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Category Archives: Q&A

Q and A: How Would the Time of Death Be Determined in a Corpse Found in Snow?

Q: In my story, the body of a young woman is found by cross-country skiers in high-mountain country. (Average temps in December: 20 degrees/low to 40 degrees/high;  elevation about 9000 ft.) If the person had been dressed in heavy clothes, and the body had been there about 24 hours, would it be completely frozen? Partially? Would there be any way to determine when death had occurred?

MT, Albuquerque, NM

Jack-Frozen

A: The corpse would be at least partially and could be completely frozen–perhaps with some of the deeper internal organs only partially frozen. It depends on the clothing, exposure, moisture, wind, etc. Also the old rule that whatever happens, happens comes into play here. So the freezing could be either complete or partial.

Under these conditions, rigor and lividity would be delayed to an unpredictable degree so these would be very crude indicators and not very useful in determining the time of death (TOD). Body temperature might be more useful—emphasis on might—but this would not be very accurate either. If the core body temp had reached the ambient temperature, this determination is of no use, since once the corpse reaches the ambient temperature it will remain stable at that temperature, making body temperature useless. For example, if the corpse reached the ambient temp after 18 hours then 24 hours would look like 36 or 48 as far as body temp is concerned.

But if the corpse hasn’t reached ambient temperature, core body temp can be used to estimate the TOD. Not very accurately but at least in the ballpark. Under “normal” circumstances, a body loses heat at about 1.5 degrees per hour, but this depends on many variables. Your scenario is definitely not “normal,” so temp would be lost more rapidly. Could be 2 or 3 or 4 degrees per hour if there is wind or cold rain for example. Let’s say the ME found the core temp was 40 with an ambient temp of 30. This means the body is still cooling since it has not yet reached ambient temperature. Let’s also say that in his experience he believes (educated guess at best) the body would lose about 3 degrees per hour under the circumstances he sees at the scene. If so, subtracting the measured corpse temperature (40 degrees) from the normal body temperature (98) and dividing by the rate of loss (3 degrees/hour) would yield the estimated TOD.

The math: 98-40 = 58; 58/3 = 19 hours.

Based on these calculations, your ME might conclude that the death occurred approximately 19 hours earlier, give or take a couple of hours.

Of course the major flaw here is that the actual rate of temperature loss might vary from his estimate so, despite the math, his assessment remains a best guess. He would likely suggest a broad range—maybe saying the TOD was between 16 and 24 hours earlier. That’s really the best he could do.

So your corpse could be partially or completely frozen and the time of death could be difficult to determine. Except for one more trick: stomach contents.

Let’s say the corpse is frozen so that temp, rigor, and lividity are of no help yet it was known that the victim had eaten a certain food at a certain time prior to his disappearance. It takes the stomach 2-3 or so hours to empty after a meal so if the ME found the undigested meal in the victim’s stomach and knew the time of this final meal from witnesses, he could then more accurately place the time of death as within 2-3 hours after that meal. Let’s say he had lunch around noon, went skiing, and was then found dead 24 hours later. If the ME found that last meal still in his stomach he might suggest that the TOD was between 1 and 4 p.m. the day before. This might be your best bet for narrowing down the TOD.

 
 

Q and A: Can My Female Character Cause Her Pregnancy To Become A “Stone Baby” By Shear Will?

Q: I am writing a story about a woman who, through sheer force of will, doesn’t allow her body to complete childbirth. The baby dies and becomes a lithopedia. My questions are:

Will there be bleeding in spite of the labor stopping? What happens to the placenta? Will the body absorb it or will it harden like some kind cocoon? Will the mother lactate? Will it cause the mother pain to carry the stone baby? Will the woman have periods? Is it plausible that the mother’s body will experience contractions years later? Or pains caused by the stone baby that she could believe are contractions? How long does it take the fetus to calcify into the lithopedia?

Nicole Nelson-Hicks, Nashville, TN

A: First of all, there is no way she could stop her pregnancy, labor, or delivery by simple force of will. The body will do what the body does and it will eject the fetus either as a stillbirth or a live child. There is no way to stop this.

Secondly, lithopedia (stone babies—singular lithopedion) tend to occur in abdominal pregnancies as opposed to intrauterine pregnancies, even though it is possible for the fetus to remain within the uterus. Conception actually takes place in the fallopian tube as the egg descends and the sperm rises – at least in most cases. A tubal pregnancy can result where the fetus grows within the fallopian tube and rarely the fertilized egg will escape the end of the fallopian tube and settle within the abdomen. Sometimes the blood supply is established and the child can grow within the abdomen. Rarely to term but it can grow. It would take 12 or so weeks for the fetus to reach a size that would be easily visible.

x-ray

In this situation sometimes the tissues of the dead fetus are not absorbed by the body but rather become walled off with fibrous tissue and this can often then calcify which is where the term stone baby comes from.

Lithopedion

Often the woman will have no knowledge of this whatsoever and women have lived late in life, and indeed very late in life, and not know this has occurred. It is often found on an abdominal x-ray that is taken for some other reason. But she could feel the discomfort or have some sensation of a mass or fullness in her abdomen and it could be discovered as a result of that.

If the pregnancy were outside the uterus and in the abdomen, as is most likely in these exceedingly rare circumstances, she would not lactate because those hormones don’t appear until very late in the pregnancy. She would most likely have normal periods, and could even become pregnant again since the uterus, ovaries, and fallopian tubes would be normal and would continue to function normally.

However, if the fetus remained within the uterus, this could interfere with future pregnancies, though not always. It would be very similar to a woman who had large fibroids, which are muscular masses that develop with in the muscular wall of the uterus and often cause pain and abnormal bleeding. Sometimes normal pregnancies occur despite these and that could be the case here.

It is possible that she could experience discomfort many years later with the fetus being located in either the uterus or the abdomen so that part of your story would work quite well.

In summary, this is an exceedingly rare circumstance and it is nothing that she could force to happen. Most likely it would be with an abdominal pregnancy but it could be an intrauterine pregnancy—though this would be even more rare. If an abdominal pregnancy, she could easily go through life normally and have other children and be completely unaware or she can develop symptoms later as I described above. If the pregnancy were intrauterine, she would likely have more symptoms and more likely be aware that something wasn’t right. But in either circumstance it would be possible for her to have normal periods and even become pregnant again.

 
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Posted by on January 28, 2014 in Medical Issues, Q&A

 

Life Imitating Art? Murder or Accident?

It’s been said that art imitates life and that often life imitates art? Is the death of “spy” Gareth Williams a murder or a tragic case of autoerotic asphyxia? Is it a true mystery anticipated by an author’s question?

 

460x

 

The Story:

http://bigstory.ap.org/article/police-spy-bag-probably-died-accident

The Question:

http://writersforensicsblog.wordpress.com/2011/09/18/q-and-a-can-a-murder-be-staged-to-look-like-an-accidental-death-from-autoerotic-asphyxia/

Two other posts on autoerotic asphyxia:

http://writersforensicsblog.wordpress.com/2009/06/02/autoerotic-asphyxia-a-very-bizarre-case/

http://writersforensicsblog.wordpress.com/2009/06/05/autoerotic-asphyxia-redux-david-carradine/

 

 

Q and A: Can My Villain “Force Feed” Pills To a Dead Woman?

Q: My hero, an investigative journalist, is looking into the death of a woman at an acid house/rave party in the early 1990′s. The novel is set in the present day and so the hero has no access to the body, just autopsy reports, coroners reports, the transcript of the inquest, etc. The woman was a light user of Ecstasy but the autopsy discovered that she had 70 ecstasy pills in her stomach. The scenario I want to create is that the hero discovers that while the woman took some of the pills willingly, she was then force fed others, and then after she died she was force fed yet more. In order for this scenario to work I’m wondering the following:

1) For how long after death does stomach acid continue to operate?

2) For how long after death would the digestive system continue to break down the ecstasy and would the ecstasy continue to be absorbed into the bloodstream?

3) Is it likely/possible that a sizeable amount of pills would remain undigested in her stomach, bearing in mind that the body was not found for a number of hours?

4) What injuries/signs on the body would there be of someone force feeding her the pills?

5) Is it possible to force feed somebody pills after death, how would they get the corpse to “swallow” and what injuries might be caused to the body as a result?

James, St Albans, UK.

 

PIlls

 

 

A: At death, all metabolic processes cease immediately since there is no longer blood flow to keep these processes going or even to keep the tissues and cells responsible for these activities alive. This includes the digestive processes. Sure there could still be a small amount of acid effect but this would only be from the acid in the stomach at the time of death and this would be quickly neutralized by the materials the acid was combining with. The bottom line is that all digestive processes cease immediately on death, more or less freezing the stomach contents in time. This is also true for the level of most toxins in the blood and urine, which offers the medical examiner a tool for determining the cause and time of death.

At death, the stomach would no longer move or churn or secrete acids and digestive enzymes so the ecstasy would remain intact as it was at the time of death. Yes there could conceivably be residual whole pills and in fact this is not uncommon in overdoses of all kinds. Some dissolve and are absorbed prior to death and others do not and these remnants can then be tested to determine what they are. All the stomach contents would remain intact until the decay process destroyed them, so if the body was found in a reasonable period of time, the stomach contents could be analyzed for their chemical characteristics, which would include the presence of any drugs or alcohol.

It is very difficult to force-feed a living person pills and so doing could lead to trauma around the mouth and face as the pills were shoved into the victim’s mouth and his mouth and nose held close until he swallowed. Or there could be no trauma and in which case there would be no way of knowing this. But evidence of trauma might suggest a force-feeding. It would be a best guess but an experienced medical examiner can usually make this determination. Since all processes and movement by the deceased stop at death, swallowing cannot occur and force-feeding a corpse is impossible. The pills would simply collect in the mouth and throat.

In your victim there could easily be undigested pills and toxicological testing of these, and of course blood and urine, would reveal what chemicals were in the victim’s stomach and system. Since your body is found several hours later there would be essentially no decay and therefore everything in the bloodstream and in the stomach would remain intact more or less as it was at the time of death. With facial trauma the ME might consider that the OD was forced, and in the absence of such evidence might simply think it was an intentional or accidental OD.

Also this ARTICLE on my website might help.

 

Q and A: Can My 1920’s Linguist Effect A Permanent Change in Another Character’s Voice?

Q: In my story, set in a time analogous to the 1920s, an errant linguist captures a young male prostitute. She hopes to recreate him into her lost daughter, which is part of a longer investigation to discover how her daughter died at her finishing school. Part of the prostitute’s transformation involves a vocal shift upward into a more feminine range.

My question: Supposing the linguist is understandably obsessive, the prostitute is helpless, and there are some generous funds available to fuel her undertaking, how long would it take for the vocal feminization techniques to have a convincing (and consistent) effect? What other aspects would their therapy focus on–semantics, syntax, word choice? Should the prostitute regain his freedom after about nine months of speaking in this artificial way, would it be difficult for him to resume speaking in his normal range?

A. Luschei, Ladera Ranch, CA 

 

A: The technique you describe is simply a different form of speech pattern where the individual is trained to talk in a certain way and at a different timbre. This is the same thing that actors do when practicing for a role that requires a certain accent or speech pattern. This is learned behavior and does not change the individual’s natural speaking voice. He could at any time fall back into his normal voice though the longer he spoke in the new voice the more difficulty he might have in unlearning this behavior. The point is that this learned behavior doesn’t cause a permanent change in his voice because he must always use the affected voice and be conscious, at least on some level, of doing so.

 

Adam's Apple

 

But there are surgical procedures that alter the timbre of the person’s voice. In the situation you describe it would be called vocal feminization. These procedures often involve suturing the thyroid cartilage (Adams Apple) and the cricoid cartilage closer together. This would cause a more permanent change. I don’t think these were done in the 1920s so you’re left with the linguist teaching the young man a type of affected speech. This training would include syntax, word choice, rate and pattern of speech, as well as things like facial expressions, body language, and hand gestures.

 

 
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Posted by on September 16, 2013 in Medical Issues, Q&A

 

Q and A: Can My ME Uncover Drugs in a Charred Corpse?

Q: I have two characters who are found dead in their house, having been at the center of a fire that turned into a wildfire. Before the fire, a hitman gave them some type of medication that he believed would not be detected in an autopsy to cause them to go unconscious or unable to move while he set the fire around them and escaped. The idea is that I want it to look — on the outside, at least — as though they accidentally caused the wildfire, starting in their home in the forest. Then, it’s discovered that they were, technically, murdered by someone giving them a strong sedative (or something) and they were burned in the fire.

When the medical examiner does the autopsy, what is he likely to be able to notice? I read that bodies are usually not burned completely in a fire, but what would the ME find? What kinds of things would he notice and talk about in the report?

Is there a drug that would have a sedative effect on the characters that would NOT show up in an autopsy? Or something that might show up with a particular test and what reasons could an ME have to run that test?

Kari Wolfe, Colorado Springs, CO

 

Iraqi Convoy Bombed During Persian Gulf War

 

A: You are correct that fires rarely destroy a body completely. The fire simply does not burn hot enough or long enough to completely destroy the body in most structure and automobile fires. The same would hold for wildfires. The body would likely be charged severely on the outside and for several inches down but deep inside most tissues would remain intact. This would allow the medical examiner to test the muscles, brain tissue, liver, blood, bone marrow, urine, and the vitreous humor inside the eyes for various drugs.

Almost any narcotic or sedative would work for your purposes but most of these are easily found with even simple toxicological screening and for sure by more sophisticated toxicological testing using gas chromatography and mass spectroscopy.

More sophisticated drugs are not revealed by a routine drug screen and therefore more difficult to find. Add to this the fact that the medical examiner might have no reason to go to the time and expense of looking for more esoteric toxins if all evidence pointed to the victim having died in the fire.

But what if the victim didn’t die in the fire? What if the victim was already dead before the fire started? This would change everything since in that case the medical examiner could not say that the cause of death was asphyxia from the fire but rather that something else must have killed the victim. In the absence of overt trauma or another obvious cause of death, the ME would likely do more complete toxicological testing.

 

How would the ME determine that the victim was dead before the fire? One clue would be the carbon monoxide level in the blood. If this is low, the victim was not breathing while the fire was consuming him. If the carbon monoxide level was high it would indicate that he was breathing and had inhaled carbon monoxide, which comes from the burning of wood and almost any other product. The normal carbon monoxide level is less than 5% but in victims of fire it can be 60 to 90%.

Also, if the victim was still breathing during the fire he would inhale soot and heat. The heat would damage the throat and airways and soot and other fire debris would be inhaled deeply into the lungs. Finding these would indicate the victim was alive while the fire burned and not finding them would suggest a prior death. This latter situation could launch a more complete toxicological analysis of the remains and ultimately lead to the lethal drug. Such testing could take many weeks, even months, so that you can delay the discovery of the true cause of death for almost as long as you need for story purposes.

Rare toxins you might consider would be succinylcholine, PSP (paralytic shellfish poisons), Rohypnol, GHB, and a few others.

 

Q and A: Can a Blow to the Head Render My Character Blind?

Q: My male character hits his head on a wall, rendering him blind. How long would he be blinded for, once the swelling that caused it goes down? Any long term effects, such as headaches and that?

Michelle Cunin, Alliance, Ohio

A: Blunt trauma to the head if it is severe enough to cause a cerebral contusion (brain bruise), where by definition there is some degree of bleeding into and swelling of the brain tissues as a result of the trauma, can easily cause a malfunction in that area of the brain. If it is the area of the brain that controls vision, your victim could easily have blindness. We call this cortical blindness since it arises from the cortex of the brain and not from the eye or from the optic nerve. In other words the loss of the ability to see comes from the brain itself. The visual cortex, the part of the brain that controls seeing, is in the very back of the brain in what we call the occipital lobe. In order for your victim to be completely blind both halves of the brain would have to be damaged otherwise he would only lose vision to his right side or his left side but not both. But this could easily happen with a blow to the back of the head or can occur after a fall where the back of the head strikes a wall, the floor, stairs, or almost anything else.

 

431px-Gray722_refined.svg

 

If the injury were severe enough to significantly damage the optical cortex then his blindness could be permanent but in most cases once the bleeding inside the brain stops and the swelling resolves, vision will return. This could take a few hours or many weeks so you have a broad range to consider when constructing your story. Any of these are possible.

The victim’s blindness might be complete or only partial in that he might be able to see shadows and shapes or one half of his visual field might be clearer than the other. This later situation would indicate that one side of the brain was damaged more severely than the other. If it were the left occipital lobe that was more severely damaged then the right half of his visual field would be the most affected. If he were struck in the left back side of the head, for example, he could lose vision of the entire right side of his visual field. It would appear as if a line had been drawn down the center of his visual field and everything to the right of the line would be black while to the left all would be normal. But since you want him completely blind it would require injuries to both occipital lobes.

Whether his vision returns or not, he could suffer from long-term headaches, dizziness, poor balance, and a few other symptoms but he could also return to complete normalcy. These symptoms could last a few days, months, or forever. All is possible.

 

 

 
25 Comments

Posted by on July 1, 2013 in Medical Issues, Q&A, Trauma

 

Q and A: Can My ME Determine If a Child Died From Exposure As Opposed To Being Locked in a Heated Vehicle?

Q: In my story, a police officer is on the scene where the body of a 3 year old child was found among the rocks and weeds of a dried up riverbed in Southern California. It is early summer. Can the CSI techs or the ME determine if the child died from being locked up in a heated car rather than from exposure to the elements where the body was found?

Jack Dietz, Production Coordinator, Las Vegas, NV

A: The simple answer is that this is not very likely however there might be a way. Much depends on the condition of the body. If it is severely decayed or has become skeletal, the ME would have little to work with and there would be no way to determine exactly where the death occurred. In either case the death would be from that catchall term “exposure.” What that means is that the victim died from lack of water or food, with water of course being the most important. Exposure deaths are almost always due to severe dehydration.

However, if the child is found within a day or two of death, the body would be more or less intact and the ME might be able to estimate where the death had occurred, given the two choices you outlined. One difference would be insect activity. If the child died in the trunk as opposed to being exposed outdoors there would be less insect activity for the amount of time since death than would be expected from an exposed corpse. If the ME determined that the child had been dead for 2 or 3 days yet there was essentially no insect activity, it would mean that she had been in a protected environment, such as an enclosed car or car trunk, for those 2 or 3 days and only exposed for maybe a few hours. On the other hand, if he found insect activity that matched his estimate of the time since death, this would favor her being in an exposed environment for those 2 to 3 days. It’s not that flies can’t get into car trunks, it’s just that most trunks are so well sealed, fly access would be very limited, if at all.

On a similar note, predatory animals would not be able to attack the body while it was in the car but if exposed predator feeding on an exposed body is fairly common. Coyotes are everywhere. Predator activity would suggest a longer period of environmental exposure.

fiberanalysis2

 

One circumstance that might be interesting for you would be if the child died in either the trunk or on the floorboard of the car. As she died from hyperthermia and dehydration, she would increasingly gasp for breath toward the end of her life and could inhale carpet fibers from the trunk lining or floor carpets. This would not happen if death occurred while exposed outside. This would of course require that the body be in fairly good condition. I think as long as you have the body found within a few days, the decay process would not have progressed far enough for the lungs to be destroyed and the medical examiner might see these fibers during his microscopic examination of lung tissue. Once he found these fibers, he would know that the victim had inhaled them and therefore was alive while in the car. So finding the fibers would at least allow the medical examiner to guess that she had been in the car near or shortly before her death.

fiberanalysis

 

Another interesting thing about this scenario is that the ME could then analyze these fibers physically, optically, and chemically and determine the manufacturer of the carpet and this in turn could lead to the car manufacturer and even the make and model year–or at least a narrow range of years since car manufacturers change their products quite frequently. This would greatly help your police officer develop suspects.

 

 

Q and A: Can My ME Distinguish Death From Asphyxia From Death Due to Head Trauma?

Q: Here’s my book situation: A man puts a plastic bag over his head to kill himself. His wife wakes up next to him (after he nearly strangled her to death and she discovers he’s killed their son) and in her horror and rage cracks him over the head with a blunt object.

Here’s my question: Can the police/coroner/forensics determine which was the cause of death–suffocation or blunt force trauma? If so, what would the signs be pointing to asphyxiation?  Also, if it matters, this is set in 1969.

Judy Merrill Larsen, author of All the Numbers

http://www.judymerrilllarsen.com

A: If the victim died first from the asphyxia, the ME would have no problem since the blow to the head would cause no bruising or bleeding. At death the heart stops and blood flow ceases and a corpse will not bleed or bruise easily. So the ME would see a mark where the victim was struck but no bleeding or bruising and know that the blow was delivered post-mortem.

If he was still alive when struck, things become a little more difficult for the ME but he should still be able to tell. Bruising and bleeding at the site of the blunt trauma would show that the victim was alive when struck but if there is no significant brain injury found at autopsy he would know that the force of the blow did not cause death and the asphyxia must have. If there is a brain injury such as cerebral contusion (brain bruise) or bleeding into or around the brain, he might have difficulty determining the actual cause of death. Of course any evidence of blunt trauma would point to homicide and not suicide since someone using a plastic bag for suicide would not likely also strike themselves in the head.

But I see a bigger problem with your scenario. If she was unconscious from being strangled, she would wake up within 10 seconds to a minute or so after the pressure was released unless she had significant brain injury from lack of oxygen. If she were simply strangled into unconsciousness, which is due to blocking blood flow thru the carotid arteries to the brain and not blocking breathing, as soon as the pressure was released and blood flow reestablished, she would wake up very quickly. Much sooner than he could put a bag on his head and die from asphyxia. For her to be out that long would require some degree of brain injury and I don’t think that’s what you want. Of course, if he drugged her first and then strangled her to the point he thought she was dead, but she in fact wasn’t, then she would awaken when the drug effect wore off. Here he could be dead for hours before she awakened.

 

 

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.

 

 
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Posted by on March 25, 2013 in Medical Issues, Poisons & Drugs, Q&A

 
 
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