The Plot: A married man in Boston mysteriously turns to ash while waiting to spring an anniversary surprise on his wife. The Fringe team is called in to investigate. Broyles tells Dunham that he’s seen this before — there were five similar deaths several years ago at a hospital in Washington DC. He tells her he was contacted by an “Eastern European” man who provided a strange formula to him and indicated it was the solution to the deaths. Unfortunately, none of the FBI’s scientists could decipher the formula several more deaths occurred before they suddenly stopped — until now.

Dunham digs a little deeper and finds that the victim had recently been visiting his sick mother at a hospital. The Fringe team stakes out the hospital, trying to find a link between this hospital and the one four years ago in DC. They find a critical care nurse named Tomas Koslov who has worked at both institutions. Meanwhile, another ash-death has occurred on the in the hospital. A review of the hospital’s surveillance tapes show a strange being made entirely of shadow moving down the hall right before the death was discovered.

The team locates and searches Koslov’s apartment but discover he has abandoned it. They are able to find a fingerprint. When they run the fingerprint they find that their suspect is man by the name of Timur Vasaleiv who is wanted by both the CIA and the Russians because he stole something important from Russia. Broyles is told that the CIA will be taking over the case, but he decides to keep his team on it anyway. A contact at the Senate sends him Timur’s file. It turns out that his brother Aleks was a cosmonaut who returned comatose from a space mission, and it is his brother that Timur has stolen from a special Russian quarantine facility. He has been keeping him in various American hospitals while posing as an ICU nurse.

Walter has been working on the formula and realizes that it represents an organism that seems to feed on radiation. The hospital patients died because they all had been undergoing radiation treatment, and the husband died because he had been on a recent cross country flight (where he had been exposed to higher than normal levels of background radiation).

Timur returns to the hospital and takes his comatose brother out of the ICU and to a hotel. The shadow tries to emerge, but using a series of car batteries, Timur shocks his brother enough that the shadow retreats. He also knocks his brother into asystole (flatline), but after a few moments, a normal heartbeat returns.

Confident that Walter can crack the formula, Agent Broyles reaches out to Timur and offers his help. Timur is trying to decide whether to take Broyles assistance when he slowly turns to ash — the shadow is loose. The FBI arrives to find the comatose cosmonaut and the dead Timur. Peter thinks Walter can shock Aleks to make the shadow return, but Walter cannot read the equipment as it is all in Russian. When they hear a young girl scream from another motel room, Broyles takes unhesitating action and shoots Aleks in the head, killing him. The girl tells her mother that there was a shadow man in the room, but he disappeared. Later, when the CIA approaches Broyles to warn him off their case, they tell him that despite being shot in the head, Aleks returned to life, and they apparently sent him back into space.

2. Feed Me, Seymour
What had the shadow been feeding off of for the past four years, after DC but before the husband died?

3. I See You
There is no way a patient is going to sit for four years in a hospital ICU like Aleks apparently did.
ICU beds are incredibly expensive. The hospital billing department would have been on the phone to his insurance company as soon as he was admitted. No insurance? While they wouldn’t have kicked him out (unless he was medically stable and had a place to go), they would have been looking at the records very closely.
If someone is in a permanent coma, they would be transferred to a rehabilitation hospital or a nursing home as soon as they were medically stable. They wouldn’t keep them in a regular hospital ICU indefinitely.
How did he get him admitted to each new ICU? ICU transfers are very irregular unless one is going from a less-equipped hospital to a better-equipped one, and that doesn’t seem to be the case here.

4. Eleven Herbs and Spices
In my brief look at the formula, there seemed to be a number of carbon atoms with more than 4 bonds. I admit that Ionly had two years of Organic Chemistry, but that seems quite unlikely to me.

5. Blackjack
Your Osama Tezuka link for the day: the little girl was watching Kimba, the White Lion.

The plot line had potential, but was dragged down by too much bad science, reliance of clichés, and deep piles of nonsense they didn’t even try to explain away. The clock moves closer to midnight.

This week’s Fringe cipher was: DEJAVU.
A list of all previous Fringe reviews is available here.

UPDATE: And I should mention that I’m already dreading next week’s show, just based on the preview, where they mention the completely debunked “most people only use 10% of their brain” myth as if it were fact.

I’m not entirely sure what to make of this scene, so I’m just going to engage is some speculation and throw out some ideas. There’s not quite enough information provided to know for sure what is going on. This may be due to cleverness on the writer’s part, or laziness. Regardless, Bendis’s glacial pacing is making this scenario last months.

We know that Luke Cage has had a “cardiac episode” — probably a heart attack — so he needs someone to restore the circulation to the arteries that supply his heart. Non-surgically, this can be done with thrombolytics (“clot-busting” drugs), or by angioplasty. Since he’s undergoing surgery, it seems he’s receiving a CABG (coronary artery bypass graft), the surgical method of restoring the heart’s circulation.

But then the surgeon mentions the pulmonary artery and also mentions a pump in the next panel (not shown here). Why is the surgeon messing with the pulmonary artery? It’s not part of coronary bypass surgery.
Is Cage’s heart so badly damaged that he requires a ventricular assist device to keep him alive (basically, a pump that helps the heart pump)? The doctor is focusing on the pulmonary artery which would mean Cage is getting a right ventricular assist device (VAD) instead of the much more common, and useful, left VAD. Frankly, neither VAD really fit Cage’s situation all that well.
Maybe he meant an intra-aortic balloon pump — which fits the circumstances better — and he just messed up the anatomy.
Or is Osborn up to something nefarious and implanting something nasty (which is my suspicion)? Time will tell, though at this rate my great-great-grandchildren will be reading the conclusion long after I’m gone.

Other thoughts:
♥ If you’re using a scalpel and the skin is “tearing”, then you’re doing something wrong. Surgical scalpels cut through skin like a hot knife through butter — if anything, it’s easy to cut too much.
♥ No mention of “cracking the chest” — opening the rib cage (because it’s hard to reach the heart, otherwise) — though the previous panel does show some rib spreaders at the ready.

The basic concept of defibrillation is to provide enough current to knock the heart back into a normal rhythm, but not enough to do any damage.

I think Norman Osborn missed that memo.

A new masked and super-powered bank robber appears in Metropolis and Superman tracks him to his lair only to find that the robber had been waiting for him with a chunk of kryptonite.

A few months before, our robber realized that if he wanted to be a successful criminal in Metropolis, he needed to find some kryptonite. He spent months tracking down every meteor¹ that landed nearby, looking for elusive chemical. He lucked out: not only did he find kryptonite, but he also found a box with some pills in the meteor. There is a note with the pills that reads “These radioactive capsules to be used only if needed to renew our super-powers on Earth. [Signed] Jor-El”

The robber took the kryptonite-embedded box back to his lair. He swallowed one of the pills, gained super-powers, and went on a crime spree. Then he lured Superman to his hideout and exposed him to the kryptonite. Leaving the Man of Steel for dead², the criminal flies off to commit more robberies.

Of course, Superman’s not quite dead yet — he takes his last bit of energy and uses his heat vision to break the water pipe in the ceiling, sending water cascading down on the box of pills, washing all the kryptonite away³. Able to stand up again, Superman grabs the box of pills and swallows one, figuring he needs the super-powers they’ll provide since his have been stolen by the kryptonite. Too late, he discovers that some kryptonite dust had gotten in the pills when Krypton exploded — the same explosion which sent the box to Earth. Now he’ll be completely powerless until the chemical leaves his system⁴.

Thinking quickly, Superman calls Batman and Robin. When the duo shows up, he gives them each one of the super-power pills, and they fly off to capture the robber. Since they’re not used to their new powers, not only do they let the villain escape, but they cause some serious property damage. Undeterred, Superman trains them in the use of their powers and they fly off again to capture the robber.

Meanwhile, Superman — using his crafty reporter skills — has discovered the robber’s new lair. Unfortunately, the robber catches Superman in his hideout and pulls out a gun, shooting him in the chest. About this time, Batman and Robin arrive and capture the villain, who is still gloating over Superman’s body. Could the Man of Steel be dead? Of course not. It turns out that while Superman may have been powerless, his suit was still invulnerable and it blocked the bullet, saving Superman’s life. It’s all a moot point now anyway, as the kryptonite has worn off and Superman has regained his powers. He gives the super-power pills to Batman who promises to keep them safely hidden away in the Bat-cave⁵.

Notes:
1. Yes, technically he was searching for a meteorite, not a meteor, but I’m sticking with what’s written in the comic for this review.
2. If I were a criminal who gained his super-powers through a pill, I would take the pills with me instead of leaving them behind. Sure, leave the kryptonite-encrusted box — just take the pills.
3. Apparently kryptonite is water soluble.
4. Kryptonite or not, shouldn’t the pills have given Superman super-powers? They were developed to give Kryptonians who lost their powers (like Superman) temporary powers. He took one after losing his powers temporarily from kryptonite exposure, so why should more kyrptonite dust in the pills stop them from working? It’s not like they’re affected by kryptonite — Batman and Robin got powers despite the kryptonite in the pills.
5. As far as we know, the pills are still there. Or at least, all but one of the pills…

The acute porphyrias cause severe abdominal pain as well as neurological and psychological symptoms. Some of them have cutaneous (skin) symptoms as well.

The cutaneous porphyrias, as the name suggests, have primarily skin symptoms. Photosensitivity — a painful rash when exposed to light — is a common problem.

In the late seventies and early eighties, several papers and a book or two were published suggesting that porphyria was the basis for vampire and werewolf legends. There is a certain undeniable logic behind the idea. People with porphyria do not venture out in the daylight, which explains the sunlight aversion of vampires (and werewolves, to a lesser extent). The disease can cause a thinning of the lips and gums, exposing more of the teeth, giving the individual a more bestial appearance. Historically, porphyria was treated by having the patient drink animal blood. Additionally, increased hair growth can be seen in some cases of porphyria and the psychiatric symptoms can lead to strange behaviors and increased violence.

It’s an interesting hypothesis, but I’m skeptical. I’m certain that people unfortunate enough to have porphyria were accused of being vampires or werewolves, but I don’t buy the idea that the entire legend is based on the disease. The theory seems to pick and choose the symptoms of different porphyrias to support the idea, creating a hodge-podge disease that doesn’t actually exist in nature (or if it does, would be extremely, extremely rare). Drinking animal blood does not equate to a blood lust — people with porphyria may understand that blood helps their symptoms, but they don’t actually crave it. The theory also describes the modern depiction of vampires — which is quite different from the how our ancestors understood them. For example, the vampire’s violent aversion to sunlight — a main part of the porphyria link — is a twentieth century embellishment to the vampire.

I’m not alone in my views as the majority of the scientific and medical community has dropped the theory (and I’m sure most have even better reasons than the ones I mentioned.) This hasn’t stopped the “porphyria = vampirism” link from appearing in pop culture over the past several decades. I’m pretty sure I remember it showing up as a side plot in an episode of St Elsewhere in the ’80s. More recently, the idea has shown up in the Batman and Detective Comics annuals as well as this week’s episode of Castle.

In the back-up story in the Batman and Detective annuals, the Gotham City Blood Bank is vandalized and robbed, and there is also an attempted murder or two. The villain — or is it villains? — is revealed to be someone with porphyria who believes that they are a vampire.

In one scene, some blood found at the crime scene is sent off to the lab and is returned with a diagnosis of porphyria.
Here’s my annotated version of that scene:

1. DNA testing — DNA and genetic testing is one of the best ways to diagnose porphyria. However, it’s a specialized test that is only run by certain labs and it takes more than just a day or two to get results.

2. There’s been DNA testing, but they still refer to it by the general term “acute hepatic porphyria” rather than which specific porphyria it is. That’s the point of the DNA testing: to pinpoint the exact enzyme deficiency.

3. I don’t think there’s any doubt where the information from this first paragraph came from, and it’s a nice accurate paragraph. [link broken; will fix later today]

4. The second paragraph is a mess though, referring to a largely abandoned theory as if it were fact. The inaccurate “blood craving” is mentioned. And what is “pale pallor?” By definition, someone with pallor is pale.

I will point out that for the most part the writer makes it clear that it is the villain who believes in the porphyria/vampirism link — and other than the lab report shown above — does not seem to endorse the connection herself.

In Castle, an insane individual who believes himself to be a vampire screams out in flames and starts to smoke when exposed to sunlight. This is later explained away as porphyria.

Now, sunlight can be painful to people with severe cutaneous porphyria, but the skin rash (blisters, usually) take several minutes of exposure to develop — and that’s in the most severe case. The skin never smokes though, that’s simply ridiculous, even for Castle.

Posting resumes tomorrow with a look at vampires, werewolves, and porphyria (see the recent Batman annuals and this week’s Castle)

I’ve mentioned how often these PSAs featured pro-United Nations themes, and this is a perfect example focusing on the United Nation’s Children Fund — better known as UNICEF. This is the third DC PSA featuring UNICEF (one, two), and here’s a bonus Casper PSA thrown in for free.

This PSA is found in DC comics from December 1957. Jack Schiff, as usual, wrote this PSA, with Ruben Moreira on art. I scanned this in from a copy of Adventure Comics #243 (which features “The Super-Toys From Krypton,” where Superboy’s childhood toys are sent to Earth. Is there anything Jor-El didn’t send from Krypton — other than more people he could have saved, I mean?) There is also a black and white version that can be found in some comics (Action Comics #235, for instance).

More PSAs

Tags: comics psa halloween unicef binky allergy jack schiff ruben moreira

The previous case studies and a bit more an explanation can be found at Dr. Scott’s Case Studies of Comic Book Medicine

Magneto lands on the X-Men’s island Utopia, but Professor Xavier is not particularly happy about it and lashes out.

All previous Psychic Nosebleed Zen posts

Tags: comics medicine nosebleed x-men magneto xavier

Found in the upper left aspect of the abdominal cavity, the spleen is roughly the size of a grapefruit and serves several important functions: It removes old and damaged blood cells from the circulation, as well as removing harmful bacteria. It assists the immune system by acting as a large lymph node. It stores extra blood to act as an emergency reserve in case of severe blood loss.

Both blunt and penetrating abdominal trauma can injure the spleen. Penetrating trauma can lead to splenic lacerations. Blunt trauma can rupture it. Unfortunately, the spleen is very difficult to repair — it was once described to me as having the consistency of a sopping, water-logged sponge. Imagine trying to sew that back together. Often the only treatment for a severely damage spleen is splenectomy (removal of the spleen), leaving the patient asplenic (without a spleen).

The main concern in people lacking a spleen is an increased risk of infection. This is not just a slight increase in risk, but a significant increase in the risk of serious infections. In the worst case scenario, there is a condition known as OPSI (overwhelming post splenectomy infection) that can be fatal within just a few hours.

Asplenic individuals are susceptible to a wide variety of germs, but the three most concerning are:

1. Bacteria that have a thick protective capsule. These bacteria include pneumoccocus (a cause of pneumonia and other infections), meningococcus (a cause of meningitis), and Haemophilus influenzae (another cause of meningitis, among other nasty infections).

2. Capnocytophaga canimorsus, a bacteria found in dog bites.

3. Parasites that like to hide within red blood cells (malaria is the main one, but also babesiosis and ehrlichiosis, rare tick-borne infections).

Asplenic individuals need to be aggressively immunized against the riskiest bacteria. They will require the pneumococcus, meningococcus, and Haemophilus influenza vaccines. The pneumoccocal vaccine may need to be repeated every 5 years. Additionally, pediatric patients who lose their spleen need to be started on daily broad spectrum antibiotics for the next 2-5 years. Those who are considered particularly high risk for infection may need daily antibiotics for the rest of their life.