RSS

Category Archives: Medical Issues

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.

 
3 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.

 

Forensics For Dummies, 2nd Edition Coming Soon

 

FFD 300X378

 

Just got the new cover for Forensics For Dummies, 2nd Edition.

It will be released from Wiley on 2-29-16

Pre-Order now

 

Surgery in Space: A Matter of Timing

Looking into the future, what would happen if an astronaut on Mars or a colonist on the Moon needed surgery? Who would do it? It’s not like a surgeon could be dispatched  to Mars on an emergent basis. Nor would it be likely one would be part of the small and carefully selected crew. So how can this problem be solved?

Maybe have a marginally trained person perform the needed procedure guided by a surgeon on the ground. Or a robotic device could be employed, while the surgeon sat at console on Earth. This is how most so-called robotic procedures are done now—-the patient is on the table while the surgeon sits at a console several feet away.

 

davinci-fig1

 

The key words here are “several feet away.”

In an Earth-controlled surrogate-surgeon or robotic procedure, the main problem the Mars-exploring patient and the Earth-bound surgeon would face is the time lag for the instructional signals to travel back and forth. This would be a significant and make surgery extremely difficult if not impossible. Depending on where each planet is in its own orbit, the two planets are separated by 34 million to 250 million miles. And the time required for a signal to travel one way varies accordingly—-between 4 and 24 minutes. Meanwhile, incisions are being made, blood if flowing, and the surgeon is twiddling his thumbs waiting to see the results of his most recent action. Not a pretty or effective situation.

So what about a completely self-contained, self-controlled robotic device? One that operated—so to speak—on its own? That would be cool. And research is moving that way.

This concept played a significant role in my second Dub Walker thriller HOT LIGHTS, COLD STEEL.

 

HLCSCover300X450 copy

 
2 Comments

Posted by on December 8, 2015 in Medical Issues, Space Program

 

Q and A: Can a Crochet Hook Be Used For Murder?

Q: I’m wanting the victim in my next mystery novel to be murdered with a crochet hook. The attacker and victim would be facing each other. The hook would be grabbed off a table and could be either hook end out the thumb side of the hand or out the pinky side of the hand (depending on what you would determine to be the easiest for delivering a fatal blow). It is an impulsive act. The victim is a 5ft. 11in., 157lb. female. Murderer is a 6ft. 1in., 298lb. male. He is a chef.

What would be the most likely spots for inflicting a fatal wound? Would the hook need to be removed (the victim bleeds out)? Can the hook be left in and the wound still fatal?

The hook is a size F 3.75mm crochet hook made of Brazilian bloodwood by the Furls Fiberarts company. I know the different woods they use have different strengths as some do not come in the smaller diameter sizes. (For example: the olivewood hooks start at 4.00mm while the blackwood starts at 3.25mm.)

Pearl R. Meaker, Lincoln, IL.

Crochet Hooks

A: Since this style of hook is made of wood rather than metal, the attack would have to be to a relatively “soft” area. Not likely this could penetrate the chest and reach the heart or get thru the skull without breaking or shattering. But grabbing the thick end and using the pointed (hooked) end as the weapon could prove deadly.

Two areas could work:

The eye–the skull behind the eye is thin and fairly easily penetrated. So a stab to either eye could reach the brain cavity and cause bleeding into and around the brain that could prove deadly. Here there would be some external bleeding from the eye wound but most would be internal within the skull. Here it makes little difference whether the

device is removed or left in place after the attack.

The carotid arteries—there are 2 carotid arteries–one on each side of the neck in the soft area on either side of the trachea–windpipe. This device could easily penetrate one of them. These arteries supply 90% of the blood to the brain. If punctured, the blood would spurt out in great pulses. Here it would be best if the device were yanked back

out after the stab so the blood would have a clear path.

In either case, the victim could die in a couple of minutes or, in the eye stabbing scenario, it could take some time—even 30 to 90 minutes or longer. Anything is possible.

 

The Plague—Yes That Plague—Is Alive and Well

Black Death

The Black Death. It hit Europe in the mid 1300s and killed millions—-some say 100 million or between 1/3 and 1/2 of Europe’s population. It changed history. It altered mankind’s view of religion. It disrupted travel and trade. It helped bring on the so-called Dark Ages.

The Black Death marches through Europe

The Black Death marches through Europe

In truth there were several plagues. caused by several different diseases, but the Black Death was especially destructive. Though it has been challenged by some, the Black Death was in all likelihood caused by a nasty little critter called Yersinia Pestis.

But that was centuries ago. Now we know what causes plague and we know how to treat it. It’s passed to humans by bites from infected fleas and can be eradicated with antibiotics. At least in most cases. So like small pox, isn’t it a relic of the past? Not really. The bug is out there and every now and then it raises its head as if to say—-Remember me?

Several cases have cropped in Colorado in the past couple of years, with two recent deaths: high school athlete Taylor Gaes and an as yet unnamed adult. Last year there were other cases of this infection.

And now another case has occurred in California–a child camping in Yosemite National Park.

So the plague is not just of historical significance, but rather is still with us.

I’ve blogged about this before and here are the links to those posts:

https://writersforensicsblog.wordpress.com/2012/02/08/black-death-bug-identified-again/

https://writersforensicsblog.wordpress.com/2009/09/22/the-plague-kills-researcher-maybe/

 
5 Comments

Posted by on August 7, 2015 in Medical History, Medical Issues

 
 
Follow

Get every new post delivered to your Inbox.

Join 2,723 other followers

%d bloggers like this: