Monthly Archives: May 2016

Trauma University – Part 5: Agony




In chapter two of The Organ Takers, paramedics Tom Burnett and Freddie Ramirez find an unconscious homeless man facedown on a Midtown Manhattan sidewalk at 4:00 am. When they roll him onto his back, Freddie says, “He’s breathing, but his respirations are agonal.” What does that mean: his respirations are agonal?


From the context of the story, I hope the readers will surmise that agonal is not good. The word is related to agony, and agony is never a good thing. But agonal respirations are not what you would experience while a sadistic former Nazi is probing a cavity in one of your molars (although that would be agonizing). In medical terms, agonal refers to “the end,” or very close to it. 


Here is the definition of agony straight from one of my medical dictionaries: Agony is defined as intense pain of mind or body, or the struggle that precedes death.


The struggle that precedes death. Agonal respirations, therefore, are feeble gasps of air that are insufficient to sustain life, and in that setting, immediate intubation or some other form of artificial respiration is paramount.


In the video below, a group of buff Australian lifeguards just happen to be frolicking in the surf when an unconscious Japanese tourist washes up on the beach. He is pulseless, and his respirations are agonal–both of which are signs that the end is near for this young man unless CPR and advanced life support techniques (ventricular defibrillation) are initiated, and quickly. As you watch, notice the feeble, inefficient  breaths that resemble a fish that is out of water and gasping for air.


Caution: some of you may find this disturbing and difficult to watch, but I will tell you ahead of time the lifeguards save the man, and his quick recovery is quite dramatic. 





If you are wondering how Taka fared after being hauled off the beach, take a look:





Now, if you are new to my posts, you may be asking yourself why all this medical stuff is on an author website? 


I am trying to connect with readers who have a morbid fascination with topics of medical and surgical interest in order to introduce you to my writing style. If you find this and the other Trauma University blog posts fascinating, you will probably be interested in my stories. My short story The Final Push is the first piece of fiction I wrote and has served as a precursor for everything I’ve written since. The style is similar to what you will find in the McBride trilogy of novels—The Organ Takers, The Organ Growers, and The Organ Killers—so if you like The Final Push (free download except for B&N Nook), you’ll like the McBride trilogy. 


For more surgical terminology, jargon, and instrumentation, go here.


To learn more about The Final Push and to read an excerpt, go here.   


To learn more about The Organ Takers and to read an excerpt, go here.