#ride or die & something else on a whole nother level

[somereaderinblue]

Penelope: Okay guys, my Husband has just been kidnapped and taken away from me.

Ctimene: where are we going to find a soldier willing enough to help u-

*busts down door*

Diomedes: they did WHAT to Ody!?

- Zobody with a Z

HOW DARE THEY TAKE HIS BRO? WHO WILL SHITTALK OTHERS WITH HIM?? WHO'S GONNA MATCH HIS FREAK NOW???

THIS IS UNFORGIVABLE! OH THE INHUMANITY!

[macgyvermedical]

Soup: a “Tesla + Bell + Edison + Mac” Medical Review

“You have a perfectly functional syringe pump with the PCA in the background, and you’re going to give him an injection with a metal needle? Also, if you’re gonna sedate him you might as well use the IV pump too??? Like, you have a whole ‘nother channel?? Most floor nurses would kill for that setup?” <--- From my notes on this ep.*

Awl - X-Ray + Penny - Duct Tape + Jack - CD + Hoagie Foil - Guts + Fuel + Hope - Wilderness + Training + Survival - Father + Bride + Betrayal - Lidar + Rogues + Duty - Nightmares - Seeds + Permafrost + Feather - Friends + Enemies + Border - Mason + Cable + Choices - Bitter Harvest - Kid + Plane + Cable + Truck -

In case you didn’t see it, the story went like this: After being knocked unconscious trying to prevent Codex from stealing an encoded map to a Tesla-era WMD, Mac wakes to find he’s lost certain memories of the event that are crucial to interpreting the weapon’s location. In order to recover the memories and stop Codex from getting there first, Matty calls on a friend at DARPA who studies experimental memory-recovery drugs. Drugged, Mac enters a dream state to track down the memories, where he encounters his mother, a man he recently chose to kill to save everyone in LA, his high-school bully, and a darker version of himself who thinks Codex’s directive to kill an eighth of the population to save the world might not be too far off the mark.

So there’s a lot to talk about here medically. For this post, I’ll go into the concussion and its aftermath, the drug and it’s administration, and the medical technology that the Phoenix infirmary seems to have at its disposal.

The Concussion/Amnesia:

Mac is knocked out by a blow to the head. He wakes up “a few hours” later in the Phoenix infirmary. I’ve talked about concussions before (see here, here, and here), so I’m not going to go into too much detail about them in this post, but essentially if someone’s out for that long, they’re in trouble.

It’s reasonably common to lose consciousness in a concussion, but it’s usually only for seconds to minutes, and if it occurs at all, that person needs prompt medical evaluation in an emergency room. Even if there ends up being no major complications, like bleeding in the brain or an increase in pressure in the skull, the recovery time for concussions with a loss of consciousness can be in the weeks or months range. Someone who’s out for “hours” is looking at a stay in a neuro ICU and probably severe and possibly permanent brain damage. Like, it’s a season-long arc at least.

Since we’re not seeing that level of medical need, I think it would probably be safe to assume that Mac wasn’t actually out for “hours” as stated. He could have been briefly unconscious, as shown in the house attack scene, but then had trouble forming memories after that, which caused him to not remember the ride back to Phoenix very well, if at all. These are still concerning enough symptoms that I would have taken him to an emergency department instead of to the infirmary, but at least with that scenario there’s a possibility what happened to him isn’t actively life threatening outside of a neuro ICU.

Unlike the extended period of unconsciousness, the portrayal of amnesia isn’t far off the mark for once. The amnesia that Mac suffers is actually pretty reasonable- trouble remembering the incident and the events just before it is common in head injuries, as is having trouble forming new memories after. Not only is accurate amnesia something that I didn’t expect out of Rob Pearlstein (writer of the infamous Guts + Fuel + Hope), but it’s something that fiction as a whole (including, I’ll admit, 1985 MacGyver**) tends to struggle with. So kudos for that specific part of this episode, Pearlstein.

The Drug:

Even if we assume Mac wasn’t unconscious that whole time, the brief unconsciousness and memory problems indicate that he still had a pretty significant concussion that needed medical care and monitoring. I’m guessing that as advanced as the Phoenix Infirmary is, it doesn’t have the capacity to do neurosurgery or intracranial pressure monitoring. That means the Phoenix medical team’s priority in this situation would essentially be to catch any major, life-threatening complication as early as possible, and if one happened, get Mac to a hospital quickly enough to save him.

The best and lowest-tech tool they have to this end is repeated mental status exams. Mental status exams have the patient answer a series of questions like “what’s your name?” “what day is it?” “where are you right now?” “what happened to you/why am I asking you these questions?”  followed up with a series of mental tasks like counting backwards from 100 by 7s or making a logical decision based on a given scenario. If Mac’s answers significantly change, from one assessment to the next, that could mean he’s in trouble. 

Because these assessments rely so heavily on Mac’s ability to answer questions and perform tasks accurately, and they’re really the only thing that’s going to catch a serious problem early enough to save Mac’s life, the last thing you’d want to do is give him a drug cocktail that would alter his perception of where he is and what’s going on around him. I’ll just… leave that there.

But let’s assume that for some reason they have a non-CT way of assessing whether Mac’s about to die from a brain bleed while in a drug-induced dream state (they do appear to have limited EEG capability- can anyone tell me if this would still be helpful in the context of the drugs?). I’m not going to talk too much about the drug cocktail itself, since it was stated as fictional (so, essentially, anything they say it does it can probably do), but since they do reference it as containing DMT, I invite you to check out the erowid experience vault for DMT for stories of other people’s experiences with it.  

I will, however, talk a little about the administration of the drug. In the episode, a syringe with a needle is used to deliver the medication. Though not explicitly shown, I assume Dr. Cheryl inserted the metal needle into one of Mac’s arm veins and injected the drug.

Something that fiction generally doesn’t understand is that inserting a metal needle into a vein in order to administer medication doesn’t happen in a medical setting. Ever. The ONLY way to administer a medication IV in a medical setting is through an IV cannula- a short, flexible plastic tube inserted into a vein, often just colloquially called an “IV”:

If Mac had one of these ^^^, the syringe could attach to one of the blue and white pieces and the medication could be injected without worrying that the needle could slip out of the vein (many IV medications must be injected slowly over several minutes, and that’s a long time to hold a needle still).

Before Dr. Cheryl gives him the drug, she takes his vitals and asks him some questions, namely whether he has ever had “a psychotic break”, then, without explaining further, asks if he thinks he will become violent.

Now, it does make sense to ask someone about their psych history when administering a drug known to have psych side effects, because those can be a lot worse or more likely for people with certain psych histories. Think about SSRIs and SNRIs- they’re good antidepressants, but when given to someone with bipolar disorder, they can greatly increase the risk of a manic episode, and that possibility has to be evaluated before the drug is prescribed.

The conversation should have started with Dr. Cheryl asking everyone else to leave the room. Asking if someone has ever experienced psychosis in front of their coworkers, is not only a serious breach of patient privacy, but could also be incredibly dangerous. If Mac had experienced psychosis, but didn’t want his coworkers to know, he’d either have to lie and risk side effects without being able to prepare, or feel pressured to release that medical information and possibly risk his job or reputation***.

Then she’d ask something to the effect of “have you ever been diagnosed with a mental illness, been hospitalized for a mental health reason, or do you take any medications for a mental health problem?” And if the answer to that question was anything that would make the drug particularly dangerous to him, she’d probably tell him the risks and her assessment that it was a bad idea to proceed.

If there was no other option for some reason (I’d argue not the case in this situation), she’d tell him what the risks were, and only then would she possibly have to ask if he knew he might become aggressive, at which point they’d come up with how he’d like her to handle that possibility.

I know it’s not quite as snappy, but I would have really liked to see it.

Plus, unless it’s been asked off screen, Dr. Cheryl hasn’t asked him if he has any other health problems, if he takes any medications, or if he has any allergies, all of which could significantly impact how safe this drug could be for Mac.

Phoenix Infirmary Medical Tech

Now let’s look at some of the bits and pieces in the background of the episode. Particularly, I wanna talk about that chair, the IV pump, and the monitor.

So, chair first- it’s a dentist’s chair. It’s good for dental things and maybe some minor procedures (we have a slightly different chair in a doctor’s office I work at- we use it for things like implanting birth control, removing warts and moles, and providing wound care), but it’s not great for anything else. It’s especially not great if you have to sit there longer than a half hour. Considering we know from previous episodes that they have a full-on hospital bed somewhere at their disposal and possibly a couple of carts (narrower beds you see in the emergency department), I gotta say it makes literally no sense to put the guy who’s unconscious from a head injury in the procedure chair.

Next, the IV pump

We talked above about administering medications “IV push”- a medication “pushed” through an IV by a syringe, one dose at a time. Another way to give IV medication or fluids is via an IV drip or “piggyback”- the medication is diluted in a bag of saline or other IV fluid, and set to continuously run into a person’s IV. These are nice for doses of IV medication that have a lot of volume (like IV antibiotics) medication that wears off quickly and may need constant adjustment (like some kinds of sedation or some types of pain medication or medications that counteract shock), or just straight up IV fluids.

IV pumps control how fast the medication or fluid goes from the bag into the person. You can vaguely control this without a pump using gravity, a drip chamber, and a roller clamp, but if you need to know precisely how many milliliters of medication/fluid per hour is getting into a person, and you didn’t start your nursing career in the 1970s, you need a pump.

The one pictured above specifically consists of a central computer box (colloquially called a “brain”) where the pump rate can be programmed, flanked by interchangeable modules that each do a slightly different thing. The modules on the pump in the episode include an infusion pump, which essentially just pumps fluid from a bag hanging above it into a person, and a PCA pump. A PCA pump holds a syringe of medication (usually pain medication) and delivers a dose of it when the patient presses a button.

Honestly I think the whole things is just chillin’ in the background making the room look medical-y, but they really could have used it to continuously administer the drug or the sedation if they’d really wanted to incorporate it.

Side note, the modules are actually kind of heavy, so you have to balance them a little or the whole thing kinda tilts (see the screenshot from the episode). Also, for some reason if you stick an infusion module on the same side as a PCA module, the brain won’t recognize it half the time. Not sure if it’s a feature or a bug. Below is how someone who has ever once used one of these things would have set it up:

The other thing they have in the episode, and the last thing I’ll talk about before I let you get back to your life (I’m sure your cat misses you by now, mine sure does), is the monitor. 

I read several user manuals for this (real) monitor system in preparation for this post. I’ve concluded that it’s way, way above my med-surg pay grade, and usually used in operating rooms by anesthesiologists to monitor sedation level (so at least in theory they could be using it correctly? I’m as shocked as you are, really). I don’t even know what half those numbers mean (beyond the SpO2, heart rate, and respiratory rate), more than just being able to say they (surprisingly) do actually reflect real monitoring options on this thing. This leads me to believe this may be some kind of weird product placement thing? As if the gratuitous use of the Toyota backup cameras weren’t oddly forced enough.

Now, beyond the fact that this is a wildly high-tech, completely overkill machine for what is happening in the episode, the thing I would like to impress upon you is that regardless of the high tech-ness, every line on a monitor requires at least some attachment to the patient. Something measuring an EKG requires at least 3 leads on the patient. Something measuring oxygen saturation and pulse requires a clip on an ear or finger. Something measuring blood pressure requires a blood pressure cuff. Something measuring temperature usually means a probe somewhere the sun don’t shine. Mac has two little leads on his forehead. That is actually hilarious. He’d be covered in wires. He would have so much adhesive stuck to him.

In case you’re wondering, the heart/lungs/brain/person outline picture on the monitor just tells you how each part of the body is doing- like, the brain will turn yellow and then red if something starts going weird with the brain-related monitoring, same with the heart and lungs. It took an insane amount of searching to figure that out. I’ve been writing this post for 4 days now.

 *I had a much longer and rant-ier intro to this but I feel like I’ve complained enough on main about how the reboot dumbed down and politically neutralized an extremely opinionated and hardline character. I do really like this show, and the storylines are really interesting, but I need you all to understand how science-based and politically charged the original one was, especially in later seasons. You had such a platform for good here, CBS, and I’m hoping against hope the generic-action-show it’s become was some kind of weird, collective misunderstanding and not a censor problem. My main problem, having finished writing this post, is that he looks really weirdly good for someone who was unconscious with a head injury and then subjected to what was another few hours unconscious and hallucinating. Like, his shirt is still tucked in. Great update to the theme song, though.

**Twice. They played the bourne-style-amnesia storyline twice.

***At this point I can only recommend you watch the 1985 MacGyver Season 7 episode “Obsessed”- it’s a ridiculous-criminal-plot episode but the undertones are all anti-ableist (both criticizing the Phoenix Foundation board of directors’ ableism in assuming Pete is no longer fit to do his (desk) job after he loses his sight, and the pressure Pete himself is under to let MacGyver go because of mental health symptoms).

[detective-prince-bluebottle]

tagged by @agatharja

first rule: tag 9 people you want to get to know better! You don’t have to do it if you don’t want to! :)

... my anxiety won’t let me tag anyone because i’m afraid i’d be bothering them

second rule: Bold statements that are true

- I am 5'7 or taller (i fucking wiiiiiiiiiiiiiish)

- I wear glasses (i’m meant to but i don’t because they get dirty and that bothers me)

-I have at least one tattoo

- I have at least one piercing (6 distributed around my ears and 1 nose)

- I have blonde hair

- I have brown eyes

- I have short hair (hells yeah boi)

- My abs are at least somewhat defined (bitch i wish, fuck off)

- I have or had braces

PERSONALITY:

- I love meeting new people

- People tell me I am funny (ppl tell me nothing. also i never speak out loud)

- Helping others with their problems is a big priority of mine (i mean i’d like to but i have no idea what to say)

- I enjoy physical challenges

- I enjoy mental challenges

- I am playfully rude to people I know (i mean kinda sometimes? idk)

- I started saying something ironically and now I can’t stop saying it 

- There is something I would change about my personality (everything i would love to not be a bland robot)

ABILITY:

- I can sing well

- I can play an instrument (i can sort of play ukulele and guitar. and ocarina i guess lol. i also took recorder lessons when i was in primary school. now that was a bad time)

- I can do over 30 pushups without stopping (lol no)

- I am a fast runner (actually i can sprint really fast but for only like 10 seconds)

- I can draw well

- I have a good memory (HAHAHAHAHA NO)

- I am good at doing math in my head

- I can hold my breath underwater for over a minute (i used to when i was like a teen but my asthma and stuff has gotten real bad since then)

- I have beaten at least 2 people arm wrestling (idk probably i mean see aforementioned unbolded good memory i can’t even remember two days ago at all i must have beaten 2 people at arm wrestling. i mean i know i’ve wrestled the arm)

- I can make at least 3 recipes from scratch

- I know how to throw a proper punch (well i mean i can do a karate punch. you start with your fist closed and facing up, held next to like your hip and your elbow’s like pointed back, and then you thrust forward and up a bit and twist your fist down inwards, so you end up with it at chest level. idk)

HOBBIES:

- I enjoy sports (i feel like eventually i will end up watching something like women’s soccer or women’s basketball, because i am a pathetic virginal gay that can’t talk to and is unattractive to girls)

- I’m on a sports team at my school or somewhere else (i tried out for soccer twice. since i’m a fatass they didn’t go well)

- I’m in a orchestra or choir at my school or somewhere else (i was in primary school i have no idea why i think it’s cuz my grandma wanted me to be? but it wasn’t all bad i mean one time we went to like a choir competition and the conductor called me a boy so that was neat as fuck. man i got called a boy a lot when i was a kid it was fucking heaven compared to now, assholes calling me ma’am and shit man get fuckt)

- I have learned a new song in the past week (what does this mean? like to play on an instrument? bitch i can’t even concentrate long enough to learn Honeybee by Steam Powered Giraffe i just get discouraged and shit)

- I exercise at least once a week (listen i intend to rectify this and go swimming every day, now that i finally realised like last year that i actually have fucking dysphoria and that’s why i hated wearing swimsuits (aside from because i’m fat as shit and disgusting to witness in a fucking onepiece like what the fuck were my parents fucking thinking making me wear shit like that when i’m obese as sin) i’m gonna get board shorts and a rashguard and wear one of my less liked binders and it’ll be so fucking good)

- I have gone for runs at least once a week in warmer months (fuck off i’m not leaving my house in fucking summer it’s fucking 40°)

- I have drawn something in the past month

- I enjoy writing (man i haven’t properly written in like 7 years because idk depression but i still write stories in my head when i’m going to sleep at night and showering and whatever)

- Fandoms are my #1 priority

- I do some form of Martial arts (i used to do karate when i was uhhh 14?)

EXPERIENCES:

- I have had my first kiss (hahahahaha *sob* i fucking wish)

- I have had alcohol (yeah man i love jagerbombs and blue lagoons, defuckinglicious)

- I have scored a winning point in a sport (fuck sports)

- I have watched an entire TV series in one sitting (okay wait does this count for like rewatches? because when i saw my first anime i was obsessed with watching it - martian successor nadesico btw - for the entire day and that’s all i did, i sat in bed and watched it all morning to night)

- I have been at an overnight event (i meannnn when i went to see the last jedi slash meet some of my friends from my guild irl for the first time i stayed over at their house on the sofa and left the next morning does that count)

- I have been in a taxi (yeah it was only recently actually, our car fucking died and we had to take some convoluted fucking public transport out of our place from middle-of-dead-ass-fucking-nowhere-ville (needless to say i hate the suburb i live in. and country) to somewhere where we could get a taxi to a car rental place. or was it a dealership? i can’t fucking remember man do you see this shitty memory in action?? it was only like 2 years ago fuck me)

- I have been in the hospital or ER in the past year (well i was IN a hospital but that’s because i was going to a dental clinic in the building)

- I have beaten a video game in one day (what game can you beat in a day man???)

- I have visited another country (i haven’t got enough fucking money lad)

- I have been to one of my favorite bands’ concerts (listen fuck you i’m totally counting livestreamed concerts, i’ve seen all of Steam Powered Giraffe’s youtube concerts and the one recorded in 2013 and you bet your ass i’m gonna pay $20 for the right to see the film of the anniversary concert)

MY LIFE:

- I have one person that I consider to be my Best Friend (i kinda consider my friend bunny my best friend but i doubt he considers me his bestie)

- I live close to my school/work (HAHAHA GET REKT I TAKE MY UNI COURSES ONLINE AHAHAHA)

- My parents are still together

- I have at least one sibling (i mean technically i have 3 but i’ve never met them. at least i don’t think i have. they can get lost far as i’m concerned)

- I live in the United States (i wouldn’t live there if you paid me. maybe if obama were still president you could’ve got me to live there if you gave me like 5 million dollars, but now i would actually rather die)

- There is snow where I live right now (god i would fucking kill for some snow)

- I have hung out with a friend in the past month (yooo i was boutta unbold this because i have no fuckin friends except my online pals but then i remembered going to meet two of my friends from online and seeing star wars with them!! holy shit i feel validated and less lonely)

- I have a smartphone (samsung galaxy s6 BOI i am so fucking angry i was gonna hold out for the s7 cuz 7 is my second favourite fucking number (first is 14 but i wasn’t gonna wait a decade for that or w/e) anyway i finally decided to just get the s6 and the fucker asshole 7 is announced like a month later aaaaaarhghdks)

- I own at least 15 CDs (i have a whole fuck ton of videogames and they’re on CDs get owned HAHA FOILED but i also have probably about 15 CDs of music if i’m gonna count the stuff my family has)

- I share my room with someone (man my room isn’t even big enough for me how you gonna fit a whole nother person in that cupboard)

RELATIONSHIPS:

- I am in a Relationship (*cries uncontrollably*)

- I have a crush on a celebrity (well i mean i wouldn’t say no to like scarlett johansson if she told me she wanted to rail me. or gal gadot. or kate beckinsale. or kristen stewart. or - okay this is probably a massive list of ladies i want to rawdog me)

- I have a crush on someone I know (i’m slightly in love with all of my female friends because they show me kindness)

- I’ve been in at least 3 relationships (alright fucking buckle up kids: i don’t count online relationships because i’m a bitter person but when i was like 10 i was in a ‘relationship’ on runescape with a boy the same age at me and i legitimately think it was actually a kid like me and not a predator because all we did was stand next to each other and talk about cows or something and make the avatars kiss (we both had male avatars because i was obviously subconsciously aware of my gender identity at that stage). when i was like 13/14 i met a girl at a camp during the school holidays (i went to camp almost every holiday) and we chatted over msn after camp ended and tbh i think she forgot who i was because she suddenly said she liked me one day so i decided i liked her too and we started to ‘date’. lasted like 2 weeks? idk but she broke it off cuz i was inattentive (i can’t remember but i guess i could’ve been i’m not a very social person believe it or not *snicker*) anyway i saw her at the next two camps and it was hella fucking awkward the first time because i wanted to be friends with her but her other friends intimidated me so i just hovered around her creepily and she got angry at me and i got sad, but the 2nd time was a lot better i think, i was extremely distressed when i saw her at the bus station for the camp transport and i sulked the entire ride, but when we all got there i accidentally fell into her friend group (i actually think it’s because the other girls were really nice and they’d seen me sulking and wanted to cheer me up, man kinda fucked up huh) i pretty much ignored her the whole time and after camp ended she contacted me on msn for some reason and idk she like asked me how i’d felt when i saw her at camp and i was honest and told her i’d been pretty upset and then she got pissed at me and never spoke to me again. wow such drama huh? oh and my 3rd ‘relationship’ was when i was uhh 16/17-ish with this girl i met on some naruto fansite. i don’t even like naruto, and i actually remember absolutely nothing about my interactions with her. like at all. i don’t remember how we met or who dumped who or whatever bullshit. i’m not sure why this is i mean maybe it’s because this was at the same time i had a massive fucking obsessive infatuation with a girl at my school and well it didn’t turn out so hot and i think i’ve blocked out a lot of shit. anyway i hope you all enjoyed that wall of text haha of course you fucking didn’t. well tough titties me lad)

- I have never been in a relationship (*cries*)

- I have admitted my feelings to a crush (fuck no holy shit)

- I get crushes easily (yeah well if any female is nice to me i’m a goner. also one time during high school i started getting crushes on all the girls in my extended english class like i think it was a new girl each week. it was a tiny class there was only like 8 of us, no stinky boys (even if i’d realised i was trans at the time, i’m not stinky :P))

- I have had a crush for over a year (it was not fun)

- I have been in a relationship for over a year

- I have had feelings for a friend (do semi acquaintances count. or ‘girls that tolerated me enough to let me sit with them at lunch’)

RANDOM:

- I have break-danced

- I know a person named Jamie

- I have had a teacher that has a name that is hard to pronounce (listen i don’t fucking remember. but i’m good at pronunciations and shit anyway)

- I have dyed my hair (it was really short and blonde i kinda looked like a skinhead)

- I’m listening to a song on repeat right now (tongue tied from red dwarf)

- I have punched someone in the past week

- I know someone who has gone to jail

- I have broken a bone (broke my ankle in primary school because i’m fat and dumb and tried to slide along the grass into the safezone during tag or whatever, also i broke my wrist when i was 18 because i’m fat and dumb and i was learning how to drive a scooter but i went around a corner too slow or idk unbalanced or some shit, i think i broke the mirror on it but fuck that infernal machine i had to get fucking surgery and get pins in my wrist. when i got them out it was actually the closest i’ve ever come to fainting like the doctor dude was straining hard to pull these ones on the side out and when they finally popped out and a ton of blood gushed out i like deflated and teetered in my seat a bit it was an experience)

- I have eaten a waffle today (never had a waffle)

- I know what I want to do in life (well idk about an actual career but i want to write a book and get it published and make tons of bank)

- I speak at least two languages (i took japanese for 6 years don’t fucking tell me that doesn’t count just because i can’t carry a conversation in the language. also i took a class on latin for a semester it was dope af)

- I have made a new friend in the past year