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Category Archives: Medical Issues

Father’s Unborn Twin Is the Genetic “Father” of His Son

A couple of years ago a happy couple in Washington welcomed a new baby boy. All was good until a paternity test showed that the father was not the father. Uh-oh. Well, it’s not really that bad. Turns out that genetic testing revealed the father was a chimera and the genetic testing was confused by his unborn twin’s DNA, which the father had absorbed in utero. Chimerism is an odd and interesting medical entity.

 

Greek Chimera

In Greek Mythology, the Chimera was a fire-breathing female that was part lion, part goat, and part dragon. Fortunately, human chimeras, which result from the combining of two or more human embryos in utero, are typically normal in every way—-except for that DNA stuff.

I’ve blogged and had Guest Bloggers comment on chimeras before:

Q&A: How Could My Sleuth Recognize a Chimera?

https://writersforensicsblog.wordpress.com/2010/07/05/qa-how-could-my-sleuth-recognize-a-chimera/

Guest Blogger: EE Giorgi: I Am My Mother’s Chimera. Chances Are, So Are You

https://writersforensicsblog.wordpress.com/2014/04/09/guest-blogger-ee-giorgi-i-am-my-mothers-chimera-chances-are-so-are-you/

Guest Blogger: Human Chimerism: Mindboggling DNA Tests Gone Wrong

https://writersforensicsblog.wordpress.com/2010/06/24/human-chimerism-mindboggling-dna-tests-gone-wrong-guest-blogger/

http://www.people.com/article/man-fails-paternity-test-twins-genes

 

Laughter Is Good Medicine

Originally posted on Mystery Fanfare:

http://mysteryreadersinc.blogspot.com/2016/06/laughter-is-good-medicine-by-dp-lyle.html

Laughter Is Good Medicine

I love to laugh. Bet you do too.

It’s good for you. It relieves stress, lowers blood pressure, and might even boost your immune system and make you healthier, definitely happier. I use it every day in my practice. With virtually every patient I see, after going through all the medical stuff, the last thing I say to them as they leave the office is: “Laugh a lot.” It’s that important.

I grew up with humor. My mom could turn anything into a party and always seemed to find the funny in everything. Dad had a drier sense of humor, but a sense of humor none the less. My sisters, cousins, and friends each had great wit.

In my early teens, as I began reading novels, I was captured by the usual suspects—Hemingway, Steinbeck, Verne—but also by the great humorists Mark Twain and Will Rogers. Later I dug into more modern humor writers like Carl Hiaasen and Tim Maleeny. I admired how each employed humor and downright knee-slapping funny in their essays and works of fiction.

Most of my early work is harsher—darker stuff with very bad guys—but I always included splashes of humor. I couldn’t help myself. Besides, humor is a great way to diffuse tension and humanize characters. But I had long wanted to write a more comedic thriller. And finally, I did.

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DEEP SIX is a humorous thriller starring Jake Longly, ex professional baseball player, Gulf Coast bar/restaurant owner, and someone who’d rather run his dive and chase bikinis than do “honest work.” At least that was his father Ray’s take. Ray has a gray past, being involved in government secret ops of some kind—Jake never knew and Ray never shared—but is now a P.I. He wants Jake to work for him. Not a chance.

But, Ray does talk Jake into doing a bit of surveillance work—watching the house of a suspected adulteress. Of course, the woman gets murdered practically under Jake’s nose. And the story is off and running.

Jake, and his latest girlfriend Nicole Jemison. turn out to be fairly effective P.I.s—though Jake is reluctant to wear that mantel. But they can’t seem to stay out of trouble, and out of the crosshairs of the ruthless Victor Bookoff and his minions. Throw in Jake’s ex Tammy and her new husband and attorney Walter, who it turns out was having an affair with the deceased woman and naturally becomes the primary suspect, along with a couple of thugs and cartel hitmen, and well—-the pot boils.

After I finished DEEP SIX, I loved it. But would others? I mean, humor is hard to judge. One person’s funny is another’s ho hum. Very tricky stuff. Turned out my agent Kimberley Cameron and publishers Bob and Pat Gussin at Oceanview did indeed love it.

Now that makes me laugh.

As Lee Child said: “We all know Lyle’s erudition and expertise—-but who knew he was this funny?”

Certainly not my cat, who sees all this as annoying and not about him—the prerequisite for him to find anything interesting. Well, you can’t make everyone laugh.

DEEP SIX is available July 5, 2016.

More Information and to Pre-order a copy:

http://www.dplylemd.com/book-details/deep-six/

 
2 Comments

Posted by on June 30, 2016 in Medical Issues, Writing

 

The Kiss of Death: Beware a PBJ Sandwich

Anaphylaxis can kill you. And do so very quickly and unexpectedly.

Our immune system protects us every minute of every day by attacking microscopic creatures that could do us harm. Things such as viruses, bacteria, and other invaders. When a foreign organism enters our body, the immune system recognizes it and immediately goes to work building antibodies against it. These antibodies attach to the foreign organism and attract various blood cells to it. Mostly the various types of White Blood Cells (WBCs) we all have. The cells then damage and devour the invader. That’s a good thing.

Abs-6

But sometimes this protective system goes haywire. It over-reacts. It creates substances that lead to an acute asthmatic attack, a diffuse rash, a swelling of the face and hands and feet and other body parts, and a dramatic, and often deadly, drop in blood pressure. We call such an overwhelming reaction  anaphylactic shock.

The treatment for anaphylaxis is the immediate injection of epinephrine, antihistamines, and steroids. These either block the allergic reaction itself or mitigate the body’s reaction to it. But time is critical. These measures must be taken very quickly. This is why many people who have serious allergies carry small epinephrine injectors such as EpiPen.

Someone who is allergic to things such as bee stings, peanuts, certain foods or plants, or some medications can suffer such a reaction even if exposed to very small quantities of the allergen. A little dab can set off a major reaction.

Case in point: Myriam Ducre-Lemay.

Myriam was allergic to peanuts. She avoided them like the plague. But one evening, her boyfriend kissed her after he had eaten peanut butter and this set off an anaphylactic reaction that took her life.

peanut-butter

Mayo Clinic Article: http://www.mayoclinic.org/diseases-conditions/anaphylaxis/basics/definition/con-20014324

Wikipedia Article: https://en.wikipedia.org/wiki/Anaphylaxis

 

Q&A: What Injuries Can Occur With a Car Bomb?

Q&A: What Injuries Can Occur With a Car Bomb?

Q: How far away would you have to be from a car bomb (the kind that is detonated by starting the car) to survive with injuries and what sorts of injuries might you sustain in the blast?

car bomb

 

A: This is a question that is virtually impossible to answer with any degree of accuracy. There are entirely too many variables involved. How big is the bomb? How big is the car? How close is close? What direction does the shrapnel fly and in which direction is the concussive force of the bomb directed? Are there any intervening walls or structures that might dampen the concussive force or block or redirect the shrapnel? Each of these variables, and many others, must be taken into account before any prediction of possible injuries can be entertained.

Lets look at a few general principles however. Big bombs cause big problems and little bombs cause less. A large bomb can produce a massive concussive force that will spread out for many yards in every direction. It can also produce shrapnel that can fly many hundreds of feet. A small bomb, needless to say, would release a smaller concussive force and any shrapnel would move at a slower rate and therefore do less damage.

Let’s assume that this is a moderate sized bomb and the victim is standing close enough to receive injuries from the explosion. There are several types of injuries that can occur with a bomb.

If the person is close enough and the bomb is of the type that produces a great deal of heat, then burns over the skin and face can occur and even the victim’s clothing might catch fire. This could produce severe injury to the flesh and the lungs.

The concussive force of the bomb is simply a wave of air molecules that are accelerated to very high speed. When the wave strikes an object or a person, damage and bodily trauma will result. This is why a bomb will destroy a building, knock down a wall, or kill a person within the concussive umbrella. If the force is strong enough it can burst eardrums, cause sinuses within the nose and face to bleed, rupture the lungs, rupture the abdomen and internal organs, and many other nasty injuries. If the person is slightly further away, or if the concussive force is dampened somewhat, then injuries to the eardrums and sinuses may occur but the other more severe injuries to the lungs and internal organs might not occur.

Shrapnel presents a very difficult and dangerous situation. With a car exploding all types of shrapnel can be fired in every direction. Chunks of metal and glass, complete doors or windows, beams of metal and even the engine can be launched in any direction. The types of injuries that someone would suffer depends upon exactly what strikes them, where they are struck, and with what speed and force they are hit. I think it would be obvious that if a car door or engine or some large piece of metal struck someone at very high velocity it would most likely kill them instantly and if not their injuries would be so severe that without very aggressive medical treatment and luck they would die from these in short order. But what about smaller pieces of glass and metal? These can penetrate the head, the chest, or the abdomen and damage vital organs and lead to death very quickly. Or they can enter the same areas and lead to massive injury and bleeding, which can then lead to death in minutes to an hour or so. Or they could simply be flesh wounds and the person could survive but would likely require surgical repair of the wounds and treatment with antibiotics to prevent secondary infections.

You can see almost anything can happen in this explosive situation.  A large explosion at a great distance could easily do the same damage as a smaller one where the person was standing close by. Any bomb where the concussive force and shrapnel were directed away from the person might produce no injuries while if the victim were standing in the path of the concussive wave and the shrapnel he could be killed instantly. And anywhere in between. This great degree of variation in what actually happens is good for storytelling since it means that you can craft your story almost any way you want.

 

Q and A: Can A Blow To the Head Cause Unconsciousness and Amnesia?

Q: How hard do you have to be hit on the head to be knocked unconscious? Is there a particular place on the head, that if struck would be more likely to cause unconsciousness? How long does it usually last? How hard do you need to be hit to cause partial or temporary amnesia? What sort of things do people forget in these situations? How long does it usually last? Are there any other physical symptoms a writer should be sure and include in a scene with head trauma?

amnesia

 

A: In medical terms a blow to the head, or anywhere else, is called blunt force trauma as opposed to sharp force trauma as would occur with a knife or some other cutting instrument. When the blow is to the head, it is called a blunt head injury.

The degree of force required to render someone unconscious is completely unpredictable and varies from situation to situation and from person to person. Though a minor tap on the head is not likely to cause unconsciousness in anyone, almost any blow of significant force can. It makes no difference where the blow strikes the head as far as causing unconsciousness is concerned. That is, a blow to the front of the head is no more likely or less likely to cause unconsciousness than would one to the side or back of the head.

The period of unconsciousness in a simple concussion, which is what loss of consciousness due to blunt force head injury is called, is measured in seconds or minutes. Unlike Hollywood where the bad guy is slugged in the jaw, knocked unconscious, and then written out of the script after that — or at least the hero no longer has to worry about him — is not what happens in real life. Think about every boxing match you’ve ever seen. One guy smacks the other one, knocking him unconscious, and 30 seconds later the guy is awake and complaining that it was a lucky punch. This is what really happens.

Unconsciousness from a simple concussion can last several minutes and maybe even up to 10 or 15 minutes, though that would be unusual. Typically the person wakes up with a minute or so but might be slightly groggy or confused for a while, again for several minutes. But if he is unconscious for longer than a few minutes, the odds are that a serious injury to the brain has occurred or that bleeding into and around the brain has happened, Both of these situation are true medical emergencies. It doesn’t sound like that’s the situation you are posing with your questions.

Amnesia can indeed follow blows to the head. Typically the blow has to be powerful enough to render the person unconscious or at least woozy before amnesia enters the picture. But I should point out that other than the time period the victim is actually unconscious there is no loss of memory in the overwhelming majority of people who suffer head injuries. Amnesia is not rare but it is not common. But amnesia can occur after head injury, so you can absolutely use this in your story.

Amnesia is an extremely odd and actually not well understood medical condition that comes in many flavors and types. For easy explanation, amnesia is often divided into retrograde and anterograde types. Anterograde amnesia is very rare and is a situation where the person cannot form new memories. This was the subject of the excellent movie Memento. I won’t dwell on this since this is not the type of amnesia your questions deal with.

 

Memento

 

Retrograde simply means whatever came before. This type of amnesia is the most common in that the person forgets things that happened before the injury. This amnesia can cover events that occurred for only a few minutes before the injury, a few hours, a few days, weeks, or months, or can go back to forever. The person can forget some things and not others, such as he might not remember his name but might remember his address and phone number. He might remember some people but not others. He might recognize people but not be able to recall their names.

Or he could have what is called global amnesia in which he remembers nothing, not his name, not where he is, not where he came from, and virtually everything else. This type of amnesia can be temporary or permanent. It may only last for a few minutes, hours, days, or months or in some people it can last forever and be a permanent loss of memories.

When memories begin to return, they can come back suddenly and completely, partially, or in fits and spurts. The person might remember some things within a few minutes but other things might be lost in the cloud of amnesia forever. Virtually anything can happen so this means that your story can be crafted in almost any way you wish.

The other symptoms that can be associated with a concussion of this type are headaches, dizziness, poor balance, nausea, blurred vision, and generalized weakness and fatigue. These symptoms usually are minor and only last a few hours but they can become more problematic and last for many days and in some people for many months. There is no real treatment other than time and perhaps medications for headaches if they become chronic.

 
5 Comments

Posted by on April 5, 2016 in Medical Issues, Trauma

 

FORENSICS FOR DUMMIES Release Day

FFD 300X378

 

Forensics For Dummies Updated 2nd Edition is now available.

Get it through your local Indie Bookstore or here:

Amazon: http://www.amazon.com/Forensics-Dummies-Douglas-P-Lyle/dp/1119181658

B&N: http://www.barnesandnoble.com/w/forensics-for-dummies-douglas-p-lyle/1013991421

 

Q and A: Can My Villain Cook Attempt a Murder Using Contaminated Food?

Q: My villain is a cook and he wants to kill the hero by feeding him tainted food. I want to avoid using a detectable poison, so I thought a deliberately introduced food-borne pathogen, such as ptomaine, botulism, E.coli, or salmonella, or something like those, would do it. But how do I get the bacteria/germs/whatever in the food? What will it do to him? How long would it take him to die, and what steps could the hero take to make sure he survives? What could the villain do to make sure the hero dies?

 

E. Coli

E. Coli Growing on a Culture Plate

 

A: This scenario will work but there are a few problems with it. First of all, using bacteria for murder is extremely unpredictable and most killers prefer a more predictable method. Just because your villain feeds contaminated food to the victim it does not mean that he will die because contaminated food rarely kills people but rather merely makes them sick. Typically people survive these types of illness—but not always. The best way to assure, or at least increase the probability, that your victim would die is to prevent him from reaching medical care.

Infectious processes most often kill by two mechanisms. The first is that they alter the function of the infected organ. For example, pneumonia can kill by infecting the lungs and filling the air spaces with bacteria and liquids we call exudates. This is simply the body’s reaction to the infection. Like a weeping wound or one that forms pus. This is what happens in the lungs and if so it interferes with the exchange of oxygen and the victim can die because the lungs fail. An infection in the kidneys can do the same thing by causing kidney failure and infection in the gastrointestinal tract, which is what would most frequently happen with ingested bacteria, can lead to severe diarrhea and dehydration or in some cases or severe bleeding and death can follow from shock.

But the most treacherous thing associated with any of these infections is the passage of the bacteria from the infected organ into the bloodstream. We call this sepsis or septicemia, big words that mean infection in the blood stream. When this happens the infection spreads rapidly throughout the body and very quickly the victim can suffer from septic shock–low blood pressure and shock from bacteria in the blood stream. This can lead to death in short order.

So regardless of which bacterium you decide to use, it would need to be added to the food and the victim ingest it. This would make him ill with gastrointestinal symptoms such as nausea, vomiting, diarrhea, abdominal pain, and perhaps bleeding in either the diarrhea or the vomiting. If untreated such an infection could then spread to the bloodstream and be deadly. But the key here is that he must be prevented from reaching medical help. Otherwise he would be treated and survive. But untreated his chance of survival is dramatically reduced. So you need to figure a way to prevent him from reaching medical care once he developed symptoms.

As for what bacteria to use, both ptomaine and botulism would be very difficult to come by. They are rare and your cook would have no access to this type of organism. He could of course damage a can of some food product and leave it sitting in a warm environment and hope that the right bacteria grew but most likely it would not be the bacterium that causes botulism. That’s actually quite rare. So there would be no way for him to predict what organism would occur under that circumstance.

On the other hand, things such as E. coli, Salmonella, and Shigella are quite common causes of food-borne gastrointestinal illness. If your chef knew someone who was infected with one of these, perhaps from a recent trip to Mexico where these are not uncommonly encountered, he could then use this individual to supply the needed bacteria. How would he do this? The best way would be to obtain some stool from the infected individual. This could be from contaminated toilet paper or an un-flushed toilet. Gross but that’s the way it is. This could then be placed into some food product and allowed to grow, which he could simply do a closet at home. He could then add some of this bacterial soup to the food product and in this way introduce a large amount of bacteria to the victim. Even better would be if he could find a way to inject this intravenously into the victim but that’s not absolutely necessary.

Again, this would make the victim very ill with gastrointestinal symptoms. Then, as I said, you’ll need to devise some scenario that prevents him from reaching medical help and if so he could easily die from sepsis.

There is an excellent non-fiction book in which a murder is committed exactly like this. It involves the murder of Joan Robinson Hill by her husband Dr. John Hill. It took place in the 1960s in Houston Texas and is an incredible story. The book is titled Blood and Money and was written by Tommy Thompson. If you can a copy of this it might help. Dr. Hill apparently grew bacteria in petri dishes at home and infected cream puffs to kill his wife. He then admitted her to a small hospital in the outskirts of Houston and he managed her care, which amounted to preventing her from getting adequate treatment since he did not offer her the treatment she needed. It became a huge and convoluted case that did indeed involved blood and money.

 
 
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