Beyond the Cover with special guest Brian Andrews and Jeff Wilson

 SHOW NOTES:

Elements of a Thriller 

Open with a Bang or a Chill or a Compelling Question 

Establish the 4 Ws Early-------Who, What, When, and Where 

Inciting Incident---Sets the protagonist's story in motion 

Establish the Story Question-What does the Protagonist want/need? 

Rising Tension 

Who/What opposes the Protagonist and Why? 

What does the antagonist want/need?  

Establish a Time or Situation Endpoint  

Scenes advance or obstruct the protagonist's attaining goal 

Each power scene poses a question and ends with: 

Yes------------------------------Weak 

No-------------------------------Better 

Yes, but------------------------Strong 

No, and further more------------Strongest 

Convergence of Space and Time-"Life in a Trash Compactor" 

Epiphany---Protagonist grasps the solution 

Personal Jeopardy---Protagonist must fear for personal safety 

Mano a' Mano---Protagonist must confront antagonist "face to face" 

Resolution---all major story questions are resolved  

From Publishers Weekly:

In Lyle's ingenious third mystery featuring retired major league pitcher Jake Longly (after 2017's A-List), Jake, who runs a restaurant in Gulf Shores, Ala., is again roped into working for his father Ray's PI firm. An attorney has contacted Ray on behalf of Billy Wayne Baker, a convicted serial killer. Though Baker pleaded guilty to strangling seven women, he insists that he killed only five of them, and wants that assertion validated. When Jake meets Baker in prison, the murderer refuses to name the other killer, claiming that doing so would lead to accusations that Jake's inquiries were biased. The investigator's task is made even harder by Baker's not even identifying which of the dead women were killed by someone else . (To his credit, Lyle makes this complicated scenario credible.) Along with his girlfriend, Jake travels to Pine Key, Fla., the scene of three of the strangulations, where the couple pretend to be researching a documentary examining the impact of the killings on the small community. The clever plot twists will surprise even genre veterans. This entry is the best in the series so far.

https://www.publishersweekly.com/978-1-60809-336-6

SHOW NOTES:  

Gunshot wounds (GSWs) come in many flavors and those to the chest can be particularly dicey. Yet, a chest GSW can be a minor flesh wound, a major traumatic event with significant damage, or deadly. If you have a character who suffers such an injury, this podcast is for you. 

Here are few interesting questions about chest GSWs: 

Could a Person Survive a Gunshot to the Chest in the 1880s?

Q: My scenario is set in 1880. A man in his early 20s is shot in the back by a rifle. He loses a lot of blood and is found a couple of hours later unconscious. Could he survive and if
so how long would it take him it recuperate? Also, would it be possible to
bring him to consciousness long enough for another man to get him into a buggy.
Is any part of this scenario possible? 

A: Everything about your scenario works. A gun shot wound (GSW) to the chest can kill in minutes, hours, days, or not at all. The victim would be in pain and may cough and sputter and may even cough up some blood. He could probably walk or crawl and maybe even fight and run if necessary. Painful, but possible. He would likely be
consciousness so could even help get himself into the wagon. 

If all goes well, he should be better and gingerly up and around in a week or two. He would be fully recovered in 6 to 8 weeks. 

After surviving the initial GSW, the greatest risk to his life would a secondary wound infection. Since no antibiotics were available at that time, the death rate was very high---40 to 80 percent---for wound infections. But, if he did not develop an infection, he would heal up completely. 

How Is A Gunshot To The Chest Treated?

Q: I have a few questions regarding a gunshot wound that my poor character
will be sustaining later on in my story. Supposing it's a fairly small caliber
bullet (typical handgun fare, not buckshot or anything) and it hits near the
heart without puncturing anything important, how long might his recovery time
be? He's a strong, kinda-healthy guy in his thirties, although he drinks a fair
amount and used to smoke. He'll be rushed to a high-quality hospital
immediately and receive the best care throughout recovery...what's his outlook?
When will he be allowed to go home, if all goes well? How long before he's
healed to normal? When will it be safe for him to walk around, drive, have sex,
etc.? 

A: In your story, what happens to your shooting victim depends upon what injuries he received. A gunshot wound (GSW to docs and cops) can be a minor flesh wound or can be immediately deadly or anywhere in between. It all depends on the caliber and
speed of the bullet and the exact structures it hits. A shot to the heart may
kill instantly or not. The victim could die in a few minutes or survive for
days or could recover completely with proper medical care and surgery. It's
highly variable but ask any surgeon or ER doctor and they will tell you that
it's hard to kill someone with a gun. Even with a shot or two to the chest. 

A small caliber and slow speed bullet---such as those fired by .22 and
.25 caliber weapons---are less likely to kill than are heavier loads and higher
velocity bullets such as .38, .357, or .45 caliber bullets, particularly if
they are propelled by a magnum load---such as a .357 magnum or a .44 magnum.
Also the type of bullet makes a difference. Jacketed or coated bullets
penetrate more while hollow point or soft lead bullets penetrate less but do
more wide-spread damage as the bullet deforms on impact. 

All that is nice but the bottom line is that whatever happens, happens.
That is, a small, slow bullet may kill and a large, fast one may not. Any
bullet may simply imbed in the chest wall or strike a rib and never enter the
chest. Or it could enter the heart and kill quickly. Or it could puncture a
lung. The victim here would cough some blood, be very short of breath, and
could die from bleeding into the lungs---basically drowning in their own blood.
Or the lung could collapse and again cause pain and shortness of breath. But we
have two lungs and unless the GSWs are to both lungs and both lungs collapse
the person would be able to breathe, speak, even run away, call for help, or
fight off the attacker. Whatever happens, happens. 

This is good for fiction writers. It means you can craft your scene any
way you want and it will work. He could suffer a simple flesh wound and have
pain, shortness or breathe, and be very angry. He could have a lung injury and
have the above symptoms plus be very short of breathe and cough blood. If the
bleeding was severe or if both lungs were injured he could become very weak,
dizzy, and slip into shock. Here his blood pressure would be very low and with
the injury to his lungs the oxygen content of his blood would dip to very low
levels and he would lose consciousness as you want. This could happen in a very
few minutes or an hour later, depending upon the rapidity of blood loss and the
degree of injury to the lungs. 

Once rescued, the paramedics would probably place an endotracheal (ET)
tube into his lungs to help with breathing, start an IV to giver IV fluids, and
transport him to the hospital immediately. He would then be seen by a trauma
surgeon or chest surgeon and immediately undergo surgery to remove the bullets
(if possible) and to repair the damaged lung or whatever else was injured. He
could recover quickly without complications and go home in a week, rest there
for a couple of weeks, return top part time work for a few weeks and be full
speed by 3 to 4 months. Or he could have one of any number of complications and
die. Or be permanently disabled, etc. It all depends upon the nature of
Injuries, the treatment, and luck. 

What Does a Close-range Gun Shot to the Chest Look Like?

Q: I have a question regarding gunshot wounds. In my latest mystery, a man and a woman, my heroine, struggle for a gun. It goes off, hitting the man in the chest. I want the man to live, but be temporarily incapacitated and need hospital care, so if the chest
isn't the best location, other suggestions are welcome. What would the gunshot
wound likely look like before and after the man's shirt was removed? Would
there be a lot of bleeding where my heroine would take his shirt off and stuff
it over the wound?  

A: A gunshot wound (GSW) to the chest would work well. For it to be quickly fatal, the bullet would have to damage the heart or the aorta or another major blood vessel, such as the main pulmonary (lung) arteries. Under these circumstances, bleeding into the chest, the lungs, and around the heart would likely be extensive and death could be
almost instantaneous or in a very few minutes. He could survive even these
injuries, but this would require quick and aggressive treatment, including
emergent surgery, and a pile of luck. 

If the bullet entered the lung, the victim could die from severe bleeding
into the lung and basically drowning in his own blood. Or not. He could survive
such an injury and would then require surgery to remove the bullet, control the
bleeding within the lung, and repair the lung itself. This would require a
couple of hours of surgery, a week in the hospital, and a couple of months to
recovery fully.  

The bullet could simply imbed in the chest wall and never enter the chest
cavity. It could bounce off the sternum (breast bone) or a rib and deflect out
of the chest, into the soft tissues of the chest wall, or downward into the
abdomen. Once a bullet strikes bone, it can be deflected in almost any
direction. Sometimes full body X-rays are required to find the bullet. If the
bullet simply imbedded beneath his skin or against a rib or the sternum, he
would require a minor surgical procedure to remove the bullet and debride
(clean-up) the wound. He would be hospitalized for only 2 to 3 days and would
go home on antibiotics and basic wound care. 

Close-range, but not direct muzzle contact, wounds typically have a small
central entry wound, a black halo called an abrasion collar, and often an area
of charring around the wound. The charring comes from the hot gases that exit
the barrel with the bullet. In addition, there is often tattooing, which is a
speckled pattern around the entry wound. This is from the soot and unburned
powder that follows the bullet out of the muzzle and imbeds (tattoos) into the
skin. The spread of this pattern depends upon how close the muzzle is to the
entry point, If it over about 3 feet, then no tattooing or charring will occur. 

In your scenario, the victim's shirt would likely collect the soot and
heat so that it would be charred and "tattooed," rather than the victim's skin.
So, the shirt would show an entry hole, charring, and blood. Once the victim's
shirt was removed, the entry wound likely be a simple hole without any charring
or tattooing, since the shirt would have collected this material and absorbed
most of the heat. The wound could bleed a lot, a little, or almost none. It
depends upon how many of the blood vessels that course through the skin and
muscles are damaged. 

Yes, her initial efforts should be the application of pressure over the
wound to control bleeding until the paramedics arrive.  

SHOW NOTES:

For years it was felt that the DNA of identical twins was indeedidentical. Since they come from a single fertilized egg, this would seem intuitive. But, nature likes to throw curve balls-and the occasional slider. After that first division of the fertilized, and after the two daughter cells go their way toward producing identical humans, things change. And therein lies the genetic differences between two "identical" twins. 

LINKS:

One Twin Committed the Crime-but Which One?: https://www.nytimes.com/2019/03/01/science/twins-dna-crime-paternity.html 

The Claim: Identical Twins Have Identical DNA: https://www.nytimes.com/2008/03/11/health/11real.html 

The Genetic Relationship Between Identical Twins: https://www.verywellfamily.com/identical-twins-and-dna-2447117 

Identical Twins' Genes Are Not Identical: https://www.scientificamerican.com/article/identical-twins-genes-are-not-identical/ 

Rare Australian Twins Are "Semi-Identical,: Sharing 89 Percent of Their
DNA: https://www.inverse.com/article/53633-semi-identical-twins-share-78-percent-of-dna  

 From HOWDUNNIT:FORENSICS

Toxicology is a relativelynew science that stands on the shoulders of its predecessors: anatomy,
physiology, chemistry, and medicine. Our knowledge in these sciences had toreach a certain level of sophistication before toxicology could become areality. It slowly evolved over more than two hundred years of testing,starting with tests for arsenic.  

Arsenic had been a commonpoison for centuries, but there was no way to prove that arsenic was the
culprit in a suspicious death. Scientist had to isolate and then identify arsenic trioxide-the most common toxic form of arsenic- in the human body before arsenic poisoning became a provable cause of death. The steps that led to a reliable test for arsenic are indicative of how many toxicological procedures developed.  

1775: Swedish
chemist Carl Wilhelm Scheele (1742-1786) showed that chlorine water would convert arsenic into arsenic acid. He then added metallic zinc and heated the mixture to release arsine gas. When this gas contacted a cold vessel, arsenic would collect on the vessel's surface.  

1787: Johann
Metzger (1739-1805) showed that if arsenic were heated with charcoal, a shiny, black "arsenic mirror" would form on the charcoal's surface.  

1806: Valentine
Rose discovered that arsenic could be uncovered in the human body. If the stomach contents of victims of arsenic poisoning are treated with potassium carbonate, calcium oxide, and nitric acid, arsenic trioxide results. This could then be tested and confirmed by Metzger's test.  

1813: French
chemist Mathieu Joseph Bonaventure Orfila (1787-1853) developed a method for isolating arsenic from dog tissues. He also published the first toxicological text, Traité des poisons (Treatise on Poison), which helped establish toxicology as a true science.  

1821: Sevillas
used similar techniques to find arsenic in the stomach and urine of individuals who had been poisoned. This is marked as the beginning of the field of forensic toxicology.  

1836: Dr.
Alfred Swaine Taylor (1806-1880) developed the first test for arsenic in human tissue. He taught chemistry at Grey's Medical School in England and is credited with establishing the field of forensic toxicology as a medical specialty.  

1836: James
Marsh (1794-1846) developed an easier and more sensitive version of Metzger's original test, in which the "arsenic mirror" was collected on a plate of glass or porcelain. The Marsh test became the standard, and its principles were the basis of the more modern method known as the Reinsch test,
which we will look at later in this chapter. As you can see, each step in developing a useful testing procedure for arsenic stands on what discoveries came before. That's the way science works. Step by step, investigators use what others have discovered to discover even more.  

Acute vs. Chronic Poisoning

At times the toxicologist is asked to determine whether a poisoning is acute or chronic. A good example is arsenic, which can kill if given in a single large dose or if given in repeated smaller doses over weeks or months. In either case, the blood level could be high. But the determination of whether the poisoning was acute or chronic may be extremely important. If acute, the suspect list may be long. If chronic, the suspect list would include only those who had long-term contact with the victim, such as a family member, a caretaker, or a family cook. So, how does the
toxicologist make this determination?  

In acute arsenic poisoning, the ME would expect to find high levels of arsenic in the stomach
and the blood, as well as evidence of corrosion and bleeding in the stomach and intestines, as these are commonly seen in acute arsenic ingestion. If he found little or no arsenic in the stomach and no evidence of acute injury in the gastrointestinal (GI) tract, but high arsenic levels in the blood and tissues, he might suspect that the poisoning was chronic in nature. Here, an analysis of the victim's hair can be invaluable.  

Hair analysis for arsenic (and several other toxins) can reveal exposure to arsenic and also give a
timeline of the exposure. The reason this is possible is that arsenic is deposited in the cells of the hair follicles in proportion to the blood level of the arsenic at the time the cell was produced.  

In hair growth, the cells of the hair's follicle undergo change, lose their nuclei, and are incorporated
into the growing hair shaft. New follicular cells are produced to replace them and this cycle continues throughout life. Follicular cells produced while the blood levels of arsenic are high contain the poison, and as they are incorporated into the hair shaft the arsenic is, too. On the other hand, any follicular cells that appeared while the arsenic levels were low contain little or no arsenic.  

In general, hair grows about a half inch per month. This means that the toxicologist can cut the hair
into short segments, measure the arsenic level in each, and reveal a timeline for arsenic exposure in the victim.  

Let's suppose that a wife, who prepares all the family meals, slowly poisoned her husband with arsenic. She began by adding small amounts of the poison to his food in February and continued until his death in July. In May he was hospitalized with gastrointestinal complaints such as nausea, vomiting, and weight loss (all symptoms of arsenic poisoning). No diagnosis was made, but since he was doing better after ten days in the hospital, he was sent home. Such a circumstance is not unusual since these types of gastrointestinal symptoms are common and arsenic poisoning is
rare. Physicians rarely think of it and test for it. After returning home, the unfortunate husband once again fell ill and finally died.  

As part of the autopsy procedure, the toxicologist might test the victim's hair for toxins, and if he
did, he would find the arsenic. He could then section and test the hair to determine the arsenic level essentially month by month. If the victim's hair was three inches long, the half inch closest to the scalp would represent July, the next half inch June, the next May, and so on until the last half inch would reflect his exposure to arsenic in February, the month his poisoning began. Arsenic levels are expressed in parts per million (ppm).  

The toxicologist would look at this timeline of exposure and likely determine that the exposure
occurred in the victim's home. The police would then have a few questions for the wife and would likely obtain a search warrant to look for arsenic within the home.  

LINKS:

Arsenic Poisoning (2007):
CA Poison Control: https://calpoison.org/news/arsenic-poisoning-2007 

Arsenic Poisoning Cases
Wikipedia: https://en.wikipedia.org/wiki/Arsenic_poisoning_cases 

Arsenic" a Murderous
History: https://www.dartmouth.edu/~toxmetal/arsenic/history.html 

Facts About Arsenic:
LiveScience: https://www.livescience.com/29522-arsenic.html 

Poison: Who Killed
Napolean?: https://www.amnh.org/explore/news-blogs/on-exhibit-posts/poison-what-killed-napoleon 

Victorian Poisoners: https://www.historic-uk.com/HistoryUK/HistoryofEngland/Victorian-Poisoners/ 

12 Female Poisoners Who
Killed With Arsenic: http://mentalfloss.com/article/72351/12-female-poisoners-who-killed-arsenic  

SHOW NOTES:

You never get a second chance to make a first impression. The same is
true for your fictional characters. So, make them vivid and memorial. How do
you do this? There are many ways. Let's explore a few of them. 

Riding the Rap--Elmore Leonard

Ocala Police picked up Dale Crowe Junior for weaving, two o'clock in the
morning, crossing the center line and having a busted tail light. Then while
Dale was blowing a point-one-nine they put his name and date of birth into the
national crime computer and learned he was a fugitive felon, wanted on a
three-year-old charge of Unlawful Flight to Avoid Incarceration. A few days
later Raylan Givens, with the Marshals Service, came up from Palm Beach County
to take Dale back and the Ocala Police wondered about Raylan.

How come he was a federal officer and Dale Crowe Junior was wanted on a
state charge. He told them he was with FAST, the Fugitive Apprehension Strike
Team, assigned to the Sheriff's Office in West Palm. And that was pretty much
all this Marshall said. They wandered too, since he was alone, how you'd be
able to drive and keep an eye on his prisoner. Dale Crowe Junior had been
convicted of a third-degree five-year felony, Battery of a Police Officer, and
was looking at additional time on the fugitive warrant. Dale Junior might feel
he had nothing to lose on this trip so. He was a rangy kid with the build of a
college athlete, bigger than this marshal in his blue suit and cowboy boots --
the marshal calm though, not appearing to be the least apprehensive. He said
the West Palm strike team were shorthanded at the moment, the reason he was
alone, but believed he would manage.

The Long Goodbye--Raymond Chandler

When I got home I mixed a stiff one and stood by the open window in the
living room and sipped it and listened to the groundswell of traffic on Laurel
Canyon Boulevard and looked at the glare of the big angry city hanging over the
shoulder of the hills through which the boulevard had been cut. Far off the
banshee wail of police or fire sirens rose and fell, never for very long
completely silent. Twenty four hours a day somebody is running, somebody else
is trying to catch him. Out there in the night of a thousand crimes, people
were dying, being maimed, cut by flying glass, crushed against steering wheels
or under heavy tires. People were being beaten, robbed, strangled, raped, and
murdered. People were hungry, sick; bored, desperate with loneliness or remorse
or fear, angry, cruel, feverish, shaken by sobs. A city no worse than others, a
city rich and vigorous and full of pride, a city lost and beaten and full of
emptiness. It all depends on where you sit and what your own private score is.
I didn't have one. I didn't care. I finished the drink and went to bed.

Trouble Is My Business-Raymond Chandler

(Marlowe meets Harriett Huntress-Chapter 3)

She wore a street dress of pale green wool and a small cockeyed hat that
hung on her left ear like a butterfly. Her eyes were wide set and there was
thinking room between them. Their color was lapis-lazuli blue and the color of
her hair was dusky red, like a fire under control but still dangerous. She was
too tall to be cute. She wore plenty of make-up in the right places and the
cigarette she was poking at me had a built-on mouthpiece about three inches
long. She didn't look hard, but she looked as if she had heard all the answers
and remembered the ones she thought she might be able to use some time.

The Neon Rain-James Lee Burke

My partner was Cletus Purcel. Our desks faced each other in a small room
in the old converted fire station on Basin Street. Before the building was a
fire station it had been a cotton warehouse, and before the Civil War slaves
had been kept in the basement and led up the stairs into a dirt ring that
served both as an auction arena and a cockfighting pit.

Cletus's face looked like it was made from boiled pigskin, except there
were stitch scars across the bridge of his nose and through one eyebrow, where
he'd been bashed by a pipe when he was a kid in the Irish Channel. He was a big
man, with sandy hair and intelligent green eyes, and he fought to keep his
weight down, unsuccessfully, by pumping iron four nights a week in his garage.

"Do you know a character named Wesley Potts?" I asked.

"Christ, yes. I went to school with him and his brothers. What a family.
It was like having bread mold as your next-door neighbor."

"Johnny Massina said this guy's talking about pulling my plug."

"Sounds like bullshit to me. Potts is a gutless lowlife. He runs a dirty
movie house on Bourbon. I'll introduce you to him this afternoon. You'll really
enjoy this guy."

SHOW NOTES:

Somerset Maugham: There are three rules for novel writing. Unfortunately, no one knows what they are. 

Terry Brooks Rules

Read, Read, Read 

Outline, Outline, Outline 

Write, Write, Write 

Repeat 

Dave Barry: Don't Be Boring

Elmore Leonard's 10 Rules of Writing

1-Never open a book with weather 

2-Avoid prologues 

3-Never use a verb other than "said" to carry dialogue 

4-Never use an adverb to modify the verb "said" 

5-Keep your exclamation points under control. You are allowed no more than two or three per 100,000 words of prose 

6-Never use the words "suddenly" or "all hell broke loose 

7-Use regional dialect, patois, sparingly 

8-Avoid detailed descriptions of characters 

9-Don't go into great detail describing places and things 

10-Try to leave out the part that readers tend to skip 

LINKS:

Elmore Leonard: "What a Guy," says Jackie Collins 

https://www.theguardian.com/books/2013/aug/21/elmore-leonard-what-a-guy-jackie-collins 

Writers On Writing: Easy on the Adverbs, Exclamation Points, and Especially Hooptedoodle by Elmore Leonard 

https://www.nytimes.com/2001/07/16/arts/writers-writing-easy-adverbs-exclamation-points-especially-hooptedoodle.html 

Jack Kerouac's 30 Tips: 

http://writing.upenn.edu/~afilreis/88/kerouac-technique.html 

6 Writing Tips From John Steinbeck: 

https://www.theatlantic.com/entertainment/archive/2012/03/6-writing-tips-from-john-steinbeck/254351/  

SHOW NOTES:

One pill makes you larger, and one pill makes you small  

And the ones that mother gives you, don't do anything at all  

Go ask Alice, when she's ten feet tall 

White Rabbit, The Jefferson Airplane 

  And then there was this excellent question from my friend and wonderful
writer Frankie Bailey that was published in SUSPENSE MAGAZINE as part of my
recurring Forensic Files column: 

What Drugs Might Cause Side Effects in My Character With Alice in
Wonderland Syndrome? 

Q: I have a question about Alice in Wonderland Syndrome (AIWS) My
character is in his mid-30s. From what I've gathered from reading about this
syndrome, it is fairly common with children and with migraine sufferers and it
is controllable. However, I want my character to have side-effects. In other
words, even though the AIWS and his migraines are under control, he is
increasingly erratic. Insomnia, impotence, and irritability would all be a
bonus. Could he be dosing himself with some type of herb that he doesn't
realize would have these side-effects when combined with the medication
prescribed for AIWS. Or is there a medication for AIWS that might cause these
kind of side-effects but be subtle enough in the beginning that the person
becomes mentally unstable before he realizes something is wrong?  

FY Bailey 

A: Alice in Wonderland Syndrome is also known as Todd's Syndrome. It is a
neurologic condition that leads to disorientation and visual and size
perception disturbances (micropsia and macropsia). This means that their
perception of size and distance is distorted. Much like Alice after she
descended into the rabbit hole and consumed the food and drink she was offered.
 

AIWS is associated with migraines, tumors, and some psychoactive drugs.
It is treated in a similar fashion to standard migraines with various
combinations of anticonvulsants, antidepressants, beta blockers, and calcium
channel blockers. Both anticonvulsants (Dilantin, the benzodiazepines such as
Valium and Xanax, and others) and antidepressants (the SSRIs like Lexpro and
Prozac, the MAOIs like Marplan and Nardil,, and the tricyclic antidepressants
like Elavil and Tofranil, and others) have significant psychological side
effects. Side effects such as insomnia, irritability, impotence, confusion,
disorientation, delusions, hallucinations, and bizarre behaviors of all
types-some aggressive and others depressive. Beta blockers can cause fatigue,
sleepiness, and impotence. The calcium channel blockers in general have fewer
side effects at least on a psychiatric level.  

As for herbs almost anything that would cause psychiatric affects could
have detrimental outcomes in your character. Cannabis, mushrooms, LSD, ecstasy,
and other hallucinogens could easily make his symptoms worse and his behavior
unpredictable. 

Your sufferer could easily be placed on one of the anticonvulsants, one
of the antidepressants, or a combination of two of these drugs and develop
almost any of the above side effects, in any degree, and in any combination
that you want. This should give you a great deal to work with.  

What is Alice in Wonderland (AIWS) Syndrome? 

A neuropsychiatric syndrome-also know as Todd's Syndrome after Dr. John
Todd, the physician who first described it in 1955-in which perceptions are
distorted and visual hallucinations can occur. Often objects take an odd size
and spatial characteristics--just as Alice experienced. They can appear
unusually small (micropsia), large (macropsia, close (pelopsia, or far
(teleopsia). 

It can be caused by many things including hallucinogenic drugs, seizures,
migraines, strokes, brain injuries, fevers, infections, psychiatric
medications, and tumors. 

Migraines are often preceded by auras-visual, auditory, olfactory. 

Lewis Carroll was known to suffer from migraines. His own diary revealed
he had visited William Bowman, an ophthalmologist, about the visual
manifestations he regularly had when his migraines flared. So it just might be
that he himself experienced AIWS and took his experiences to create Alice. 

LINKS:

AIWS Wikipedia: https://en.wikipedia.org/wiki/Alice_in_Wonderland_syndrome 

AIWS Healthline: https://www.healthline.com/health/alice-in-wonderland-syndrome#outlook 

AIWS NIH Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909520/ 

AIWS and Tumor: https://www.livescience.com/64520-alice-in-wonderland-brain-tumor.html 

AIWS and Visual Migraines: https://www.webmd.com/migraines-headaches/alice-wonderland-syndrome#1  

SHOW NOTES:

Fentanyl is a synthetic opioid that is as much as 300 times more powerful than morphine sulfate. It can be injected, ingested, inhaled, and will even penetrate the skin.

It is used in medical situations frequently for pain management, sedation, and for twilight-anesthesia for things such as colonoscopies. 

Fentanyl is the number one cause of drug ODs.

Americans have a slightly higher than 1% chance of ultimately dying of an opioid overdose. That's better than one in 100 people. In fact, 60 people die every day from opioid ODs. That translates to over 22,000 per year. In fact, US life expectancy dropped slightly between 2016 and 2017 due to opioid overdoses.

Thirteen people suffered a mass OD at a party in Chico, Ca in January, 2019.

It is often added to other drugs such as heroin to "boost" the heroine effect. Unfortunately, Fentanyl is much more powerful than heroin and when the two are mixed it becomes a deadly combination. It's also often added to meth and cocaine.

How powerful is fentanyl? A single tablespoon of it could kill as many as 500 people; 120 pounds as many as 25 million people. A recent bust, the largest in US history, recovered over 250 pounds of Fentanyl secreted in a truck crossing the US-Mexico border--enough to kill 50 million people. 

When cops arrest people who possess or are transporting fentanyl they must take precautions not to touch or inhale the product as it could prove fatal. The opioid crises is the reason many cops carry Narcan (Naloxone) with them as either an injection or a nasal spray. It reverses the effects of narcotics very quickly. 

The "Dark Web" is a source for many things that can't be purchased or the open market. Weapons, hitmen, and drugs. But even many of these dealers won't deal Fentanyl. 

Could fentanyl be used as a weapon of terror? Absolutely. A fentanyl aerosol sprayed into a room of people could easily kill everyone present in a matter of minutes. It is a powerful narcotic that acts very quickly and depresses respiration so that people die from asphyxia. 

In 2002 a group of around 50 Chechen terrorists who took 850 people hostage in a Moscow theater. Many of the attackers were strapped with explosive vests. The standoff lasted 4 days until the Russians pumped Fentanyl-maybe carfentanil or remifentanil-through the vents and took everyone down. All the terrorists were killed but unfortunately over 200 of the hostages died before medical help could reach them. 

Carfentanil--Been around since 1974 but just now entering the world of drug abuse. Used in darts as a large animal tranquilizer. AN analog of fentanyl but is 100X stronger.

The famous Kristin Rossum "American Beauty" case involved fentanyl.

LINKS:

Fentanyl Deaths Top Car Accidents: https://www.breitbart.com/politics/2019/01/15/accidental-opioid-deaths-top-car-accident-deaths-for-the-first-time/

Mass OD in Chico, CA: https://www.ems1.com/overdose/articles/393267048-Calif-mass-overdose-highlights-severe-new-phase-of-opioid-epidemic/

Narcan: https://en.wikipedia.org/wiki/Naloxone

Even many "Dark Web" Dealers won't sell Fentanyl: http://www.newser.com/story/268019/even-dark-web-dealers-refuse-to-sell-this-drug.html

Fentanyl As Terror Weapon: https://www.breitbart.com/asia/2019/01/03/report-experts-insist-opioid-fentanyl-could-be-used-as-tool-of-terror/

Fentanyl as WMD: https://www.bloombergquint.com/business/killer-opioid-fentanyl-could-be-a-weapon-of-mass-destruction#gs.UwnsSzO8

Carfentanil Wikipedia: https://en.wikipedia.org/wiki/Carfentanil

Kristin Rossum Wikipedia: https://en.wikipedia.org/wiki/Kristin_Rossum

 SHOW NOTES:
 

Here in the 21st century we know a great deal about infectious diseases. We can treat bacterial
infections with antibiotics, immunize people against numerous diseases,
understand how viruses work, and have a huge fund of knowledge about surgical
sterility and disease prevention. This was not always the case. In fact, in the
history of medicine, all of this is fairly new.  

During the 14th century, Europeans didn't understand infectious diseases so when the Bubonic Plague, also known as the Black Death, struck, they had no understanding of what was
going on, how to prevent it, and, more importantly, how to treat it. They were
at the mercy of a bacterium that currently is easily treatable. The Black Death
killed between a third and a half of the population of Europe and dramatically
altered the trajectory of world history.  

 Simply put they say: 

1-If an organism is causing a disease, it must be present in those who suffer from the disease and
not in those who are healthy. 

2-The suspected organism must be isolated from the diseased individual and grown in culture. 

3-The cultured organism must then be given to a healthy individual and reproduce the disease. 

4-The organism must then be isolated from this newly diseased individual and identified. 

Each of these steps is necessary to show that a particular organism causes a particular disease and is transmissible from one person to another. Basically, this is how infectious diseases work. 

Unfortunately, Koch's Postulates were not put forward until the 1880s, a couple of decades after the
Civil War.  

During the Civil War, almost any battlefield injury could lead to death, most often from a secondary
wound infection. A gunshot to the leg, or arm, or really anywhere could become infected quite easily and this infection could spread through the entire body causing sepsis, which would ultimately lead to death. More soldiers died from infection than from their injuries. Surgeons at that time understood the danger of infections, even though they didn't know what caused it, and had no clue how to prevent or treat them. This meant that serious limb injuries were treated with amputation. Get rid of the injured limb and hopefully lessen the possibility of a secondary infection. Of course, post-surgical infections were also common and also lead to death. 

Not only were sterile techniques and antibiotics unavailable at that time, but also any form of
anesthesia was not to be found on most battlefields. Ether was around, having been first demonstrated by William T. G. Morton in 1846, but it's use and availability wasn't widespread. This means that a battlefield surgeon's best skill was speed. Sort of the surgical equivalent of "ripping off the Band-Aid." Any surgery was agony and the quicker it was done, and the sooner it was over, the better for the victim. And the amputated limbs piled up.  

It seems that Virginia's Manassas National Battlefield Park has yielded what can only be called a
"limb pit." It is a place where surgeons deposited removed limbs. This discovery underlines the state of surgical treatment and its brutal nature during the 1860s. 

LINKS: 

http://www.newser.com/story/260874/first-civil-war-limb-pit-is-excavated.html 

Germ Theory: https://en.wikipedia.org/wiki/Germ_theory_of_disease 

Koch's Postulates: https://en.wikipedia.org/wiki/Koch%27s_postulates 

Joseph Lister: https://en.wikipedia.org/wiki/Joseph_Lister 

Ignaz Semmelseis: https://en.wikipedia.org/wiki/Ignaz_Semmelweis 

John Snow: https://en.wikipedia.org/wiki/John_Snow 

Louis Pasteur: https://en.wikipedia.org/wiki/Louis_Pasteur 

William T.G. Morton: https://en.wikipedia.org/wiki/William_T._G._Morton 

History of General
Anesthesia: https://en.wikipedia.org/wiki/History_of_general_anesthesia