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Site-008, Dir. of Medical Board
<008-overseer@authority.rpc>
To: <cpr.ytirohtua|skeegoloib-eciffo#cpr.ytirohtua|skeegoloib-eciffo>
Sent: 8:00 AM, December 12, 2020
Subject: Research Assistance (Office of Analysis and Science)
Greetings from Site-008's Medical Staff.
In light of recent events regarding the Authority's temporary loss of resources, our site has made preliminary budget cuts to its own assets. Specifically, we have temporarily shut down the funding of our Research Department to facilitate operational capabilities without compromising its functionality.
A recent study indicated a 60% increase in medical diagnoses acquired by our patients since January of 2019. Many of these are conditions that we have never seen officially registered before, often due to how rare they are (or have been up until now) and the general lack of information. These diseases are so rare, we have thus far been designating them by the names of the patients affected by it, and not any underlying pathophysiological mechanism of understanding. For what it's worth, people are dying from these.
The lowered budgets across the board will definitely result in poorer working and living conditions, lower access to health care services, and worse outcomes. Thus, hereafter, we humbly request aid from the Biology Department in helping us deal with these circumstances while our Research Wing is temporarily suspended from operations. It would be in the Authority's best interest, we believe, to allow a one-time reallocation of funding and resources including testing equipment, PPE,1 the necessary test mediums, and other emergency-use items needed to study such hazardous conditions. Now the threat of contracting the diseases in some of the most unfavorable institutional circumstances we have had to live through in recent memory is very real and hard to ignore.
These are dangerous times, and many lives may depend on it. Let us know what you can spare, I promise we'll make the best out of it.
Sincerely,
- Dr. Anna Aerts
Attached file:
Biology Department, Office of Analysis and Science
<cpr.ytirohtua|skeegoloib-eciffo#cpr.ytirohtua|skeegoloib-eciffo>
To:<008-overseer@authority.rpc>
Sent: 19:09 PM, December 13, 2020
Subject: RE: Research Assistance (Office of Analysis and Science)
Greetings from the Biology Department!
After a careful and considerate examination of the document provided, the Biology Department has green-lighted the continued investigation and formalization of these medical conditions. We will continue our correspondence once the logistics are complete, which should be about a month before the Office applies the budget cuts to our subdivision. The hard deadline is March 26th. We unfortunately cannot guarantee access to resources beyond that point. However, you and your team have the interim available with the facilities and equipment at your disposal.
This is a great opportunity to showcase our brightest minds working together, and rest assured, they are some of the most passionate, dedicated men and women in the Research division. I believe very promising ventures will come from this, and that an opportunity has presented itself for our multidisciplinary relations to potentially benefit from arrangements such as this, hopefully extending beyond whatever budget cuts await our department.
Sincerely,
- Dr. Garcia Anaand
((UPDATE)) MARCH 28 2021: I'm sending out an emergency memo to all personnel. This is a report that we thankfully got working on in time. It details some highly proliferative disease states that we have seen rampant since the absolutely debilitating budget cuts our department and really the whole division has had to suffer. Make sure everyone is informed on this and get it to our medical team especially. It will be crucial for everyone's continued safety. You should hopefully be able to deal with these medical conditions with our supplies, but be warned; in the event of a mutation/evolution of a disease or a chemical spill, such as in the virology lab, we will not hesitate to contact the on-site ASF team to put the area in quarantine ASAP. I can't guarantee anything at all after that.
For the love of God and at all costs, don't expose yourself to any of this.
- Anaand
Attached file:
ACCESSING FILE…
ACCESS GRANTED
Low Coherency Syndrome
Low Coherency Syndrome (LCS), also known as Anderson's Syndrome, is a collection of neurological degenerative effects that are caused by being directly exposed to an area with an ACS below 3. This is one of the most frequent illnesses Authority personnel are directly exposed to, and by far, one of the few that has been officially recognized by it. Low Coherency Syndrome has a mortality rate of 90% during its critical phase, with suicide constituting nearly all of the recorded causes of deaths.
Etiologies: Due to low ACS having such an effect on the way a subject perceives his surroundings, it's not uncommon for one to be accidentally exposed to a Visual Hazard when entering a low ACS zone. The symptoms can develop as quickly as initial exposure, and have been recorded to increase exponentially if exposure is prolonged.
Diagnosis: LCS is commonly diagnosed upon clinical presentation, with at least 3 symptoms present. This is regarded as adequate grounds for initial or prophylactic treatment measures. Confirmation is obtained via detailed coherency analyses, recommended at intervals of 4 hours for 48 hours, or as long as symptoms last.Clinical Course:
| Phase: | Symptoms:2 | Signs:3 |
|---|---|---|
| Immediate. (60 minutes within initial exposure) | Headache, tinnitus,4 photosensitivity, and other migraine-like symptoms. | Elevated cardiac rate, irregular heart rhythm, increase release of cortisol.5 |
| Latent Period. (1 hour - 12 hours after exposure) | Paranoia, Cognitive Impairment, Hallucinations, Panic Attacks | Intense eye movement, sweating, breathing difficulties, vomiting, dilated pupils. |
| Critical (13-24 hours after exposure) | Neurodegeneration (varies on a case-by-case basis). | Body tremors, difficulty with walking, self-harm |
Management: Protection gear should be worn. The current recommendation from the Protectorate is the ODAvX.6 Mission leaders and tactical experts should be consulted first and foremost for any mission wherein low coherency may be encountered.
Given exposure as a result of improper planning, a failure of protection apparatuses, or simply a degree of incoherency that is too powerful, reactionary treatment may be initiated, though with diminishing degrees of return with prolonged exposure.
Intensive amnestic therapy may be used to treat patients during the Latent Period of the disease, before the low coherency seats itself more firmly in the patient’s consciousness. This is a temporary “band-aid” solution, as the patient is essentially “rebooted” from the initial impressions of the low coherency, which the brain takes some time to “re-disorient” itself to. However, the low coherency will inevitably overwhelm the patient with time. Recovery after a Critical period is possible, but all patients who survived this period have showcased long-lasting neurological diseases as a result, with noted atrophy of the brain's major ventricles, resulting in a permanent loss of brain matter.7 Therefore, proactive preparatory measures and/or treatment during the early stages of Low Coherency Syndrome is crucial for the rapid recovery of the patient.
Patients diagnosed with Low Coherency Syndrome: 12,001.
Patient deaths attributed to Low Coherency Syndrome: 8,120.
Perilunar Permapsychosis
A specific form of LCS, Perilunar Permapsychosis (PLP), initially known as Chatraparthi's Disease,8 and also known colloquially as “moon madness”, is a constellation of neurological degenerative effects that are caused by being directly exposed to the upper lunar mantle. PLP onsets in a fashion identical to the subclinical indications of LCS, such as mild visual and auditory disturbances. A unique feature of PLP is that such sensory perturbations are regularly documented in both awake and sleep states, and tend to "creep" or "bleed into" other sensory systems, such as tactile, taste, or smell phenomena. Additionally, such hallucinations tend to be more communal in nature, with proximal individuals reporting similar or identical hallucinations.
Etiologies: PLP is correlated with a Newkomecule10 in both severity and duration of effect. So far, this compound has been isolated to lunar space, although inert portions of the molecule have been discovered in extremely remote regions on Earth.11 It is unknown but presumed unlikely that the compound retains its active effects within both the high oxygen content and12 the gravitational attrition of Earth, which is generally unfavorable to the formation and integrity of Newkomecules.
Diagnosis: Diagnosis is typically established by clinical presentation in or around known areas of RPC-099. Endoscopic retrograde cholangiopancreatography (ERCP) with a scope may be indicated when the clinical presentation is ambiguous, or if a terrestrial case is suspected.13 The detection of filiform, linear, and wavy material in the common bile duct, gastric tract, or hepatic venous system are diagnostic and should not be sampled for histological confirmation. The proteolytic enzymatic activity that is either produced by the instances or that accompanies them can cause lesions and perforations in body lumens, accelerating sepsis and death.
Clinical Course:
| Phase: | Symptoms: | Signs: |
|---|---|---|
| Immediate. (60 minutes within initial exposure) | Blurring of vision in the periphery, the detection of vaguely syllabic tones, etc auditory hallucinations that are commonly described as "scratching" or "tearing". | Other known sequelae of general immediate-phase LCS. |
| Latent Period. (1 hour - 12 hours after exposure) | Profound, shared sensory hallucinations | Neuro-fatigue including a loss of proprioception14 and erratic behavior in both Wernicke's area15 and Broca's area.16 |
| Critical (13-24 hours after exposure) | Unknown | Extensive biological and/or memetic inoculation and contamination. Compulsory motor neuron firing, including spasms of the bronchioles (results in involuntary coughing), and seemingly targeted attempts to relieve itching on the skin (this is despite extensive general anesthesia, such that reflex responses typically used to detect life are negative), coma, the anomalous materialization of helminthic,17 sub-fractal representations RPC-099-A in body cavities, most commonly the stomach. |
Management: Parasitic infections of the susceptible memetic apertures are a major concern in extraterrestrial, non-Euclidean, and modified ACS zones, typically with significant morbidity and mortality. Personnel should be aware of these infections in view of increasing travel and migration.
Individuals who are to be in close proximity to RPC-099 should receive a constant low-dosage drip of Prosectide through a peripherally-inserted central IV to mitigate the LCS-like symptoms and allow for mobility for mission purposes. No prophylactic medication is necessary for those otherwise following safe exclusionary zone practices.
Surgical resection, decompression, or evacuation of the affected organ systems may be considered if the patient is transported to and operated on within the Earth's atmosphere. Otherwise, clinicians should consider the near 99% mortality rate of this stage of the disease. Available measures are largely palliative — including caregiver-assisted total-care and cognitive rehabilitation therapies (limited success) — or more directed methods in order to achieve immediate quietus from suffering.
Patients diagnosed with Perilunar Permapsychosis: 26.
Patient deaths attributed to Perilunar Permapsychosis: ≥9. Totals in progress
Tropical Proboscis Dermatitis
Tropical Proboscis Dermatitis (TPD), also known as Willaburn's Infection or "Shy Guy's Disease", is an infestation of RPC-███, an anomalous variant of Culiseta longiareolata.18 Located in tropical zones along the equator of the Earth, the disease is commonly seen in containment teams deployed to these regions who have had no past exposure to similar exo-parasites, or who lost their immunological invulnerability after they left the endemic zone. They are an exceptionally high danger for extreme illness due to their presence in often otherwise uninhabited areas.
Larval stage of RPC-███ with a notable proboscis, used to infiltrate the host's facial arteries.
The infection is categorized by the gradual development of Culiseta longiareolata larvae within the dermal and subdermal layers of the patient's skin. The larvae embed into facial pores upon infection in the bloodstream and germinate by parasitizing the nutrients in blood flow. Chemical agents are released by the larvae that cause dilation of the facial arterioles, resulting in sustained craniofacial erythema.19
Upon maturation the RPC-███ instances detach and become mobile to find another host and continue their breeding cycle.Etiologies: For a full analysis, see document: RPC-███.
Diagnosis: TPD can be diagnosed by the familiar progression of the signs and symptoms of the stages (below). Blood samples can confirm nanoparticulate fecal matter that is excreted by juvenile instances. Additionally, a blood count can be performed, which will usually show an elevated white blood cell count, particularly eosinophils, suggesting a parasitic infection. Infection of RPC-███ becomes patently obvious in the progressive and later phases.
Clinical Course:
| Phase: | Symptoms: | Signs: |
|---|---|---|
| Immediate. (1-2 days of inoculation) | Extreme and prolonged flushing of the face, along with the onset of malarial ailments. | Fever, elevated white blood cell count, elevated eosinophil count, positive excrement blood smears, positive occult stool parasitology stain tests.20 |
| Progressive. (Days 2-5) | Fatigue | Anemia, reduced activity tolerance, dehydration. At this stage, the larvae become juveniles and begin to be grossly visible upon the skin. They mature with their bodies extending in a superficial direction to the skin, with their proboscises embedded in individual skin pores. This results in the bodies of the mosquitos being suspended about 5 cm above the surface of the skin, with the proboscises holding them upright. These will often sway with patient movement and bump into one another if concentration is high enough, giving the wave-like appearance of hair. Diagnosis of this stage is easiest under low light, as the bioluminescence of the hemolytic21 and anticoagulant22 chemicals of RPC-███ mix with the ingested blood, causing the blood sac on their thorax to illuminate. Juvenile instances measure 10-30 mm in length. |
| Late (Day 5-21) | Extreme psychological distress, blood loss, pallor, cyanosis,23 anorexia. | Insomnia, mental deconditioning, physical wasting, secondary infection (bacterial). The juveniles have fully matured by this point, at approximately 10 cm in length each. Generally 20-50 instances upon the patient's face at one time. The patient's facial features are nearly or totally obscured by the instances. |
Management: Caution is to be exercised in those in the initial stages of the disease, particularly in the extreme heat and humidity found in the native environments. The excessive flushing of the face releases significant body heat and can lead to heat-stroke or dehydration much faster than in normal conditions. Antiparasitic medications such as hydroxychloroquine have shown promise, however, their efficacy has been questioned and remains indeterminate absent extensive clinical trials. IV hydration is encouraged if oral intake seems inadequate.
As the larval forms of RPC-███ begin to grow and their capacity to engorge themselves in the host's blood increases, blood-loss anemia becomes a concern. Blood transfusion should be initiated (1 packed-red-blood-cell unit per 12 hours) if blood counts fall below the lower thresholds of normalcy. However, this has been documented to exacerbate the number and size of eventual RPC-███ instances a patient will host upon their face, so this measure should be conducted as a last resort.
It has been learned from experience that attempted removal of the developing RPC-███ instances by pulling or twisting results in the exsanguination (and expiration) of the patient. Autopsies have shown that this is due to:
- the inordinate amount of blood-thinning chemicals that RPC-███ produce to aid their consumption of host blood,
- sheer, shredding, and ripping tissue trauma that results from the forceful removal of fibrous tissues that extend from the inflow portion of the proboscis into the intima24 of the host's arteries.
Thus, it is not advised to attempt to remove the RPC-███ instances in any manner, and instead let their growth cycles complete in situ.
Severe cases can see the patient's facial orifices obscured and even totally occluded. The most concerning result is an inability to eat or in some cases breathe. Enteral nutrition is recommended by way of a nasogastric tube. This should be inserted in anticipation of eating difficulties no later than 2 days after the identified onset of the progressive phase. Additionally, intubation and ventilator assistance is recommended if the concentration of budding juveniles exceeds 5/cm2, as this is indicative of a catastrophic occlusion of all airways.
After the mature RPC-███ instances dislodge themselves from the facial pores of the patient, secondary abscesses and decubitus ulcers can be addressed. Most commonly, these are colonized by the natural, opportunistic flora of the skin, such as Escherichia Coli, Corynebacterium striatum, or Staphylococcus Aureus. These can be treated with systemic antibiotics pending cultures and sensitivities taken from the individual sites. The clinician may use discretion to decide whether or not oral or intravenous antibiotics are necessary. In extreme cases, dead-tissue debridement and curettage may be indicated, in some cases with follow-up consults with Plastic Surgery for reconstruction.
It is advised that any and all mature RPC-███ that are captured be incinerated at that time to discourage endemic spread, and to dissuade re-infection, as an initial host is up to 65% more likely to be targeted again.
Patients diagnosed with Tropical Proboscis Dermatitis: 342.
Patient deaths attributed to Tropical Proboscis Dermatitis: 19.
Memetic Infohazardous/Cognitohazardous Colonization
Info- and cognitohazards (I/CHs) represent one of the greatest challenges to both Authority medical personnel, as well as personnel of the greater Authority.25 It is estimated that 1 in 3 Authority personnel will experience memetic colonization of their thoughts and/or behaviors during their time employed. Most of these are mild and are quickly dealt with by the body's memetic immunocompetency26 in a short time. However, some classes of memes are doubt-resistant and can imprint themselves onto the consciousness with enough force and impulse to render the patient's thoughts unidimensional and their cognizance monomaniacal.
More disturbingly, powerful I/CHs can obliterate all volition or computational variety inherent in the human neurological system, and establish a 1:1 correspondence between thought (or meme) and subsequent behavior. Observed behaviors of this manner include things as concrete as: walking, gesturing, engaging in suicidal/homicidal tendencies; to as nebulous as falling in love. ~70% of identified hazards confer a substantial increase in the subject being more susceptible to suggestion, which makes the range of possible illegitimate volition on the part of the patient nearly infinite.
Memetic payloads from I/CHs can range from nanomemetic complexes to gigamemetic ones, and at least one identified cognitohazard27 has the noospheric energy content to instantaneously wipe the thoughts and memories from all of Earth's population, 1,000 times over. While most I/CHs encountered are not on such cosmic scales, their ability to be lethal is no less a concern.
Etiologies: I/CHs occur in a staggering variety of manifestations. The most obvious instances are in the form of glyphs which can be anomalously embossed upon objects. However, they may also be invisible to the naked eye, and even to advanced detection apparatuses. I/CHs may colonize a patient through any of the senses; in some severe cases, all simultaneously.
Diagnosis: Threats from infohazards and cognitohazards are particularly challenging, as their pathophysiology is not corporeal, and leaves virtually no discoverable causation for diagnosticians to work with. However, analyzing subjective output such as free association, linguistic analysis, and/or exhaustive behavioral monitoring, may be promising, at least for the most invasive memes. Diagnosis is otherwise typically based on the exclusion of other possible, non-anomalous conditions involving the neurological system. However, this is made much easier in the event that a detection apparatus is present, or an I/CH is highly visible, and the patient has been known to be around or perceptive of it.
Clinical Course: The effects of I/CHs are typically immediate and only rarely do they progress through extended or chronic stages. However, when they do, such disease courses are typically degenerative in nature, as the memetic activity's byproducts28 will deplete the patient's faculties over time, "burning out" their use as if a lightbulb. Colonization typically lasts for as long as the I/CH is present, as long as the patient is in its radius of effect, or as long as any factor generating the I/CH29 is active.
Management: Those in the line of duty who anticipate possible exposure to I/CHs should take all memetic inoculants and vaccines several days prior to mission start. They should also be equipped with the appropriate protective gear at all times. Research and experience have shown time and time again that primary preventative measures are by far the most effective and successful. Secondary and tertiary care for those who have already been colonized are typically morbid and can be fatal in consequence.
In general, prophylactic administration of RPC-925 is recommended at a maximum of one hour prior to the mission start, and either hourly thereafter if the mission is brief,30 or used judiciously at the operator's discretion. 5 administrations or more in a 24 hour period is considered an overdose and may negate any benefit previously experienced. Prolonged use of RPC-925 is not recommended, as the bacterial colony can mutate, becoming more susceptible to the body's immune system and natural antibodies (these will rid the bacteria from the body before any positive effects can be enjoyed).
As an extreme measure, willful, chemical demyelination31 of certain neurological tissues may slow the mechanism of action of several I/CHs. For example, medically-induced demyelination in the optic nerves via a rapid injector lancet directly into the pupil and the underlying aqueous humor can reduce ocular-borne I/CH transmission rates by up to 85%, if necessary.32 While such measures are rarely needed, they offer an emergency maneuver by which to delay the onset of rapid I/CH colonization, in hopes that the cause may be ceased, or the patient may be transported out of the radius of effect.
Intensive amnestic therapy may be used to treat patients, given mild I/CHs.
The use of viderics is a controversial method of treatment, and the authors of this review cannot recommend them beyond the most minimal of doses and in the most desperate of situations. Generally, there is about a 50% chance that an administered videric will rid the patient of an I/CH memetic capture and a 50% chance that the increased perception into and past immediate reality will exacerbate the I/CH's potency and stronghold.
It is not advised to restrain an individual under the influence of a behavioral I/CH, unless absolutely necessary, as this may increase the likelihood of injury to both the patient and any caretakers. However, impeding a patient's speech — such as with a humane scold's bride, or chemical pseudo-paralysis of the vocal cords — could be essential in preventing the spread of particularly virulent and phoneme-borne memes.
In the event of spatiotemporally loculated I/CHs,33 surgical options are a possibility, given the appropriate facilities and personnel. For instance, a patient who was experiencing debilitating seizures due to a multi-supradimensional I/CH colonizing the individual throughout their occupied space and time, was successfully rid of these by a corpus callosotomy.34
Patients diagnosed with I/CH colonization: ~700,000.
Patient deaths attributed to I/CH colonization: 15,328.
Heimerzitosis
Heimerzitosis, previously known as ''CSD-1213 Condition'', is a fungal infection caused by Trichophyton Concentricum Cognitum. This species of dermatophyte adapted to the environments of Site-008, developing an affinity for patients who have been recently exposed to amnestics.
Etiologies: Trichophyton Concentricum Cognitum remains dormant in the patient's skin and can even leave if the patient washes their skin with common hygiene products. However, once a Class A Amnestic has been consumed by the patient, the fungus will enter its active stage and attempt to reach the prefrontal cortex35 via chemotaxis after the memory of the patient has been altered and the chemicals of the brain are reacting accordingly to it. This is done by infecting the eyeballs of the patient, and using the nerve conducts as means to reach the brain.
Hermezitosis is seemingly attracted to 438, the main component of amnestics.36 Because 438 leaves the human body by going back to the infoplane, and the fungus cannot follow, T.C. Cognitum is left with a persistent impression (or "memory") of the chemical that it can never obtain, but will seek out nonetheless. As such, it remains with the neurological system indefinitely.
Diagnosis: Hermezitosis can be diagnosed by the familiar progression of the signs and symptoms of the stages (below). Tissue, saliva, and grey matter samples can also confirm the presence of Trichophyton Concentricum Cognitum. Finally, the progression of the infection in the Latent stage is only common with Cutaneous Anthrax, but the irregularities in the eyes will always be a clear factor of Hermezitosis.
| Phase: | Symptoms: | Signs: |
|---|---|---|
| Initial (6 hours after infection) | None. | As the fungi spread, skin rash develops in the face of the subject, most notably in the area closest to the eyes and nose. |
| Progressive (23 hours after initial infection) | Partial/Complete Blindness. | The fungus has now reached the cornea of the subject, manifesting as an irregular form of cataracts. In this stage, an ''Amnestics challenge'' can be performed by holding a pill or open capsule of a Class A amnestic to the periphery of the affected orbitals; the cataract-like pools of fungal bodies and proteins will migrate to the side of the eye closest to the pill.37 |
| Latent (2 days after the skin rash developed) | Headache, sweating, fatigue, fever. | Blisters have formed at the site of infection, if untreated, the skin will be damaged to the point where necrotic ulcers will manifest. Such ulcers are painful due to the inflammation of the facial muscles. |
| Critical (3 days after initial infection) | Severe anxiety, migraine, nausea, tachycardia. | Eye necrosis indicates the fungi has reached the areas of the brain most commonly affected by Class A Amnestics. It will continue to consume the subject's brain matter even after they die either from a pain-induced cardiac arrest38 or an internal brain hemorrhage. |
Management: Most common medicines such as Griseofulvin, as well as constant showering and facial hygiene, prove to be effective at stopping the fungus from spreading. However, the effectiveness of this treatment varies depending on the phase, growing weaker as the infection spreads further. Heimerzitosis can be prevented provided that the patient follows a healthy routine and has not been routinely under the effect of Class A Amnestics. The minimal dose of amnestics needed is recommended in all scenarios, to prevent the fungus from exiting its dormant state.
Responsible, judicious stewardship of amnestics is the primary mode of prevention for this disease.
As a last and emergency resort, a patient's ocular nerves may be surgically severed at their proximal bases (just prior to their crossing before integrating with the brain). See attached Procedures and Techniques for a full surgical tour of the operation.
Patients diagnosed with Heimerzitosis: 200.
Patient deaths attributed to Heimerzitosis: 113.
FOOTNOTES