Why Do Men Have Nipples? (15 page)

•
posthypnotic amnesia:
Memory loss sustained from hypnosis. Can include inability to recall events that occurred during hypnosis or information stored in long-term memory.

•
transient global amnesia:
Spontaneous memory loss that can last from minutes to several hours and is usually seen in middle-aged to elderly people.

Here are some movies that Hollywood executives would like to forget:
Gigli, Ishtar, Howard the Duck, The Postman,
and
The Adventures of Pluto Nash
.

WHAT WOULD HAPPEN IF YOU STUCK
SOMEONE IN THE HEART WITH A NEEDLE
AS IN
PULP FICTION
?

“No, you don’t gotta fucking stab her three times! You gotta stab her once, but it’s gotta be hard enough to break through her breastbone into her heart, and then once you do that, you press down on the plunger.”

—Lance (Eric Stoltz),
Pulp Fiction

No, intracardiac injection is not recommended for routine use during CPR. Translation: ER docs don’t ever inject anything directly into people’s hearts. There is an uncommon procedure called a pericardiocentesis when a needle is inserted under the breastbone and into the sac around the heart to remove excess fluid. This is done when fluid or blood surrounding the heart is restricting its function. This is only done in serious emergencies.

In
Pulp Fiction,
John Travolta and Samuel L. Jackson are trying to save Uma Thurman from a drug overdose by injecting her with adrenaline. Instead, they should have given her an injection of a medication called Narcan to reverse the effect of the heroin. Adrenaline (epinephrine) is often given during cardiac arrest but only through a vein. Sorry, not as dramatic but definitely less painful.

WHY DOES EVERYONE IN THE MOVIES GO
INTO SHOCK?

In the movies and in the dictionary, “shock” can mean to strike with great surprise and emotional disturbance. In medicine, “shock” is a major medical emergency. When doctors talk about shock we are referring to the failure of the circulatory system to maintain adequate blood flow. This requires rapid treatment, otherwise it can lead to death.

There are a number of different causes of medical shock, including bleeding (hypovolemic shock), inability of the heart to pump enough blood (cardiogenic shock), severe infection (septic shock), and life-threatening allergic reactions (anaphylactic shock). People suffering from shock have low blood pressure, difficulty breathing, a weak rapid pulse, cold and clammy skin, decreased urination, and confusion.

So, the shock that we so often see on-screen should be more appropriately called freaked out.

CAN PEOPLE REALLY WAKE UP AFTER BEING
IN A COMA FOR YEARS?

If real life were a soap opera, then the answer to this question would always be yes. Unfortunately, coma is a very serious problem and although people do wake up, the longer they remain in this state, the less likely they are to return to consciousness. This is a very delicate question because doctors can’t really predict which patients will wake up and which will not.

If you look carefully in the original movie
Coma,
you will see Tom Selleck, that’s right, Magnum, P.I., in a state of suspended animation. Recent movies like
While You Were Sleeping, Kill Bill,
and
Talk to Her
also used coma in their stories. The medical story of coma isn’t as glamorous as Hollywood portrays.

To begin, there are several different categories of coma, or disorder of consciousness. Consciousness can generally be divided into two main components, arousal and awareness. Coma is defined as a state of unresponsiveness from which an individual has not yet been aroused. Patients in a coma are neither awake nor aware of their surroundings. On average, coma doesn’t usually last very long. After several weeks, most patients either regain some level of consciousness and if not are classified as being in a persistent vegetative state. Persistent vegetative state is characterized by complete lack of awareness of self or one’s environment. These patients can appear awake and even have their eyes open but are totally unaware of their surroundings.

Another category of consciousness is the minimally conscious state, an intermediate stage of consciousness, which indicates that a patient is somewhere in between a persistent vegetative state and normal consciousness. These patients can show intermittent signs of awareness.

The “locked-in” syndrome is a rare condition that must be distinguished from disorders of consciousness. It is characterized by complete paralysis of the voluntary muscles in all parts of the body except for those that control eye movement. These patients can think and reason but are unable to speak or move.

DO YOU REALLY NEED TO REMOVE A
BULLET RIGHT AWAY LIKE THEY DO IN
OLD WESTERNS?

It certainly would be dramatic if we had our gunshot trauma patients take a swig of whiskey and bite on their belt as we removed the bullet with a knife that had been sterilized by heating over a fire. I also would love to ride a white horse to work every day but that doesn’t happen either.

In old Westerns, there is an urgency involved with removing a bullet, as if this is the life-saving maneuver. In reality, doctors are not concerned with the presence of the bullet but rather the damage that it does on its way in or out. We often see patients who get an X ray for another reason only to find a bullet from a previous injury.

There are some special situations when we worry about leaving a bullet in a person’s body. When bullets or fragments are near large blood vessels, nerves (especially the spinal cord), or in a joint, then they can migrate and cause damage. In these cases, bullets are usually removed.

People have also asked whether or not you can get lead poisoning from bullets that are left in the body. In general, lead fragments in soft tissue become surrounded by fibrous tissue and are therefore essentially inert. If a bullet is in a joint, there can be a problem with lead poisoning. A study in Los Angeles in 2002 looked at more than four hundred patients who had bullets retained in their bodies. They found increased levels of lead in a small percentage of patients. Bullets or shotgun pellets are 50 to 100 percent lead and people are more likely to have problems with lead poisoning if there are multiple bullets or multiple fragments in the body. Sorry to disappoint you spaghetti Western aficionados, but the old whiskey-and-leather routine is just for show.

IS THERE REALLY A MEDICATION THAT
ACTS LIKE A TRUTH SERUM?

Action heroes like Arnold Schwarzenegger often find themselves faced with an interrogator who uses a truth serum to get the hero to reveal his secrets. In the movies, our heroes are able to resist these potions and hide the truth. Hiding the truth seems to also prepare action heroes for a successful career in politics.

They seem pure fiction, but truth serums do exist. Barbiturates such as sodium amytal and sodium pentothal were first used as truth serums in the early twentieth century. These drugs inhibit control of the central nervous system and were used by physicians to help patients recover forgotten memories or repressed feelings. They are also used for patients with suspected conversion disorder, a condition in which psychological problems produce physical symptoms.

An “amytal interview” is performed by administering a small amount of this drug intravenously. The drug produces a state of drowsiness, slurred speech, and relaxation. This condition makes patients more susceptible to suggestion, allowing the potential to uncover repressed feelings or memories.

Today these interviews are seldom performed. The “truth serum” will not necessarily make you tell the truth. Patients may lose inhibition but will not lose all self-control. Therefore, they are still able to control their behavior and lie. Studies have shown that during these “amytal interviews,” patients often demonstrate a distorted sense of time, show memory disturbances, and have difficulty distinguishing between reality and fantasy, so the line between fact and fiction becomes even more blurred.

WHAT IS ON THE RAGS THAT VILLAINS USE
TO MAKE THEIR VICTIMS PASS OUT?

We’ve all seen it in the movies. The bad guy grabs someone from behind, places a rag over the victim’s nose and mouth, and instantly the person slumps to the floor.

This isn’t exactly how anesthesia is administered in a hospital, but many people wonder if this rag trick is possible, and if so, what is the chemical on the rag?

Chloroform and ether are the two possibilities. In the mid-1800s, both of these chemicals were being used as anesthetics. Chloroform is the more common substance discussed in these cinematic knockouts but actually doesn’t work as swiftly as portrayed. It usually takes several minutes to induce a state of unconsciousness with chloroform. Chloroform also causes a lot of side effects including nausea, vomiting, and skin irritation.

Ether was discovered in the 1500s and later used as an anesthetic. It was also used to treat respiratory ailments such as asthma. Ether became popular and turned into an early party drug that people used to get high. Unfortunately, ether can’t deliver that dramatic takedown either.

Another option for the quick movie knockout involves secretly dissolving a pill in a drink. This is often referred to as “slipping a mickey” or a Mickey Finn. Spiked drinks in this sense contain Chloral hydrate dissolved in alcohol. Chloral hydrate is a sedative that is used in hospitals today, often to sedate children prior to procedures. Other modern movie knockout options are the so-called date rape drugs: GHB, Rohypnol, and ketamine.

CAN YOU DIE FROM CHOKING ON YOUR
OWN VOMIT, LIKE THE DRUMMER IN
SPINAL TAP
?

In the movie
Spinal Tap,
Eric “Stumpy Joe” Childs, the second drummer in the eponymous band, died in 1974 from choking on vomit. As the movie reveals, “The official cause of death is he died of choking on vomit. It wasn’t his own vomit. He choked on somebody else’s vomit.”

This event is said to have been inspired by the death of John Bonham, the drummer of Led Zeppelin. In 1980, Bonham was found dead after a drinking binge. He apparently had passed out and choked on his own vomit.

This is a true and potentially dangerous possibility with excessive alcohol intake. Death from alcohol abuse most often occurs from aspiration. Aspiration is defined as breathing the vomit into the lungs, which causes the victim to essentially drown.

DO PEOPLE REALLY HAVE MULTIPLE
PERSONALITIES, LIKE IN
SYBIL
?

The 1976 TV movie
Sybil
was based on a book of the same name written by Flora Rheta Schreiber. Both of these accounts were based on a real-life patient and psychiatrist but recently there has been controversy over whether the real Sybil actually had multiple personalities at all. Other movies like
The Three Faces of Eve, Psycho,
and
Me, Myself Irene
have also dealt with multiple personality. Once this disorder was popularized in the movies, the number of diagnosed cases increased dramatically.

Multiple personality disorder is no longer the term used to refer to this disease. It is now referred to as Dissociative Identity Disorder (DID). DID is defined as a disorder where two or more distinct personality states or identities alternately control or take over a person’s mind. This disorder is a result of many factors, most commonly severe emotional stress.

CAN YOU GET SCARED TO DEATH?

You can scare the pants off someone or be scared shitless, scared stiff, or scared out of your wits. But is it really possible to be scared to death?

There is significant evidence that psychological and emotional stress can increase the likelihood of a heart attack. So it makes perfect sense that the stress of fear could lead to sudden death.

In
The Hound of the Baskervilles,
a famous Sherlock Holmes story that has been adapted into film several times, Sir Charles Baskerville dies of a heart attack after being frightened by a ferocious dog. An article from the
British Medical Journal
in 2001 entitled “
The Hound of the Baskervilles
Effect: A Natural Experiment on the Influence of Psychological Stress on the Timing of Death” examines whether this phenomenon is actually true. These researchers wanted to show that people are more likely to die of a heart attack when they suffer extreme emotional stress, so they focused on the death rate on the fourth day of the month. In Japanese and Chinese cultures, the number four is associated with death and is feared and avoided. This is not true in other cultures.

When the death rates between Japanese and Chinese Americans and white Americans were compared on the fourth of the month, the researchers found that death rates on this day peaked in the Japanese and Chinese but not in other groups. So it seems as though you can be scared to death—by the number four at least.

CAN YOU DRINK YOURSELF TO DEATH LIKE
NICHOLAS CAGE IN
LEAVING LAS VEGAS
?

Even if you don’t end up choking on your own vomit, alcohol is still pretty dangerous. The consumption of even small quantities of some types of alcohol, such as methanol or rubbing alcohol, can be fatal.

With ethanol, the alcohol that is found in vodka and wine, for example, too much can certainly lead you to the pearly gates. People often wonder how much alcohol can be life threatening. In medicine, we use the term LD
⁵⁰
to describe the dosage or amount of alcohol that causes death in half of the population. The LD
⁵⁰
for alcohol is equal to a blood-alcohol concentration of 0.4 to 0.5 percent. That would be about four to five times the amount required to make you legally drunk.