[hisses]
Certainly don't try to suck out venom,
because that's never really been shown
to improve the outcome of any snakebite.
I'm Dr. Cyrus Rangan.
I'm a medical toxicologist
with the California Poison Control System,
where I've been assistant medical director
for the past 20 years.
Today we'll be looking at toxicology scenes in movies
and judging how real they are.
Who the h--- are you?
Hail Hydra.
What it looks like is that he has a false tooth
that actually contains cyanide.
The concept of actually hiding cyanide in a false tooth
seems to be a little bit more folklore than it is fact.
And in fact, when you talk to people
at the National Spy Museum,
they'll tell you that this is not something
that people really engaged in.
But did villains maybe back in, you know,
the time of Nazi Germany, things like that,
did they use cyanide capsules to commit suicide
so that they would not be incriminated later?
Yes, that practice actually did occur.
There still are some problems with this.
The concept of the foaming followed very quickly by death
is probably more theatrical than it is expected symptoms
that you would see from a scientific standpoint.
Is it possible that someone might have
some excessive drooling or foaming
while they're experiencing other symptoms
of cyanide poisoning?
Sure, that's possible.
But for that to be the only symptom
and then so quickly followed by death,
that's what gets a little bit far-fetched here.
Cyanide, although it is a relatively fast-acting poison,
meaning it doesn't take hours to kill you,
it still does take a few minutes at least.
And perhaps in that five- to 10-minute period,
that's when death generally is seen.
I could give this somewhere between maybe a 3 or a 4.
Qyburn here is the cleverest man I know.
Clever enough to learn what poison you used
to murder Myrcella.
The Long Goodbye, was that it?
Qyburn: The Long Farewell.
That's the one.
Well, obviously, we are not aware as toxicologists
of any poison that is even nicknamed The Long Farewell.
So it sounds like it's entirely made up.
Cersei: How long does the poison take?
Qyburn: Difficult to say. Hours, days.
It depends on the subject's constitution.
But death is certain?
Qyburn: Oh, yes, your grace. Quite certain.
If we are to go with his assessment
that this could take several hours
or perhaps days to kill you,
there are some toxins out in the world
that could act like that,
and the one that comes to mind is the disease botulism.
And botulism is a disease that does work
relatively slowly from that standpoint.
The concept of putting it on somebody's lips
and kissing that person
and then being able to neutralize that
with some kind of an oral antidote
is a little bit far-fetched.
When it comes to poisons and antidotes or antitoxins,
it really depends on the poison itself
in terms of whether there is an antitoxin
or an antidote available.
It's not common that we would have a very deadly poison
that you could take immediately,
and then give an antidote immediately orally
that is suddenly going to neutralize that poison
and limit its ability to kill you
if it's something that would kill you otherwise.
For this one, I would probably put it
in the range of about 2 to 3.
I smell nothing.
What you do not smell is called iocane powder.
It is odorless, tasteless, dissolves instantly in liquid,
and is among the more deadly poisons known to man.
For Westley to say that it dissolves instantly
in any liquid is also a little bit far-fetched,
because, for example, things that dissolve well in water
don't dissolve well in alcohol and vice versa.
So to say that it dissolves in any liquid
is something that probably goes beyond the realm of science.
We're talking about a poison here
that kills someone very, very quickly,
and there aren't really many poisons that can do that,
that can kill you within seconds
where you look just fine and then suddenly die.
I spent the last few years building up
an immunity to iocane powder.
In general, when we're talking about poisons,
these aren't things that you can really
build up an immunity towards.
You can build up immunity towards infectious diseases,
but building up an immunity towards a poison
is not something that we generally see.
There is a concept that's called tolerance.
So, for example, with drug users,
they tend to require higher and higher doses
of whatever drug of choice they use
in order to achieve their desired effect,
and that's a different kind of concept.
But the concept of immunity from a poison
is not something that we would consider scientific.
I would probably give it a 3.
Peeta!
That's nightlock, Peeta!
You'd be dead in a minute!
I didn't know.
So, nightlock is fictional as far as the name is concerned
and probably is derived from nightshade,
and perhaps they're combining it with hemlock,
which is another poison.
But when you look at those particular berries,
those look like what are called Atropa belladonna berries,
which is commonly referred to as deadly nightshade,
where you could get dizzy, kind of confused,
a little bit loopy, and possibly unresponsive.
And sometimes patients can be so severe
that they get seizures and coma,
and if you're going to die from deadly nightshade,
that would be the reason.
Where it does fall apart a little bit for me
is when she says that it will kill you in a minute.
The bottom line is that you should never, ever, ever
do your own foraging unless you are a botanist
and someone who's well trained.
I'd probably put it around a 4.
[hisses]
When I was a kid, whenever we went hiking,
we always carried olive oil and a razor blade
in case of a snakebite.
The depiction of this particular snakebite wound
looked a little bit unusual to me.
Usually, a snakebite is a subcutaneous injury,
where the fangs make it down into the tissue
at or below the skin layer,
and then you start to get a lot of destruction
of the tissue around that area
and a lot of inflammation and subsequent swelling.
So you don't expect to see
that sort of voluminous bag of fluid.
Maria: So brave.
What we have learned, however,
over the last several decades,
is that cutting into a snakebite wound
is probably a very bad thing to do.
And we've seen many cases where people
actually introduce more injury into the situation
than help the situation.
So people are cutting into arteries and veins,
cutting into nerves, cutting into tendons.
So these are very bad things that can happen
as a result of slicing into that wound.
So in general, we don't slice into snakebite wounds.
Ah!
Mom: Good boy.
And we certainly don't try to suck out venom,
because that's never really been shown
to improve the outcome of any snakebite.
In medieval times, people back then said
that you should coat your lips with olive oil
and open the wound and suck out the venom.
And, again, this was back from medieval times,
but unfortunately, a lot of those kinds of treatments,
especially for envenomations,
carried over through the century.
The general rule of thumb for any snakebite
is simply to get to a hospital as soon as humanly possible.
There really is no other first aid
that you really need to do
other than to keep the patient calm
so you can be evaluated
and evaluated for the need for antivenom.
I would actually rate the accuracy quite low,
somewhere between 0 and 1,
and simply because they are talking about treatments
that could really make a bad situation worse.
Castor beans.
Jesse: So what are we gonna do with them?
You're going to process them into ricin.
Ricin, of course, is a real toxin
derived from natural sources.
It actually comes from the castor bean or the castor seed.
When you're ingesting ricin,
it causes mayhem in your gastrointestinal tract.
So what's going to happen is you're going to
experience extremely voluminous fluid loss,
and it can be so severe that it's impossible to catch up
by just simply drinking and trying to replace those fluids.
And can it cause death?
Yes, it can, from all those fluid losses.
Walt: It's toxic in small doses.
Also fairly easy to overlook during an autopsy.
And that's probably true, that if someone
was experiencing extreme vomiting and diarrhea
and dehydration and then death,
ricin is not necessarily the first thing
that people would think of.
People would think more about infectious diseases
causing those kinds of problems.
Walt: Kind of under the weather?
Like you've got the flu?
That would be the ricin I gave you.
Oh, my God.
There is no direct antidote for ricin.
It's really, the treatment
is what we call in medicine supportive care.
So in other words, we treat the bad symptoms
that occur from the actual poisoning itself.
You know, she was on the phone and conscious and, you know,
so if she was experiencing symptoms,
she probably was in the very early phase.
So she probably could get herself to a hospital
and maybe get ahead of the poisoning
by making sure that she's got IV fluids on board
as soon as possible
before the severe symptoms took place.
Yeah, it's entirely possible that he's giving it away
a little bit too early for her
so that she could potentially get treatment and survive.
As far as the scientific accuracy,
I would give this an 8.
Dealer: And fold.
It begins, of course, with Bond
drinking a poison from his glass.
What we learn later is that this poison was digitalis.
Now, digitalis is a real poison.
It's a real compound.
But digitalis itself is available
in a number of different plants.
So there's a plant called foxglove,
another one called lily of the valley.
It's actually a medication,
and it helps the heart pump more efficiently.
And when given under medical supervision,
under precise circumstances, and we're checking drug levels,
it's a reasonable thing to do for patients.
However, in large doses,
digitalis and other related compounds
can cause severe poisoning.
Some poisons can cause some major symptoms
with just a very, very small dose.
Digitalis probably would not be one of them.
I would not expect digitalis in the form
of a couple of drops in a martini glass
and then after that is then, you know,
distributed throughout the rest of the glass
and then a couple of sips later
you're suddenly experiencing digitalis poisoning.
That's a little bit far-fetched.
And while it is true that if you instill
a concentrated salt solution into your stomach very rapidly
it will likely make you vomit,
making somebody vomit after taking a poison into the stomach
is actually not well supported scientifically.
So this is not really a practice that we espouse anymore.
So that's something where he was probably
really wasting his time.
Bond's been poisoned.
He's going into cardiac arrest.
Stay calm.
Ventricular tachycardia. Digitalis.
So now they have identified the toxin in record time.
Now, that is a real term, and that's a term
referred to the lower chambers of the heart
uncontrollably beating very, very fast,
and that is something that does require immediate treatment.
One thing that I could say that they represented
more or less effectively
was the feelings that he was having,
the symptoms that he was having.
So it sounds like he was having
a pounding feeling in his chest and some nausea,
and he's sweating.
Those are the kinds of symptoms
that you might expect from digitalis poisoning.
Take the blue combi-pen, Bond.
Mid-neck into the vein.
That will counteract the digitalis.
They have him inject something into his neck.
The term "combi-pen" is something that,
it's a simply made-up word.
I'm just hazarding a guess that lidocaine is what they used,
because that is something you can inject into people
who have ventricular tachycardia from a poisoning.
But as I mentioned before, it's got to be given
under very well-supervised circumstances.
Now get yourself off to a hospital.
Bond: I will do.
As soon as I've won this game.
If you have any poison on board
that's causing an abnormal heart rhythm,
yeah, you want to restore the heart rhythm back to normal,
but that doesn't cure you of the poison.
But what he actually needs
is the real treatment for digitalis,
which is digitalis-specific antibodies,
and that actually is the first-line treatment.
It is a little bit unbelievable
that he's not rushing to a hospital right now
to get that key treatment that he actually needs.
Probably give this about a 3.
Jellyfish sting!
Oh, it hurts, it hurts, it hurts!
Well, there's really only one thing you can do.
What? What is it?
You're gonna have to pee on it.
What I think they really did get right
is the fact that jellyfish stings
tend to impart immediate pain,
and it's quite severe for a lot of people as well,
depending on how much of the jellyfish tentacle got on you.
Where I think it falls apart
is when it comes to the treatment.
It's long been folklore
that you should urinate on a jellyfish sting.
There is no scientific backing to it.
You simply use the seawater to wash off
any remnants of those tentacles
that may still be on the site.
Those remnants include
tiny little cell-like bags called nematocysts.
If they remain on your skin, they can still discharge,
and so we like to use salt water, essentially,
to cleanse those off gently.
So, urine has the potential
to be able to accomplish that too.
You're better off just using the seawater
than peeing on yourself.
If you put fresh water onto a jellyfish sting
where those nematocysts are still on your skin,
they can discharge under conditions of fresh water.
So if your urine perhaps is too dilute at that moment,
you could actually discharge those nematocysts
and cause more pain.
In a lot of cases, urinating on yourself
probably won't make things too bad for you.
It probably won't help, but in certain situations,
it could make things worse.
This is not a good illustration about what to do afterwards.
I would give this around a 6.
Kitai: Dad, I can't feel my hands!
Cypher: The poison is affecting your nervous system.
Stay even.
An insect sting or insect bite
that could result in the depression
of the central nervous system,
that's probably not going to happen from most things
in this sort of immediate fashion that we're seeing here,
within seconds or within minutes.
There is actually a disease called tick paralysis,
where there's a certain kind of tick, a hardback tick,
that actually has a neurotoxic venom
that's injected in very, very tiny amounts into us
but can actually cause full-body paralysis.
But the tick has to latch onto you
and stay there for several hours, perhaps even a day.
So there is that real possibility
that, yes, an insect could give you paralysis.
Would it happen this quickly?
I don't think so.
Inject yourself directly into your heart
with the first stage.
Do it now.
We give the liberty that this is a science-fiction movie
and that there is some fictional superbug out there
that is causing this paralysis.
But would we have a situation
where we thought a neurotoxin injected from a bug
would need to be treated by an injection into the heart?
That's where things fall apart for me as well.
If you had, for example, an allergic reaction
to, let's say, a beesting,
you could still also give intravenous epinephrine
by putting it into a vein.
But if you didn't have that access,
you didn't have the ability to set that up
and time's ticking away,
you can make the argument that you could give
an epinephrine shot directly into the heart.
And that actually is the initial treatment
we would give for nerve-agent exposure.
It would be atropine directly into the heart.
So, yes, there is an argument to be made
for intracardiac injections of certain medications
in very specific circumstances,
but certainly not for an envenomation.
I'd probably put this in the range of about 0 to 1.
I'd say the one that's most scientifically accurate
was the one from "Breaking Bad."
They used good, correct terminology
and gave an illustration of what is supposed to happen
to a person under these circumstances.
The most fun to watch, I think, was "Princess Bride,"
as I think it is for most people.
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