Pathophysiology resources?

ChaseJxyz

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I have a POV character who is a (magic) healer so he's able to observe processes and uses his medical knowledge to "fix" people. e.g. someone has sore muscles for overuse, so he would repair the "frayed threads" of the muscle fiber.

I'd like to think that I have a pretty decent grasp on anatomy and physiology, but it's when stuff goes bad, and how, that I'm struggling. Stuff like on the CDC's website for laypeople doesn't give me enough information and most Wikipedia pages on this stuff requires me to read 10 other articles to figure it out (ditto most academic articles, assuming I'm even able to gain access to them). An example from today was a patient dying of 3rd/4th degree burns. I know what that'll look like, that the nerves are probably destroyed, and with large swaths of unbroken skin there's issues with staying hydrated and keeping out pathogens. I didn't know what, exactly, would "feel"/be going wrong to cause death, so I went looking. I found a study stating that most of the confirmed causes of death for pediatric burn patients was sepsis, and the info on it is either Incredibly Vague (this is what it is, here are some symptoms, take some antibiotics) or Incredibly Technical (cytokine storms, a huge list of things inflammation can do). The only thing I was really able to get out of it was hypotension, and I had already assumed that was a thing in the first draft since that's going to happen, anyways, if you're on death's door (I also had pulmonary edema which I don't think is right since there's probably not enough body fluid left to have anything to edema, but I can't actually find an answer to that).

Is there something like 101/102-level resource for pathophysiology somewhere out there? I'd rather not have to buy a medical textbook just for research or find someone to ask these questions to (don't have any friends in any sort of medical field or any sort of biology, sadly) since it can be A Lot and bugging them on every question I might have would be tiring for everyone involved.
 

MaeZe

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It's not "frayed muscle fibers" that causes pain after exercise. It's a buildup of lactic acid from anaerobic glycolysis, the production of energy with limited oxygen.

The reason sepsis overwhelms the bodies of burn patients is they have lost a very important organ: the skin.

You might look for a used an anatomy and physiology book. The basics would be fine for your purposes and the fact a med student needs an updated one doesn't mean you do. So that leaves a lot of discarded books out there.

Another option is the library. That depends on what libraries you have access to. And right now libraries are closed as well as used book stores, but you can access their books online. My library lets you order the books then when they are ready you pick them up through a window. For used books you can order them online from Powell's books or eBay.

And you might try refining your search questions. I play around a lot with search terms when I'm not finding what I want.
 
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ChaseJxyz

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You're right about not needing an up to date textbook, the body doesn't change too much over the years (who needs the intersitium, anyways?). I work for an online book seller and just bought some for <$2 each, shipping was more expensive than the books themselves. So those'll be really helpful once they come in, thanks for that.

I think my issue is that I keep asking "okay, but then what?" and want to know the layer "beneath" it. One time I wanted to know how computer kernels operate and it got to the point that I was asking how logic gates work and none of my engineer/programmer friends knew the answer to that. So for this situation, it's severe burns causes loss of skin, which means loss of water/loss of an important barrier for bacteria, which means massive infections, which means [something], and maybe some additional steps, which then causes death through the cessation of [something]. What are those somethings? That's what I'm struggling with.
 

MaeZe

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which means massive infections, which means [something], and maybe some additional steps, which then causes death through the cessation of [something]. What are those somethings?
Massive infection means sepsis and that means septic shock. And that kills by loss of blood vessel tone due to inflammation (complex processes no reader needs to know), blood pressure drops below what you need to maintain life. All your major organs fail.

When you get too deep it can take the reader out of the story. Keep that in mind because you want to have a reason to go deep.
 

neandermagnon

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***CONTENT WARNING: graphic descriptions of burned human bodies***

If you're asking about what is happening physically at a cellular level in severe burns, the cells are literally burned away (combusted) and the flesh around them is cooked - the proteins are denatured (change shape) and so look different - similar to how chicken changes colour texture as it cooks BUT human flesh is not like chicken. I've been led to believe it's more like pork but obviously have no personal experience of the matter, and the pork thing could be urban legend. (Though pigs are considered to be quite similar to humans in a number of ways.) 4th degree burns are pretty horrific as you've got a lot of flesh literally burned away - can be right down to the bone, and bone itself will burn.

Different proteins denature at different temperatures - you die if your core body temperature gets to around 41 centigrade because that's when some proteins essential for life processes (not sure which ones, always assumed it'd be respiration) are denatured therefore can't function and the cells die. If enough brain cells die, you die. If a person survives 4th degree burns it's a bit different because the core body temperature won't have got high enough to die but the localised area where the burns are would've been far, far hotter - just that part of them is cooked. If the person is burned to death a fire they likely would have died due to their core body temperature reaching 41 degrees. However most people who die in fires die of smoke inhalation before the heat/fire gets to them. Their bodies may later be burned in the fire if it isn't put out. Dying of heat exhaustion at 41 degrees won't make a person look cooked like a piece of pork, but severe enough burns literally cook a person. Death occurs when the core temperature reaches 41 degrees though I'm not sure how instant the death would be as if the person is burning their temperature will be increasing rapidly. Basically, humans are made of meat and meat cooks at high temperatures. Also if the burns are localised the flesh will cook and burn away while the person's still alive - not sure how long that could go on before the core body temperature is too high or if there would be death or loss of consciousness from other factors (such as passing out due to the extreme pain).

If you look up stuff about archaeological remains from Pompeii there's interesting info about heat death because the human remains show signs of dying very quickly from extreme heat in pyroclastic flow from the volcanic eruption and the effects this has on the human body - there's a particular thing that happens where the muscles cause the body to be in a particular shape that looks like they're in a boxing match - in earlier decades they were thought to be fighting off falling ash - I can't remember the exact details but archaeologists often know a lot about what happens to the human body with certain modes of death and injury, due to basically doing autopsies on archaeological remains.

If your character's magical ability involves healing 4th degree burns it'll involve uncooking flesh (which is an irreversable change... but presumably magic can reverse it) and growing the burned flesh back again, including the skin, muscle, nerves, and all the other damaged tissues/organs/parts of organs.

For sepsis, first you'd get bacteria invading anywhere that they can grow - there will already be bacteria on the skin although the heat that caused the burns may have killed them, but other surrounding bacteria will start to grow there again as the flesh cools. Once the bacteria get inside the tissues/bloodstream (if the person's still alive) then the body will mount an immune response. Sepsis is the immune response gone into overdrive in a kill or cure kind of way. I don't know the specific details. As a reader though, if I'm reading about someone healing 4th degree burns by magic while seeing what's going on at a cellular level, I'd expect them to be growing back burned flesh. If someone has survived 4th degree burns and is in a stable condition then stuff like sepsis and dehydration is an issue. So if they survived the fire initially, were stabilised in hospital/by medical people away from the fire and died a day or two later, then sepsis could be the cause of death. But if they die due to being burned in the fire they died of the heat itself and the burns. But still bear in mind that the most common cause of death in house fires etc is smoke inhalation. e.g. if your burns character was rescued from a burning building too late, it's most likely they died of smoke inhalation, not burns or heat.

Hope that helps. Bear in mind that I'm not medically trained. My degree is in human sciences.
 

ChaseJxyz

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I've been led to believe it's more like pork but obviously have no personal experience of the matter, and the pork thing could be urban legend.

Maybe that Reddit thread of the guy who made foot tacos would know the answer to this. I should read that one of these days.

The burns were caused by a type of magic fire so it's "stuck" on the patient (I imagine it like getting burnt from molten sugar) and no one really knows how to undo/stop it. Regrowing lost flesh/bone is possible but takes a lot of energy; the healer character only has so much energy and has to work on several patients so he has to make tough decisions. He wants to save everyone but knows he can't, but he also can't make himself kill a patient, whether through action or inaction. So all of this ends up being a big character moment, part of it being he realizing just how much this patient was suffering because of his choices. What you've shared definitely will help with describing that (and given me more things to look up), thank you!
 

neandermagnon

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Maybe that Reddit thread of the guy who made foot tacos would know the answer to this. I should read that one of these days.

Is that a thing ??!! I've read some really mad stuff on Reddit...

The burns were caused by a type of magic fire so it's "stuck" on the patient (I imagine it like getting burnt from molten sugar) and no one really knows how to undo/stop it. Regrowing lost flesh/bone is possible but takes a lot of energy; the healer character only has so much energy and has to work on several patients so he has to make tough decisions. He wants to save everyone but knows he can't, but he also can't make himself kill a patient, whether through action or inaction. So all of this ends up being a big character moment, part of it being he realizing just how much this patient was suffering because of his choices. What you've shared definitely will help with describing that (and given me more things to look up), thank you!

That sounds like a really interesting story. I agree that it would take a lot of magical energy to regrow all the burned flesh, because the damage is so catastrophic.