rusquen (rusquen) wrote in little_details,

Diagnosis to order

You people were so great, I came back for more :)

Setting: our world sometime in future, technology is a bit more advanced but not unrecognizably so.

Character A is a man in his fifties, who used to be very athletic (army), but approximately ten years ago suffered a serious injury - a stab wound from a blade weapon, probably to his side or abdomen. He had also fractured his dominant wrist, which resulted in permanent stiffness. Spent a year or so in various hospitals, then retired from the army and went on to become a... let's say, for simplicity's sake, a politician. He doesn't smoke, doesn't drink much, and generally tries to keep in shape.

Character A gets poisoned. It doesn't matter how or with what at this point, if need be I'll invent some futuristic substance. What matters is that the poison either causes or convinsingly imitates an attack of some familiar disease.
I'm looking for what disease that might be. It needs to be something unsurprising, so it doesn't arouse too much suspicion right away. It would also be awesome – but not comepletely necessary – if it could be linked to Character A's old injuries.


  1. The poisoner does NOT intend to actually kill the victim. However, they're counting that the victim will receive advanced medical care within 15-20 minutes of the attack. So the disease needs to be something that is fairly unlikely to kill right away, but it's okay if it's likely to kill within the next couple of hours/days/weeks – they may have invented a reliable treatment for it in the future.

  2. The patient must be unable to coherently communicate with anyone for at least two days after the attack. I mean, anyone and by any means. Unconsciousness is best, failing that - high fever and total lack of making any sense. He has information he wants to share, which I as an author don't want him to share yet. If it helps, the poisoner did not necessarily plan for that – they just wanted to keep the guy from being too active and getting underfoot. Uncommunicativeness could result from unexpected complications or unforseen drug allergies (although unforseen drug allergies are kind of unlikely, seeing as he had spent so much time in hospitals just ten years earlier - they probably know what he is allergic to by now).

  3. Time limits. The patient collapsed approximately two hours after being administered the poison, so the disease needs to be something that develops fairly quickly. For these two hours, he was under a fair amount of psychological stress and may have taken a mild sedative. About an hour before collapsing, he was well enough to ditch his security and drive away. About twenty minutes before collapsing, he had some (unpoisoned) coffee and then proceeded to have a difficult conversation with a friend while walking down a street. The friend did not suspect any health issues until Character A actually started falling of his feet, but then, the friend has no medical expertise plus it was a very difficult conversation, so stuff like pallor and pained expression could have been attributed to emotions.

  4. The patient definitely needs to be talking, and, preferably, walking three weeks later.

Any ideas what it could be?
I've tried googling heart attacks (risk of instant death too high), acute cholecystitis (involves gallstones which probably won't develop in two hours), asthma (nice dramatic effect, but he'll start talking way too early), and pancreatitis (looks like it won't be sudden and incapacitating enough, plus I can't figure out if it can result from a ten-year-old injury).

UPDATE: Ok, so while the post was in pre-moderation, somebody suggested a solution, which I'd like to check for viability :)

Ten years ago, the patient got stabbed in his left side. The left kidney had to be removed and replaced with prosthesis; the pancreas got nicked, but the advanced futuristic medicine seemed to have done a good job healing it. Ever since, the patient leads a fairly healthy lifestyle – sedentary and stressful one, but without bad habits, and he does excercise.

As far as the poisoners know, the patient's only medical issues are a fractured wrist which hadn't healed properly and an artificial kidney which functions pretty well. They intend to give him something like chronic pancreatitis. Of course, the lifestyle is kind of wrong for that, but other possible causes of pancreatitis include viral infections, metabolism problems, hormonal disbalance and taking certain kinds medication (in particular, antidepressants and anti-migraine drugs, which he could be taking as far as the poisoners know), so it's not unthinkable that he gets it. Especially since organic food is not readily available in that setting and he may have been consuming something unhealthy without realizing it.

However, turns out the advanced futuristic medicine makes mistakes, too, and there was some slight defect left in the pancreas – scar tissue or something – so it reacts much more vigorously than expected and actually starts bleeding. Instead of gradually increasing pain, a visit to the doctor, and a bed rest with a strict diet, the patient suddenly goes grey in the face, complains of sharp abdominal pain radiating into the back, and passes out in the middle of a conversation. Paramedics diagnose shock, and, from bruises appearing on the side – acute hemorrhagic pancreatitis. He is taken to surgery, developing hypoxia along the way.

The pancreas is removed and replaced by prosthesis; for the next few days he is kept in ICU under oxygen and tranquilizers. At the end of the week he's allowed to wake up; after two weeks or so he is released from the hospital (I mean, present-day pancreas transplant seems to take about 10 days, but let's make allowances for the prosthetics and the hypoxia complication). After that, he's probably still not feeling too well for a while (couple of months or so – weakness/dizziness, breathlessness, pain in the upper abdomen especially after meals?) and has to pay attention to what he eats, but, on the whole, is back to normal.

The doctors are a bit thrown off by that whole story, though, because they can't figure out what caused the problem. If it was the diet – what the heck was he eating? If it was a virus – how did he contract it? If it was metabolism/hormonal issues – why now? Somebody recalls there's a substance X that could cause an attack like that, and that the the whole thing happened at a suspiciously opportune time. However, nobody has any proof of foul play.

Am I overstretching the suspension of disbelief somewhere?
Tags: ~medicine: illnesses to order, ~medicine: poisoning
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