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Saturday, October 4, 2014

"Dirty Harry" syncope


When I found an abstract entitled "Dirty Harry" syncope in PubMed, I was intrigued. Silly me, I wondered whether the term refers to an existing medical condition. After reading the article in question (it's actually just a brief account of a case), I laughed. The story is almost disappointingly commonplace, but funny all the same. The attending physician obviously had a sense of humor.

Syncope, colloquially known as "fainting" or "passing out", is a transient loss of consciousness due to inadequate blood flow to the brain, most commonly resulting from low blood pressure. It is usually preceded by symptoms such as dizziness, nausea, weakness, sweating and loss of vision ("black flakes"). There are three broad categories of syncope: cardiogenic (due to heart problems), reflex (neurally mediated) and orthostatic hypotension. The condition is very common, especially in teenagers and aged people. In itself it is fairly harmless, although it may indicate a much more serious health problem, e.g. heart disease.

And now for the case report, published in the Canadian Medical Association Journal in 1972:

"Hollywood can apparently influence our health as well as our minds. The midnight visit of a 21-year-old girl to the Emergency Room of the Kingston General Hospital was recorded as follows by the intern on duty, Dr. B. R. Reid:

PHYSICIAN'S RECORD: Watching particularly bloody portion of the movie "Dirty Harry" at 11:00 p.m. Felt dizzy and thought she would be sick. Put head between knees with no relief. Asked boy friend to escort her to bathroom and on the way fainted. No injuries incurred. Vital signs stable and patient feeling much better. 

DIAGNOSIS: "Dirty Harry" syncope.

INSTRUCTIONS TO PATIENT: Never see Dirty Harry again!"




Clint Eastwood in his famous role as "Dirty Harry" Callahan.


The description sounds like a classic case of situational reflex syncope triggered by the sight of blood on the screen. Fainting spells during a brutal movie are probably much less common today than over 40 years ago, since we're all pretty much desensitized to TV violence.


Literature:

Simon JB. (1972) "Dirty Harry" syncope. Can Med Assoc J. 107(4): 280. 

Wikipedia: Syncope

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