This is topic No, not the writing bug... in forum Open Discussions About Writing at Hatrack River Writers Workshop.


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Posted by wetwilly (Member # 1818) on :
 
Okay, any medical minds out there who can help me out, here's what I'm looking for. I need a disease that is lethal, uncurable, so that the diagnosis would be, "you have such-and-such a disease, which means you will definitely die and there's nothing we can d about it." It also needs to give the person a fairly limited life span once it's diagnosed, preferrably within the "you have about six months to live" range, or thereabout. Also, the symptoms of the disease should not be very severe until the victim dies; they need to be able to hide the fact that they have this disease from their family up until the day they die.

Fairly specific requirements, but if anybody knows of a disease that would fit the bill, I would greatly appreciate it. The story is in the future, so I suppose I could just invent my own disease to do what I need it to do, but I'd rather have it be a real disease if I could.
 


Posted by TruHero (Member # 1766) on :
 
A nice inoperable brain tumor should do the trick. My wife's uncle died from one. He got the diagnosis and didn't tell anybody. He died about 7 months after the doctor diagnosed it. His wife thought that he just had bad migraines. Nobody figured out what was wrong until he died. He spent his last few months making sure his family would be well taken care of, savings accounts, bonds, insurance policies etc...

Unless you REALLY need it to be a disease...
 


Posted by Whitney (Member # 2176) on :
 
You have all kinds of cancers you can write about that depending on 1) severity or acuteness and 2) how well the person can hide pain, weight loss, etc. A couple of the most deadly is lymphatic cancers or pancreatic cancers. Usually they are not very responsive to chemo or radiation because they spread very quickly throughout the body. Cancers are insidious because people mistake the symptoms for other things before they are diagnosed.

AIDS is another one that you will show symptoms that depending on the circumstances that can be hid until the very end, and will kill you eventually.
 


Posted by Doc Brown (Member # 1118) on :
 
I agree that a brain tumor is a good one. Depending on the location of the tumor the symptoms can be almost anything you want, from headaches to total blindness, from memory lapses to paralysis. A brain tumor can be inoperable and lethal but it's not communicable.

Most tumors are so painful that it's hard to hide them, but ironically the brain doesn't feel much pain. It can't get much worse than a really bad headache.

I'm not sure about the reliability of death date forcasts for any brain tumors. You might want to establish that the doctor who makes the prediction has a lot of experience and a superior instinct for these things. When Dr. X says "you have six months" he is always right, and no one knows how he does it.
 


Posted by Survivor (Member # 213) on :
 
AIDS isn't a good one unless the actual terminal disease is something that fits the criteria on its own. If you get diagnosed before your health is obviously compromised, your outlook for surviving a decade or so is quite good.

I'm going to have to go with an inoperable tumor. If it's in the right place, then predicting death should be pretty straightforward. Tumor is growing at rate X, we can slow it by R, it will destroy vital functions (put it in the cerebellum) and kill you at or around Y.

A tumor in your cerebellum probably won't do anything to you until one day all your autonomic functions turn off. It wouldn't cause any pain (though the part where your heart stops probably doesn't feel good). And a very small tumor in that area can do you in. I think that tumors in that part of the brain are pretty rare. I'm going to go see about that.
 


Posted by goatboy (Member # 2062) on :
 
Esophageal Cancer. It afflicts 12,300 Americans per year. 12,100 of them die. Most people don’t realize they have it until they can’t get anything to go into their stomachs when they try to eat. Untreated, you starve to death (or die of dehydration) in a matter of a few weeks. Treated (with a feeding tube), you survive until the cancer eventually spreads enough to kill you.
 
Posted by Survivor (Member # 213) on :
 
No good, you can't hide a feeding tube from your family.
 
Posted by Phanto (Member # 1619) on :
 
The brain tumor idea is great, imo, because it also gives you an explanation for any sort of weirdness you want to throw into the story -- now your character can change in any way imaginable! (I do recall reading a true story about a guy with a brain tumor that made his body produce tons of the hormone for breast milk...)
 
Posted by TruHero (Member # 1766) on :
 
The accursed "Man-boobs" strike again. Poor sucker! no pun intended!
 
Posted by wetwilly (Member # 1818) on :
 
Ha! That makes me think of Bob from "Fight Club."

The brain tumor sounds like it fits the bill pretty well. I will have to do some research on them and find out exactly how they effect people. Thank you all for the help.
 


Posted by Robyn_Hood (Member # 2083) on :
 
The first thing I thought of was a brain tumour, which has been heavilly endorsed already. However, I dismissed it because it seems so cliché, especially in sci-fi where it gives the patient some sort of telepathic or psychic power (i.e. Cerulean Blue episodes of X-files, Phenomenom starring John Travolta).

My second thought was an aneurism. I remember watching an episode of The Practice which involved a little boy who had been hit by a car while crossing the street. The doctors for the insurance company of the driver discovered the boy had a stressed blood vessel in his brain that could burst at any time. There were no symptoms at all and the boy's own doctors hadn't even noticed it.

Fortunately for the kid, it was operable, but you could try placing it somewhere that would make it too dangerous to operate. I'm not sure how long you can live with an obviously stressed blood vessel, and without any symptoms, it would have to be discovered more or less by accident.

Just some thoughts.
 


Posted by Survivor (Member # 213) on :
 
The aneurism wouldn't be so good because it could burst at any time, you couldn't predict when it would go.

Brain tumors that affect behavior would be in the cerebrum, and would generally be operable (not fun, but operable). Because they have to get very large before they become life threatening, they can be (and usually are) treated with chemo and radiation, neither of which can be hidden from the family (unless your character is refusing these treatments).

A very small tumor growing steadily in between the cerebellum and medulla oblongata is inoperable (even getting a biopsy would be extremely difficult and risk crippling or killing the patient), cannot be readily treated with chemo or radiation without killing the patient, and can cause very few or even no obvious symptoms until death occurs. A good doctor could plot its growth well enough to predict death to within a month or so.

Brain tumors are popular in fiction because of just this sort of thing. Depending on where you put them, they can do a lot of tricks. But you can always just make up a disease...like saying that he has an alien embryo implanted in him (of course, if it were implanted anywhere but inside his brain, modern medical techniques could probably remove it without too much difficulty).
 


Posted by Robyn_Hood (Member # 2083) on :
 
Just some links about aneurisms:

http://news.bbc.co.uk/1/hi/health/medical_notes/603437.stm

http://www.heartcenteronline.com/myheartdr/common/articles.cfm?ARTID=606

http://www.heartcenteronline.com/myheartdr/common/articles.cfm?ARTID=551

http://www.thefreedictionary.com/aneurism

I got these links by Googling Aneurism, and there seems to be a lot of info out there. On a side note, the husband of a lady I worked a few years ago, had died suddenly of a cerebral aneurism. He collapsed, went into convulsions and died within five minutes. There was no warning.
 


Posted by NewsBys (Member # 1950) on :
 
I'm no doctor, but I worked at a hospital for a few years and picked up some knowledge. My understanding is that while Aneurisms can come on suddenly, and can kill without warning. If they are detected early, they can be treated. As the patient recovers, they can have stroke-like lingering effects.

[This message has been edited by NewsBys (edited September 20, 2004).]
 


Posted by Robyn_Hood (Member # 2083) on :
 
quote:
The aneurism wouldn't be so good because it could burst at any time, you couldn't predict when it would go.

True enough. But medical predictions are still just educated guesses regardless. There are people out there who were given only months to live and have gone to live for years. Conversely, some people are given six months and die in less than four.

If predictability of the time of death is important to the story then an anuerism may not be the best choice. If, on the other hand, the character just needs to die of medical condition six months into the story, an anuerism could still work.

The doctors could say, "You have a problem, we can operate, but you might not make it through the operation or you may end-up a vegetable. Without the operation you will likely die soon but we don't know exactly when."

I know cancer is a common disease. In Canada, I believe it is second only to Heart and Stroke as a cause of death. However, it is used a lot in fiction and it might be more interesting to try using something different or less common.
 


Posted by Survivor (Member # 213) on :
 
Yeah, the issues of treatability and prediction are pretty central to the specification ww handed us.

Aneurisms are also a lot more treatable than many tumors, particularly to modern medical techniques. The nice thing about a tumor is that non-cancerous tumors can have growth rates that go like clockwork.

Medical screwups...the extreme cases are when the doctor pronounces you dead and you turn out to be still alive, and when the doctor says you'll be fine and you're actually already dead. Even so, some guesses are a lot more educated than others.

If you want something totally different, I say just make a disease up out of whole cloth. Say that it's a new kind of virus. The infected cells will function normally while the virus slowly reproduces itself in the cellular nuclei. But at about six months of incubation, the growth curve will mean that cells will start to pop open and release their contents. These second generation viral shells will incorporate specific antigen markers allowing them to reinfect your other cells (including already infected cells) at a very high rate. Already infected cells being reinfected will burst as well, so the post incubation reinfection will be a cascade effect, and overwhelm your body completely. Fortunately for you, the virus is pretty host specific, your secondary infection won't readily infect anyone else unless they have identical antigens to you. Since your family can't be infected by you, you decide not to tell them.
 


Posted by NewsBys (Member # 1950) on :
 
I like Survivor's idea.
It will give you the opportunity to create all sorts of gruesome and interesting symptoms. Plus, you can tailor the symptoms to the needs of your story, and no one can say you didn't get the science right, because you created the disease.
 
Posted by Survivor (Member # 213) on :
 
Or it could be a two-parter. Imagine a virus that infected your body and didn't do much, but it would be fatal next time you caught the flu.

"Well, the good news is that Tarkington's disease won't kill you. In fact, once the rash goes away, it won't have any symptoms at all. Unfortunately, the next time you catch the flu...you'll die."

Or it could make you fatally allergic to pollon or something. But for that you could probably just move to the Artic.
 


Posted by MaryRobinette (Member # 1680) on :
 
Well, this isn't the disease you were looking for, but it's a freaky one and it might have some potential. Fatal Familial Insomnia. http://www-personal.umd.umich.edu/~jcthomas/JCTHOMAS/1997%20Case%20Studies/AAkroush.html
Does the person have to drop dead, or if they can choose to end their life before the bad part comes?
 
Posted by mikemunsil (Member # 2109) on :
 
Widely dispersed aspergillosis. Eaten alive from the inside out by a fungus. >shudder<
 
Posted by Survivor (Member # 213) on :
 
Ugh. Can you imagine? You're in your mid twenties, thinking about marrying this great person, and then your mother comes down with this thing. And of course, you've got a fifty-fifty of having the same thing.

I mean, I've never even really contemplated what it would be like to inherit something like male pattern baldness or a predisposition to obesity.
 


Posted by wetwilly (Member # 1818) on :
 
Actually, Mary, the end of the story depends on the main character ending it early, after a pretty twisted descent into madness.

Holy crap, the fungus one is messed up.
 


Posted by MaryRobinette (Member # 1680) on :
 
So the terminal insomnia might actually work. When do we get to read this frightening thing?
 
Posted by Jeraliey (Member # 2147) on :
 
You could also look into Creutzfeldt-Jakob Disease. It involves some of the elements you said you wanted.
http://www.cjdfoundation.org/pdfs/CJDBrochureFN.pdf
It seems to do some of the things you're looking for.

I'm actually planning on using it as a base for a disease I need to kill one of my characters. It's pretty useful (at least, as a plot device), and has a lot of forms.

Good luck!
 




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