Monday, December 21, 2015


So this happened:

I am over the moon. I know I just posted about another book deal below for QUACKERY, which is adult nonfiction. Well, it's been almost three years since my last YA book deal, which was CATALYST. And I have written many things since that time, but this book is so special to me. I adored every minute of writing this book. It's a touch more literary for me, it's not sci-fi like my previous books, and it's more diverse book than I'd done before (one of the main characters is half Korean, half Black.) And I've been haunted by the song, The Wreck of the Edmund Fitzgerald by Gordon Lightfoot since I first heard it as a child, which mentions the Witch of November (here it is on YouTube.)

Here's the pitch that I had given to my agent:

Hector is a troubled teen, running from a violent secret.

Anda is the physical embodiment of the storms that sink the great ships of Lake Superior every November.

Isle Royale is the island on the lake, deserted every winter because it’s so inhospitable that no human can bear to live there.

No one is supposed to be on the island. One is fleeing the violence in his life; the other has violence running through her veins. Together, they will unearth secrets and truths that could destroy or save each other.

At 70,000 words, THE WITCH OF NOVEMBER is a YA mix of magical realism, contemporary issues, and romance. The novel will appeal to fans of Nova Ren Suma’s Imaginary Girls, Michelle Hodkin’s The Unbecoming of Mara Dyer, and Kendare Blake’s Anna Dressed in Blood.

I'm thrilled to be working with the Entangled Teen team, including my editor, Kate Brauning (who is a talented YA author as well--her book HOW WE FALL is pretty amazing. :)

The book will be out in later summer or early Fall 2017. I'm so excited to share it with you!

Follow Kate Brauning on Twitter, and please add THE WITCH OF NOVEMBER to your Goodreads TBR list!

Wednesday, November 18, 2015

Book Deal News: QUACKERY!

So this happened:


Okay, I had to get that over with. It's been almost three years since my last book deal, so yeah. Lots of celebrating!

But also, I guess this needs a little explaining? After all, I've published two YA science fiction novels, and whoa, here I am delving into the world of adult nonfiction.

Well, lately I've been thinking of my writing career with a different, larger perspective. I've published poetry, medical essays, research papers, and YA fiction. I've blogged about the writing process and with Medical Mondays, helping other writers with their medical accuracy. I'm still practicing medicine and trying to remember to buy that gallon of milk because we've been out of it for, oh, two days at the house.

Basically, lots of juggling. But what's been happening in the last few years, literary-wise, is that I've been finding myself drawn to certain projects because of the sheer fun of it. CONTROL and CATALYST are science fiction, but I don't see myself as only a science fiction writer. In fact, before those two books, I'd written a YA historical, and urban fantasy. I've wanted to write adult fiction, but the idea never came so I didn't pursue it before (I have recently, it's a recently completed WIP). Two years ago, I wrote a dragon fantasy set in Asia; before that, a MG magical fantasy; I've also written a contemporary/magical realism/paranormal book last year. Then there was the horror short story in AMONG THE SHADOWS.  I'm all over the place, because I'm passionate about a lot of story concepts. Some of these projects are actively looking for homes; others are quietly sitting on the back burner for another chance in the future.

But if there is one thing I'm consistent about, it's my love of science, medicine, and the human condition. They are the three threads, twisted together, that have taken me on a huge journey in the last several decades.

So I want to introduce you to QUACKERY. I'll be writing it along with Nate Pederson, a gifted journalist, librarian, and friend (he's the spouse of April Tucholke—she's responsible for bringing these two geeky heads together).

I'm SO excited. You have no idea what sorts of gross, fascinating, bizarre things I'm digging up for this book! 

*cackles impishly*

Also--please follow Nate on Twitter. He's new to Twitter, and I'm sure he'd welcome a hello from the writing community!

Monday, October 26, 2015

NaNoWriMo, CATALYST ARC giveaway, and Grosheries

National Novel Writing Month. It's that particular November rite of writerly passage in which people feverishly commit to writing 50,000 words in a single month.

click here for site! I'm logged in there as LydiaKang :)
I know, I know. Naysayers often quote the usual things, something involving "art" and "time" and "amateur" and "literary terror" in the mix. Agents worry about the deluge of barely revised novel submission in December and January. Writers try to remember the several novels published that started as a NaNo baby (was it one, or two? Actually, it's a huge list.)

Well, I've never been able to NaNo because I've always been involved in heavy revisions during the month. But this year, the timing is right. And by that I mean:

1. I have an idea (it's called "Stitched" and I can't tell you what it's about, I'm superstitious)
2. I have time in October to outline the idea
3. There is a giddy happiness regarding said idea
4. Unlike other novels I've written, the research is minimal. I'm super comfortable with this world.
5. I have friends who plan on plying me with a lot of advice, sympathy, virtual donuts, and occasional group screams of frustration.
6. I'm planning on providing my picky, inner editor a subscription to Netflix and a 200 gallon drum of caramel and cheddar popcorn. Nothing's going to slow me down.

Add me as a buddy on the website, if you're participating!

In case you missed it, I have several ARCs of CATALYST still in hand, and am giving them away on Instagram.

And on a last note, I did this fun, random Twitter linguistics experiment after hearing my three children (two of which were born in NYC) pronounce the word "groceries" like this: GROSHERIES.

I was shocked. I pronounce it GROSSERIES. No H! H's don't need to be there!

So here's the results of my Twitter experiment.

How do you pronounce it? Are you doing NaNo this year? And finally (if you're not on IG) leave a comment if you'd like to request an ARC of CATALYST to review and I'll enter you into the draw. :)

Monday, October 12, 2015

Events Updates: Omaha and Chicago!

Hey everyone! If you're in Omaha, I'll be at the Omaha Lit Fest this Saturday, October 17, along with friend and colleague Dr. Bud Shaw to discuss how our practice of medicine and surgery affected our writing.

If you're in town, I'd love to see you. This is my first time at the Omaha Lit Fest and I'm excited to see what it's all about!

On Sunday, October 18th at 2 PM, I'll be in the Chicago area for the Among the Shadows book signing and Halloween party! It will be at Anderson's Bookshop in LaGrange, Illinois and attended by Mindy McGinnis, Demitria Lunetta, Kate Karyus Quinn, Kelly Fiore, and Lenore Appelhans.

Hope you see you there!

Monday, September 28, 2015

Medical Mondays: I Am Titanium

(That's one of my favorite songs, by the way.)

Today, we've got a question from a friend and author, Elle Cosimano. She's the author of the YA thrillers Nearly Gone, the sequel Nearly Found, and the upcoming Holding Smoke.

Coming May 3, 2016 from Hyperion
Elle asked: Do hospitals still use metal plates for reconstructive surgery, or do they use some other type of material? Assuming his skull was damaged [during an assault], is it reasonable to mention that he had metal plates in his head?

The short answer? Yes.

Here's the longer answer. In a situation where someone had enough trauma to the skull to warrant surgery, it's possible that they would need titanium implants during the surgery. In one scenario, only titanium screws and thin, narrow plates would be used to put broken pieces of skull together. In a situation where the skull injury is too large to be covered by native skull pieces, a larger piece of plating or mesh might be used.

Photo Credit
I sort of have a fondness for titanium, so here are some more thoughts.

Why is titanium used in medical implants? Titanium is an inert metal that is biocompatible with the human body, so rejection isn't an issue. It's also able to osseointegrate, meaning that bone can grow right up to that metal, without having scar tissue in between.

Do they have to stay there forever? For the above scenario, yes. For things like artificial joints, those tend to have a more limited life span of 15-20 years (or more) due to the wear and tear of the components of the actual socket. Other life span factors include the health of the patient, bone health, and activity levels.

Will the patient stick to an MRI machine, or a giant junk yard magnet?
No. Titanium is non-ferromagnetic, so MRIs are safe (however, if it's near the area being examined, the implant can cause blurring or streaks, called "artifact," of the images.)

How about metal detectors? Depending on the detector or screening tool at the airport/school/building, titanium implants could set off an alarm.

Other bodily uses? Titanium dioxide, which is the most common form of titanium found naturally, is also the white stuff used in physical sunblocks. Lots of body piercing jewelry is also made with implant grade titanium.

I need to impress my friends. Really? Well okay, if you insist. Melting titanium will explode on contact with water. Also, in titanium polluted soil, Scotch Bonnet mushrooms will bio-decontaminate the soil. There you go.

On that note, here's a link to David Guetta and Sia's song, Titanium. Because it was in your head anyway, right? ;)

Monday, September 21, 2015

Book Giveaway! Last Night in the OR: A Transplant Surgeon's Odyssey, by Dr. Bud Shaw

Plume Books/Penguin Random House/2015
Many of you know I've lived in Omaha for almost a decade now, after being a home-grown East Coast girl. I also did my twenty-four years of schooling and training in the East too. (I had to add that up recently when a middle schooler asked me how many years of work it took to be a doctor. I think I scared him out of a future in medicine! Oops.)

What many don't know about Omaha is this: it is not, in fact, littered with cow pastures.
And also this: it possesses a prolific, supportive, and thoughtful contingent of artists.

Bud Shaw is one of them, and it's been wonderful working with him on the literature side of things these last several years.

Dr. Shaw is a writer, poet, and retired transplant surgeon who developed the liver transplant program at the University of Nebraska Medical Center. He's written over 300 journal articles, 50 book chapters, and was nominated for the prestigious Pushcart Prize in 2013 for his essay, My Night With Ellen Hutchinson. He also became a friend during the time that I joined a workshop called the Seven Doctor's Project back in 2009.

Yesterday, I attended his book reading and signing at The Bookworm Omaha for his debut book, a memoir about his career in surgery and the very human journey he experienced. Here he is, kindly crouching down for the photo because he's so damn tall. (Everyone in Nebraska seems so damn tall to me, at least.)

He recently wrote this wonderful article in the New York Times about a singular experience of watching two of his identities collide, being a physician and parent.

A few words about the book:

“This is just about the best book about surgery and a surgeon I have ever read—by surgeon or civilian alike. It is warm, honest, straightforward, sad, amusing and compelling from beginning to end.” —Lee Gutkind

"Shaw's lean prose offers insights into medical professionals' private perspectives as well as a sobering sense of human fragility and the scientific strides taken to counter it. A bracing, unusual personal narrative that should appeal to aspiring physicians as well as to those considering the "big questions" around high-risk surgery." —Kirkus

“Dr. Shaw's memoir is a uniquely human journey of a man who performed superhuman feats.  His written candor made me (a surgeon as well) cry, laugh, recoil, cheer, and ponder life's true meaning.  I could not put this book down.”—Paul A. Ruggieri, M.D., author of Confessions of a Surgeon

You can find Dr Shaw's book at our local indie bookstore, The Bookworm, and also at Barnes & Noble, IndieBound, and Amazon

And I'm giving away a signed copy!

a Rafflecopter giveaway

I hope you get a chance to read it!

Monday, September 14, 2015

Medical Mondays: Fluoride Toxicity and Saying No To That 100th Cup of Tea

I've been wanting to do a #MedMondays on this one for a while.

In the United States, pretty much everyone is familiar with fluoride. The element fluorine is the lightest halogen and exists as a highly toxic, yellow gas at room temperature. But we know it better in its anionic form, fluoride.

It's in our drinking water and toothpaste, and helps to prevent tooth decay and keep our teeth strong. (But did you know that several countries have chosen to no longer fluoridate their water? The CDC says it's one of the top ten greatest public health achievements. Others have argued that it's a compulsory, mass medication in our drinking water. Thoughts?)

A little too much fluoride in your drinking water (or swallowing too much toothpaste) can cause dental fluorosis, which is harmless but causes cosmetic changes to the enamel in the form of stained and pitted teeth.

What about more severe toxicity? Well, it turns out that not only your teeth are affected by fluoride, but your bones. In some areas of the world, particularly where the fluoride levels in the water are high due to contaminated water supplies or geological sources, fluorosis can occur.

Chronic fluorosis, which is from consuming too much fluoride over time, can result in denser but brittle bones, calcified ligaments, stiffness and joint pain.
The arrows are pointing to excessive calcium deposits on the forearms and spine. Source: NEJM
Acute fluoride toxicity can occur in areas after industrial explosions or accidents (like from a hydrofluoric acid spill), or more commonly by ingestion of too way much fluoride-containing dental products. Symptoms can include nausea, vomiting and diarrhea (the trifecta of GI distress! In doctor's notes, we write that as N/V/D, in case you were wondering), kidney damage, heart damage, and possibly even death.

And guess what? You can get it from tea, too. Tea plants tend to accumulate fluoride from the soil. See those x-rays up there? They were from a woman who drank >100 tea bags worth of tea every day for 17 years (read here for the New England Journal of Medicine article.)

People who drink a lot of brick tea are at risk, too. What is brick tea? I actually snapped this photo at one of my favorite tea shops, thinking it looked just like an ink stone for Asian calligraphy.

Apparently, this type of tea can be made from older tea plants, and so they accumulate more fluoride than your usual cup of tea.

For more information, check out the CDC page on dental fluorosis and the WHO page on fluorosis due to drinking water. For parents, here's the info page on dental fluorosis by

Have fun brushing your teeth and overthinking the entire process! :D


It's here! So excited to be part of this dark YA anthology with some of my favorite authors!

About the book:

You’ve been there.

It’s dark and you’re comfortable. You’re just about to fall asleep when you can’t help but wonder if maybe tonight the thing you’ve always been sure exists will finally find you.

The best short stories stick with you, and the stories in this book especially, are meant to cast long shadows. The authors who contributed to this anthology are not only familiar with what lurks among the shadows, we choose to spend time there. Our monsters all live in different places—under beds, beside peaceful streams, inside ourselves, down mine shafts, in the sky. The darkness you’ll find in these pages knows no boundaries, so it’s only fitting that these stories cover many genres.

Reality can be just as terrifying as anything our imaginations conjure, which is why the darkness in these pages isn’t relegated just to flights of fancy or the paranormal. In choosing such a wide range of stories, our hope is that everyone will find something to make them clutch their bedcovers a little closer.

In realistic contemporary stories from Joelle Charbonneau and Kelly Fiore, depression, addiction, obsession, and isolation are all the stuff of nightmares. Other stories by Justina Ireland, Phoebe North, and Geoffrey Girard straddle the line, making us question what is real and what is false. Mindy McGinnis explores the question of not knowing yourself, while Kate Karyus Quinn speculates on the effect of learning that every terrible thing that’s ever happened to you has been manufactured for the entertainment of others.

Demitria Lunetta and Gretchen McNeil each take a closer, horrific look at human nature. Lenore Applehans delves into a post-apocalyptic future, while R.C. Lewis discovers the darkness that lurks on another planet in her science fiction narrative. Then of course there are the paranormal stories from Beth Revis and Lydia Kang, each digging into the many types of monsters that might wait for us in the dark.
Overall, you’ll find a wide range of horrors represented, including demons, aliens, and one of the most frightening creatures ever—human beings.

So set aside an hour or two, switch on some lights and come join us… among the shadows.

Monday, September 7, 2015


So excited that this book is coming out soon! We have lots of blog tour stops scheduled and there will be excerpts from the book at each stop.

Read some choice bits from this dark YA anthology--there is something there for every reader. :)

9/7/2015A Backwards StoryExcerpt- Lenore Appelhans

9/7/2015Bookhounds yaExcerpt- Beth Revis
9/8/2015The Book CellarExcerpt- Joelle Charbonneau
9/9/2015The Cover ContessaExcerpt- Kelly Fiore
9/10/2015Fiction FareExcerpt- Lydia Kang
9/11/2015Ohana ReadsExcerpt- Demitria Lunetta
9/12/2015It Starts At Midnight - Excerpt-Geoffrey Girard
9/13/2015The Bibliophile ChroniclesExcerpt- R.C. Lewis
9/14/2015CreatyvebooksExcerpt- Justina Ireland
9/15/2015Please Feed The BookwormExcerpt- Mindy McGinnis
9/16/2015Seeing Double In NeverlandExcerpt- Phoebe North
9/17/2015She Dreams in FictionExcerpt- Gretchen McNeil
9/18/2015Curling Up With A Good Book- Excerpt- Kate Karyus Quinn

See you on the tour! The book releases September 15th and is available for pre-order on Amazon. :)

Monday, August 31, 2015

Medical Mondays: Having Fun With Blind Spots

There are so many little quirks of normalcy in your body. Maybe I'm well-suited to being a doctor since I find most of these endearing and fun (I'd entertain myself during boring lectures by finding the valves in my wrist veins, forcing the blood to flow backwards and making them pop out like...okay, never mind. You get the idea.)

I'd also have fun with finding my blind spots. It's kind of cool to watch your body parts disappear on purpose.

Let me explain.

Yes, you and everyone else have a blind spot. Two, in fact.  Here's how it works. The main nerve of your eye, the optic nerve, has to pass through the back of your eyeball to connect to your brain. The back inner surface of your eyeball is the retina, filled with photosensitive cells that help you see images. But in that one area where the optic nerve passes,  there are no cells with the ability to detect light and images. Why have you never noticed? Well, your brain does a great job of "assuming" what should belong in that blinded area, so you never notice. Also, with two eyes, they compensate for each other's blind spot.

Here's how to see your blind spot in action. 
1. Cover your left eye with your left hand.
2. Hold out your right arm, and with your right hand, make the "bull horns" sign (pointer and pinkie finger raised, palm facing away from you).
3. Stare at your pointer finger nail with your right eye, and slowly bring your hand closer. Keep your eye on your pointer finger nail the whole time.
4. At some point, the tip of your pinkie will disappear. Viola! That's evidence of your blind spot. (If this doesn't work, here's another method that's pretty cool.)

I'm not quite sure how you writers will end up using this in your stories, but it sure is entertaining when you're procrastinating or in a boring meeting. Just know that people will wonder why you're making random hand gestures for no apparent reason. Heh.

Also? Only vertebrates have this issue. The octopus does not have a blind spot. Have fun with that random, somewhat useless factoid today! Cheers!

Friday, August 14, 2015

Among the Shadows Giveaway!

AMONG THE SHADOWS releases in a month and we're having a giveaway for 5 paperback copies (plus signed swag!) and 5 digital copies. The swag bundle includes signed bookmarks by Beth Revis, Joelle Charbonneau, Kelly Fiore, Mindy McGinnis, Lydia Kang, Kate Karyus Quinn, Gretchen McNeil, and Demitria Lunetta! There are also some extra goodies like postcards, bookplates, stickers, and more! 

Among the Shadows is now available for pre-order on Kindle...AND we're also running a Goodreads giveaway through mid-October! 

 a Rafflecopter giveaway

Sunday, August 2, 2015

Catalyst Giveaway!

Hey! I'm running a five-book giveaway on Goodreads. If you haven't had a chance to read Catalyst, then click the links!

Goodreads Book Giveaway

Catalyst by Lydia Kang


by Lydia Kang

Giveaway ends August 17, 2015.
See the giveaway details at Goodreads.
Enter Giveaway

Monday, July 13, 2015

Medical Mondays: Dealing with a Fictional Amputation

Hello friends! I received this question recently, and it brings up a lot of the fictional issues that can come with a surgical procedure. The question comes from Deb Salisbury, a blogging friend and an expert in historical fashions.

My thirteen year old MC injured his foot, contracted gangrene, and had his foot amputated at the ankle.

Would he be up and wandering around town on crutches after ten days? Or twenty?

After six months of good healing, how much trouble would he have walking in a wool-stuffed boot if he lost his crutch? Would blisters or sores form if he wasn't used to it? At the very least, he's emotionally dependent on his crutch, in my story. Would he still be physically dependent on it?

FYI: The story is fantasy in nature, and there are magical elements in the world, which will be helpful for staving off infections. I would also assume that surgery wasn't terribly sophisticated, as we are dealing with pre-modern techniques and instruments in this world. 

There are also a few more assumptions. First, that the character at baseline is healthy (this matters for wound healing and general strength). Second, that there were no complications to surgery (I know--this is a BIG assumption. Historically, amputees often died soon after surgery from massive hemorrhage or infection. But for this story, we need our character alive and only with an amputation. So. Let's assume the surgeon/medical person could somehow tie off or cauterize blood vessels, creative a nice flesh flap to cover the wound, and sew it all up nicely). In this idealized case, the superficial aspect of the wound ought to heal within two to three weeks. 

However, the deeper parts of the leg tissue from the amputation itself takes a longer time to heal, up to eight weeks, and even then it's a continuum of healing. So I was glad to hear that he wasn't faced with using a prosthesis soon after surgery, which might not be realistic in this world. 

He probably could use crutches within a few days after the surgery, and using a prosthesis at the six month mark would likely be okay. It would be tough on him, though, because I'm assuming without modern prosthetics, the boot won't fit great, the wool would be rough and he hadn't yet "hardened" his stump to this kind of pressure and stress yet. There would be issues with blisters and stress on the skin. His muscles in that leg would also be weak from disuse (no tried and true physical and occupational therapists in this fantasy), so he'd have to deal with that too. At the beginning of using the prosthetic boot, my guess is he'd be dependent on the crutch, but not after he got used to it and built up his stamina. 

For more information, here's a great overview by Johns Hopkins on dealing with an amputation before, during, and after the surgical period. 
Here's the National Amputation Foundation website with FAQs for new amputees. 
This is a great essay on the history of amputation, by Meghan Wooster. 
And also for history's sake, this is a great Pinterest board with photos of historical prosthetics. 

Thanks Deb for a great question!

Monday, July 6, 2015

Bonus CATALYST Scene!

Hey guys! I posed this bonus scene from Vera's POV in Catalyst for the YA Scavenger Hunt a few months ago. Here it is, and I hope you enjoy it!

To read a bonus scene from Control from Cy's POV, click here. :)


I am green.
Hear me roar.
Well, I’m greenish.
This is what I say to myself in the mirror in the morning. I’ve dragged myself from Hex’s four, deliciously heavy arms, out of the common room where we’ve all taken to sleeping at night. We’re all too chicken to sleep alone these days, though no one will admit it.
Back in my room, I push aside the softened, dying vines that used to creep from floor to ceiling. It used to look like a jungle in here; now it’s as if winter has permanently taken root. We have to conserve energy now, and I’m only allowed enough power to fuel the clamshell tanning bed where I get my daily dose of UV.
I study my reflection with a critical eye. My face is greener than the rest of my body, which is turning that un-tasty shade of pond scum and fall leaves. No matter that my curves are perfectly intact. Hex says my body is a figure-eight racetrack and I heartily agree, particularly when I’m kicking his ass in Kendo. I love how that pisses him off.
 But I mourn the absence of sunlight in my life. The chloroplasts in my skin ache for photons, for drenching solar radiation. There is no other way to explain the way I feel, locked away from the sky because we can’t risk showing our faces outside of our home, Carus. We can’t go up to the agriplane anymore.
Dammit. I’m hungry as hell.
After a breakfast of soil brownies, I go straight to Marka’s room. She’s like our den mother, and ever since the Senator’s assassination, she’s been locking herself up and watching the news incessantly. Carus isn’t safe anymore. Worry is shrinking her already thin frame. She might disappear in a stiff breeze, and it terrifies me. But terror is a good friend. It makes me mad, and anger is how I fuel myself with the energy to fight. Fight who? We’ll find out soon.
I sit on the bed and Marka barely notices.
“Did you eat breakfast?” I ask.
She barely shakes her head. Her eyes are glued to the screen before her. Nervousness gnaws at me, and I start chewing my fingernails, which still taste of nitrogen and phosphorus from breakfast.
Soon, Hex and Zelia show up. Hex puts two hands on my shoulders, and they’re steady, but I can still feel the apprehension in his fingertips. Zelia sports dark circles under her eyes, and her hair is violently frizzy. She probably lost another night of sleep, and it’s no wonder. We all miss Cy, but she loved him most, and carries his loss like an infection that sickens her. She won’t talk to me. She won’t talk to her sister, Dyl, about it, either. I’ve never been good at warm and fuzzy. I hover near her at bedtime, at meals, hoping that just being around is enough. When I hold her with a glance that says Are you okay? I miss him too, she always looks away.
There’s only one cure for her despair. Cy.
I look away from Zelia, only to find Marka watching me with her concerned doe eyes. Even now, I remember that look. Memories flood me, of lying in a cold, stinking gutter, crying as warm hands leave me behind. After being discovered and deposited in a dark, locked room at the local orphanage, those big eyes of Marka found me. She swaddled me with an extra blanket and picked me up.
“Aren’t you the most beautiful thing that ever sprouted on this earth?” she cooed.
Hex says it’s not possible to have memories from when I was a baby. Maybe I’m making half this up. Maybe I’m just recalling what Marka told me as a child. But I swear, I remember her eyes. They understood the love I’d wanted from my parents, and hurt I received in return. They spoke of more love and pain to come, whether I liked it or not.
The news conference begins, and Marka’s eyes snap to the screen.
My skin goes icy, because somehow I know. This conference will bring no good news.
Today is the beginning of the end, and we all know it deep in our bones.

Monday, June 29, 2015

Medical Mondays: Water, The Poison We All Drink

Ever consider water as a means of sickening your characters in a novel? Yes? Well then, this post is for you. :)

Have you ever heard someone say, "Oxygen is poisonous. After all, 100% of humans who breathe it will eventually die."

Well, the same could be said about water. Except water can kill a heckuva a lot faster if the situation is just right (or wrong, rather). We're talking about water intoxication.

That's correct. Water can intoxicate you, and I do mean in a toxic way. It's also known as water poisoning, or the medical term, dilutional hyponatremia ("low salt in the blood").

There are several situations in which one can become seriously sick or even die from water intoxication.

  • Endurance athletes: Think of marathoners who collapse at the end of a race and need hospitalization. When you're sweating a lot of salt water, your body *thinks* it needs to retain fluid because you're sweating and exercising, AND you're drinking large quantities of pure water, it's a perfect set up for this condition. 
  • Heat Stress: It's a hot day. You're sweating buckets and drinking huge amounts of water to compensate, and then you get a headache...and confused...and pass out. Yep. 
  • MDMA use: Also known as "ecstasy", this street drug not only causes body temperatures to rise (hyperthermia), but users drink a lot of water because of it. On top of it, MDMA can cause the body to secrete a hormone called ADH (antidiuretic hormone) which slows down the ability to urinate out the excess fluid. 
  • Really Stupid Challenges and Games: I'm a huge non-fan of all those internet challenges and games. Like the Cinnamon Challenge, or the choking-somebody-until-you-pass-out challenge. Well, there's also a water drinking challenge, and guess what? People die. This unfortunate woman died after a radio contest was held to see if people could drink large amounts of water and not pee. This 12 year-old died playing water poker where she had to drink a glass of water if she lost a hand. 
  • Psychiatric Illness: All doctors learned about this in medical school. It's called psychogenic polydipsia, in which a sufferer feels compelled to drink water constantly. 
  • Accidental/Unintentional: Babies can become water intoxicated because it takes relatively little water compared to their body size to make them ill. Adults can drink too much water for the wrong reasons (for example, they get nervous before a medical test, or are trying to dilute their urine before a drug test, or are trying to suppress their appetite and drink too much water too quickly). 
  • Torture: Enough said. 
So what is the mechanism of water intoxication? Basically, a healthy pair of kidneys can clear about a liter of water per hour. If you overdue this and drink too much and too fast and retain more water than your body needs and can get rid of, your blood sodium will start to become dilute. 

When this happens, your body cells (which contain a healthy, well-regulated amount of sodium) start to take in water to try to even out the sodium concentration discrepancy between what's inside the cell, and what's outside. So cells start to swell. Like your brain cells. Which is really, really bad. 

Symptoms include headache, confusion, irritability, muscle cramping and twitching. When it's worse, nausea and vomiting, coma, seizures, brain damage, and death. 

How much can kill you? Drinking 3-4 liters of water too quickly could make you hyponatremic. The lady in the water drinking contest drank about six liters of water in a three hour period before she died (that's just over one and a half gallons of water). 

For all of you out there who are now pushing away that glass of water in abject fear and horror, don't! Remember--drink to satisfy your thirst, use common sense to stay hydrated, stay cool, don't do stupid internet challenges, and you won't end up on one of my Medical Mondays posts. :) 

Also, don't use Ecstasy. Bye now!

Monday, June 15, 2015

Medical Mondays: Hello Mummy! (Corpse Decomposition, Part 2)


Boy, it's been a while since I did a Medical Mondays. A few days ago, I received a question on Facebook that prompted me to revive the blog, Frankenstein-like, with a zap of inspiration.

For those of you who are new to my blog or Medical Mondays, here's the short of it. I'm a doctor of Internal Medicine with a background in biology and neuroendocrine research. When I started writing fiction back in 2009, I started blogging but didn't know what to blog about. After all, everyone had a writing journey story to tell. What did I have to add to the mix?

Well, it turned out that I was doing a too-good job of keeping my medical career and my creative side completely separate. I realized, hey, I have a way to give back to the writing community.

I can do medical consults. For free. 

So I told my writer friends I'd help answer their fictional medical questions to help them make their stories more accurate, or at least find the right diagnosis or situation to fit their plot needs. But sometimes, I'd just blog about interesting science or biological randomness just to spur imaginations. (in fact, it was one of my own posts that gave me the idea for the main character in CONTROL.) And voila, Medical Mondays was born.

Since then, I've been happy to help out lots of authors, some of whom were my blogging buddies way back when, like Theresa Milstein, Angela Felstead (this is her question!), Stina Lindenblatt.

I've also consulted with newer friends, including Elle Cosimano (Nearly Gone), C.J. Flood (Infinite Sky), Mindy McGinnis (A Madness So Discreet), Megan Miranda, Tara Sullivan (The Bitter Side of Sweet), Emma Pass, Sarah Fine, Justina Ireland, and more but I'm forgetting the whole list!

So what questions did I get? Take a glance at the tab up yonder and see what I've blogged about before. :)

So here's today's question: Are there body parts that would keep for centuries and not rot? 

*cracks knuckles*

*hopes that readers have a strong stomach*

So a few years ago I blogged about corpse decomposition and what happens under relatively normal circumstances, including which body parts decompose the fastest and slowest. Sometimes, under ridiculously good conditions, it can decay super fast (if you have a strong stomach, check out this video of a pig decomposing underwater. Yep, they videotaped the whole thing and it's so utterly gross and I couldn't look away while gagging quietly).

Today, we'll talk about why things might slow down and be preserved for longer than expected. Consider this part deux.

So. Why would a human body NOT decompose? 

1. Lack of moisture. Like in the poor pig demonstration above, moisture is decomposition's friend. It allows a good environment for bacteria to go to work dissolving a corpse. Without it, the body turns into (forgive me) a sort of human jerky. Bacteria have a lot of trouble breaking down desiccated flesh (which is why jerky is so good for camping, since it won't rot easily. I am sorry jerky lovers, but you are eating mummified food. Yep.)

The Egyptians used to augment the dryness of the environment when creating mummies by using natron--a drying salt found locally that was stuffed into and packed around corpses to dry them out.

Other famous mummies include the Saltmen, who accidentally died in salt mines in Iran and were found 2200 years later, complete with intact pork tapeworm infections.

2. Temperature. Most of us are lucky to have the brilliant technology of the refrigerator and freezer at our beck and call. Not only do they keep food fresh longer, they are also fantastic for mummification. (Lydia is not a serial killer. Please repeat this. The only thing I mummify in my fridge is long-forgotten Laughing Cow cheese.)

There are a lot of mummies found due to their being pretty much flash-frozen and sort of freeze-dried upon death. These include the famous mummies of the Inca and the 500 year old Greenland Qilakitsoz mummies.

3. Acidity. In the fight against decomposition, a low pH is good. We all know that acid is great at preserving. Hello pickles.

The Bog men are famous for their startingly well-preserved bodies. Tollund Man is one of the most famous. In the peat bog, the lack of oxygen, cold temperatures, and high acidity (despite the moist environment) could even preserve facial expressions.

4. Chemical Preservation. So this sort of includes the embalming practices of ancient Egypt and numerous other cultures, but it also includes the more modern methods of using preservatives like formaldehyde to embalm corpses. Sometimes brandy works great! (Vice Admiral Horatio Lord Nelson). In other circumstances, people have asked to have their body parts preserved and mounted, doll-like and thoughtfully arranged, for visitors (Jeremy Benthem).

More recently, the plastination of bodies has made its rounds on display around the world and as a means of academic anatomical study. (I can't help but mention that there was a questioning of the ethical issues surrounding these display exhibitions: see this NPR article.)

So there you go. If you need body parts in your novel to last a LONG time, use some of these methods above to pickle, freeze, or dry out your corpse in question.

Fun times, people. Fun times. This is what you get for hanging out with writers.

And sorry to make your stomachs churn!