Defense Mechanism

Assalamualaikum

Honestly, i want to put this in my facebook. But the internet is too stingy to me tonight, so i just let it be. This is the notes i use for my study group when i explained on defense mechanism. I really like this topic, hope this will help:

Psychological Defenses

Defense mechanisms are automatic psychological processes that protect an individual from anxiety and the awareness of internal or external threats or stressors. People are often unaware of these processes as they operate (although others may be painfully aware of them!). Defense mechanisms can be classified into groups or levels that indicate how they affect an individual's functioning.

High Adaptive Level: Defense mechanisms in this group result in optimal adaptation to stress. The defenses usually maximize feelings of well being and do not interfere with the conscious awareness of feelings, ideas, and their consequences.

• Affiliation involves dealing with stressors by turning to others for help or support. This involves sharing problems with others but not trying to make someone else responsible for them.
• Altruism involves dealing with stressors by dedicating yourself to meeting the needs of others. The individual receives satisfaction vicariously or from the response of others.
• Anticipation involves dealing with stressors by anticipating the consequences and feelings associated with possible future events and considering realistic solutions.
• Humor involves dealing with stress by emphasizing the amusing or ironic aspects of the situation.
• Self-Assertion involves dealing with stress by expressing your feelings and thoughts directly in a way that is not aggressive, coercive, or manipulative.
• Self-Observation involves dealing with stress by reflecting on your own thoughts, feelings, motivation, and behavior, and then responding appropriately.
• Sublimation involves dealing with stress by channeling potentially disruptive feelings or impulses into socially acceptable behavior (e.g., playing rugby to channel angry impulses).
• Suppression involves dealing with stress by intentionally avoiding thinking about disturbing problems, wishes, feelings, or experiences.

Mental Inhibition Level: Defense mechanisms in this group keep potentially threatening ideas, feelings, memories, wishes, or fears out of awareness. Diminished awareness can affect the person's ability to relate to others.

• Displacement involves dealing with stress by transferring strong feelings about on situation onto another (usually less threatening) substitute situation.-->Displacement involves taking out our frustrations, feelings and impulses on people or objects that are less threatening. Displaced aggression is a common example of this defense mechanism. Rather than express our anger in ways that could lead to negative consequences (like arguing with our boss), we instead express our anger towards a person or object that poses no threat (such as our spouses, children or pets).
• Dissociation involves dealing with stress by breaking off part of memory, consciousness, or perception of self or the environment to avoid a problem situation (e.g., amnesia).
• Intellectualization involves dealing with stress by excessively using abstract thinking and generalizations to avoid or minimize unpleasant feelings. React in a cold way, focus on intellectual aspect only
• Reaction Formation involves dealing with stress by substituting behavior, thoughts, or feelings that are the exact opposite of your own unacceptable thoughts or feelings (which the person is usually not aware of).-->treating someone you strongly dislike in an excessively friendly manner in order to hide your true feelings. Why do people behave this way? According to Freud, they are using reaction formation as a defense mechanism to hide their true feelings by behaving in the exact opposite manner
• Repression involves dealing with stress by removing disturbing wishes, thoughts, or experiences from conscious awareness. The person may still be aware of the feelings associated with the repressed issue, but will not know where the feelings come from.-->Repression acts to keep information out of conscious awareness. However, these memories don't just disappear; they continue to influence our behavior. For example, a person who has repressed memories of abuse suffered as a child may later have difficulty forming relationships.
• Undoing involves dealing with stress by using words or behaviors designed to negate or make amends symbolically for unacceptable thoughts, feelings, or actions. (taubat?)

Disavowal Level: Defense mechanisms in this category try to keep unpleasant or unacceptable stressors, impulses, ideas, feelings, or responsibilities out of awareness.

• Denial involves dealing with stress by refusing to acknowledge some painful aspect of reality or experience that is apparent to others.
• Projection involves dealing with stress by falsely attributing your own unacceptable feelings, impulses, or thoughts to another person.-->a strong dislike for someone, you might instead believe that he or she does not like you. Projection works by allowing the expression of the desire or impulse, but in a way that the ego cannot recognize, therefore reducing anxiety.
• Rationalization involves dealing with stress by concealing the true motivations for a thought, action, or feeling by using elaborate, reassuring, and self-serving (but incorrect) explanations.

Action Level: This level is characterized by defenses that deal with internal or external stressors by action or withdrawal.

• Acting Out involves dealing with stress by using action rather than reflection or feeling. Defensive acting out is often associated with "bad behavior" when there are underlying emotional conflicts. Acting out' means literally means acting out the desires that are forbidden by the Super ego and yet desired by the Id. We thus cope with the pressure to do what we believe is wrong by giving in to the desire
• Help-Rejecting Complaining involves dealing with stress by complaining and making repeated requests for help that disguise hidden feelings of hostility toward others, which is then expressed by rejecting the suggestions, advice, or help that others offer. The complaints may involve physical or psychological symptoms or life problems.
• Passive Aggression involves dealing with stress by indirectly and unassertively expressing aggression toward others. The person displays an outward superficial cooperativeness that masks the underlying resistance, resentment, and hostility. This defense may be adaptive in situations where direct and assertive communication is punished (e.g., abusive relationships)

Defense Mechanisms of Distortions

Distortions in regards to defense mechanisms are broken down into three separate levels; minor, major and dysregulation. Minor image-distorting level is characterized by distortions in the image of self, body, or others that may be used to maintain self-esteem. Examples include:

• Devaluation: attributing exaggerated negative qualities to self or others.
• Idealization: attributing exaggerated positive qualities to self or others.
• Omnipotence: acting as if self is possessed with special powers or abilities and is superior to others.

Major image-distorting level is characterized by gross distortion or misattribution of the image of self or others. Examples of this level include:

• Autistic fantasy: excessive daydreaming as a substitute for human relationships, more effective action, or problem solving.
• Projective identification: falsely attributing to another the feelings, thoughts or impulses of self; differing from simple projection by the fact that the individual doesn’t fully disavow what is projected; rather misattributes them as justifiable reactions to the other person. Frequently the individual induces those very feelings in others that were believed to be there, making it difficult to untangle the situation.
• Splitting of self-image or image of others: compartmentalizing opposite affect states and failing to integrate the positive and negative qualities of self or others into cohesive images. Self and object images ten to alternate between polar opposites.

The more severe level of distortion, defensive dysregulation, is characterized by a failure of defensive regulation in individuals’ reactions to stressors, which lead to a pronounced break with objective reality. Examples of this level include:

• Delusional projection: attributing non reality-based thoughts, emotions and impulses to others.
• Psychotic denial: gross impairment in reality testing.
• Psychotic distortion: gross impairment in perceiving reality differently than others

This is not exhaustive of the multitude of defense mechanisms that individuals use to communicate. Interactions can be complex and though an understanding of defense mechanisms is helpful; when impaired, it is wise to leave it to professionals to conduct in depth analysis of another’s words or actions.

In addition these are some funny exercise...But of course, these are my opinions, not real answers.:D

okay what defense mechanism is this? Easy one right, this is displacement. Then again, i might be wrong.

If u ask me, i'll say this is idealization (attributing exaggerated positive qualities to self or others)

Im not sure exactly, but this one seems like rationalization... Or we could say its projection too...

(rationalization:dealing with stress by concealing the true motivations for a thought, action, or feeling by using elaborate, reassuring, and self-serving (but incorrect) explanations)

well, this one is not really a defense mechanism, more like disorganized behaviour

With that, i end my post with some pictures on Freud Model Personality, the Id, Ego and Superego

Holistik Approach dalam hidup

Semoga Allah permudahkan urusan hamba-hambaNya yang menuntut ilmu hanya kerna mancari redhaNya, menjadi hambaNya yang akan memimpin manusia seluruhnya ke jalanNya yang lurus. Sungguh, siapalah kita dan apa sangatlah usaha kita study 2 minggu ni... Kalau sudah ditakdirkan lulus, maka 2 hari study day pun boleh lulus,kalau dah ditakdirkan gagal, sebulan study month pun tak dapat membantu. Usahalah, Allah memandang pada usaha kita, maka usahalah dengan ikhlas, mengikut batasannya, tetap menjalankan ibadah dengan lebih tekun dan mempertingkatkan amal. Bukankah usaha itu sendiri harusnya holistik (ingat PPD je holistik?). Jadi mengapa surau perlu kosong? Mengapa mathurat perlu keseorangan? Mengapa perlu subuh begitu sunyi? Dimana holistik approach kita sebagai hamba Allah. Study, study jugak, tapi janganlah kita merasakan seperti seluruh nyawa kita bergantung pada study, di tempat lain, bumi Mesir, saudara seislam kita sedang berjuang untuk menegakkan islam, takkanlah disebabkan study kita jadi tak endah pada mereka? Dimana holistik approach kita sebagai manusia itu sendiri? Exam terlalu 'memakan' kita sampaikan kita jadi lupa tujuan utama hidup kita, untuk menyembah Pencipta kita, Allah s.w.t.

Ada yang menyangkal dan mengatakan bahawa study itu sendiri adalah salah satu bentuk penyembahan kepada Allah. Yeke? Habis tu kalau dah melewat-lewatkan solat, tidur lewat sampai bangun pagi tak sempat subuh, tinggalkan bacaan Quran, dan sebagainya, sembah Allah yang macamana tu? Astaghfirullah.... Ya Allah tunjukkanlah kami kepada jalanMu yang lurus, moga kami tidak termasuk dalam golongan orang-orang yang rugi...


Akhir kata, kembalilah kepada fitrah kita sebagai manusia, kita bukanlah robot yang dicipta khas untuk pass exam, tapi bakal doktor yang harusnya punya sifat kemanusiaan. Jadi lah manusia!MANUSIA, dan jadilah manusia yang tidak putus beramal soleh. Usahalah seholistik mungkin untuk mencapai kejayaan dunia, moga kejayaan akhirat itu pasti.

Complicated ME

Sometimes i wonder about the things i can do
what about all those chances i miss?
the time when opportunities stood in front of me
but then i step back, face down in misery

why do i do the things i do?
why don't i do the things i should do?
why do i restrict myself from doing it?
what make me strong?
and what makes me weak?
what makes me consistent?
what makes me gives up?

these are questions running through my thoughts
whenever there is a storm in my heart
whether its a feeling i have for life or just for a moment
it becomes significant since its MINE

i wonder wonder and wonder again...

can i blame others for my mistakes?
should i blame them for not being supportive?
am i the only who feels like this?
or does everybody also feels the same?

i wonder what runs through your minds
when you decide something and i decide the other
when i thought of something but you thought of the other
sometimes i feel so alien
other time i just thought that i am lonely

can anyone understand this being called "me"?
her heart have dark places that even she haven't discover
at the same time the bright places is a dangerous glare
her range of emotions is near bipolar
she is clueless of most of the things,even the closest one to her

am i to be blame?
are they to be blame?
who are to be blame?
it this is a test?
should i still be questioning?
am i wrong?
can i undo it?

i'm not saying i hate myself
not even near to saying i wanted to be someone else
even if God were to give me an exchange
i would want to stay the same
not to be anyone else

its just that there are these questions
its rhetorical, no need for your answer
the questions i ask Allah
i ask and ask....
and i will keep asking....
because only Allah understands...
this complicated being called ME
and only Allah can answer these questions

so leave me in my own "beautiful mind"
whether you can accept it or not
whether its pathological or not
somehow somewhere
i play a role in this world
even how small it is....
i do believe it
that in a way
i am special
if i'm not...
i wouldn't...
be here...
today....

My Artwork the 2nd

I have to say that I enjoy making posters for Palestin issues, and even the last time, it came out quite good

I came up with an idea to do a countdown... This is Ramadhan special

Of course we have iftar, always have n always will...

Ah-ha... this is d first KBM-Special poster... don't forget to check out the "story" behind this poster...

go to link: http://keindahanbersamamu-ppukm.blogspot.com/2010/11/lepaskan-diri-dari-penjara-dosa.html

this was made for Fahmi's entry, his very first entry.. Go to Link:

http://keindahanbersamamu-ppukm.blogspot.com/2010/10/gara-gara-hiburan.html

I really like the book : Super Health... Its very medic n scientific! I hope to do more posters like these

I really like this poster.... :D

Go to link: http://keindahanbersamamu-ppukm.blogspot.com/2010/11/ziarah-sahabat-nursing.html

Ha-ha... this is a special father's day poster i guess... This is d first time i have my family member as a model for my poster... Me dad~~~ but there's a sad n touching story to be shared here... Go to link:

http://keindahanbersamamu-ppukm.blogspot.com/2009/06/cerita-tentang-ayah-bukan-sekadar_22.html

and the award for the most popular post goes to~~~Prof Har's talk!!Yeay! congrats to prof har... I guess she have quite an influence :D... Go to link:

http://keindahanbersamamu-ppukm.blogspot.com/2010/11/perkongsianour-role-in-sex-related.html

and the 2nd most popular post goes tooooo.... DERU!!Oh yeah! im so happy for DERU!!

go to link: http://keindahanbersamamu-ppukm.blogspot.com/2010/11/post-deru.html

kisah raja n ikan: 

http://keindahanbersamamu-ppukm.blogspot.com/2010/11/kisah-raja-dan-ikan.html

we have a monthly "ta'lim by ustaz emran.. there will be a third one, n yes, still on shahadah.. shahadatain is very very important people....

more Surau's program...

this poster was made after i met a psychiatric patient who have suicidal ideation... she make me think a lot that i came up with this:

http://doctorimanrozali.blogspot.com/2010/12/what-makes-you-live-life.html

this one is on Hijrah : http://zatelimanrozali.blogspot.com/2010/12/mari-berhijrah.html

this is a perkongsian on PERINTIS's forum: http://keindahanbersamamu-ppukm.blogspot.com/2010/12/pada-7-disember-2010-bersamaan-1.html

this is actually an artwork i made specially for the book PERSIAP is making, the inter-language book?

i think that was it.. huhu...

The Doctors We Are Becoming

This article was written by Leana S. Wen, MD where she talks about her experience and feelings during her internship (which I assume the housemanship, as we called)... Its a very good article, unlike other "immature" stories of people sufferings during housemenship, I find this article very helpful in its own way. The best way to learn to survive is learning from someone passionate enough to actually survive at the same time still stand strong to what they believe to be the right thing to do

DO ENJOY READING IT (^_^)

"Excuse me… um… how exactly do I order the Tylenol?"

I look up. In front of me is a young man wearing a pressed shirt and striped tie. "I'm Ben," he says, introducing himself to me as an intern on his very first day of residency. It's not really a statement that needed to be said; none of us would have mistaken him for anything but. How to order Tylenol is a seemingly self-explanatory action, but last year it was me asking that question. As I lead him through the order entry system, I reflect on the past year. How have I grown in this notoriously grueling yet life-changing internship year? What advice would I impart to the new cohort about to impart on this same journey?

Clinically, I am stronger than I was a year ago. Clinical training in a supervised setting is indeed the purpose of residency and why tens of thousands of young people in the prime of our lives devote many long hours to our hospitals. Internship is all about becoming more comfortable with management of everything from routine urgent care presentations to medical resuscitation of very sick patients. Throughout the past year, I've seen my classmates and I progress from asking "What next?" to thinking through and acting on most treatment decisions ourselves. Part of that clinical development is knowing how much more there is to learn, and it remains daunting and inspiring to see that, as much knowledge and skills as we have gained, there is still a long way to go.

Professionally, I feel more comfortable in my role as clinician and resident physician. I remember on my first day of internship practicing my introduction in the mirror. "Hello, I'm Dr. Wen, your doctor," didn't seem quite right. Too curt, yet oddly redundant. "Hi, I'm Leana, your doctor." Not right either. Too informal. "Nice to meet you, I'm Leana Wen, one of the doctors." OK, but who are the other doctors? The struggle with something as basic as introducing myself is symbolic of my biggest challenge in intern year: feeling at home as a resident. My training occurs at two main hospitals and two other affiliated sites. Not only were there dozens of residents and attendings and literally hundreds of ED nurses to meet, each month was a different rotation with more new people and new ways of doing things. It took me until the end of intern year to feel at ease with my colleagues. Being part of AAEM/RSA has been instrumental for me to feel at home in my specialty. Now, not only do I know my 60 co-residents, I am connected with thousands of residents across the country.

Intellectually, this has been a year of alternating disappointment and growth. So much of medical school was about memorization and pattern recognition; I was afraid that residency would teach more of the same. I did not want to be an automaton who did nothing more than input data and run algorithms like a "Choose Your Own Adventure" book. EM, perhaps more so than other fields, has the potential to turn into an algorithmic exercise. However, there are plenty in our field who believe that EM is far more than figuring out a disposition. As my mentor, Dr. Josh Kosowsky, likes to say, "EM is the modern home of diagnosis." What other field presents so many diagnostic puzzles in any given day? Checklists have their place, but algorithms should never replace the art of healing. One of my most valuable lessons this year, one that has kept me intellectually challenged and emotionally engaged, is to make sure to hear each patient's story as their narrative, not just as a chief complaint followed by yes/no answers.

Personally, one of the battles each of my classmates has struggled with is finding balance. Internship is pretty far from a "normal" life: it throws off anyone to work under fluorescent lights for six days a week, to eat nothing but hospital food for three meals a day, and to not see family and friends for a day and a half. Our days are so long that by the end of a shift, it's often hard to find energy to do the things that used to make us happy. Yet, as busy and as tired as we get, we shouldn't make residency just about working, sleeping and eating. I've watched each of our classmates emerge from survival mode to making time for the things that matter to us, from training for triathlons to watching sci-fi flicks to getting a scuba-diving certificate. As for me, I'm ballroom dancing and playing the piano again, and a much happier person for it.

Despite finding better personal balance, one of my classmates said during our end-of-the-year intern retreat that he wasn't sure he liked the person he was becoming. This resonated with all of us. In intern year, each of us can recall instances when we've become more abrupt with family, short with sales clerks, perhaps impatient or even disdainful with patients. However, as difficult as our lives may be at times, as grueling as it may be to work night shift after night shift, we cannot lose track of our fundamental purpose of being healers and advocates for our patients. It's a profound privilege that we have to take care of patients in the time of their greatest need. It's a profound honor that families place care of their loved ones in our hands.

"That was an awesome day. Thanks for showing me around!"

I smile. It's the end of Ben's first shift. His hair, impeccably groomed ten hours ago, sticks out in the back and strands point towards the ceiling. His face bears the telltale imprints of mask and eyeshield. His blue tie is flecked with blood. (I feel sure that from now on, his attire will consist of scrubs.) I wonder what Ben's reflections after intern year will be. I know that he, too, will develop clinically and grow into his professional role. I hope that he finds his intellectual pursuits rewarding and his personal balance satisfying. Above all, I hope he retains his humanism, his ideals for why he chose to enter this healing profession of medicine.

Forensic Post: Asphyxial Death; Hanging

As a continuation to my previous forensic post, today im gonna talk about the second asphyxia death, hanging. I never seen autopsy on hanging also, another “cis…!” for that…Honestly, writing this post itself feels a bit creepy, but that's me, I'm not sure why I'm kinda attracted to these creepy stuff. But let this post be a lesson to us all, SUICIDE IS PAINFUL, NEVER TAKE YOUR OWN LIFE 

Death by Hanging

Is also a form of asphyxia death, where the body is wholly or partially suspended by a ligature around the neck. Simple eh? But you see, even thou someone might hang themselves; it’s not necessarily for them to actually die due to asphyxia. For all you know, it might be death due to cerebral congestion from the external jugular vein compression (4.4 lbs), cerebral anoxia from common carotid artery compression (11 lbs), vagal inhibition from vagus/carotid body compression causing cardiac arrest, fracture or dislocation of cervical vertebra or it could be a combination of both coma and asphyxia. Well, all of that sounds painful enough!

Of course, we should also think about the manner of death, in this case, natural can be rule out because it’s not likely someone found to be hanged would be dead naturally ( but if someone were to die naturally but then was hanged after their death to make it look like suicide, then it is possible right? But who would do such a thing? That would be so twisted, why am I thinking as such? Heh!). So the focus should be on suicidal, murder and well, accidental is also possible but would be quite rare.

What are the signs?

Externally you can see a ligature mark and it is the ONLY specific sign. This ligature mark depends on the nature if the ligature use and the types of knots.

A fixed knot is when we “ikat mati awal-awal”, so once the person is hanged, the knot won’t move. Because usually the knot will be loose, the ligature mark seen will be in V shape since the upper and “knot” part of the ligature is not in contact with the skin.

A running noose is the adjustable knot. Once pressure is exerted on the ligature, usually by the weight of the person, the knot adjusted to the neck and chokes the person to death. Thou it sounds terrible, some believe that it’s less painful compare to the fixed knot (but how can they know right? Hehe…). Due to the nature of the knot, a running noose ligature mark will be complete, circular and more horizontal and we may even see the knot impression mark.

That’s the first thing about ligatures, there are more things to observe at the ligature mark:

• Where is the point of suspension?
• What would the duration of suspension be? Longer duration even prominent ligature mark
• What is the constriction force, complete or partial, complete hang? Or maybe just kneeling or sitting position
• What is the texture of the ligature, diameter, single or double, shape and pattern? Help knowing the type of ligature used
• Are there any scratch marks at the neck near the ligatures? This indicates struggling to be free, thou this does not rule out suicidal since hanging could be painful

Other important feature of hanging that can be observed is

• the head, normally it would inclined to the opposite site of suspension,
• the face will be congested, the tip of the tongue can be protruded and bitten,
• the saliva might be dribbling from the mouth and see the eyes, it might be close, partially open or might have a serene look
• the penis would be turgid, congested and semi erected
• the nail is cyanosed
• and the postmortem staining will depend on the parts of the suspended bodies. Since those who dies due to hanging normally is not lying on the ground, the usual post mortem staining at the back would be absent. Instead it may confined to the feet, if its full hanging, or at the legs, buttocks, hands and arm if the bodies were found to be in sitting position. Interesting isn’t it?

back to Allah, the One and Only True God

We always think of hanging as suicidal, and most of the time it is. Taking life with our own hands is consider as “major sin” and you don’t get to heaven if you do that. No matter what happen in our life, there is always a way to solve it. God don’t create problems for us so that we will be stuck for the rest of our life, thou sometime it may seem that way, but largely it depends on our own effort to actually do the right thing. To all problems from any aspects of life, the right thing to do is ALWAYS and ALWAYS to return to your beliefs. Seek the right way by diverting ourselves to the right path. After all the main reason for God to send a “big test” to us is to make us divert ourselves back to Him, beside testing our belief. So suicide is NEVER the way to get out from any sort of problems! There’s a lesson to be learn here kids! Till next time, thank you for reading! :D

Forensic Post: Asphyxial Death; Drowning

Not like my everyday post, today I like to talk about…. DEATH… More specifically, asphyxial death. Why? Because it’s a big and important topic, with many medico legal and interesting aspect and also because I never get the chance to actually observe one yet (cis..!).

Asphyxia is the condition of lack of oxygen arising from an obstruction to the air passage from within or out. Generally, those who died due to asphyxia might have cyanosis, general visceral congestion, venous congestion, increase venous back pressure, stasis of the blood, pulmonary edema, serous effusion, post mortem fluidity of blood, petechial hemorrhage, cardiac dilation, biochemical changes and pseudo-Rouleaux formation due to heamoconcentration in the blood.

Under asphyxia we have drowning, hanging, sexual asphyxia, strangulation, manual strangulation (or throttling) and last but not least, suffocation. Well they all sounds the same, but there are not actually. Since there are too many of it, maybe I talk about the others in my other post, today, we talk about, drowning. Death due to drowning…

Drowning

Is when the air entry is prevented from entering the lungs by water or any form of fluid matter into which the head had fallen and remained in. Get it? You know, head in water, air prevented in, and cannot breath. Note here, it is the head that remained in, so if someone were to be push in a small bucket containing water (or even pasta sauce) just enough to immerse the head, and the person dies because of it,  it is already consider as drowning. (and I learn that from watching detective conan haha)

Before jumping to any conclusion, there are a few aspects of drowning to think about

Was death really due to drowning? What was the motive? I mean they might have died due to natural disease before falling in the water or suffer a natural disease while they are in the water. It could also be an injury before they fell or be thrown in the water or died from other effect of immersion other than drowning… so how can we tell? Before starting the autopsy, we have to answer a few questions where we go back to the basics, the 4 manner of death, accidental, suicidal, homicidal or natural… So the purpose is to rule out what’s not and rule in what it is. So lets go through…

Signs of Drowning

What are the post mortem signs of drowning? The signs could be further divided to external and internal signs which can further be subdivided to presumptive and specific. Basically, the presumptive external signs are bodies which are wet, covered in seaweeds, cyanosis, congested eyes, presence of “washerwoman’s skin”, “goose skin” or cutis anserine, and retraction of scrotum and penis. But more importantly are the specific external signs which are fine white, tenacious, lathery froth or foam like soap with blood oozing from the mouth and nostrils. This can be reproduced by exerting pressure to the chest. Another important sign is the cadaveric spasm, which is the clasping or grasping of objects found in the water. For the internal signs, the white tenacious foam can also be found in the air passages to the terminal bronchiole. There can also be logging and ballooning of the lungs.

Laboratory test

When there are drowning bodies, laboratory test of the pulmonary and blood is important to determine the possible cause of death and the actual place the drowning took place. An important key point in the lab test is the diatoms. These are microscopic unicellular algae that can be found in certain water. Since it is indestructible, we can determine whether the victim was alive or not before they were immersed in the water by looking for these diatoms in the lungs, blood, brain, liver, kidneys and bone marrow. If they are alive, these diatoms have time to circulate around throughout the body. By comparing the diatoms too, we can determine whether the alleged crime scene (locus of crime) was true or not.

Don’t forget about the blood! Since the bodies died in the water, we can also determine whether the water was salty or fresh water by looking at the blood. Is it crenated or are there burst spherocytes?

What about the pulmonary tissue? There will be two aquosum. The first one is emphysema aquosum, where the alveoli is filled with water, mucous and also air, the inter alvelolar septa is also ruptures. Another one is oedema aquosum where the inter-alveolar space is filled with water, the interalveolar membrane is widened due to edema and it may also rupture.

We should also do biochemical test to check the chloride content, magnesium and specific gravity of the blood.

Of course there are other things regarding drowning I didn’t cover here, but basically that’s about it. So, thank you for reading! See you again in the other forensic post! (^_^)