Time at the Hospital

For the past few weeks in Surgery Waiting at the Hospital not much has occurred.  The paperwork was done on time, patients came and went, poor handwriting was puzzled over like Sanskrit.  Each day was pretty much the same, until this week.  One of the tasks we have at the Surgery Waiting desk is to catalog all of the people coming and going from the Intensive Care Unit.  No one in my knowledge has come up until now (we are not a ICU heavy hospital).  A whole family rushed up frantic and even had a priest with them.  They wished to give their loved one their last rites.  I was calm and had someone stay behind to fill out the paperwork while a call was sent back to ICU to confirm the patient was there and could see visitors.  The whole family unit had to take turns to see their family in groups of three.  It was all very tense as the mood bled into the rest of the waiting room.  Eventually these people left and the mood returned to placidity.  But it was quite terrifying how that aura of fear was able to visibly control those who were not even involved.

Stress and Fear

I may have made some comparisons between stress and fear in earlier posts, and it is true that the two overlap quite a great deal.  Fear as whole is a more short term reaction to immediate threats and stress/anxiety are more long term reactions to perceived threats.  Many of the symptoms of stress are similar to those of fear, just in a lesser intensity (meaning no shock can occur).  

Increased muscles tension (to help with rapid movement) is a major symptom of fear, however, in the case of stress the muscles are in a constant state of tensions straining the muscles and bones leaving an almost constant sensation of pain.  The heart is another major organ that reacts to the 'fear state' by increasing the blood flow through the body, pushing the heart into working overtime.  This is also an effect of stress that could lead to hypertension, stroke, or even a heart attack.  The hormones released are the same for both fear and stress these are what trigger the increase in glucose production in the 'fear state'.  However when stress is not fear and the body doesn't use this massive amount of glucose it could cause major problems even leading to diabetes.  And those individuals who already have diabetes are at even greater risk.  Not major problem is found in the nervous system but the constant signaling of the other organs to perform these tasks leads to continued pain for the body.

Adrenaline

The phrase 'rush of adrenaline' is common in action movies and stuntmen.  But what is a adrenaline really?  Adrenaline is the hormone and neurotransmitter also known as epinephrine.  Hormones are used to quickly pass messages to organs in the body en masse, it is controlled by the endocrine system.  Epinephrine in particular is a major factor in the 'fight or flight' response.  It's response is to increase blood flow to muscles, output of heart, pupil dilation, and blood sugar.  All symptoms of the body response to fear.  It does this by effecting the alpha and beta receptors.

Alpha receptors have several common effects such as vasoconstriction of veins and decreasing motility of smooth muscle in intestines.  Specific vessels that are targeted in fear are the skin, gastrointestinal system, kidney's and brain.  They also are the reason behind contractions in pregnancy.  Beta receptors are more commonly used in relaxing smooth tissue rather then heightened tension in alpha receptors, but they also increase cardiac output (heart rate, conduction velocity, stroke volume).

As epinephrine controls a great deal of the body when forcing it into a high activity state it can also be used to a beneficial medical way.  It can be used to treat cardiac arrest with its control over beta receptors, asthma - alpha, croup - alpha.  Side effects due include a state of anxiety as the body is forced into and artificial 'fear state', but the benefits outweigh the costs.

Shock

Shock is a byproduct of lack of blood circulating through the body.  Many different problems can cause shock but the most well known is the fear response.  As I have said before one of the first reactions to the body moving into the 'fear state' is increased blood flow and moving blood away from non-essential areas.  Areas like extremities (hands and feet).  This is formally known as vasoconstriction with a narrowing of the blood vessels resulting in a lack of blood circulating.  What the body is trying to do is force the creation of adrenaline hormones, 'shocking' the body into action.

So all in all shock like fear is ultimately a defense mechanism, but this form comes with some nasty side effects.  It is actually a life-threatening emergency sometimes resulting in uncontrolled bleeding, severe burns and spinal injury.  Every person reacts differently to rapid influx of hormones into their system.  Some take it extremely poorly and the body can't handle the sudden change of internal environment.  This along with the 'fear state' already in effect leaving their immune system compromised results in a backlash of fatal proportions.

Superhuman feats

People often mention offhand of a loving mother lifting a car of her baby.  It's the power of family!  Nothing can keep a lioness from her cub!  This is both true and false.  The body and mentality of someone can very well release limiters that cause superhuman feats, but it's not only the power of motherly love that can do this.

As I have said before when the body goes into a 'fear state' it shuts down all non-essential systems of body function and focuses on both faster healing of wounds and increasing energy available for muscles to use.  Reflex arcs are also known to be more active in these situations.  Allowing the body to move and react at peak form something that is just not physically possible in an everyday situation.
An example of this is when Tom Boyle Jr. at about 8:30 PM on a summer evening in Tucson saw the Comaro in front of him skid and hit a bike.  For a few seconds the Comaro kept going dragging the bike and it's rider 18-year-old Kyle Holtrust.  One of Kyle's legs became jammed under the car and couldn't be moved.  Boyle rushed over and started to lift the car, he was able to hold to car enough for Kyle to pull his leg free (about 45 seconds).  Boyle was six foot four, 280 pounds and lifted a Comaro weighing 3,000 pounds beating the world record by just under 2,000 pounds.  This is the power of fear.

Automatic Body Response

Automatic body responses or reflexes as they are commonly known as are involuntary and near instantaneous movement in response to stimulus.  Reflexes can be grouped into categories such as conditioned, primitive, stretch, or cranial.  Each type named for the either the part of the body they effect or how they are obtained.  For example, stretch reflexes generally have to do with the peripheral nervous system moving muscles.  A conditioned reflex on the other hand is something that can be "taught" to to person or animal through continued stimulus.

The body reacts to stimuli through an exchange of information from the peripheral nervous system to the central nervous system where the brain connects the stimulus to an appropriate action.  Then this information is transmitted again to the peripheral nervous system to act on the decision.  This whole process while much too fast to compare to the macro movement of the body is still too slow when in the perspective of fear and actual danger.  So that's when reflexes are triggered.  Reflexes are essentially the peripheral nervous system overriding the controls and acting when certain stimuli interact with it.  This is known as a "reflex arc".  A reflex arc is when the two types of neurons found in the body act independently of each other one (interneuron) reports to the spine and brain while the other (motor neuron) is already triggering a response.  Allowing the body to move away from danger quickly while still informing the brain.