Outliers Writing University Podcast Series

CRIMINAL MISCHIEF 16: Arsenic: An Historical and Modern Poison

From HOWDUNNIT:FORENSICS
Toxicology is a relatively new science that stands on the shoulders of its predecessors: anatomy, physiology, chemistry, and medicine. Our knowledge in these sciences had to reach a certain level of sophistication before toxicology could become a reality. It slowly evolved over more than two hundred years of testing, starting with tests for arsenic. 
Arsenic had been a common poison 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. 

CRIMINAL MISCHIEF 15: Introducing Characters

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.

CRIMINAL MISCHIEF 14: Elmore Leonard's Rules of Writing

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

GET TO KNOW Best-selling Author Lee Goldberg

GET TO KNOW Best-selling Author Mary Burton

GET TO KNOW Best-selling Author Cody Blocker

GET TO KNOW Rocker and Author Dee Snider

CRIMINAL MISCHIEF 13: Alice in Wonderland Syndrome

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
From 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

CRIMINAL MISCHIEF 12: Fentanyl—A Most Dangerous Game

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.
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
 

CRIMINAL MISCHIEF 11: Civil War “Limb Pit” and the History of Infectious Diseases

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.
The transition from ignorance to enlightenment concerning infectious processes was a long process and involved some of the giants of medicine. Names like Ignaz Semmelweis, John Snow, Louis Pasteur, Joseph Lister, and Robert Koch. The observations of these famous scientists were ultimately distilled into Robert Koch’s famous Koch’s Postulates, which proved the Germ Theory of disease. These postulates served as the foundation for our understanding of infectious diseases, and still do today. 
Simply put they say:
!-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