Thunderbolts #111: A Medical Review
Thunderbolts #111
Warren Ellis, writer
Mike Deodato, Jr., artist
Thunderbolts #111 was brutal; a little too brutal for my tastes actually. On the other hand, the medical aspects were correct and well done.
Jack Flag is fleeing from the new Thunderbolts. He acquits himself well and manages to evade the team. At least until he runs into Bullseye. More accurately, Bullseye sneaks up behind him and stabs a sai in his back:
Bullseye: I just jammed the blade through your vertebral canal into the end of your spinal column.
Bullseye: Radio Moonstone, tell her the target’s not going anywhere. I just destroyed his cauda equina. He won’t walk again.
As the spinal cord leaves the brain and travels down the spinal column, a pair of spinal nerves split off at every vertebra. The spinal cord ends around the L2 vertebra (roughly ¾ of the way down the back) and all the remaining spinal nerves fan out from this point to travel the remaining way down to whatever level they exit the spinal column. Because this has the rough appearance of a horse’s tail, it is called the cauda equina which is Latin for — wait for it — horse’s tail.
An injury to the cauda equina can cause paraplegia, loss of sensation to the legs, as well as difficulties with bathroom and sexual functioning.
The last scene of the comic features Norman Osborne in his office. After a bizarre conversation with his secretary, he fiddles with some pill bottles then finally pops two pills.
Tegretol (generic name carbamazepine) is used primarily to treat seizures. It is also used to for trigeminal neuralgia and to prevent migraines. A common off label use of Tegretol is to treat Bipolar Disorder (old name: manic-depression)
Lithium is also used to treat Bipolar Disorder.
Doses seem a little small though…
March 9th, 2007 at 6:21 pm
I’ve got to ask. How medically sound can a title be when one of the characters has a costume that is constantly stabbing him? And then he doesn’t suffer any kind of ill-effects from blood loss or having bloody wounds all over his body?
March 10th, 2007 at 1:02 pm
Official Comment
That’s an excellent point. So let’s just pretend the first paragraph reads:
March 12th, 2007 at 12:12 pm
Yes, I think we are to conclude that Osborne has bipolar disorder. (Or, rather, that he’s being treated for bipolar disorder, which is no guarantee of an accurate diagnosis even in the real world, let alone the comic book universe, with its notoriously fishy psychiatrists.)
I agree that the doses are small. I can’t tell the dose of the Tegretol from the bottle, but the lithium is 150mg, which, if we presume he’s only taking one of each pill, is “placebo only” dosing.
A small point, but there is a brand-name extended-release capsule form of carbamazepine called Equetro that actually has the FDA indication for treatment of mania (which, as you know, just means that the drug company jumped through the hoops to get FDA approval for something which everybody already knew was effective for bipolar disorder). The brand-named Tegretol in the panel is obviously a competitor of Equetro and would be off-label (but commonly used) for bipolar disorder, as you say.
I think Lithane is usually a brand name for lithium outside the US (such as Canada), but I could be wrong.
March 12th, 2007 at 3:08 pm
Man, it’s good to be a government flunkie. Not only do they ignore your long history of mental instability and serial murder, but you get cheap Canadian drugs as well! It’s a wonder they need the nanites at all to keep the Thunderbolts in line.
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