12. Why would they stab their classmate 19 times? Apparently to serve as “proxies” for The Slender Man and to show that he really existed.

Crazy is as crazy does.

And then there’s the 14-year-old who read about Slender Man and decided she needed to burn down her home—-with her mother and brother inside. Fortunately there were no injuries but the house and family car took a hit.

But such internet hoaxes aren’t confined to the world on teen angst. It has also entered the world of legitimate medicine. And has done great harm.

MMR

Ever seen a case of Whooping Cough? Diphtheria? Probably not. I’ve never seen diphtheria and whooping cough (pertussis) only a couple of times way back during my pediatrics rotation as a junior medical student. The reason these and other childhood diseases such a rubella and mumps are now not so common is a robust and widespread immunization program that has done a stellar job in keeping these illnesses at bay.

Enter Dr. Andrew Wakefield. He apparently created an entirely fraudulent research study that suggested that the MMR (Measles, Mumps, and Rubella) vaccine caused Autism. Based on this scam, allegedly funded by an “ambulance-chasing” law firm, many well-meaning and fearful parents refused to vaccinate their children. This led to outbreaks of these uncommon diseases. Here in my own backyard, Orange County, CA, we had an outbreak of pertussis that could be traced for the most part to a single pediatrician who bought into this “bad science.”

The truth? There is not a single piece of legitimate evidence to suggest that MMR is in any way related to autism.

And Slender Man does not exist.

 
3 Comments

Posted by on October 16, 2014 in Medical History, Medical Issues

 

Frankenstein and Creativity

Dr. Frakenstein

An interesting article recently appeared in The Atlantic on the origins of creativity and whether it is innate or can be learned: “Can Creativity Be Learned?” by Cody C. Delistraty. It makes for interesting reading and raises some intriguing questions. For example, creative folks tend to have more grey matter in the right posterior middle temporal area of their brain. Is this what makes them creative or does this result from them flexing their “creative muscle”? Chicken or egg?

Temporal Lobe

The author uses Mary Shelly and her classic horror story Frankenstein to underline his points.

In a past post on this blog I briefly talked about how Mary Shelly’s classic story came about. Here is an except:

On a literary and historical note, Frankenstein might never have been written had it not been for a volcanic eruption on the other side of the world. In 1815, Mount Tambora in Indonesia erupted with such force that it filled the air with millions of tons of ejected particulate matter. This rose into the high atmosphere, dropped world temperatures for many months and resulted in 1816 being called the “Year Without Summer.” Snow fell in New England in July!

During that summer, Mary Wollstonecraft Godwin, her lover and future husband Percy Bysshe Shelley, and Lord Byron settled into Villa Diodati on Lake Geneva. The summer was so cold and wet that they spent much of their time in the villa talking and telling stories. They decided to have a writing contest and see who could write the best short story. Mary’s story evolved into the classic Frankenstein; or the Modern Prometheus.

There has long been controversy over how Mary came up with such a story, She said it came to her in a “waking dream,” but some have suggested that her father had told her stories of a doctor who did such experiments and others have suggested that she and Shelley had actually visited Castle Frankenstein, the birthplace of Johann Conrad Dippel, a physician and alchemist who did indeed perform reanimation experiments on corpses. Either way she wrote a kick-ass story that has survived for nearly two centuries and will survive for many more.

The full post can be found here: http://writersforensicsblog.wordpress.com/2009/09/14/more-decapitation-and-reanimating-the-dead/

 
4 Comments

Posted by on September 22, 2014 in Forensic Psychiatry, Medical Issues, Writing

 

Crime and Science Radio: From Firefights To Fiction: An Interview With Military Surgeon and Author Dr. Jeffrey Wilson

dg2 500X667

Join Jan Burke and DP Lyle in a discussion of combat surgery and fiction writing with Vascular and Trauma surgeon Dr. Jeffrey Wilson.

BIO: Jeffrey Wilson has at one time worked as an actor, a firefighter, a paramedic, a jet pilot, a diving instructor, a Naval Officer, and a Vascular and Trauma Surgeon. He also served numerous tours in Iraq and Afghanistan as a combat surgeon with both the Marines and with a Joint Special Operations Task Force. He has written dozens of short stories, won a few fiction competitions, and currently has a 3 book deal with JournalStone Publishing for his novels. His first novel, THE TRAITEUR’S RING, was published in 2011. His second book, THE DONORS was released in June of 2012 and won a Gold Medal in the sci-fi/fantasy/horror category from the Military Writers Society of America. FADE TO BLACK is his third novel from JournalStone. Jeff and his wife, Wendy, are Virginia natives who, with children Emma, Jack, and Connor, call Tampa, Florida home. He still works part time as a Vascular Surgeon and as a consultant for the Department of Defense when not hard at work on his next book.

me hind

LISTENhttp://www.blogtalkradio.com/suspensemagazine/2014/09/09/crime-and-science-radio-with-special-guest-jeff-wilson

Dr. Jeffrey Wilson’s Recommended Reading:

Service by Marcus Luttrell

Lone Survivor by Marcus Luttrell

American Sniper by Chris Kyle

LINKS: Website: http://www.jeffreywilsonfiction.com/index.html

Annals of Surgery: Combat casualty and Surgical Progress: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1570575/

How Stuff Works: What Equipment Do Army Combat Surgeons Have?: http://health.howstuffworks.com/medicine/army-medicine/army-combat-surgeon-equipment.htm

You Tube: 212th Combat Field Hospital (Warning: Graphic Content): https://www.youtube.com/watch?v=1Qvt3YSAHpE

You Tube: Battlefield surgery PART 1 2 Survival: https://www.youtube.com/watch?v=yOI3oBQxxRc

Fade To Black on Amazon: http://www.amazon.com/Fade-Black-Jeffrey-Wilson/dp/1936564858/ref=sr_1_1?ie=UTF8&qid=1407420070&sr=8-1&keywords=Fade+to+black+by+jeffrey+wilson

Fade To Black at B&N: http://www.barnesandnoble.com/w/fade-to-black-jeffrey-wilson/1115405616?ean=9781936564859

You Tube: 212th Combat Field Hospital (Graphic): https://www.youtube.com/watch?v=1Qvt3YSAHpE

You Tube: Battlefield Surgery: https://www.youtube.com/watch?v=yOI3oBQxxRc

FTB

 

I Can Read Your Mind, Sort Of

1409303341802_wps_6_journal_pone_0105225_g003

From the Abstract “Conscious Brain-to-Brain Communication in Humans Using Non-Invasive Technologies” by Grau, Ginhoux, et al:

More fully developed, related implementations will open new research venues in cognitive, social and clinical neuroscience and the scientific study of consciousness. We envision that hyperinteraction technologies will eventually have a profound impact on the social structure of our civilization and raise important ethical issues.

You think?

This fascinating research is sort of Sookie Stackhouse meets the Vulcan Mind Meld. Intriguing and scary.

1409303301877_wps_4_journal_pone_0105225_g001

 
Leave a comment

Posted by on September 18, 2014 in Medical Issues

 

Snake Handling and Jesus: What Could Possibly Go Wrong?

Mark 16:17-18 (King James Version):

17: And these signs shall follow them that believe; In my name shall they cast out devils; they shall speak with new tongues;

18: They shall take up serpents; and if they drink any deadly thing, it shall not hurt them; they shall lay hands on the sick, and they shall recover.

Many snake handlers refer to this, and other, Biblical quotes to justify the taking up of snakes. Rattlesnakes and copperheads seem to be the creatures of choice and these deadly serpents are an integral part of their church services. As is ranting non-sense syllables—-the speaking in tongues part. Not to mention that they typically avoid medical help when such help is needed. Sometimes taking strychnine in the belief that this will add another layer of protection against the venom. After all . . . any deadly thing . . . shall not hurt them . . .

Don’t think that snake handling is a thing of the past or is relegated to the backwoods of the South. Though most still thrive in Appalachia, there are over a hundred such churches and they stretch from coast to coast.

What could possibly go wrong?

Well, actually, a lot. Snake handlers have died from bites, when a visit to the ER could have saved them. But religion is a powerful motivator and often over-rides common sense.

For example:

Jamie Coots, the pastor of the Full Gospel Tabernacle in Jesus Name in Middlesboro, Ky: http://abcnews.go.com/US/snake-handling-pentecostal-pastor-dies-snake-bite/story?id=22551754

Punkin Brown: http://www.hiddenmysteries.org/religion/pentecostal/snakeskill-fool.shtml

And one Glen Summerford, pastor of the Church of Jesus with Signs Following, attempted to murder his wife with a rattlesnake. The story in chronicled in the wonderful American Book Award winning and National Book Award nominated book SALVATION ON SAND MOUNTAIN by Dennis Covington.

Glen Summerford: https://www.newoxfordreview.org/reviews.jsp?did=1095-hartman

My third Samantha Cody thriller ORIGINAL SIN deals with such preachers. Sam visits her old friend Tennessee CV Surgeon Lucy Wagner and both find themselves entangled with the patriarch of a snake-handling church. And everything goes wrong.

 

OS 200X300

 

ORIGINAL SIN:

Dr. Lucy Wagner was on top of her game. The only cardiac surgeon on staff, a new pediatric cardiac unit dedicated to her, and an impeccable reputation not only put her at the apex of the local medical pyramid but also garnered a few powerful enemies. Such is the nature of jealousy and greed. Turf wars can get ugly. Still all was good until the day old John Scully, the spiritual founder and leader of a local snake-handling church, died on her operating table. Fainting spells, nightmarish dreams, and patient after patient succumbing to some violent psychosis followed, putting her career, and her life, in jeopardy. Aided by long time friend and ex-boxer, ex-cop Samantha Cody, Lucy must reach deeply into her family’s past and into her own soul to find the strength to confront old and very powerful forces she never knew existed.

More Info on ORIGINAL SIN: http://www.dplylemd.com/DPLyleMD/Books-SCody.html

 

Cat Poop and Cancer

toxo1

 

Toxoplasmosis.

That’s a big scary word. What it means is an infection with a parasite known as Toxoplasma gondii or T. gondii. And many millions of us are infected. Especially if you are owned by a cat. For the most part such infections are harmless and cause no symptoms or known problems but at times it can cause a flu-like syndrome and rarely severe illness. Here is an article from the CDC on this interesting little critter.

What’s interesting about a T. Gandii infection, or exposure, is that it causes an immune response in humans that is similar to that found in cancer victims. It’s possible that exploiting that immunological reaction could be a useful approach to cancer treatment. Much research lies ahead but it is interesting.

 
4 Comments

Posted by on July 29, 2014 in Medical Issues

 
 
Follow

Get every new post delivered to your Inbox.

Join 2,556 other followers