Is there a Doctor in the house? (moved from Novels)

It worked in Romeo and Juliet because back then we didn't have heart monitors and other sensitive technical means of detecting life signs. A potion that slowed breathing to nearly nothing and made the heart beat so faintly that it would be unlikely to be detected by touching the wrist or neck was much more plausible in that era. Even a stethoscope would foil such a plot today, and a coma is very different from death. In a coma, a patient still has a pulse, respirations, and brain waves.

If you're writing a book with any sci-fi elements, though, the world is your fictional oyster. You can get away with making up new technologies such as a reanimating serum or a faked death that will fool modern medicine pretty easily, that way. However, if you want your book to be contemporary and realistic -- that is, without the "what if" elements of sci-fi, you're probably stuck.

How long would the heart be stopped? Because it doesn't take long for little brain cells to die.

What might work-- though I don't know your story-- is to have a doctor in on it. He could put the character into a medically induced coma (which they do sometimes today for various reasons) and declare that the patient won't ever wake up again. No one doubts said doctor, but when the time is right, the doctor revives the character and after a few days recovery, the character can scoot off with his lover, or however you want the story to go from there. There are risks-- but it's not like fiction doesn't have a long history of the walking-away-from-a-severe-concussion-with-no-side-effects sort of thing plenty of times.

It's hard to offer too much help without knowing what exactly you're trying to accomplish. There may be alternatives to get you from plot point A to plot point B that are a little different than you had in mind, but might still work.

I don't know if completely making it up is the best idea. And 5 minutes is basically the max for survival, not brain damage--I believe brain damage starts kicking in around 2.5 or 3 minutes without oxygen. Personally, I'd see what other ways the person could "die"--maybe he or she runs away from home and the old life, leaving a suicide note and planting "evidence" of suicide (like depressed emails sent to a trusted friend, maybe visiting certain websites or even somehow obtaining a prescription for pills that could be used for that purpose. Otherwise I think having the doctor declare the person is in an irreversible coma, sending the comatose patient to another hospital via helicopter, and maybe staging a helicopter crash? That's probably too absurd. But you get the point.

Will a Master work?

Anyway, I remember seeing a documentary once a few years back about people who for some reason (I don't for the life of me remember why) would appear dead to the point that they would wake up in the morgue. It was some kind of natural but very rare situation, if I remember right, but essentially their vital signs would be so depressed that a person wouldn't notice them. The heart would still beat, but it would beat slowly and weak and the doctors wouldn't feel it and would declare them dead. I wish I could remember the name of it.

So I suppose if that sort of thing happens, it's entirely possible that a person could have their vital signs depressed to the point of being declared dead. Though...if the doctor is in on it, why not just have him declare her dead even if she isn't? They can put her in a coma, and then the doctor can pretend to take her signs and say she's dead, and if he's trusted I don't see any reason why it wouldn't be believed.

I agree that having her actually have no heartbeat would be WAY too dangerous unless they're planning on lowering her body temperature to do it, and even then it's a really dangerous and not guaranteed to work scenario. It could slow brain damage, but the chances of being able to revive her for one and having her suffering no permanent damage for two would be high enough to make me say it's not a viable situation. Unless there was a really good reason for it.

kaitie said:

Anyway, I remember seeing a documentary once a few years back about people who for some reason (I don't for the life of me remember why) would appear dead to the point that they would wake up in the morgue. It was some kind of natural but very rare situation, if I remember right, but essentially their vital signs would be so depressed that a person wouldn't notice them. The heart would still beat, but it would beat slowly and weak and the doctors wouldn't feel it and would declare them dead. I wish I could remember the name of it.

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I think I know what you're talking about, I saw something similar about voodoo in Haiti supposedly bringing people back from the dead. What actually happens is that some priest poisons a fellow with tetrodotoxin (from pufferfish) and datura. As wiki says:

Together, these powders were said to induce a death-like state in which the victim's will would be entirely subject to that of the bokor.

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Symptoms of TTX poisoning range from numbness and nausea to paralysis, unconsciousness, and death, but do not include a stiffened gait or a deathlike trance.

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It lowers their heart rate to the point where they can be pronounced dead. After the person is pronounced "dead" he's nailed in his coffin. A few days later the guy that was meant to have died is wandering around in a state of shock.

You don't have to include the zombie bit though.

I've also heard that certain meditations can lower your heart rate to nearly zero.

I think to make it believable, you might want to look into cooling. It is an accepted medical practice in cases where you need to shut down the brain to cool people down with ice to prevent brain damage.

I have no idea of the requirements, or the limits. An MD, and better yet a surgeon, should answer that one.

Have you read about the case of the only known survivor of rabies? I believe her body was cooled to the point of near-death, for almost a week. The doctor basically shut down her brain because rabies targets and replicates in the neurons, so in order to kill the virus, he had to kill the brain. It's an incredible story.

I'm in med school, which means I really don't know anything more than the general population. I think even a lot of doctors will tell you that wikipedia is probably your best bet if you don't want to get too clinical about it (if not doctors, then med students will tell you this).

There was a movie similar to that back in the '80s called Flatliners, remember, with Julia Roberts and Keifer Sutherland? They were medical students and would make each other "flatline" and then bring them back. They injected something, and then restarted each other's hearts, to see what was on the other side.

You might want to do a search in the Story Research forum rather than Novels. I think some older threads there might help.

How about taking the doctor out of it? Does all this have to happen in a hospital? In a modern setting without easy access to medical personnel, say at a cabin or in a blizzard, the standard for proof would drop from stethoscope to naked eye. A lot of people have no idea of how to take a pulse. Your 'Juliet' is at home, has been talking about suicide, perhaps, takes pills, a not-medically-trained, easily-panicked character finds her lying there, assumes that she is dead, perhaps tries to take a pulse, does it wrong, freaks out and runs off the spread the bad news.

How long do you want to stop the person's heart?

Adenosine, 6 mg rapid IV push, will give you a nice flatline for maybe thirty seconds (or, if you're unlucky, a lot longer).

You want them paralyzed, unconscious, and unable to remember what happened? Try a combo of fentanyl, rocuronium, and midazolam, IV. That's the set for Rapid Sequence Induction. Be prepared to breathe for them, because 4-6 minutes without oxygen will give you brain damage.

Cold is good for reducing vital signs to the point where they may not be easily detectable.

Narcotics are good for depressing breathing and inducing unconsciousness.

Consider using gamma hydroxy butyrate or flunitrazepam (the so-called Date Rape Drugs) in your story.

But I tell you what: If you use the names of any real drugs, someone who knows what they really do is going to throw your book across the room. Even if you don't use the names of any drugs, some people are going to throw your book across the room.

Other ways to fake it: Set your story long ago, or in a remote situation.

Or, make your character a mystic who can control his/her body functions.

If you're looking for a natural cause, narcolepsy with attendant cataplexy will give you something close to what you're asking for.

socact said:

Have you read about the case of the only known survivor of rabies?

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I don't suppose you have a link to something modern? The only survivor I know of survived in a permanent vegetative state, but then med school was a few decades ago for me.

This reminds me of the recent House episode I watched where the guy was apparently declared dead and then started bleeding and screaming during the autopsy. A real doctor who reviews the medicine of House episodes had this to say about it:

At least once or twice a year there’s a story in the news about someone found alive in the morgue or at autopsy. As others have pointed out, the patient in question usually doesn’t fare that well — coma and/or brain damage. (Now this patient was shown afterward all but comatose, a point conveniently ignored for the rest of the episode).

Usually it’s not as much a medical mystery as an administrative SNAFU. Patient is found down, EMT declared him dead. Shuffled from one hospital morgue to another and no one ever rechecks ’til the patient starts moving or moaning. So he may have had periods of “extreme bradycadia” but his heart may have been beating better at other times.

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GeorgeK said:

I don't suppose you have a link to something modern? The only survivor I know of survived in a permanent vegetative state, but then med school was a few decades ago for me.

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I remember reading about the survivor who was not in a permanent vegistative state, back in the 1970s (?) or so. I think is was a young person or a child, but that was long ago, so I'm not sure of the details. A more recent survivor is still recovering.

http://www.usatoday.com/news/health/2007-08-29-rabies-survivor_N.htm
Of course, she's from Wisconsin and everyone knows those cheeseheads are tough.


This guy, however, did not recover as well;
http://www.nytimes.com/1989/11/24/n...s-to-pay-5.98-million-to-rabies-survivor.html