Prosopagnosia: I See You But Who Are You?

 

Heather Sellers doesn’t know who she is. I mean she knows, but she can’t recognize her own reflection in the mirror. Or the faces of others. She suffers from Prosopagnosia, or face blindness. It’s not as uncommon as you might think, but most often it is mild and only slightly aggravating.

Acquired prosopagnosia often results from head trauma, stroke, or developmental prosopagnosia (as Heather Sellers has) seems to genetically determined and begins at a young age, before the development of normal facial recognition abilities. How do these folks recognize family and friends? And themselves? Usually by some combination of voice, clothing, hair style, mannerisms, walking gate, body language, or some combination of these and other cues.

Here is an interesting video of someone who has this malady.

 

PTSD: Blame Your Hippocampus/Amygdala Complex

PTSD is an increasingly common psychiatric condition that has many origins and manifestations. As with most psychiatric conditions there has been a long of history of scientists searching for some physical explanation, or at least an underlying substrate for these conditions. Everything from schizophrenia to criminal behavior has been studied. PTSD is no different.

Now a new study from Duke University, published in the Archives of General Psychiatry last November, sheds new light on possible anatomical changes in those susceptible to developing PTSD. This alteration lies deep in the brain in the hippocampus/amygdala complex, which is part of the larger Limbic System, areas of the brain associated with emotions, stress responses, learning, memory, socialization, and many other things. The researchers studied 200 combat veterans and found that PTSD sufferers tended to have smaller amygdalar and hippocampal volumes as compared to “normal” subjects.

Does this mean we now have a test for determining who is vulnerable to developing PTSD? Not yet. But this study is a step in that direction.

My first Dub Walker thriller, STRESS FRACTURE, dealt with PTSD and its treatment.

 

 

Dystextia: A New Take On An Old Stroke Sign

“every where thinging days nighing”

“Some is where!”

 

 

This gibberish was texted by a 25-year-old, 11-week-pregnant woman to her husband. I know, you’re thinking it’s another case of autocorrect, that often annoying function on all these “not so smart” phones. But, that’s not the case.

She was taken to the Emergency Department where signs of a stroke–right-sided weakness, disorientation, and the inability to speak–were noted. An MRI confirmed the diagnosis. Fortunately, with anticoagulant treatment this young lady is doing fine.

Of the many signs of a stroke (Cerebrovascular Accident or CVA) and a TIA (Transient Ischemic Attack) difficulties with speech are the most variable and interesting. The medical term is aphasia. It can be receptive–the victim is unable to recognize spoken or written language–or expressive–the victim can’t say what he/she wants to say or it comes out as gibberish. Aphasia comes in many flavors and is a very odd symptom complex.

In this case, the aphasia was expressed as difficulty in “writing” a coherent text message. Dystextia seems like the correct moniker for this sign.

 

Q and A: Can My Chronic Arsenic Eater Die From Arsenic Poisoning?

Q: I am currently doing research for a historical novel, one of my main characters, a prosperous middle aged male, was an arsenic-eater who used this drug regularly for some time, at least two years probably longer, he became addicted to it and took increasingly large doses. He eventually died from an overdose of arsenic, possibly intentionally (as in suicide). Could you give me some information about what type of physical as well as psychological symptoms he may have had both as a habitual user as well as dying from n overdose of this drug?

Brandy Purdy, author of The Boleyn Wife, The Tudor Throne, and The Queen’s Pleasure

www.brandypurdy.com

http://brandypurdy.blogspot.com

A: Arsenic (AS) can cause both chronic and acute poisoning and it was indeed used in the past by many people as a folk remedy for almost anything. So was strychnine. Though chronic users can tolerate increasing doses there is still a tipping point because AS builds in the system over time until it becomes lethal—even if repeated small doses are taken. This can take weeks or months depending on dose. And if the dose is very small, one that matches the elimination of the AS from the body, then this can go on for decades. But if the intake is above the elimination rate, it will accumulate and eventually kill the taker.  For your story you don’t have to worry about the math just have your character use it for however long you want and the readers will assume the dose was too small to kill. And then when it accumulated to the point of death–or until someone either tampers with his dose or gives him an excess—have him become acutely ill and die and the readers will buy that also.

You used the word addiction here but that is not correct. AS is not addicting as would be a narcotic. It is not even habituating as are some sedatives and sleeping pills. If he stopped using it he would have no withdrawal and in fact would feel better as the effects of the AS faded.

The symptoms of AS toxicity are predominantly GI and neurological. Symptoms include nausea, vomiting, weight loss, diarrhea, abdominal pain, headaches, irritability, insomnia, poor balance, numbness and tingling of the extremities, and a few other symptoms. Your victim could have these in any combination and in any severity. His symptoms could be mostly GI, mostly neurological, or any combination of the two. They can be constant, progressive, or wax and wane. And if he used very small amounts, he might have no symptoms at all.

With acute poisoning these symptoms can be very severe and appear quickly and violently. His vomiting and diarrhea would be bloody and his abdominal pain severe. With an acute poisoning, death can take many hours and is not pleasant. He could take the AS for many months or years and feel fine and then begin to develop the above symptoms, mild at first, but they would progress in severity until he died. This progression could be over a few days, weeks, or months. Anything is possible. And, if someone gave him a large dose on top of this progression in toxicity, he could die within hours.

FOLLOW UP Q: Thank you very much, that does help but I am confused about something. Is a psychological addiction or dependency possible? In his diaries this man writes about taking larger doses and feeling stronger and being in terrible pain and headaches, vomiting, and coldness or numbness in his hands and feet, when something prevents him from having his regular doses. That’s why I used the word addiction, I assumed this was withdrawal, but I didn’t realize this was not a part of arsenic use.

FOLLOW UP A: Yes that’s possible. It’s called the placebo effect–means that if someone believes that something helps them then it will. Health food stores have made a living off this for years. If he felt that the AS made him stronger and when he couldn’t get it he would be weaker then he could easily feel that way. The truth is the exact opposite, since AS toxicity actually makes one weaker not stronger. But reality is perception. This would be a form of “psychological addiction” for lack of a more accurate term. So go with it since whatever he believes is true is true to him and that’s really all that counts in his world.

 

 

I Smell Your Fear

The most primitive of our senses is olfactory–the sense of smell. It is also the most emotionally powerful. Once we have smelled something it is filed in our brains forever, and if we ever encounter the odor again, it is almost instantly recalled. Often with memories of that first encounter. A certain food, perfume, chemical, you name it, can pull us back in time more deeply than can any sight or sound.

 

 

But can you smell another’s emotion? Can you detect fear, or anger, or disgust with your nose? Animals can. If one dog or gazelle or wildebeest in a group senses fear, the other members of the group immediately sense the same danger. Herd mentality. Some of this might be transmitted through body language or certain movements, even facial expressions, but pheromones released by the concerned group member play a big role. So why shouldn’t we humans have the same ability?

Apparently, we do.

If the results of a recent study done by Gün Semin and colleagues from Utrecht University and published in Psychological Science can be believed, humans possess the ability to communicate emotions through chemical signals. This is an interesting study that used sweat to analyze these chemical transmitters.

 

Fake Pot Can Take Out Your Kidneys

News Flash: Illicit drug manufacturers are not chemists. They do not have BS, MA, or PhD degrees. They do not work for Johnson & Johnson or Pfizer or even your local pharmacy. What they do is mix up unknown substances in a used cat box in a dingy garage and sell it to kids.

Case is point: Spice or K2. These are synthetic cannabinoid compounds—basically fake pot. Sure they get you high. Sure they turn a frat party into a psychedelic funhouse, but they can also land you in a dialysis unit. Not that sounds like fun, doesn’t it?

As Jimi would say: “Purple Haze all in my brain.”

Of course, sadly, Jimi is dead.

 

 

Q and A: What Potentially Fatal Disease Could My Young Female Character Suffer From in 1955?

Q: I have been browsing through FORENSICS AND FICTION but do not see the perfect solution for my story. In my WIP, set in 1955 St. Louis, a 10 year old girl has a medical problem which is difficult to diagnose. She has been living on the streets but is rescued by an older woman who takes her for medical help. Once the doctor determines the problem, he recommends treatment. Trouble is, the only place for treatment is California, so they must take a road trip. (I want it to be CA because I want them to travel on Route 66)

At first, I considered exposure to sewer gas as a good diagnosis. But once she got out of the sewers she would get well. That won’t do. I’m thinking it must be an autoimmune disease or a parasitic or unusual infectious disease. Can you think of a fatal disease in those categories which would have had cutting edge treatment being done experimentally in CA in the 50s?

Catherine Leggitt, Author, Inspirational Speaker

www.catherineleggitt.com

A: As you pointed out, sewer gas wouldn’t work since once your young lady was free of the environment its effects quickly reverse. I would suggest leukemia. In 1955, acute leukemia in a child that age was common, there was no treatment, and most sufferers died. The mortality remained around 90% for many types of leukemia until well into the 1970s. It could be months or many years between first becoming ill and dying, but death was almost inevitable in 1950s. The timeline would depend on how aggressive the particular leukemia was and how well your child handled it. But medicine could do very little.

In leukemia, white blood cells (WBCs) are overproduced by the bone marrow. These cells are abnormal in that they don’t fight diseases as do normal WBCs. This would leave the child susceptible to infections such as pneumonia, urinary tract infections, even the flu. Each bout of any of these could be weathered with antibiotics—penicillin and sulfa drugs were around in 1955—or she could die from any of these diseases.

Leukemia Cells are seen here as large and purple; the smaller pale red ones are RBCs

As the WBCs increase in the bone marrow they literally “squeeze out” the marrow cells that make red blood cells (RBCs) and platelets. Low RBCs we call anemia and here she would be fatigued, short of breath with activity, and her physical abilities would be limited by these factors. She might appear pale and take on the look of someone who is chronically fatigued, which she would be. Platelets are involved in blood clotting so with low platelets she would bleed easily, with even the most minor trauma. She could easily have episodic nose bleeds and would bruise very easily.

Most leukemia victims suffered all three of these derangements–high but abnormal WBCs, low RBCs, and low platelets–so your girl could have any of the above symptoms, in any combination, and in any degree of severity.

Since there were no effective treatments in 1955, patients and parents sought all kinds of treatments. Herbs, electrical current, tonics of all types (most of which were alcohol based), faith healers, and almost anything you can think of. Your young girl could easily be referred to someone “out in California” by her local St. Louis doctor.

This should give you a lot to work with for your story.

Google Leukemia and you will find many sources but remember that things are much different now than in 1955. Here are a couple of links to get started:

http://serc.carleton.edu/woburn/overarching/leuk_treatment.html 

http://www.nature.com/leu/journal/v15/n4/full/2402065a.html

 

Q and A: Can My Character Survive An Arrow to the Back Yet Have Long-term Pain?

Q: In my fantasy world, a healthy young man of about twenty-three gets shot in the lumbar portion of the back with an arrow. The physicians manage to remove most of it, but left behind fragments that were too close to his spine. He lives until fifty years old, but suffers from bouts of agonizing pain, numbness and tingling in his legs and feet, and sometimes trouble walking. Would it be viable for someone to live almost twenty-five years with pieces of an arrow lodged in their back? And do the symptoms I describe coincide with that sort of spinal trauma?

Liz Penn, author of ISHTAR FLUX

 

A: Yes, this could easily happen and it doesn’t even require that fragments are left behind because the scar tissue left from the injury and from the surgery to remove the arrow could also irritate the lumbar spinal column and the nerves that arise from it. This scar tissue would remain forever and could cause chronic low back pain, pain down the leg, numbness and tingling, and could even interfere with what we call proprioception–the feeling of where your foot is. This could easily cause him pain and trouble with walking. If you want fragments to be left behind it would be best that the arrow were made of ancient materials such as flint, which is what many American Indian tribes used, since modern metal arrowheads don’t easily fracture and would likely be easily removed as one piece. It is of course possible that a small piece could break off the tip but if you want fragments I would go with the flint variety.

 

 

Quacks Are Everywhere and Have Been For a Long time

One of the things I like about reading the Journal of the American Medical Association (JAMA) is the section on articles published in the Journal 100 years ago. In November of this year an interesting article that was published on November 9, 1912 was republished. There was titled “Telepathic Diagnosis!”

It seems that Dr. J. A. Quackenbos uncovered the story of a telepathic Belgian woman who apparently had the power to diagnose diseases from afar. It seems to perform her magic she must be put into a quasi-trance by hypnosis and from there she can psychically travel to the afflicted person and look inside them and determine what their medical problem might be. Wow. Wish I could do that. It would’ve saved me countless hours of head scratching and worry over the past 40 years.

Patent Medicines

At first glance you might think that Dr. Quackenbos is the origin of the term quack. But that’s not the case. It actually comes from the old Dutch word kwakzalver, which means  a person who chatters or prattles. From that the word quack, which means someone who fraudulently pretends to have medical skills that are not real, evolved. Quacks have been with us throughout history from the ancient patent medicine and snake oil salesman to the modern day manufacturers of pills and tonics and potions that are supposed to cure everything from schizophrenia to diabetes. Is all PT Barnum supposedly said, “There’s a sucker born every minute.”

 

PT Barnum and Tom Thumb

 

 

A New Small and Fast DNA Analyzer

One question I’m often asked is how long it takes to get a DNA result back from the lab. Currently it can be a few hours though a day or two, at best, is more realistic for most labs. But now it looks like NEC is working on a new suit-case-sized DNA analyzer that uses microfluidic “lab-on-a-chip” technology and can do the job in about an hour. Their goal is to lower that to around 25 minutes.

This microfluidic technology has many medical and research uses and a couple of the gadgets are roaming around Mars on the rover. This new DNA technology bears watching.

Curiosity Rover