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Category Archives: Medical Issues

Is Truly Autonomous Robotic Surgery Far Off?

Robot Surgery

You’ve probably heard of robotic surgery. Sure sounds cool and very much like Star Trek. I mean, Bones could do this in his sleep. Right?

But robotic surgery in its current iteration is actually more “remote” surgery. It’s still performed by a surgeon but he sits across the room from the patient at a console where he manipulates handles that in turn do the surgery. A series of lights, cameras, and instruments are inserted through cannulae into the patient, and the surgeon manipulates the instruments under visual guidance and performs the procedure not unlike he would if he were standing next to the patient. This is very expensive equipment as you might imagine.

But, distance can prove a problem here. Time lag is never a good thing in surgery. The surgeon needs everything to happen in real time, particularly if an emergency arises or things go wrong. There is no time for delay under these circumstances.

Think about space travel. Let’s say, that a colony is being constructed on Mars. The initial explorers would be few in number and would have skills more related to space travel and geology and other scientific endeavors. Having a surgeon and a well-equipped operating room might not be possible. Not to mention, most surgeons are not trained to do all procedures – – or at least they are not comfortable with doing them. Robotic surgery could eliminate this problem. But not in its current form. For example, what if a surgeon is performing a gallbladder removal using a robotic device? The patient is on Mars; the surgeon is on Earth. The time lag for instructions to travel the roughly 250,000,000 miles back and forth would be daunting. Currently, communication with the various Rovers that are roaming around the red planet pass through one or more satellite systems and can take anywhere from three or four minutes up to 20 or 25 minutes. In surgery, such delay could prove catastrophic.

The solution, of course, is a completely autonomous robotic surgeon. One that can perform the surgery – – from skin to skin as surgeons like to say – – on its own. One that does not require any ongoing instructions or feedback. One that “sees” what is needed and performs all the needed tasks to complete the surgical procedure. Very heady stuff.

But such research is ongoing right now. A system known as the Smart Tissue Autonomous Robot (STAR) is in development. It’s in its beginning stages and therefore still fairly crude but it is a step in the right direction.

In my second Dub Walker thriller, Hot Lights, Cold Steel, the arena of robotic surgery in the hands of a megalomaniac is in play. Dub and crew, of course, must uncover what is going on and track down the culprits.

 

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Can Your Pacemaker Snitch On You?

Don’t you just hate it when your pacemaker snitches on you? I mean, apparently all you wanted to do was burn down your house and collect the insurance money but then your pacemaker spoke up. Your plans went up in smoke – – no pun intended.

Pacemakers surely have changed since I was in medical school. Back then, they had to be inserted in the abdomen and the pacemaker leads shoved up through the diaphragm where they were screwed into the heart muscle. It was a major procedure, done under general anesthesia. The device weighed around a pound and only lasted 12 to 18 months. Then you had the pleasure of doing it all over again.

Also, back then, pacemakers were mostly a safety net. They were used for people who had very slow heart rates, even episodically, to prevent dramatic drops in the heart rate that could lead to dizziness, falls, and loss of consciousness. Pacemakers were often set at 60 to 70 beats per minute which meant that your heart rate could never fall below that. The pacemaker would sit and watch the rhythm and any time the rate dropped below these parameters, the pacemaker would kick in and supply the electrical impulse the heart needed.

Things are much different now. Today’s pacemakers are small, about the size of a wristwatch in many cases, last a decade or more, and will do much more than simply provide a safety net. They can help regularize abnormal rhythms, increase heart rate in response to exercise, and do a myriad other things to make them more efficient and helpful.

They also store data. This means that the pacemaker can periodically be interrogated and everything that has gone on in the individual’s rhythm over the past few months is available for analysis. And some of the newer models actually send the data to a central monitoring station in real time. My how things have changed.

For Ross Compton, his pacemaker, which was of course equipped with all this new technology, just might have snitched on him. According to investigators, Compton allegedly torched his house, likely in an insurance scam. He said that once he saw the fire he began unloading his most important belongings out a window and ferried them to his car. It was a real fire drill of sorts.

However, when his pacemaker was interrogated it showed no changes that would be consistent with such frenetic activity. No arrhythmias, no high heart rates, nothing to suggest extreme physical activity during the time in question. Had he actually been lugging stuff out the window and racing to his car one would expect that his heart rate would be greatly elevated from the exertion. Apparently, that’s not what was found.

It’s going to be interesting to see how this case turns out.

 

Chemical Assassinations: A Sordid History

Using chemicals for murder is not a new concept. It’s been around for many centuries. Socrates was killed with hemlock, and arsenic became so popular that it was known as “inheritance powder,” for obvious reasons. Chemicals have also been used in political assassinations.

Recently Kim Yong Nam, the half-brother of North Korean leader Kim Jong Un, was apparently assassinated using Sarin. It seems that a pair of young ladies had the toxin on their hands and made contact with the victim, transferring the toxin, causing his death. The details of exactly how they pulled this off are unclear. One of the big questions is how did they avoid poisoning themselves? The first thought of course is that they wore latex surgical gloves or something similar but that doesn’t appear to be the case. The second thing that came to my mind is that maybe they placed a barrier such as petroleum jelly on their hands before applying the Sarin or VX but this doesn’t appear to be the case either – – and this would be a risky move. Many have speculated that they took the antidote for this poison ahead of time. This makes sense and is definitely possible.

Sarin and VX are organophosphates similar to many insecticides. They are also classified as anti-cholinesterases in that they bind with the enzyme cholinesterase and block its actions. Cholinesterase is essential for nerve transmission throughout the human body. It’s complex biochemistry but in the end this chemical causes widespread derangements in normal bodily functions.

The symptoms that result are numerous and include chest pain, shortness of breath, headache, nasal congestion, constricted pupils, nausea, anxiety, seizures, and ultimately death. The treatment for Sarin exposure is to employ chemicals that counteract or override this derangement. The most common ones are atropine, Pralidoxime, and lastly the sedative and anti-seizure drug diazepam.

It is entirely possible that the young ladies involved in this assassination had pretreated themselves with atropine and possibly Pralidoxime. In fact the US military has such antidotes prepackaged in an autoinjector that is known as Mark I NAAK – –NAAK stands for Nerve Agent Antidote Kit. This is the most likely explanation for how they pulled this off.

Political assassinations using chemicals are not new. In 2006 Alexander Litvinenko was poisoned with polonium 210 that had apparently been placed in his iced tea.

Litvinenko

Dioxin was the culprit in the damage to Viktor Yushchenko.

Yushchenko

Perhaps the most famous chemical assassination took place in 1978 when Georgi Markov was jabbed in the leg with a point of an umbrella. At first it seemed to be an accident, no big deal, a mere pin prick, but Markov’s health quickly declined and he ultimately died. It was later found that a tiny pellet containing ricin had been injected into his leg, supposedly by the KGB.

Markov and Pellet

Deadly chemicals have been around for many millennia and have been used many times to bring about the death of others, political or otherwise.

 

Q&A with Expanded Audio Discussions Now on the Suspense Magazine Website

Q&A with Expanded Audio Discussions Now on the Suspense Magazine Website

Check out the new posts John Raab of Suspense Magazine and I put together. Read the Q&As and listen to the expanded discussions. Hope each proves helpful for your crime fiction.

Can DNA Be Used To Identify Multiple Assailants In a Three Decade Old Rape?

http://suspensemagazine.com/blog2/2016/12/20/d-p-lyles-forensic-file-episode-1/

In 1863, Could An Autopsy Accurately Determine the Cause of Death?

http://suspensemagazine.com/blog2/2017/01/09/in-1863-could-an-autopsy-accurately-determine-the-cause-of-death-d-p-lyle-answers-this/

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

http://suspensemagazine.com/blog2/2016/12/31/can-my-female-character-cause-her-pregnancy-to-become-stone-baby-by-sheer-will/

More to come.

Want more cool questions from crime writers? Check out my three Q&A books.

M&M 200X300

More Info and List of Included Questions

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More Info and List of Included Questions

MF&F 200X320

More Info and List of Included Questions

 

Psychopathic Brains and MRIs

MRI Brain

 

Psychopath, sociopath, borderline personality disorder, choose your phrase as these are often used interchangeably but in the end they are terms used to describe certain criminal offenders. In many cases, the worst of the worst. These individuals are often impulsive, lack self-control, and have little, if any, empathy with others, particularly their victims. The annals of serial predators are filled with such persons.

Forensic science has for many years searched for a true lie detector and a reliable method of determining someone’s criminal tendencies. Most have not panned out. One recent investigative arena is the use of functional MRIs to determine segmental brain activity in both “normal” and “psychopathic” individuals. The hope is to discover reliable and repeatable differences that might prove useful in criminal investigations.

MRI

One current study at Radboud University in the Netherlands has revealed some interesting results. It appears that persons with sociopathic tendencies possess an overly active “reward” area of their brains while at the same time showing some loss of communication between this area and one that is used for “self-control.” Obviously this leads to a dangerous combination of psychiatric defects. If someone is reward driven, impulsive, and narcissistic, while at the same time lacking any sort of consistent control of these impulses, it is easy to see that criminal behavior could follow.

Though this study and none of the others that have looked into this area of psychopathology have delivered the “smoking gun” of psychopathic behavior, they are intriguing investigations.

 

King Henry the VIII’s Brain Injury and Behavioral Changes

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King Henry VIII was often a bad boy. I mean, he had two of his many wives executed, for starters. But he was an historical giant—-he took on the Pope and established the Church of England—no small feat in the 1500’s.

But he also developed erratic behavior later in his life. Many date his significant personality change to a head injury following a fall beneath a horse in a 1536 jousting match. He apparently remained unconscious for two hours.

But could a blow to the head cause a dramatic personality change? Absolutely.

There are many types of brain injuries that could lead to such an outcome: Concussions (usually multiple such injuries are needed before personality changes would occur—if at all); Cerebral contusions (brain bruises); intracerebral bleeds (bleeding into the brain tissue; and subdural hematomas (bleeding in the space between the brain and the skull). In Henry’s case, I suspect the later might be the case.

subdural

Subdural Hematoma

Subdural hematomas follow blows to the head and here blood collects in the dural space—between the brain and the skull. It can be small and inconsequential or larger and compress the brain. It can occur immediately or be delayed by hours, days, weeks, and even months. The increased pressure on the brain can lead coma and death. Less dramatically, it can cause headaches, visual impairment, weakness, poor balance, sleepiness, confusion, and, yes, personality changes.

 

Sonny Liston: Cause and Manner of Death

sonny

Former Heavyweight Champion Sonny Liston is best remembered from his two losses—first to Cassius Clay, then Muhammad Ali. Ali changed his name between the two fights. But Sonny was a tough guy. He ruled the heavyweight division with an iron hand. Until Ali burst of the scene anyway.

muhammad-ali-vs-sonny-liston

But Sonny was no match for the needle. The cause of his death is easy—-a heroin OD. But, the manner of death isn’t so apparent. A situation not uncommon in drug OD deaths.

The cause of death is what actually killed the person while then manner of death is the by whom and why. It basically comes down to—-by whose hand and for what purpose did the death occur?

The four (plus one) manners of death are: Natural, Accidental, Suicidal, Homicidal, and Undertermined—-the latter a fancy way of saying “I don’t have a clue.”

A heroin OD is not natural but can it be accidental, or suicidal, or homicidal? You bet. And it’s not always possible to determine the manner in heroin-related deaths.

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FROM FORENSICS FOR DUMMIES:

Uncovering the four manners of death

The manner of death is the root cause of the sequence of events that leads to death. In other words, it answers these questions:

# How and why did these events take place?

# Who or what initiated the events and with what intention?

# Was the death caused by the victim, another person, an unfortunate occurrence, or Mother Nature?

The four manners of death are

Natural: Natural deaths are the workings of Mother Nature in that death results from a natural disease process. Heart attacks, cancers, pneumonias, and strokes are common natural causes of death. Natural death is by far the largest category of death that the ME sees, making up over half of the cases investigated.

Accidental: Accidental deaths result from an unplanned and unforeseeable sequence of events. Falls, automobile accidents, and in‐home electrocutions are examples of accidental deaths.

Suicidal: Suicides are deaths caused by the dead person’s own hand. Intentional, self‐inflicted gunshot wounds, drug overdoses, and self‐ hangings are suicidal deaths.

Homicidal: Homicides are deaths that occur by the hand of someone other than the dead person.

Undetermined or unclassified: These are deaths in which the ME can’t accurately determine the appropriate category.

Just as causes of death can lead to many different mechanisms of death, any cause of death can have several different manners of death. A gunshot wound to the head can’t be a natural death, but it can be deemed homicidal, suicidal, or accidental.

Though the ME can usually determine the manner of death, it’s not always easy, or even possible. For example, the manner of death of a drug abuser who overdoses is most likely to be either accidental or suicidal (it also could be homicidal, but it’s never natural). When the cause of death is a drug overdose, autopsy and laboratory findings are the same regardless of the victim’s or another’s intent. That is, the ME’s findings are the same whether the victim miscalculated the dose (accidental), intentionally took too much (suicidal), or was given a lethal dose (homicidal). For example, perhaps the victim’s dealer, thinking the user had snitched to the police, gave the victim a purer form of heroin than he was accustomed to receiving, so that his “usual” injection contained four or five times more drug than the unfortunate soul expected. Simply put, no certain way exists for determining whether the person overdosed accidentally, purposefully, or as the result of another’s actions. For these reasons, such deaths are often listed as Undetermined.

So was Sonny’s death an accident? A suicide? Or did the hand of another intervene and murder Sonny? We may never know.

Was Sonny Liston Murdered?: http://theundefeated.com/features/was-sonny-liston-murdered/

 
 
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