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Monday, February 13, 2012

Downton Abbey: Reality check about Spinal Paralysis, Spanish Flu, etc. (Web MD)

Downton Abbey: A Miraculous Recovery Marred By Worldwide Tragedy


By Brianne Moore


 Warning: This post contains spoilers The soap bubbles keep pouring forth, don’t they? Fast on the heels of last week’s amnesia and missing heir storyline, we have a miraculous recovery, a mysterious death by poison, and a convenient outbreak of a deadly disease.

First up—ding, dong, the witch is dead! Say farewell to Vera Bates, a cartoon villain if ever I saw one. She’s shuffled off the mortal coil with the help of arsenic, and she’s in good company: arsenic was so popular as a poison amongst the upper classes for centuries it was known as “inheritance powder,” given its ability to speed up the inheritance of impatient heirs.

George III, a member of the Medici family, and Napoleon are all believed to have been poisoned with arsenic at one point. For years it worked well ecause it was odorless and left no traces in the body. It has such a terrible reputation we’re still terrified of it, even today.

It fell from grace after the Marsh Test was invented in 1836 and led to a break in the famous LaFarge poisoning case in 1840. Symptoms of arsenic poisoning include headaches, confusion, diarrhea, drowsiness, convulsions, vomiting, muscle cramps, hair loss, and finally coma and death. So the question is: was Vera murdered, or did she commit suicide?

Only time will tell. Of course, the big news is Matthew’s Miraculous Recovery (soap opera plot #8,479—suddenly reversed paralysis!) His sudden tingle at the end of the last episode was a sign of things to come, and come they did as he managed to leap to his feet to keep his beloved Lavinia from taking a tumble.

Never mind the man’s been in a wheelchair for over a year and his muscles would most certainly have seriously atrophied—he’s walking again! It’s a miracle! Naturally, Dr. Clarkson is summoned and puts it all down to a case of spinal shock. This is a bit of a problem, because spinal shock, though it does often cause below-the-waist paralysis for a while, typically wears off within 4-6 weeks. Only in extremely rare cases does it take a few months. Matthew was injured more than a year ago. Methinks the author failed to do the research on this one.

The most disturbing aspect, though, is everyone’s cavalier attitude toward the doctor, even after he tells them that a specialist believed it was spinal shock all along, but Clarkson withheld the information because he was so sure he was right and didn’t want to be proven wrong. That sort of arrogance and condescension is astonishing and alarming, and brings up a lot of other questions. What else has he been ignoring because he’s so certain his diagnosis is right? Why didn’t he mention this other diagnosis when Matthew told him he was feeling tingling in his legs (Clarkson outrageously just told him it was all in his head, despite this other diagnosis)? Why on earth did the specialist never speak to Matthew or a member of his family directly about any of this? Why does everyone just shake Clarkson’s hand and invite him to dinner instead of firing him on the spot?

Seriously, this man’s a lousy doctor with a terrible bedside manner. He’s proven in the past that he’s not exactly up on the latest treatments; nor is he all that interested in furthering his own education. This man is bad, bad news and an object lesson in why it’s a good idea to check out your medical records yourself, if possible. But before long all that’s forgotten as history intrudes on Downton with the arrival of the Spanish Influenza Pandemic (which had nothing to do with Spain at all), even though by this point in time the pandemic was largely winding down (it officially died off by December 1920, but most of the later cases were in far-flung areas where it took a while for the disease to arrive).

The 1918 pandemic was particularly devastating: it’s estimated that between 50 and 100 million people died worldwide, and some 500 million (27% of the world’s population at the time) were infected. The virus—a form of H1N1 we’re all too familiar with today—would present with typical flu symptoms—fever, headache, nausea, fatigue, before patients experience a cytokine storm in which their bodies’ immune systems overreact and attack the body. This might explain why most victims were young and generally healthy people, as opposed to the very old, young, and sick who were often felled in flu pandemics.

Though it was winding down, World War I played its part in the spread of the disease. The first victim was believed to be Albert Gitchell, a company cook at Fort Riley, Kansas. His illness spread quickly through the camp, and soldiers on their way to the front carried it with them. The mortality rate from the flu is not known, but it may have killed more than the Black Death in the 14th century, and it’s become known as the Greatest Medical Holocaust in History. Around 28% of the population of the United States was infected, and 500,000 to 675,000 died.

Britain lost as many as 250,000 of its citizens. India was the hardest hit—17 million people died of influenza there. Most of the deaths were not due to the influenza itself but because of bacterial pneumonia, a secondary infection related to the flu. That explains Lavinia’s rally and sudden decline. Recent research into the pandemic has found evidence the virus originated in poultry and swine used for food at Fort Riley. Despite extensive research, however, the 1918 pandemic remains, largely, a mystery.

Still, the horrors of it have remained in human memory, so every time a new influenza strain rears its head, people start to panic. Luckily, we’re a bit better equipped to diagnose and handle a massive outbreak than people were in 1918.


WEB MD:  http://blogs.webmd.com/tv-checkup/2012/02/downton-abbey-a-miraculous-recovery-marred-by-worldwide-tragedy.html

4 comments:

  1. I think you need to do a little more careful research on Downton Abbey before criticizing it. Matthew had not been in a wheelchair for over a year, as you suggest. He was wounded in August 1918 at the battle of Amiens, and first felt tingling in Nov 1918. He stood up briefly in a crisis situation in January 1919, and was able to walk with a cane in April 1919. While his ability to stand up after even a few months of paralysis may be a little bit of poetic license, 3 to 5 months is within the realm of possibility for recovery from spinal shock.

    In addition, the Spanish flu came to Downton Abbey in April 1919, NOT 1920, as you suggest. So that time frame in the series is also correct.

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  2. #1 - I would never criticize Downton Abbey. I am totally hooked

    #2 - These were not my comments, this was an article written in WEB MD, an online medical thing. They have a blog evidently and I just thought it was funny that serious doctor types were so ticked off at Matthew's doctor.

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  3. Sorry, Karen. I didn't realize they weren't your comments. My comment was directed at the person who wrote the WebMD article. I get a little annoyed at all the criticism about the historical accuracy of Downton Abbey, by people who aren't even accurate in their criticism. Besides, it's a drama, not a documentary, and if it were absolutely accurate in every detail, it would probably be boring.

    I am also hooked - love the characters, the dialogue, the beautiful setting, and I don't mind if it is a little melodramatic at times. It's a refreshing escape from all of the cynical, crude so-called "realism" of so many TV shows today.

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  4. No problem whatsoever. I too am a little tired of the nit picking. This doctor sounded pretty intense though and was ready to go after the DA doctor for misleading his patient. Everyone is hooked on this and I CANNOT wait until the next series.

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