Heat stroke needs to be understood

By Lee Ping-ing 李秉穎  / 

Fri, Aug 02, 2013 - Page 8

Forensic examiners came to the initial conclusion that heat stroke caused the death of army conscript Hung Chung-chiu (洪仲丘) after he was ordered to perform punishment drills while in disciplinary confinement. This is a reasonable conclusion to make. However, the average person will likely have a hard time understanding exactly what heat stroke means.

Heat stroke, as most people understand and use the term, refers to a condition experienced in hot weather, including fatigue and confusion. However, in its medical sense, heat stroke refers to a potentially fatal condition caused by a breakdown in the body’s cooling mechanism.

Continued physical exertion in a hot environment not only causes the body to accumulate excessive heat, but dehydration and a loss of electrolytes caused by continued sweating can also cause a breakdown to occur in the body’s cooling mechanism.

When a person experiences a slight rise in body temperature and when their nervous system is functioning normally, they may suffer symptoms such as headache, dizziness, nausea, vomiting, weakness and fainting. Such a condition is referred to as heat exhaustion, and it is the cause of most cases of fainting.

When a person’s temperature exceeds 41oC, the body’s major organs, including the brain, will be affected. The death rate when this happens is as high as 50 percent. This is what “heat stroke” really entails and it is the most serious of all heat-related conditions. However, in daily conversation, the Chinese language uses “heat stroke” to refer to both of these states, which are very different in nature.

Since there is such a vast difference between what is meant by “heat stroke” in daily usage and in medical terms, the terminology to refer to “heat stroke” in Mandarin should be changed to something that better describes its grave nature.

In the Hung case, the medical officer in charge, Lu Meng-ying (呂孟穎), was immediately placed into police custody, despite there being no evidence that he did anything wrong. What is really hard to understand is how his superiors could have been so harsh on Lu when they have a responsibility to look after their subordinates. If Lu handled the matter by himself and failed to send the body off for an autopsy as soon as death was confirmed, as is standard procedure, surely he could have been sent to the police for questioning in line with regulations for investigations involving the delayed return of a soldier’s remains.

Regardless of what method was used in handling the case, if someone dies, an investigation is always necessary. Is being a medical officer in the military some form of curse? Why was Lu placed in police custody straight away?

Lee Ping-ing is an associate professor of pediatrics at the National Taiwan University Hospital.

Translated by Drew Cameron