Author Question: Drug Induced Amnesia

Amie Asks:

I was so pleased to find your blog. I have a medical question and I'm hoping you can help me. What I'm wondering is if there is a way to induce memory loss. Could a villain cause someone to have amnesia by drugging them or fiddling with their hippocampus?  (I plan on my character eventually getting their memory back.) Even if all you have is a theory, I would love some advice.

Jordyn Says:

Well, we know that there are drugs that affect memory as we give these to help patients forget painful procedures. These would be drugs like Versed (a short-acting benzodiazepine), Ketmaine (a general anesthetic but doesn't wipe out your respiratory drive), Propofol (which was what Michael Jackson was using to help him sleep-- allegedly) and GHB (the date rape drug).

Wikipedia actually provides a *nice* list of memory altering substances that you can find here.

As far as a surgical procedure-- sure, you could destroy those brain cells but there would be no bringing them back. My guess would be the damage would be permanent.

I think it would depend on what length of time you'd want your character to be amnestic for. For a short time (several hours) I'd probably pick a drug to use on the character. A longer time-- some sort of injury with perhaps a *hope* the memory came back or, perhaps, the villain wants there to always be a memory loss but the character recovers.

Brain injuries, unlike other types of injuries, do not follow a straight and narrow path so there is a lot of leeway for the author here.

Other than that-- maybe you'll be the one to dream up some sort of way to temporarily injure memory cells that no one else has thought of.

Best of luck!

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Amie Johnson graduated from Indiana Wesleyan University with a bachelor of science in Christian education, and is a member of the Bryant Wesleyan Church. The Valley Without Her is her first novel, written in small installments during nap time and after little boys went to bed. Ideas were scribbled on little scraps of paper, and her efforts were often interrupted by diapers, drinks of water, and requests for impromptu puppet shows starring plastic coin pouches. Amie lives in rural Indiana with her husband, Keith, and their two small sons, Jesse and Samuel.

Author Question: Fire Extinguiser Versus Face

Theresa S. asks:

While fighting off an attacker, my MC strikes him across the face with a fire extinguisher canister. She's shorter than him, so the swing would be upward, and it struck him (on, near, around) the
cheekbone. I imagine this could create a gash, yes? And if it did, what do you think the gash would look like?

He will not visit a hospital (so he won't get stitches), but instead will have a friend "patch it up" which, I'm not quite sure what that will entail.

Jordyn Says:

Hi Theresa,

Thanks so much for sending me your question.

Yes, this type of injury could easily cause a laceration to the cheek. In my experience, it would be a linear or straight cut of varying size maybe at the largest 1-2 inches. He also has the possibility of facial fractures (after all, those things are big and heavy) and a chance of traumatic brain injury as well (something along the lines of a concussion.)

The best way to get a cut "patched up" as you say is to use butterfly closures but many people do not know how to apply them correctly. A sticky end of two pieces should be applied on either side of the cut, then the edges drawn together, and then opposing sides taped down. Almost like you're pushing the ends of a box together.

Here's a video that covers how to apply butterfly closures but it doesn't use my technique which I do find more effective.

Hope this helps and happy writing.

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Theresa Santy recently won the FaithWriters Page Turner Contest for her novel-in-progress. She has a passion for writing but also loves Jesus, family and friends, laughter, and flip-flops. Learn more about Theresa @ theresasanty.com.

 

Up and Coming

Hello Redwood's Fans!

Well, we are mostly recovered here from our winter colds and seriously hoping for Spring to return-- except perhaps my husband who is the skier in the family and the last one suffering from whatever respiratory virus invaded our home.

What's your favorite season? I actually don't mind winter unless I have to be out in it. And even then it's okay unless it is completely FREEZING like today. I am ready for spring.

This week I'm focusing on author questions. First one deals with injuries from smacking a villain in the face and the other deals with amnesia.

Also, the Bloodline Trilogy is one sale on Amazon for Kindle at $1.99 a piece! Definitely a good time to pick them up.

Also, we're doing the 12 Days of Christmas all year long over at my FB author page. You are automatically entered for that month's drawing just by answering the posted questions. Hope you'll join us. 

Have a great week,

Jordyn

Jahi McMath: Follow-up

After I posted my thoughts on the Jahi McMath case a good friend of mine (Hi, K.S!!) e-mailed me this article that posits Jahi can regulate her own body temperature, therefore her hypothalamus is working, and therefore she is not brain dead.

I'm always fascinated in what people think of these issues and instead of just waving things to the side as nonsense, I try to look at things in a logical sense to see if they have merit. I think all people on BOTH sides need to do this.

Now, it is an interesting point that if she can do this-- is part of her brain functioning?

The first thing to note is the post is authored by Dr. Byrne whose bio states is a certified neonatologist and pediatrician. I mean, to be honest, his bio is impressive. It seems he should be quite knowledgeable in this area.

The first issue I have with his article as that the medical information he has is not sourced. So, how did he get this information? He doesn't state in his own piece that he examined the child though this article states he did. But if you read through Dr. Byrne's piece-- it seems as though he has collected facts from elsewhere. I mean, why not say, "I examined Jahi and these were my findings."

At one point, the doctor states:

"The 'poor care' I am referring to here is the prolonged starvation; the protracted and unnecessarily repeated apnea testing conducted in a potentially deleterious manner; the deprivation of needed thyroid medication; refusing to treat an adrenal gland problem that arose; et cetera."

From the hospital stand-point, they were waiting for her family to come to terms with the brain death issue-- which is likely why they weren't feeding her. My guess is they were providing IV fluids to keep her hydrated. The apnea test he refers to is a test for brain death and he doesn't expand on what he thinks was deleterious. The deprivation of thyroid medication actually supports the theory of brain death because her brain was not signaling to produce these hormones-- and same with the adrenal gland issue.  

The only other instance I found that mentions her self-regulation of body temperature is this article where her attorney, Christopher Dolan, states this. Well, one, he's not exactly unbiased. And two, I'm always wary of medical information coming from a non-medical person. BEWARE. I mean, don't come to me for advice if you're in jail. What makes me more suspicious is that Christopher Dolan, according to this article, is trying to change state law from using brain death as legal death. He sates it should always be the family's decision to terminate life support--- not the state's.

This is my personal opinion but the more he keeps this case in the forefront-- the more he is paid. I may be cynical but he has reasons other than family advocacy to keep this case going ($$$ and notoriety to name a few.) I pray he is doing this for the right reason.

This is just a big can of worms. Again, I am pro-life. I believe in the value of life but there does come a point that because we can doesn't mean we should and, for me, prolonging a death is just that.

What about you? What should be considered legal death: the heart stopping or loss of brain function? Who should decide to withdraw care when there is no hope of recovery?

Those Terribly Inaccurate EKG Tracings On Book Covers

Imagine my surprise when I found someone just as incensed as I was about medical inaccuracy in print but with a different focus. He analyzes book covers. So, I hope you'll join me in the land of analyzing book covers and discover why nobody's heart beats this way. Ever.

Welcome, Drew!!

I don’t mean to alarm anyone, but aliens are coming.

As we speak, the Voyager 1 and 2 satellites are crossing the bounds of our solar system into the interstellar medium. Once those spacecraft are discovered by extraterrestrial life forms, they will decipher the code on the Voyager Golden Records allowing them access to the hidden files within, including the location of Earth. The aliens will then return here expecting to find intelligent life, and when we don’t deliver, there will be a reckoning. 

I submit to you, these most egregious book covers:

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How can cholesterol sufferers or aliens trust any of the information in these books when we can’t even be bothered to put a proper heart rhythm on the cover? Now look at these novels:

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Think novels should get a free pass? Think you’ve seen enough? Well just check out these actual ECG training manuals:

     

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The squiggly lines seen on these book covers are supposed to be electrocardiograms (ECGs or EKGs), which are graphical representations of the electrical activity of the heart. Electrical conduction follows very specific pathways through the heart, creating predictable line patterns on the ECG. It is a science, and every ECG you see above is a complete fraud. It is easy for artists to forge ECGs with little or no accuracy, because the general public does not know what a real ECG looks like. For the sake of our planet, it is time we come together to eradicate this scourge. 

The Normal Sinus Rhythm

Many books have been written about the normal structure of various ECG waveforms. It would be impossible to duplicate all of that information here. But we can at the very least cover what a normal ECG should look like: the normal sinus rhythm.

Wikepedia

The whole picture above represents one beat of the heart, and is one sinus heartbeat. The repeating pattern of sinus heartbeats is then referred to as a sinus rhythm. This rhythm is named for the part of the heart where its normal electrical impulse originates, and not for the things in your head that fill up with snot when you’re sick. Each aspect of this beat is labeled with a letter of P through T, and each wave represents a different, specific operation of the heart as it moves through one coordinated beat. You will notice right away that it appears vastly different from any of our previously mentioned book covers. 

There are very specific tolerances for how large or small, wide or narrow each wave can be in a healthy heart. Normally this ECG would be printed on graph paper for ease of measurement, but since we are dealing with art and advertising it is sufficient to be ballpark proportionate. Follow these rules:

1. There is a flat baseline from which the different waves rise and fall. 

2. The first wave is the P wave, which is typically rounded in shape, and smaller than the rest of the waves in the sinus beat.

3. There is a small pause after the P wave.

4. Waves Q, R and S are all lumped together into something called the QRS complex, and the QRS complex is fairly narrow. 

5. There is another small pause after the QRS complex.

6. And finally, the T wave is a rounded wave in shape, and is usually larger than the P wave.

String these together not too close, and not too far apart, and you will have a sinus rhythm with a normal rate of 60-100 beats per minute. To learn more about proper ECG waveform, check out Rapid Interpretation of EKG's by Dale Dubin, MD. Dr. Dubin makes these ridiculously easy to understand, and you will become an ECG expert in no time. 

In the future, our alien overlords will judge our species by our literature and our art, and we will be punished accordingly. Heed my words people, we must ensure this doesn’t happen by designing our book covers, TV commercials and billboards as accurately as possible. Take some time to study the shape of the normal sinus rhythm. Learn, and correct others who have not yet found the way. The fate of our world is in your hands.

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Drew Rinella is a paramedic and fighter of lost causes. He maintains an archive of bad and wrong ECGs in advertising at http://stupidheartrhythms.blogspot.com. As a free public service, Drew will review your cover art for proper morphology. Email him at drew.rinella@gmail.com.

Up and Coming

What's going on Redwood's Fans? Me-- well, a nurse can only stay well so long during "respiratory season" when around every turn she is dealing with infected children. Both patients and her own, loving family.

Hopefully, I'll be on the mend soon.

To keep my spirits up I've been reading and I'd like to introduce you to novelist John Faubion. His debut novel, Friend Me, is quite an interesting read about what it means to replace "real life" relationships with social media and delves into the moral and ethical implications of infidelity and when that actually starts. An intriguing read I recommend. Plus, he has an interesting choice of weapons that is medically related.

If you need cheering up here is a chance to win Poison (book #2 of the Bloodline trilogy) and an Amazon Gift Card over at author Paula Wiseman's blog. Just leave a comment to be entered.

Also, I'd like to give a shout out to Forrest who did a very nice review of the ENTIRE Bloodline Trilogy. I think he read all three books in one week! Thanks for the nice words, Forrest.

For you this week:

Tuesday: I'm happy to introduce you to Drew who is a medical nerd like me and he'll be analyzing ECG tracings on book covers. He writes a very humorous post that includes some nice ECG training that is understandable to all levels-- from novice to advanced medical nerd.

Thursday: A follow-up on the Jahi McMath case.

Hope you are happy and healthy.

Jordyn

Space Heater Safety

Once in a while-- I feel the need to do a little public safety.

Since it is winter and unusually cold this winter-- keep these space heater tips in mind. Most of these came from an ABC news piece from the link below. I highly recommend viewing the video.

The Dangers of Space Heaters | Video - ABC News

1. Make sure the space heater has 3ft around it.

2. Don't use extension cords.

3. The space heater has an automatic shut off.

4. It can burn--- children should be supervised at all times when they are around them.

5. Have a carbon monoxide detector.

6. Make sure furnaces are in good working order.

Stay safe peeps. 

Book Review of The Psychology of Dexter: Part 3/3

This is my last post on The Psychology of Dexter and some of the posts that I found interesting. You can find Part I and Part II here.

There are two more essays I'd like to highlight. The first being The Psychology of Dexter's Kills by Marisa Mauro, PsyD.

I don't know about you but I get confused on the difference between the killer's MO and his signature and this essay provided good definitions that I thought I'd share here.

The modus operandi, often referred to as MO, are specific actions taken by the perpetrator in order to complete a crime. To be considered part of an MO, an action must be necessary and not superfluous, to carrying out the crime. As the MO is a set of learned behaviors that are used because they work. 

The signature, sometimes referred to as a "calling card" is another element of criminal behavior that occurs during the commission of a crime and entails all the aspects of criminal behavior that go beyond those necessary for the completion of a rime. A signature is most likely to be used by serial offender. 

Some examples given for signature were:

• Abusive, vulgar language.
• Excessive use of force.
• Scripted conversations.
• Actions to produce psychological trauma such as domination or humiliation.

The last essay entitled Deception by Bella DePaulo, PhD talked about how good loved ones are at perceiving deception. Sadly, not very good at all.

When put to the test, romantic partners in particular are not very good an knowing when their loved ones are lying and when they are telling the truth. The problem is they want to believe that their partners would never lie-- especially to them.

Even though sweethearts were hardly better than chance when they were asked directly whether their partners were lying, they did seem to know on some level, that something was not quite right. The strangers did not show as much sensitivity to the more subtle signs that something was amiss.

So-- I guess good news and bad news there.

Do you watch the show Dexter? If so, what mental health issues fascinate you about the series?

Up and Coming

Hello Redwood's Fans!

Awww--- this week includes Valentine's Day. What special plans do you have? Do you have any traditions you'd like to share?

Sometimes, sharing the love means sharing a laugh so I'm linking to this post by fellow author and friend, Mike Dellosso, who is a physical therapist. In this post he discloses some patients confusion over medical terminology. Mike's books are great if you ever have a chance to check them out. They are not really medical thrillers but great suspense tales nonetheless.

For you this week:

Tuesday: Concluding my three-part series on The Psychology of Dexter.

Thursday: At times, I'll do a little public service post and this one is timely due to all the brutally cold weather people are having. Evidently, in some areas, people are running out of propane and turning to space heaters for warmth and this has led to an increase in fires. You can read some recent stories here and here. Thursday will be space heater safety tips-- stay warm but stay safe.

Jordyn

Book Review of The Psychology of Dexter: Part 2/3

I'm continuing my series on the non-fiction book The Psychology of Dexter which includes several essays examining some of the mental health aspects of the show. You can find Part I here.

The next essay I found interesting was Naughty by Nature, Dexter by Design by Joshua L. Gowin. This piece took a look at whether psychopaths are genetically that way or become that way through their environment. What I found intriguing was his discussion of a callous personality type and what it meant for children. Again, what follows comes directly from the text.

1. "Inheriting a callous-unemotional disposition is a significant risk factor in developing antisocial behavior and psychopathy. In most circumstances, antisocial behavior is equally the product of nature and nurture, but inheriting a callous disposition shifts the balance in favor of nature. Antisocial behavior in callous children reflects a genetic influence of roughly 80%." Some ways to identify that your child may have this callous personality type is that they don't soothe another child when they are crying or are insensitive to another child's pain. They do not regret mischief.

2. "The most effective treatment was to provide positive reinforcement for pro-social behavior. Because these children tend to be fearless, punishment does not deter them, but they are as sensitive to reward as other children." I found the discussion about fearless children in this essay pretty fascinating as well.

What do you think? Are psychopaths created by nature or nurture?

For more information on callous personalities check out the following links:

1. http://en.wikipedia.org/wiki/Callous_and_unemotional_traits

2. http://www.ncbi.nlm.nih.gov/pubmed/18489213

3. http://www.sciencedirect.com/science/article/pii/S0191886912003431

4. http://www.mental-health-today.com/articles/pd.htm

Book Review of The Psychology of Dexter: Part 1/3

Frequent followers of this blog know I'm a fan of the television show Dexter-- not necessarily for its medical accuracy but for its amazing plot and character development. Honestly, I wish I would have been the author to create a series about a vigilante serial murderer working for the police department.

Sheer genius. You can read some of my medical analysis of Dexter here and here.

So, of course, I was intrigued when I found the non-fiction book The Psychology of Dexter that includes a collection of essays on various topics analyzing the show from different mental aspects and, over the next few posts, I'm going to highlight some interesting tidbits I learned along the way.

The first essay I found interesting was titled Rethinking Dexter by Lisa Firestone, PhD. What follows are quotes from the actual book or are very close paraphrases. This particular essay dealt with childhood PTSD and  whether or not early treatment of psychopathic children could reduce their violent nature in the future.

1. "Research shows that a child's cruelty toward animals almost always arises out of an abusive family environment. Humane education that focuses on developing empathy toward animals generalizes to empathy for human beings. The National District Attorney Association suggests that targeted therapy at this could save future lives."

2. "Research suggests that psychopaths almost always are treatable if they receive intensive therapy for a proper duration of time." which throws out the theory that there is not hope for these types of people.

3. "Studies have shown that almost 100% of children who witness parental homicide develop PTSD because of the severity of the traumatic event. Eighty percent of children that have been imprisoned, rendered immobile in some way (buried alive, tied up, or tortured) will develop PTSD as well."

4. "Childhood trauma has an impact on actual brain development. It can cause serious structural abnormalities in the frontal lobe, known as 'the seat of emotion.' Brain researchers have found that these abnormalities often result in deep-seated personality deficits such as an inability to be empathetic."

4. "When childhood events are traumatic enough to cause PTSD, children dissociate from themselves as the helpless victim and identify instead with the aggressor. They identify with the very person who is hurting them, who they see as strong and not vulnerable to the type of pain they are experiencing. This is the only survival strategy available to the child."

5. "An additional common symptom of early childhood PTSD is post-traumatic play, in which children repeat themes or aspects of the trauma they experienced. This does not relieve anxiety."

Are you surprised by any of this information as it relates to childhood PTSD?

Up and Coming

Hello Redwood's Fans!

How has your week been? Mine-- not too much remarkable this week. Just developing a new medical trilogy and my mind is spinning in circles with plots.

So, because I don't have much to share I thought I'd share this video with you that is way up on the cuteness scale. A man singing puppies to sleep. It is stinkin' adorable.

For you this week.

I'm beginning a three-part series on the non-fiction book The Psychology of Dexter which includes several essays from mental health types about the show. Very interesting stuff.

Hope you're having a great time!