Gotham City is in America, Right?

April 27th, 2006

Filed under: Comics, Medicine

Scene from Batman: Legends of the Dark Knight #200

I’m just wondering why the emergency medicine intern at Gotham General Hospital is ordering paracetamol — a British drug — for her patient? Paracetamol is the British name for what we in the States call acetaminophen – probably better known by its brand name Tylenol.

It also seems to me that acetaminophen is a pretty weak pain killer for a patient who has suffered so much facial trauma that he needs a surgeon. If I were the patient, I know I’d want something stronger.

(I suspect we can blame Eddie Campbell, the British co-writer of this issue, for the use of paracetamol.)

  • Despite my nit-picking, the emergency medicine in this comic (Batman: Legends of the Dark Knight #200) is very well done. The narrative drags a little bit in the second half when it degrades into a moderately inventive “find the bomb before it explodes” storyline. The medicine in this comic actually deserves a post of its own, which I’ll get to sometime next week (hopefully).
  • I notice that Joker’s venom, at least its gaseous form, is called Smilex in this comic. Is this the first time the name Smilex has been used in an in-continuity Bat title? As far as I know, the name orginated in the Tim Burton Batman movie.

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13 Responses to “ Gotham City is in America, Right? ”

  1. Cliff S.
    April 28th, 2006 at 12:42 am

    Not a doctor in any way, but my best guess (and tell me how wrong I am):

    Maybe in such a severe beating they’re worried about possible brain trauma and don’t want to give anything stronger (like opiates) until they know more about the extent of the patient’s injuries. Pain’s better than respiratory failure.

    And IIRC they’d only give acetaminophen (or the U.K. equivalent) since, unlike most NSAIDs like aspirin or ibuprofen, it doesn’t interfere with clotting. Because he also may have intracranial bleeding, or may need surgery soon, they want to avoid increasing his blood loss. And anyway it looks like that guy’s facial hematomas are going to be bad enough without help!

  2. Randy
    April 28th, 2006 at 7:02 am

    I was wondering that same thing about the use of “Smilex” in this story. I hope someone can aswer this question for us.

  3. Scott
    April 28th, 2006 at 8:36 am
    Official Comment

    Cliff,

    You have a valid point about possible brain trauma, but I think I’d still give the patient a little morphine or some such; one of the nice things about opiates is that you can reverse their effect quickly with Narcan if you need to.

    And I just realized that I forgot to mention that she neglected to specify a dose of the paracetamol, which is always a dangerous thing to do.

  4. W
    April 28th, 2006 at 5:21 pm

    Cliff, I’m not a doctor either, but I’m pretty sure that asprin does interfere with clotting.

  5. difficult pateint
    April 30th, 2006 at 2:39 pm

    The doc was probably worried the patient was a drug seeker . . .they’ll do anything for drugs, right? :o/

  6. Zzedar
    May 1st, 2006 at 8:36 am

    Maybe the doctor is English, and is carelessly using the British name? I know when I went to England, I kept forgetting and using the American words for stuff.

  7. Scott
    May 1st, 2006 at 9:15 am
    Official Comment

    Zzedar, I thought about that, and it’s possible. But the educational experiences she describes earlier in the comic suggest Gothma City upbringing and schooling.

  8. Marionette
    May 2nd, 2006 at 11:03 am

    Oh, so that’s what Tylenol is. I’ve seen it mentioned in american TV and movies for years and I always vaguely wondered.

  9. Ratbat
    May 2nd, 2006 at 7:54 pm

    It’s been called ‘Smilex’ at least once before, I think it was an issue of Robin some years ago. I remember thinking the same thing then, though.

  10. Marge
    May 3rd, 2006 at 11:21 am

    That’s totally what would happen in a British A&E (Accident and Emergency, ER equivalent). You’ve got a fracture that’s broken the skin? Oh, a couple of paracetamol will see you fine.

  11. Jonathan Hamilton
    May 12th, 2006 at 1:32 pm

    Technically, Legends of the Dark Knight isn’t an in-continuity Bat title.

  12. Dr Archeville
    May 29th, 2007 at 3:54 pm

    The DC Technical Manual: S.T.A.R. Labs 1993 Annual Report (a sourcebook for Mayfair’s DC Heroes Roleplaying Game) stated that Joker Venom is “a hellish mixture of hydrogen cyanide and Strychnodide (a strychnine derivative), the toxin causes immediate cessation of heart and brain functions. As a side effect, the victim’s muscles contract in such a way as to severely tighten and discolor the victim’s skin, especially in the facial area. This leaves the victim’s corpse permanently scarred with a clown-like grin in tribute to his killer. Since the Joker Venom is just as deadly if absorbed through the pores as it is if inhaled, the Joker occasionally releases it in gas form throughout the central heating/cooling vents of a building.”

  13. Wanderer
    March 17th, 2008 at 9:36 am

    You’re right; the “Smilex” name for the nerve agent dates only to the 1989 movie. In-continuity, it’s normally called “Joker Venom” or “Joker Juice”.

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