Creating a Monster: Part 4/4

Today we end Dale's zombie fest. Hasn't it been interesting? Remember, leave a comment for your chance to win two zombie fiction books. Drawing will be midnight tonight!! Must live in the USA to be eligible.

Now-- try not to bite your nails as you read an excerpt from Dale's novel....

What is in a zombie virus? This is not something from a supernatural realm. We are talking about a living organism that changes what we know about human anatomy. In the series, “The Walking Dead”, the zombie virus killed the host, and then reactivated a portion of the brain. While I use that template, I take it one step further.

 Here is an excerpt from the first draft of Smell of the Dead:

           Topher tried to wipe the blood off then Davis stood up fast. Too fast for someone who was in perfect health, way too fast for someone who is sick. He staggered a little as the coughing started to go down. He stood clutching his stomach. He removed his goggles then Topher saw his eyes. Davis had brown eyes before, but now the iris was black with the pupil pearl white. The sclera was reddish white, as if he had been doing some kid of super drug.

            He looked bewildered. He twitched his head about taking in his surroundings. Reddish black blood trickled from his mouth. The smell was atrocious. Topher… confused slowly backed up. Davis sniffed at the air, and then sharply turned his head towards Topher. He looked at his old friend like he was the last meal on the planet. Davis’s lips twitched like an animal ready to devour.



pilotkid100



            Topher tried to jog from Davis but couldn’t get much speed up. Davis breathed hard as he charged towards Topher. Davis grabbed Topher and shoved him down on the ground, biting at his neck. Davis could only clamp his mouth on cloth from the coat.

            Throwing the best jabs he could, Topher fought against his friend. With no air in his lungs to cry out, he kept trying to get his friend off of him.

            Finally he got a hold of the knife he used earlier. He rammed the knife into Davis’s kidney, but he didn’t budge. Stabbing him over and over, Topher was still on the bottom of a violent attack.

            Topher got his arm around to in front of him and thrusted the blade into Davis’s eye socket.

            Davis let out a groan losing his bearings Topher pushed him off then grabbed a small shovel from his pack. He slammed it into Davis’ face, knocking him down. As he tried to get back up, Topher continued to hit him with the shovel.

            Then Topher started coughing this time. It was enough that it made him double over wrenching in pain. A tiny bit of blood spat up with some of the fibers that he had seen in the blood from Davis.

            His mind went fuzzy then became clear, like surreal a dream. Forcing himself to continue on, Topher retrieved a rope from his pack and tied up Davis. Red and black fibers perturbed from Davis’ face, with cloudy blackish circles of swollen skin. Davis got back up to his feet after the final knot was tightened. Ramming shoulder first into Topher’s chest, he ran like a Cheetah through the snow packed rocky path

.

            Davis was a madman.

            Uncontrollable.

            Topher couldn’t understand what the hell was wrong with his friend. One moment he was dead, the next some kind of monster from a Dean Koontz novel.

            Davis jogged up the rocks towards the cave from which they came. Then he collapsed meeting the snow face first.

            Topher wondered if Davis could get frostbite in this weather after what happened to him? At this point frostbite was the least of his worries. This was indeed a strange condition. And the fact that Dr. Michael Davis worked as a microbiologist with the CDC on the same project as Terry Marshal and Lefty Craven, the very project that forced the whole group to run, made him wonder how many of them had come in contact with the virus.

            Ribs ached in pain, another cough tore its way though Topher’s lungs and pried his jaws open in a relentless rapidity of malevolent force.

With the onslaught bursting through his mouth and the hundred mile an hour wind that kicked up out of nowhere, Topher hit the ground embracing himself to keep his body from tearing itself apart.

            Curled in the fetal position, covering the snow carpeted rocks inches from his mouth, Topher projected blood laced with the strange looking fibers. This was a little different then what Davis went through. There was, however, no mistaking the fact that the same virus infected him. The wind hammered his body as the chill swept down his spine. With his coat zipped up, his goggles covering his eyes, and wearing his gloves, Topher could still feel the frigid cold. The chill mixed with the sensation of hot pinpricks throughout his entire body.

            Fibers penetrated his skin as his insides churned.

With the character Michael Davis, I start the story off with him sick. Has been sick for days. As he slowly turns into the undead, not only has he infected others, but the virus changes from subject to subject.

Davis works like a human laboratory. As it grows inside, terraforming his innards, the virus becomes stronger, and effects the host quicker once they are infected.

With the fibers of Morgellons Disease, they have now become a condition of the zombies.  In Smell of the Dead, the zombies start out fast then slowly become slower as they deteriorate. But the trademark that will persist, are the fibers. They penetrate through the skin everywhere. They work like cactus spines that carry the infection.

The Lyme and MRSA are aliments of the turning.

Scientists in the real world are always tinkering with viruses, looking to combine them as either a weapon, or as a vaccine. There has even been talk of taking one type of bacteria and using it as a new kind of energy to power the world.

******************************************************************************

Author Dale Eldon lives in a Macomb, Illinois, and takes care of a sick mother while working overnights at McDonald's. He spends his free time with loved ones and writing his butt off. Between blogging and writing anthology submission calls, he is currently working on a zombie trilogy for a series of novellas and a novel.

Up and Coming

Hey everybody... how'd the week go?

Mine... interesting. Glad it is Saturday!!

Here's what we have this week at Redwood's Medical Edge.

Monday: Dale Eldon finishes up his zombie mayhem with an excerpt from his novel. Very interesting read but not for the faint of heart so reader beware. Remember, leave a comment on any of Dale's Monday posts and be entered to win for a chance at two books. Must live in the USA to be eligible. Drawing Halloween night at midnight.

Wednesday: Sarah Sundin concludes her pharmacy series with a focus on hospital pharmacy. They are true life-savers... trust me on that.

Friday: Historical overview of 19th century medicine. Nice post for historical writers.

Have a great week and not too much candy on Halloween!! Watch out for those zombies. Dale is lurking somewhere....

EMS Call: Respiratory Arrest

Dianna is back for her monthly EMS post. I'd like to pass along my congratulations to her for winning in the ACFW Genesis contest this year! This is a much sought after award and will turn the heads of editors her way. I know we will be seeing her books published in the coming years.

Today, she focuses on the aspects of a respiratory call. This will help add those factual details for your scenes.

EMS 18, respiratory distress at 1234 Greene Road, at 1234 Greene Road on TACH channel 7.

joeyvest

As we climb into our ambulance posting (parked) at our station, my partner and I radio in we’re en route to the above scene. Lights and sirens, we rush out of the garage. En route, we’re notified via our computer that the patient is a 24-year-old female and is conscious and breathing.

Once on scene, we find the scene is safe and no dispatched law enforcement. Typically a fire crew arrives on scene first (prior to us) since there are about three times more firehouses than EMS stations globally, thus they’re closer than we are. However, fire is not always dispatched along with EMS, so for this sample EMS call we’ll say fire wasn’t dispatched.

Upon our arrival at the patient’s side, my general impression of her is she’s SOB (short of breath) and in respiratory distress (dyspnea). She’s sitting in the tripod position (leaning far forward with her palms on her kneecaps) and she’s breathing shallow and fast (tachypnea). She’s not cyanotic (blue lips or fingernail beds), so she’s perfusing fine at the moment and not hypoxic (lack of efficient oxygen), but that can quickly change.

I won’t discuss everything we’d do on a respiratory call like this, but if you need clarification or further explanation for your fictional writing needs, please do not hesitate to ask me.

julezcourt

As my partner whips out a non-rebreather mask and connects it to the oxygen tank at 15 lpm (liters per minute) then slips it over her mouth and nose, I assess her breathing rate and quality and find it definitely out of range, certainly labored and not efficient to sustain life, so I assemble a BVM (Bag Valve Mask), and my partner bags her.

As I continue with my patient assessment, and notice she’s diaphoretic (cold and clammy skin) I consider assembling a nebulizer (I’d squeeze atrovent and albuterol into a tiny circular plastic cup and attach the nebulizer contraption to the NBR (non-rebreather).

I attach her to our cardiac monitor via a 12-lead (ECG patches) to interpret her heart rhythm and heart rate, and I slip a pulse-ox on her finger (pulse-ox is attached to the monitor) to obtain her blood oxygen level.

I won’t go into any detail about heart rhythms, but I’ll simply say she has a dysrhythmia, her heart rate is at 118 (tachycardia = too fast), and her SAT is 87% (blood oxygen saturation), which is too low. Via my stethoscope, I auscultate her lungs and heart. I hear normal heart sounds, but I hear rales in her lungs. We insert a line (IV).

Our patient falls unconscious, and remains unresponsive. Cyanosis (blueness) begins to appear. She still has a pulse, but she’s no longer breathing, so she’s in respiratory arrest (apnea).

Based off my assessment and what information I gained from her roommate on-scene, I believe the diagnosis is pulmonary edema (various causes that I won’t go into). As I assemble the CPAP—Continuous Positive Airway Pressure—and attach it to her face, my partner pushes (inserts into the line) vasotec and fentanyl.

We place her onto our stretcher and load her into our ambulance for transport. En route, I monitor and reassess her constantly, perform any and all interventions as necessary, and retake all vital signs very five minutes.    

Thank you in advance for reading and for your comments.

******************************************************************************* 

After majoring in communications and enjoying a successful career as a travel agent, Dianna Torscher Benson left the travel industry to write novels and earn her EMS degree. An EMT and Haz-Mat Operative in Wake County, NC, Dianna loves the adrenaline rush of responding to medical emergencies and helping people in need, often in their darkest time in life. Her suspense novels about characters who are ordinary people thrown into tremendous circumstances, provide readers with a similar kind of rush. Married to her best friend, Leo, she met her husband when they walked down the aisle as a bridesmaid and groomsmen at a wedding when she was eleven and he was thirteen. They live in North Carolina with their three children. Visit her website at http://www.diannatbenson.com 

Contemporary Pharmacy Practice: Part 3/4

Sarah Sundin continues her four-part series on contemporary pharmacy. Today she focuses on the community pharmacist. This series is providing a lot of great background information for these health care professionals and potential fictional characters.

Back to Sarah....

Fiction writers do mean things to their characters. If those mean things require pharmaceutical care, you may need to introduce a pharmacist character or understand how pharmacies work. As a pharmacist myself, I want to help you get those details straight.

Today’s article discusses community pharmacy practice. Previous articles gave an overview of the profession, and discussed pharmacy education and training, and the following article will discuss practice in the hospital setting.

Community Pharmacy

About 65% of America’s pharmacists work in retail pharmacies inside drug stores, supermarkets, or mass merchandisers such as Walmart, Costco, or Target. There are approximately 23,000 independently owned pharmacies in the U.S., and 39,000 chain stores.

Setting

In the typical American drugstore, the pharmacy is toward the rear of the store, with over-the-counter (OTC) medications stocked close to the pharmacy. A counter divides the pharmacy from the rest of the store, usually with prescription drop-off and pick-up in separate areas. The secure pharmacy area is set further back, usually behind bulletproof glass. Access is restricted to pharmacists and pharmacy technicians. Other persons are allowed inside briefly to make deliveries or for housekeeping, and only with a pharmacist present.

The pharmacy area includes a main counter with computer workstations. Shelves hold bulk medications divided by type—oral tablets and capsules, oral liquids, suppositories, topicals (creams and ointments), eye and ear medications, inhalers, and injectables, plus bulk storage. Each pharmacy has a refrigerator for temperature-sensitive drugs and a locked cabinet or safe for the most heavily controlled substances (C-IIs).

Traditionally, the owner pharmacist ran the complete store as well as the pharmacy, and this configuration still occurs in smaller independent stores. However, in most situations, a store manager runs the main store, while the pharmacy manager runs the pharmacy. The pharmacy manager must be a pharmacist and performs administrative as well as dispensing duties.

Working Conditions

Most community pharmacies employ one or two full-time pharmacists, plus on-call or floating pharmacists to cover absences. Several pharmacy technicians work each shift as well. Most pharmacies are open from morning to early evening to cover the after-work rush, as well as shorter hours on weekends. Therefore, most pharmacists and techs work odd hours—morning shifts, afternoon to evening shifts, and alternating weekends. Larger pharmacies may be open twenty-four hours.

Pharmacists and technicians work on their feet. Pharmacists are required to dress professionally—a dress shirt and tie for men, a nice blouse and dress pants or skirt for women. Technicians tend to dress “business casual.” The traditional pharmacist’s short-sleeved lab coat that buttoned up the side to a high neck is rarely worn nowadays. Most pharmacists and techs wear a white hip-length lab coat with short or long sleeves.

Work Flow

Pharmacy technicians are allowed to do many duties, but those requiring professional judgment are restricted to the pharmacist. The precise division of labor varies between stores.

The prescription is taken in by a technician, who checks to see if the prescription is complete and that the patient’s information in the computer is current. The prescription is then entered in the computer. A pharmacist checks if the drug and dose are appropriate for the patient’s condition, age, and weight, and checks for potential problems due to allergies, drug-drug interactions, or drug-disease interactions. Sometimes the pharmacist needs to call the physician due to illegibility, errors, clinical interactions, or to verify a controlled substance prescription. The correct medication is pulled from the shelf, and tablets or capsules are counted on special counting trays. Larger stores often use automated systems to count and fill. The pharmacist performs a final check, and the medication is dispensed to the patient.

Patient Consultation

As accessible and visible health-care professionals, pharmacists often advise patients on proper treatment of ailments needing over-the-counter medications, including when to see the physician. Also pharmacists consult with patients when medications are dispensed to make sure the patient understands the proper use of the medication and side effects to watch for.

Immunizations

Offering immunizations is a growing role for pharmacists, with 147,000 certified to give vaccinations. Pharmacists enjoy this chance to serve the community and improve public health.

Controlled Substances

Many of the medications used for legitimate medical purposes are also drugs of abuse with high street value. Therefore, pharmacists must balance two conflicting community needs—to provide health care to those who need it, and to prevent diversion, fraud, and theft. High security, locked cabinets, background checks, and multiple counts are used to prevent outright theft and in-house diversion.

However, fraudulent prescriptions are often phoned in or written on stolen prescription pads. The pharmacist must use professional judgment to determine if each prescription is authentic. Does the prescription use improper medical jargon? Unusual and large quantities? Is the patient paying cash for a high bill? Do they come in after the physician’s office is closed? A pharmacist can legally refuse to fill any prescription for any reason. However, recently patient advocates threaten lawsuits if they believe access to medications is blocked.

The Community Pharmacy Experience

Overall, working in a community pharmacy is fast-paced and often stressful, especially when dealing with insurance companies or when disgruntled patients or irritated physicians vent their frustrations. However, most pharmacists can overlook these issues, knowing they’re providing excellent health care and helping patients get better.

Sources:

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Pharmacists, on the Internet at http://www.bls.gov/oco/ocos079.htm (visited October 17, 2011).

American Pharmacists Association http://www.pharmacist.com/

National Community Pharmacists Association http://www.ncpanet.org/

National Association of Chain Drug Stores http://www.nacds.org/index.cfm

******************************************************************************

Sarah Sundin is the author of the Wings of Glory series from Revell: A Distant Melody (March 2010), A Memory Between Us (September 2010), and Blue Skies Tomorrow (August 2011). She has a doctorate in pharmacy from UC San Francisco and works on-call as a hospital pharmacist.