The Evolution of Ragers

[Selsie Turner]

While Aftermath is all about the Zombie and Rager love, it is also very much centered around a plausible scientific explanation for a plague of the undead. MCB and I based the room concept on actual viral pandemics. Multipurpose vaccination shots -- MMR, or Measles-Mumps-Rubella, for example - are absolute science-fact, and so are live-virus vaccines and resulting vaccine sicknesses. The only "science-fiction" on our front page is from October 2012 on, when fictional simultaneous outbreaks of H1N1 and H5N1 cause WHO scientists to create an unintentionally deadly vaccination shot intended to combat both influenza strains.

It is also a fact that viruses mutate; that is simply the nature of the beast, so to speak. Many of us have kicked around ideas about how our room's particular virus might mutate. Just as our characters' growing understanding of the Rager-to-Zombie virus has evolved to shape our role-play, so too would the virus evolve. Considering how much research went into the room concept to begin with, it probably comes as no surprise that I started researching viral mutations.

This site in particular got me thinking: www.birdflumanual.com/articles/influenzaEvolutionAdaptation.asp

I paid particular attention to the lines which read "Another unique feature of the 1918 Spanish flu was the presence of killer gene segments (lethal polymorphisms). These gene segments are associated with widespread organ failure and damage not seen during the seasonal flu or the minor pandemics. Disturbingly it was discovered recently that not only was H5N1 bird flu... following the same evolutionary path taken by the 1918 virus it had also accumulated many of the same lethal polymorphisms found in Spanish Flu. These observations are among some of the reasons to think that if bird flu achieves pandemic status it will be a man killer on par with the 1918 strain."

Ooh! That fits right in with the room concept! Suh-weet!

Further reading brought me this gem: "Influenza has two natural hosts; the members of the avian and mammalian species. In addition to mutation there are at least two other ways the flu virus can come up with new combinations of genetic material. When two flu strains infect the same host cell at the same time they can exchange genetic material with each other. If the exchange is of one or more whole genes the process is called reassortment. If two strains exchange a short segment of a gene the process is called recombination."

Ah-hah! And that's what happened when the vaccine shot went haywire! Two strains infecting the same host at the same time and exchanging genetic material with each other to create some fresh new hell... that in my devious brain caused a Rager-to-Zombie plague!

Which brings us back to logical viral mutations and how this could factor into our role-play. Evolution is necessary to prevent our role-play from becoming stagnant, but how much is too much?

Talking, reasoning, GED-earning, track-star zombies. Sorry, that's just too much. Even re-animated and decaying at an inexplicably slow rate, dead is dead. I'm a die-hard Romero fan, but Land of the Dead jumped the shark for me. Dead things don't learn. Steve Miner's Day of the Dead remake, on the other hand, was my personal definition of zom-bomination. (Yes, I made up a word. -grins-) Dead things don't get stronger and more athletic post-mortem. They don't run up walls like demon chimpanzees. Zombies only seem stronger because they are incapable of feeling pain, fatigue, or self-preservation, the three things that keep normal human beings from bashing themselves mindlessly against a barrier until their arms and noses literally pulverize and fall off. And please, let's not even go there with hive-mind zombies. If they weren't telekinetic before, they're not telekinetic now. They're just... freakin'... walking corpses. AotD zombies are going to keep right on shufflin' like they always do, and that's not open for debate.

But how about Ragers? Is it absolutely set in stone that they scream, spit blood, race around at top speed, and attack anything that moves for 5-7 days before keeling over dead and getting back up as a zombie?

And what about the capabilities of our human survivors? As the basic storyline goes, only 23% of those who were vaccinated died, and only 5% of THOSE people experienced Rage and eventual reanimation. In other words, 77% of those who were vaccinated were immune to the sickness. But... some of our zombie apocalypse survivors were simply never vaccinated. Selsie, for example, never got the shot. This means there would be survivors in the AotD world with absolutely normal immune systems. Survivors who could contract H1N1, H5N1, or both. Survivors who were immune to the original strains but who could still get their asses kicked by the mutations. To be clear, these strains would be your non-zombiefying, non-Rage-inducing kinds of flus... and don't take that lightly! Folks without proper medical care or weak immune systems die of the NORMAL flu all the time. The 1918 Spanish Flu - which was far from normal - killed 40-100 million worldwide, and AotD's H1N1/H1N5 pandemic took a similar toll INDEPENDENTLY of the aforementioned 23%. Those possibilities alone can provide us with plenty of storyline fodder!

Since the Rage Sickness is its own virus, thanks to the live-virus vaccination that created our perfect storm of fictional disease, it, too, would mutate. So let's return to the subject of Ragers. Is it absolutely set in stone that they scream, spit blood, race around at top speed, and attack anything that moves for an absolute maximum of 5-7 days before keeling over dead and getting back up as a zombie?

In my opinion, no.

My theory? What makes sense in -my- head? According to the AotD timeline, we are some 16 months from the outbreak, and the original blood-spitting variety of Ragers are about as dead as dinos. Rager bites infect humans with Rage. Zombie bites infect humans with a nasty case of dead that skips the Rage-stage entirely. Ragers, version 1.0, simply don't have a long enough shelf-life to infect survivors indefinitely. As MCB and I discussed a few months back, they would eventually run out of ready supplies of uninfected humans to bite and either run afoul of zombie hordes and be torn apart or drop dead and join the legions of the undead a whole lot faster than they would be able to replicate/maintain/increase their number in a 5-7 day span. "But, Selsie," you might say, "Nessie might be a dino! Crocodiles and alligators are pretty much dinos! Sharks haven't changed much in millennia, either!" Yes, yes. However, for all intents and purposes, dinos and Ragers v. 1.0 are extinct.

Here's how I think it would go. Or... HAS gone (and a HUGE thanks to Darlene, Noah, Carter, Noisewater, and others who have nudged story lines in this direction)...

As the Rage virus mutated, the infected started surviving longer. Perhaps there was a longer incubation period and a more gradual presentation of symptoms. A "slower burning" Rage, if you will, that took longer to cause brain death. The end result - an all-out frenzy swiftly followed by an incurably high fever, brain death, and resurrection - is the same, hence why we thought we were still seeing 1.0 Ragers. Between infection and resurrection, however, we have a whole new creature on our hands.

So what would these 2.0 Ragers be like?

Well, first of all, "Rager" might not be such an accurate term for this "inbetweener." Maybe "Creeper" or "Stalker" would be more apropos. Essentially, you have a sociopathic homicidal psycho with some ability to reason. Darlene had a sub-plot in which she and Luc were almost torn to shreds by a female Rager who used her equally infected child as a decoy. Noah described what he was pretty sure was a Rager with uncharacteristic patience that stalked him for several days. I'm not talking Hannibal Lector by any means. These things are completely out of touch with human emotions or anything resembling our concept of ethics or morality. They would not be able to pull off "normal" for any length of time and have most likely lost the ability to read, write, or speak. I certainly don't imagine one of these things walking up to the compound and holding a perfectly reasonable conversation with the watchtower guards, then going rabid wombat the instant the gate opens, nor do I envision one of them going all MacGyver on our asses. They would be unkempt, animalistic, and outright freaky (I'm imagining the jerky head movements of the mutants in I Am Legend right about now, minus the weird hairless skin)... but even "dumb" animals are known to send decoys to lure out prey or stalk a particular quarry for incredible distances while waiting for the opportune moment to strike. I don't think it would be outside the realm of possibility for a Rager v. 2.0 to try to pose as a wounded human for just long enough to lure a survivor into attacking range; to pick up a brick or a club; or to climb a tree... or a chain link fence. Like untreated syphilis, however, the virus is ultimately fatal. As the sickness moves toward its terminal stage, weeks or months down the line, the Rager's ability to reason diminishes until it becomes the blood-spitting rabid creature we all know and love... to shoot in the head.

Well, I've written about 1500 words now, so I should probably get to my ultimate points! Bottom line: I'm not trying to jump the shark. I hate it when TV shows and novels do that, and that is the last thing I want to see happen in Aftermath. Our room concept isn't "broke" and doesn't need "fixing," but I don't see anything wrong with a little cosmetic enhancement. While I'm leaving the zombies as-is, I would personally like to see our concept of Ragers evolve in the manner outlined above, along with the possibility of further lethal polymorphism-variety influenza epidemics. I simply think this would make things a little more scary and challenging!

But this is not just my room, it is our room. I may be RC, but I am not a dictator. Anything that requires tweaking the webpages should be decided through discussion and majority consensus rather than unilateral decree, in my opinion, so I want to hear what you all think before moving forward in this direction!

[Sophie]

I like this idea. It seems that the virus somehow damages the brain.

I've attached an article about brain damage and rage (the whole thing since I don't know how long it's archived) that would really give us some additional food for thought.

From When Rage Explodes, Brain Damage May Be the Cause, New York Times, August 7, 1990

When Rage Explodes, Brain Damage May Be the Cause

By DANIEL GOLEMAN
Published: August 07, 1990

Correction Appended

''HE was a scientist, but he was acting strangely,'' said Dr. Stuart Yudofsky, a psychiatrist who consulted on the man's case. ''At work, when something didn't go right, he would scream and threaten his co-workers. At home, if his 4-year-old spilled some food at the table, he'd get so mad at her, he'd punch holes in the walls with his fist. It was completely out of character.'' For several years the scientist was treated by a series of psychotherapists, who urged him to examine his childhood for deep-seated conflicts that might explain his rages. Then a psychiatrist prescribed a sedative. Nothing helped.

Finally the scientist was referred to a neurologist, who traced the beginning of the violent outbursts to an auto accident in which the scientist had received a severe head injury. When the scientist was treated with propanolol, a medication used to control blood pressure, his rages stopped.

The scientist's case exemplifies a new advance in understanding explosive anger: that the most common cause is brain injury or neurological disease, and that there are now medications that can control it far more effectively than can the approaches most commonly used by psychiatrists.


But researchers say that despite the advance in understanding the causes of violent rage, too little attention is being paid to people who suffer from such attacks, and that as a result they receive inadequate care.

''The brain basis for violent rage often goes unrecognized, and a great many patients with the problem are being given improper care,'' said Dr. Yudofsy, chairman of the department of psychiatry at the University of Chicago Medical School. ''This has been a huge unsolved problem for psychiatry.''

The rage resulting from neurological impairment is distinct from ordinary anger. It is a sudden and unpredictable storm of overwhelming fury that is triggered by a trivial event and that builds into an explosion in an instant. It serves no purpose for the person who is swept away and typically leaves remorse and embarrassment in its wake.

The work on rage bears great significance for several groups, like the estimated four million people in the United States with Alzheimer's disease. Studies have found that about a third of Alzheimer's patients have uncontrollable rages. Inability to handle the patients' outbursts of rage is the single most common reason given by families of Alzheimer's patients for sending them to nursing homes or hospitals.

Apart from those with Alzheimer's disease, one million people suffer brain injuries each year from strokes, tumors or blows to the head; 180,000 of them are injured in auto accidents. Some degree of constant irritability or explosive aggression occurs in as many as 70 percent of those who suffer serious brain injury, studies have shown. For those working with such patients in hospitals, dealing with outbursts of anger is troubling and frightening.

Insights on Criminal Violence

The research may also offer insights into some criminal violence: two studies involving a total of 29 murderers on death row in at least four states found that almost all had a serious brain injury that may have triggered their violence.

''Explosive rage is very common, since it can be a symptom of any malady that destroys brain cells,'' said Dr. Yudofsky. ''And I suspect brain damage is, by far, the most frequent cause of these violent outbursts, though no one has exact numbers.''

The new treatments may mean a fresh start on life for people who have suffered from the attacks of rage.

Other experts caution that there are many cases of explosive rage that cannot be explained by brain damage. ''There are a large group of people with brain damage who do not have explosive rage, and a sizable group of people with rage who have no brain injury,'' said Dr. Gary Tucker, chairman of the psychiatry department at the University of Washington medical school.

Even so, brain damage is increasingly being recognized as a cause of the problem. Dr. Louis J. West, chairman of the psychiatry department at the medical school of the University of California at Los Angeles, said, ''The number of cases where brain damage explains an explosive rage is not so small as we used to think.''

In some studies, up to 70 percent of those with outbursts of rage were found to have neurological damage. A University of Pennsylvania study of 286 psychiatric patients prone to unprovoked attacks of rage found that 94 percent had some kind of brain damage. The cause ranged from head injuries and stroke to encephalitis and Alzheimer's disease.

Factors Found on Death Row

Like violent psychiatric patients, violent criminals have also been found to have a disproportionate share of brain injuries. For example, of the 29 death row inmates all were found from hospital records or neurological tests to have had a head trauma, ranging from falls from trees in childhood to regular beatings.

''There is no question that much violent crime can be traced, in part, to brain injury, especially in criminals who are repeatedly violent,'' said Dr. Dorothy Otnow Lewis, a psychiatrist at New York University Medical School, who conducted the research on death row inmates.

But Dr. Lewis says that brain injury alone is not likely to provoke such intense violence. ''The most lethal combination is a history of neurological damage and abuse in childhood,'' said Dr. Lewis. ''When you have a kid who has some organic vulnerability, like a brain injury, and you add being raised in a violent household, then you create a very, very violent person.''

Her conclusions stem from a study of 95 boys who were studied at a Connecticut correctional school in the late 1970's, then were tracked seven years later using records of their subsequent arrests maintained by states and the Federal Bureau of Investigation.

Those who, as teen-agers, showed no sign of neurological problems or childhood abuse had not committed a violent crime as adults. Those who had some brain impairment, or who had been abused in childhood, committed an average of two violent offenses.

But those who had both brain impairment and an abusive family history had committed an average of five violent crimes. Nine who had been convicted of murder were in this category. Avenue for Criminals? Experts in law and psychiatry doubt that the findings suggest an avenue for criminals to evade punishment for violent crimes. ''Being swept away by emotion does not mean one did not know right from wrong,'' said Dr. Park Dietz, a psychiatrist in Newport Beach, Calif., and formerly a professor of law and psychiatry at the University of Virginia.

Nevertheless, he said, ''it is legitimate to bring up a brain impairment at sentencing to mitigate the blame for the defendant and so get a lesser sentence.'' And, he said, it was becoming increasingly common for defense lawyers to raise neurological problems in their client as a defense of last resort when there is no other sign of mental illness.

Injuries to certain parts of the brain, such as the frontal areas of the cortex, are the most likely to result in attacks of rage, researchers say. According to one theory, these brain areas ordinarily control aggressive impulses that originate in lower brain centers. When the controlling areas are damaged, the inhibitions disappear, allowing rage to be expressed freely.

For that reason, a new diagnosis, a ''disinhibited type'' of dementia, has been proposed for inclusion in the next edition of the official psychiatric diagnostic manual.

''There is good evidence that explosive rage is one sign of a disinhibition syndrome,'' said Dr. Tucker, who heads the committee studying such new diagnoses.

''But we see rage attacks as one example of a more general category of inappropriate emotional behavior due to brain trauma. It can take many forms, such as exposing oneself, or swings from crying to laughing.''

Unique Psychiatric Syndrome

Dr. Yudofsky, on the other hand, leads a group of psychiatrists who argue that explosive rage marks a unique psychiatric syndrome in itself and that a specific treatment is now available for it.

Dr. Yudofsky said that most patients treated for explosive rage were being given the wrong medications. ''The majority of these patients are prescribed sedatives like heavy tranquilizers or antipsychotic medication,'' he said. ''You see patients in hospitals looking like zombies. They've been oversedated to keep them under control.''

One of the most promising new treatments for rage is propanolol, a beta-blocker more commonly used to treat hypertension that has none of the debilitating side effects of the sedatives.

In a study published in the spring issue of The Journal of Neuropsychiatry and Clinical Neurosciences, Dr. Yudofsky and colleagues showed that the drug was highly effective in calming rage in white rats.

The researchers first made lesions in the rats' brains in a procedure that ''creates a very violent rat,'' Dr. Yudofsky said. The researchers then put the rats on a device that delivered a shock to their feet.

When the rats were paired, they attacked each other four out of five times when the shock was applied. But after they were given injections of propanolol, they attacked only about one in five times, or at the same rate as before the operation.

Drug's Usefulness

A number of studies in humans also suggest the usefulness of propanolol. One of the most recent, reported at the meeting of the American Psychiatric Association in May, was conducted by Dr. Jonathan Silver, director of neuropsychiatry at Columbia Presbyterian Medical Center in New York City.

That study used a group that is among the hardest to treat: 21 patients whose violence has kept them in the locked ward of a psychiatric hospital for an average of 10 years. Overall, there was a 50 percent reduction in the number of angry outbursts, from an average of one incident a day, to one every other day. In seven patients the reduction was greater than 75 percent.

In addition to propanolol, other medications have shown promise for controlling rage. Most mute the activity of catecholamines or serotonin, brain chemicals involved in emotions like anger.

The other medications include lithium, used to treat manic-depression; buspirone, used to treat anxiety; and carbamazepine, used to control seizures.

It was this last drug that was of crucial help to Paul Streicker, president of an advertising and public relations agency from Providence, R.I., who had attacks of rage following a severe brain injury from an auto accident.

''As I was recovering, I was highly irritable,'' Mr. Streicker said. ''Once in the hospital I threw a can of soda at my dietitian. At home, I'd have fits of rage where I'd take a swing at a lamp and yell.''

But when Mr. Streicker began taking carbemazapine, his emotions were tamed.

Experts say learning not to feel guilty or embarrassed about outbursts can help prevent self-reproach and depression.

''People can also relearn some emotional controls,'' Dr. Yudofsky said. ''Drug treatment should be in tandem with psychotherapy and family therapy.''

Correction: August 11, 1990, Saturday, Late Edition - Final An article in Science Times on Tuesday about links between explosive anger and brain injury or disease misidentified a drug that shows promise in treating the problem. It is propranolol.

[Nick]

I like this idea too. It makes complete sense.

[dwindsweptwayne]

*nods* This makes sense to me.

[Selsie Turner]

Ooh, great find, Sophie! I find it especially interesting that it's any kind of brain injury or neurological disorder, whether head trauma, Alzheimer's, stroke... And according to MCB, an episode of CSI that was on last night detailed explosive rage due to encephalitis, which is one of our actual Rager Flu symptoms!

He says he thinks of this new type of Rager as a non-verbal autistic with fits of psychotic rage, which is a fairly accurate analogy since some people with autism violently lash out when overloaded with sensory information. As the diseased Rager's brain swells, I could see increased sensitivity to light, sound, etc., just like a rabid animal experiences, and when the trigger is tripped too far... attack!

[Manhattan]

Sophie,

That's a great find! It makes a lot of sense! Especially considering I used to breed Doberman's, it's the human version of the rage suffered by this particular breed of dog.

[Andrew]

"non-verbal autistic with fits of psychotic rage" sounds like a few goreans I've seen. ~chuckles~

But that aside the above is a huge wealth of info for the room and should prove...interesting!