ER doctors figuring out the cause for amnesia

[trovia]

The setting is 2006 in America. My protagonist is a 28-year-old male of excellent health who works as an ER doctor. Last he was seen by his co-workers, he was stumbling away from a party piss-drunk. The next day, he is found wandering the streets being disoriented, confused, and unable to tell how he got into that state. The paramedics recognize

Comments

[sushidog]

Korsakoff syndrome can cause retrograde (you may have problems searching for it if you spell it "retrogate"!) amnesia; it's common in alcoholics but is actually due to a deficiency in vitamin B1 (long-term alcoholics often don't eat properly); so if they think he's an alcoholic, they might consider that

[trovia]

Thank you! This is all very useful information, including the bit about how the existence of multiple personalities is being debated. Korsakoff syndrom escaped me entirely. I guess that's the problem with looking at links compiled by writers - alcoholism isn't so much of an issue when people write amnesia fic.

Misspelling is fortunately not an issue (though not unlikely to happen in this pesky second language), as I can trust in Google auto-complete. :) I found plenty of information, but there's a point where Google foo stops being useful, you know?

[rosehiptea]

It may be worth bearing in mind that the existence of genuine multiple personalities is still very much debated by psychiatrists; many alleged cases have turned out to be people faking it for one reason or another, and a lot of doctors are not going to accept it as a diagnosis even if it is suggested.

That's what I was thinking -- I'm not an expert but I do know it's very much not a go-to diagnosis for most professionals, or something people will think of based on amnesia.

[trovia]

That is absolutely what I'm counting on. I'll try and make it look misleading, too. Wouldn't want anybody to look incompetent.

[pamuya]

If you drink enough you can black out. Does this help?
http://en.wikipedia.org/wiki/Blackout_%28alcohol-related_amnesia%29

To be honest unless they could prove he was seriously ill and didn't test positive for illegal drugs they would probably just give him a banana bag and send him on his merry.

[trovia]

Normally yes, but since he works at the hospital in question, he gets special treatment. If co-workers in any profession like doing something, it's fussing.

Not quite what I'm looking for, but thank you very much anyway! It's useful information to have.

[pamuya]

Ah must have missed where you said he worked there. Sorry about that!

[trovia]

Hey, no problem. :)

LOL, your icon.

[tortillafactory]

(Some of this was already covered but commenters above me as I was writing this, but hopefully some of it will still be helpful!)

I googled "severe amnesia alcohol" and I found this article, which seems to confirm popular knowledge re: alcohol-related amnesia ("blackouts"). Which is to say - it leaves previous memories intact, interfering only with the brain's ability to form new long-term memories while under the influence. However, there is also Wernicke-Korsakoff syndrome, a vitamin B deficiency in the brain that can happen in alcoholics and causes more severe amnesia

[sushidog]

Korsakoff syndrome is a funny one, actually; sufferers tend to make stuff up to fill in the blanks, so they'll come up with weird stories, sometimes patched together from things they've read or seen on TV, or featuring famous people or whatever. So if he's admitting to having no memory or to being confused, that would suggest to them that it's not Korsakoff. Plus if they've been working alongside him for the last couple of years, they will figure that they would have noticed if he was drinking heavily enough to cause a nutrient deficiency. So yeah, I reckon they'd consider Korsakoff but reject it, and a psychogenic fugue is going to be the most likely candidate once they've ruled out brain injury and infection.

[trovia]

Yeah, they'd have noticed if he was such a heavy drinker, definitely. This is a great bit of trivia with the false memories, though! False memory syndrome is something I'm very familiar with, so I could always have a character go on a tangent on this topic. ;)

[trovia]

I'm unclear on one thing from your post - you say they're not aware that he's slid into another personality, so what symptoms are they aware of?

He's forgotten the last four years of his life. He thinks he's a med student (instead of a full doctor), he goes by his middle name, and as far as he's concerned, he lives in a different city. Also he doesn't recognize anybody at the hospital, which would be a major pointer. :) He's basically slipped into a personality that he retired some years ago.

Anyway, your comment is giving me many useful pointers about how to phrase my technobabble. Thank you very much!

[quizzicalsphinx]

You might do a search for "black-out binge drinking," which really can cause that kind of amnesia. Most ERs would be familiar with this condition and would probably assume he just had a total black-out (during which memories are not formed). It's not likely anyone would suspect that he had DID (which is what they're calling MPD these days), if he had no previous psych history or before an eval.

[sushidog]

Alcohol blackouts can certainly cause blank periods, but those blank periods cover the time while drunk; alcohol doesn't wipe out existing memories, formed before the period of drinking, so binge-drinking isn't going to wipe out four years-worth of memories.

[quizzicalsphinx]

My bad, I somehow missed the "four years" bit. Carry on!

[trovia]

Yeah, even though I'm sure there are people in that hospital who believe in the condition, I'm counting on the fact that it would be a perfectly unlikely diagnosis to make. Which is why I'm having so much fun with this story. ;)

Thanks for the answer!

[lilacsigil]

What's in the character's medical history? It's very unlikely that he just happens to have a trauma-related dissociative disorder showing up in that way for the first time at such a late age with no relevant psych history.

[trovia]

Good point. I've got it covered, fortunately. He's had the condition since he was a child. I couldn't give you any details, since I'm not done with his biography, but I think I've got it covered. Anyway, it's not the first time it manifested, it's just the first time it manifested in such a way that medical professionals had a chance to notice. Thanks for making sure. :)