Polite Dissent

Kinetic #1 (“Superzero”), #2 (“Crash”)
Kelley Puckett, writer
Warren Pleece, artist

In Kinetic, we meet Tom Morrell, a high-school senior who suffers from “over a dozen major syndromes.” His mother reminds him that he has hemophilia, diabetes, and monmyelic amotrophy, before scolding him and injecting him with a large shot. Tom has difficulty in school, getting picked on by both teachers (indirectly), and students (directly). Because he walks a pretty girl home and misses his “shots”, he has some sort of spell and passes out, requiring his admission to the hospital. He then resolves to kill himself. Issue #2 continues where issue #1 left off, with Tom trying to kill himself. It also includes a great deal of back story and flashbacks, but not much new medically.

I can find no medical references to “Monomyelic Amyotrophy“. So either writer Puckett has made up a disease (which I have no problem with), or it is a typo for Monomelic Amyotrophy. I suspect the latter because Tom exhibits the symptoms of this condition: a weakness and wasting of the muscles of a single limb. It is most common in males between 15 and 25, so that fits as well.

Tom also suffers from Hemophilia, a genetic disorder where the body is missing one of the proteins that allows blood to clot. Therefore, people with hemophilia are prone to bleeding much more than a normal individual, and even a small cut can prove significant. Tom’s mother was right to worry when he was considering shaving. Hemophilia A is treated with an IV medicine called desmopressin (DDAVP), Hemophilia B is treated with an infusion of clotting factor (either genetically engineered or from human blood donors), and Hemophilia C requires infusion of plasma to stop bleeding.

Diabetes is the third condition that Tom suffers from. Summed up quickly, diabetes occurs when a person cannot utilize the sugar and other carbohydrates they ingest, and the sugars build up to high levels in their blood. There is Type I Diabetes (otherwise known as Juvenile Onset or Insulin Requiring Diabetes) that occurs when a person’s pancreas stops making insulin. It must be treated with insulin injections. Type II Diabetes (also known as Adult Onset or Non Insulin Requiring Diabetes) occurs when a person becomes resistant to the insulin that their body produces. It can generally be treated with oral medication, but may ultimately require insulin. Given Tom’s age and thin appearance, it is most likely that he suffers from Type I diabetes. This requires insulin injection to treat.

Insulin syringes are small slender syringes, either ½ or 1 cc in size. His mother appears to be holding about a 5 cc syringe, but it could be one of the newer multiple-injection syringes which are larger than the traditional insulin syringes. Insulin injection is done subcutaneously — not deep like a flu shot, but just under the surface of the skin. Insulin can be injected in the outer arms, abdomen, thighs, or buttocks, but the injection site needs to be rotated regularly. If Tom were my patient, I’d expect him to be injecting his own insulin by this age, but clearly there are some messed up Mother-Son dynamics here.

I’m not quite sure what sort of spell Tom has while walking home. Most likely he is developing Diabetic Ketoacidosis (DKA). When Type I diabetics develop an extremely high blood sugar, they can become deathly ill and even die. It usually results from stress, infection, poor diet, and/or not taking their insulin. Vomiting is common sign of DKA. However, incontinence does not occur with DKA (just the opposite actually — dehydration). While he did apparently miss his afternoon insulin injection, it’s too soon for DKA to set in as it usually takes a couple of days for the sugar to build up to a high enough level. Of course, his spell could be because of one his nine other unnamed syndromes.

In the hospital, Tom is hooked up to several wires and tubes. There are two leads going to the heart monitor (there should be 4 leads), and a tube in his nose. This tube could be nasal canula (to supply oxygen) — but in that case, it should be in both nostrils — or is could be a nasogastric tube, used to drain the stomach contents or provide liquid to the stomach. He also has an IV line in place, so it makes no sense for the nurse to inject the medicine directly into his arm, the IV would have been much easier and faster.

Overall, it is clear that a great deal of research went into Kinetic. The only concerns I saw were minor, and took place almost exclusively in the hospital setting (we can probably blame those on the artist, not the writer). I am also interested whether Puckett meant Monomelic Amyotrophy, or made up his own disease Monomyelic Amyotrophy.

In reality (such as it is in comics), Tom’s biggest issues appear not so much to be medical, as maternal.