The Schiensh of Bond: The World is Not Enough

I just saw the new Skyfall trailer, and now I am so blummin excited! But until then, there is BlogalongaBond. In this month’s BlogalongaBond I look at some of the less believable bits of The World is Not Enough, no, not Denise Richards being an Atomic Scientist (or a nuclear physicist, or something) Only slight less credible – The bullet going through Renard’s brain making him superhuman – in TWINE: all this cackwaffle is in your head.

Twenty-six minutes into the film we make the acquaintance of the film’s antagonist – the anarchist Viktor Zorkas AKA Renard. The hot doctor with a moronic name gives us the, ha, medical history. 009 put a bullet in his brain:

…It’s moving through the medulla oblongata killing off his senses: touch, smell; he feels no pain, he can push himself harder and longer than any normal man. The bullet will kill him, but he’ll grow stronger every day until the day he dies.

Dr Molly Warmflash

Firstly, how on earth did a bullet get into Renard’s brain, then get stuck in a way that means it’s slowly travelling through the brain? The bullet presumably got deflected which slowed it down. Also, the bullet has, presumably avoided all major blood vessels. Had any blood vessels been ruptured by the wayward bullet, the resulting haemorrhage or haematoma (small blood clot) would severely impair the oxygen supply to the brain (oxygen supply to brain v.v. important – death occurs in minutes if it is disrupted). Another problem would be swelling of the brain as the damaged parts of the brain start to become inflamed and swell up. The brain has the consistency of set yoghurt or blancmange, so it’s very easy to damage. Swelling of the brain would lead to structures on the outer surface pressing on the inside of the skull getting damaged.

Although it is highly unlikely that the bullet would still be going through Renard’s brain with the same trajectory with which it entered, the migration of a bullet inside the brain following a gunshot wound is not unheard of. Movement of a bullet is influenced by, amongst other things, gravity and the weird pulsing movements of the brain itself. Even given the above, a remarkable number of people survive brain injuries. As it travels through the brain, the bullet will compress tissue, damaging it. This damage also spreads to surrounding tissue, so the injury is not just limited to the brain displaced by the bullet.

I pulled the following list of complications from a paper assessing complications following brain injury

Out of 442 patients

Infection (Local or systemic) 27 (6.1%)
CSF fistula 20 (4.5%)
Hydrocephalus 9 (2%)
Intracranial hematoma 16 (3.6%)
Wound healing problems 8 (1.8%)
Drug reactions 52 (11.7%)
Total (patients with complications) 132 (29.8%)

I coughed my way derisively through Warmflash’s description of Renard’s condition because clearly the good doctor knows nothing about the anatomy of the brain.First off, the bullet is not travelling through the medulla oblongata. The medulla oblongata (often referred to simply as the medulla) is the lower part of the brainstem, it joins the brain to the spinal cord. It is also one of the most crucial parts of the brain as it houses the cardiovascular and respiratory centres. This makes it vital in maintaining blood flow and blood pressure. More importantly, it controls breathing – without the medulla sending messages to the lungs, you would stop breathing.

The following caveat applies to what is written below – I have failed two neuroanatomy exams. But, armed with Jurgan K Mai’s Atlas of the Human Brain and the MRI section of the Allen Brain Atlas, I aim to stomp this into teeny weeny waffly pieces.

I have attempted to extrapolate the route of the bullet through Renard’s brain using screen caps of the film and the Allen Brain Atlas. This has been rather tricky as the trajectory of the bullet is in three dimensions. However:

The bullet enters the skull via the frontal bone. The first part of the brain affected would be the medial orbital gyrus or the obitofrontal gyrus. The orbitofrontal gyrus is part of the prefrontal cortex. This is the part of the brain involved in reasoning and decision making, but are also considered to be involved in reward and reinforcement pathways. So presumably, Renard’s decision making abilities would be impaired. But then, he is an anarchist, so maybe no one noticed. Altered structure of orbitofrontal regions have been identified in numerous psychiatric disorders including schizophrenia, mood disorders and drug addiction.

Once past the frontal lobe, the bullet passes through white matter – these are the cables that join the bits of the brain together. From here, the bullet passes through the putamen and globus palladus – both structures of the basal ganglia. The basal ganglia plays an important role in the regulation of movement. The basal ganglia is the part of the brain that is impaired in patients with Parkinson’s disease, this is seen primarily as a difficulty in initiating movement. Close to the globus pallidus is the nucleus accumbens. The nucleus accumbens appears to also have a role in reward pathways, decisions and emotions.

By my guess, the hippocampus would also be trashed by the bullet. The hippocampus is thepart of the brain that is involved in consolidating short term memories into long term once. One of the best studied cases of this is Henry Molaison who had the hippocampi removed from both sides of his brain. He was studied for years; the key findings were that he was unable to form new memories like that guy from Memento. But he was able to learn new motor skills. The inability to learn anything new is not a particularly useful skill in a super villain.

Until this point, all the damage done by the bullet is on the right side of his brain. As a general rule, the right side of the brain controls muscles and receives touch input from the left side of the body and the left side of the brain controls and receives input from the right side of the body. In a right-handed person, the left side of the brain is often the side of the brain that deals with speech and language, whereas the right side of the brain is more important in things like spatial reasoning and utilises non-verbal cognitive processes (it’s a little hazy when you consider left-handers). It is the woolly intuitive brain, whereas the left side is the subjective, analytical brain. Given Robert Carlyle is right handed, I’m going to assume Renard’s ability to deal with people’s emotions and seeing the big picture are impaired – hence why he needs Electra’s guidance as a supervillain.

So far in TWINE the bullet has only made it as far as the pons. The pons is the uppermost part of the brainstem, all the neurons that carry information to and from the brain to the spinal cord travel in here, so damage can have catastrophic consequences. By this point, the bullet has reached the midline, so it is probably affecting both sides of the body. It also houses important structure that are involved in hearing, balance and taste, in addition to the nerves involved in sensing touch and controlling movement of the face. Crucially, the pons contains the reticular formation – a structure vital to maintaining consciousness – if this is damaged, it will lead to a coma. If the bullet damages any of the nerves that control the arms or legs passing through the pons, Renard would be paralysed. So some of what Dr Warmflash is accurate – if only by accident. He should lose his senses only towards the end as the bullet enters the pons. There seems to be little evidence that Renard will lose the ability to feel pain.

Warmflash’s assertion that Renard’s inability to feel pain mean that he has superhuman strength are somewhat simplistic. M and the doctor tell Bond that because Renard cannot feel pain he has extraordinary strength. This doesn’t make sense. Sustained or intense exercise is limited in humans by a number of factors; the first is muscle fatigue. The nerves that activate the muscle may reach a point where they are not able to fire fast enough, the muscle no longer contracts. There is no pain involvement, so Renard’s muscles will fatigue in the same way as anyone else’s. A second consequence of muscle overuse would be depletion of the stuff that powers the muscle like oxygen, glucose and calcium. In this case, the muscles simply fail to contract and there is no associated pain – thus, Renard’s inability to feel pain would not affect this. The third way in which exercise could affect muscles would be where it causes muscle damage and while this would cause pain, and Renard would be able to push through what would unbearable pain. However, pain is important for us in preventing or limiting us damaging our bodies. Renard’s injuries would likely go untreated and they would get worse. He would be prone to infections in the injured areas.

There are genetic conditions which result in people not being able to feel pain. Patients have, in general, normal touch sensation (except temperature). Rather than making people stronger, congenital pain insensitivity increases the risk of infection as wounds go unnoticed. Here is an interesting account of a girl unable to feel pain. Other problems associated with inability to feel pain include not being able to feel when there is damage to the eye. As a consequence, eye infections become common, and eyesight can be permanently impaired.

And now I’ve lost all my readers just in time for Die Another Day, which is just as well because the utter bollocks in that are going to drive me nuts.

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