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More On Dan Brown And Liquid Breathing

In this week’s Newscripts, I wrote about some of the science Dan Brown used to spice up his latest novel, “The Lost Symbol.”

Schematic of partial liquid ventilation being applied to an infant in respiratory distress. Courtesy of Thomas Shaffer

As mentioned, Brown uses the concept of “liquid breathing” in the book as a way to snatch his hero, Robert Langdon, from the jaws of death. That Langdon survives really shouldn’t surprise anyone: A) He’s the main character and therefore cannot die, and B) Brown couldn’t write another cash-cow story about symbology and secret societies without the code-breaking protagonist. But I apologize if I’ve ruined it for you.

So Langdon survives being trapped in an enclosed tank that ultimately fills with liquid. It turns out that the tank is a total liquid ventilation (TLV) chamber, and Langdon is “drowning” in oxygenated perfluorocarbons rather than water. No fewer than eight chapters go by while Langdon is enveloped by the fluid, seemingly in limbo. (Yes, I said eight.)

I asked Thomas H. Shaffer, professor emeritus of physiology and pediatrics at Temple University School of Medicine, whether the scenario Brown describes is plausible. According to Shaffer, “a person could survive for a limited time without circulation of [perfluorocarbons], provided the liquid was rich with oxygen and devoid of carbon dioxide.” In addition, he says, if the fluid is cold (to lower metabolism) and treated with drugs to alter the subject’s state of mind (as Brown mentions), it could assist the process.

However, Shaffer notes, the book “sadly only reflects a rather dark application for the use of breathing liquids.” In Newscripts, I mention the use of the technique for treating respiratory illness in infants, but oxygenated perfluorocarbons also have application in head cooling (for stroke and cardiac-arrest victims), drug delivery, deep-sea diving, and space travel.

In addition, current medical use of liquid breathing doesn’t usually rely on TLV, but on partial liquid ventilation (PLV). In this method, Shaffer says, a volume of liquid is added to a distressed lung to reexpand it. Then, a conventional ventilator is used to exchange respiratory gases, and perfluorocarbons are continuously added (they evaporate during ventilation).

If Brown’s use of liquid breathing to save Langdon still seems ridiculous to you, that’s all right. I’m sure you feel the same way about Langdon surviving a fall from a plane sans parachute in “Angels & Demons.” I gently remind you that, although Brown uses history and science to shape his stories, they’re still fiction. Sometimes, you just have to enjoy the ride.

Whether Brown needs an editor is another subject. “The Lost Symbol,” in true Brown form, makes judicious use of italics

for thoughts and VIPs (very important points ) and repeats ideas over and over and over again to make sure you’re paying attention. In addition, “fun facts” often appear out of place. It seems as though Brown was looking for someplace to stick some tidbit, then closed his eyes, pointed his finger, and just inserted it regardless of plot line. The story could also have ended several chapters and an epilogue sooner than it did.

But maybe that’s just me. What do you think?


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  • Jan 4th 201022:01
    by T. Shaffer


    Thank you for sending me a hard copy of your article. After speaking with you, I had to read the book.

    I was surprised that Dan Brown paid great attention to historical detail, and for me, Washington, DC will never be the same. However, I was somewhat upset in the way he described the Professor’s experience with breathing liquid.

    Of most concern, he characterizes the breathing as painful and causing some long lasting agony associated with the process. I realize that this is fiction; however, in commenting on this process, it was like he had an interview with one of our patients. In my experience, patients with PFC liquid in their lungs can not feel the liquid, let alone hurt from it.

    Based on reading these comments in ” The Lost Symbol”, it could very well discourage patient enrollment in a potentially life saving process. No parent would want to have their child subjected to a painful experience. As noted in the readers digest article (Readers Digest- Miracle Girl http://www.rd.com/living-healthy/miracle-girl-makes-medical-history-for-premature-babies/article26938.html) there was certainly benefit from this technique.

    It would be nice if we could inform Mr. Brown about this issue, and perhaps he could attribute the painful experience with the drugs in the PFC liquid or the emotional distress of potential drowning. Since Mr. Brown has been successful in creating movies from his novels, it would be appropriate to get the facts straight , so that the readers/viewers are not mislead.

    In the book “the Abyss” James Cameron described our technology very effectively. Perhaps, Mr Brown would want to get his facts straight.

    Thanks again for bringing all of this information my way.

    Best regards and I hope you have a great response to your article.

    T. Shaffer

  • Jan 12th 201016:01
    by Lauren Wolf

    Dr. Shaffer, thanks for your comments on the article and blog post. I guess one of the good things about Dan Brown’s books is that they make interesting science accessible to a wider audience and get readers interested in researching some of the concepts themselves. The bad thing, obviously, is when there are inaccuracies.
    It wasn’t clear to me either whether Brown was saying that the technique would cause pain because of the emotional distress and the way in which they had to rapidly extract Langdon from the tank, but there is no mistaking that he described it as an awful experience.
    I always wonder how much fact-checking authors do in these situations.

  • Feb 22nd 201002:02
    by Phil Doak

    I’m actually in the process of reading Brown’s book now, and decided to look up this “tidbit” he mentioned to see the expanse of its plausibility, It was very interesting! Now seeing its actual uses I have more clarity on the subject, thank you! I love how Dan writes in so much factual (ok, semi-factual) science in his books, a great mix of actual science and fiction. I will say, though, that it was this total unknowing of the technology that kept me in suspense while waiting to see if he would be found in time to be revived. If it wasn’t for the painful experience he described (nearly exactly how he described it through the cardinal’s character in Angels and Deamons) it would not have been as captivating; being a writer (ok, wannabe writer…) I would have done the same thing. Thanks for all the correct facts!!!

  • Nov 3rd 201014:11
    by Leslie Dos Santos

    A writer of fiction is not in any way obliged to describe anything in his/her work according to someone else’s standards. The point is to gear plot, “facts,” character, themes to the intended audience to produce the intended effect. Brown has provided his reader enough information about Langdon so that the reader understands that Mal’ach has re-created Langdon’s childhood brush with death by drowning (which has affected his life from that moment on). Such a re-creation could not be anything less that painful, in a terrifying way for Langdon who is facing his worst nightmare. However, if the reader wants to “read” the experience in its most positive light, Langdon’s encounter in the tank may be a catalyst to free the professor from the phobias that have stayed with him since his childhood trauma. In any event, Brown has full license to use whatever information he wants to create the best fiction he can; it’s ridiculous to hold any writer to a standard of “accuracy.” Fiction depends on the reader’s willing suspension of disbelief!

  • Mar 11th 201105:03
    by John Smith

    If you don’t like a certain author, why do you read their books? The cash cow comment was nonsense as well. If you had a talent that you could make good money from i’m sure you’d use it and if you didn’t you’d be a complete idiot.

  • Mar 25th 201121:03
    by Paula E.

    I, too am in the process of reading The Lost Symbol. I had to stop and look up liquid breathing. Fascinating. I love Dan Brown’s books because I learn so much about science, history, etc., that I never would have known, otherwise. Excuse me. I have to finish the book before my head explodes from the pressure of excitement!

  • May 4th 201111:05
    by Ellen Dunwiddie

    I am reading Dan Brown’s book “The Lost Symbol”, I have learned things new to me and have looked on the ‘net to see how authentic the facts are….things I have heard of, but didn’t know much about them eg. waterboarding…..Also, history of DC. I have read all of his books and enjoyed each and every one of them…..

  • Oct 13th 201110:10
    by Lee Montgomery

    Love Dan Brown’s book for all kinds of reasons, particularly the “truthfulness” of much of it. I find it particularly comforting with the focus on the coming enlightenment of mankind in the midst of all this terrible darkness, particularly in the U.S. Bring it on!

  • Mar 3rd 201206:03
    by The Dragon

    With regard to the Comments made by T Schaffer and by Lauren Wolf.
    Please remember that authors do have sense and that they use as Dan Brown does Poetic Licence.
    With with regard to to fact that it would be a painfull experience to feel you were drowning is an understatement,and if you were unaware of what was happening then it would be traumatic to the end.
    You are forgetting T Shaffer and Miss Pope that when you are adminstering TLV it is done usually in a controlled environment and under medical statutes that the patient or their Guardians have discussed so that it is usually painless to go under and to recover from useing the correct tecniques.
    Dan Brown is describing a totally different scenario.
    Where you have a kidnapped person confined to a small space and and undergoing severe memory trauma then he thinks he is drowning and Mr Brown is describing his apparent “after death experience”
    with regard to the recovery to “LIFE” as explained it was not the normal procedure which as far as we know (THIS HAS NOT BEEN PERFORMED ON AN ADULT YET)
    but it described a fairly accurate description of what ussually happens when someone has ingested a great deal of sea water.
    and the Character Sato Voices this opinion but has limited time so has to take this urgent action to get Langdon back.
    and under these circumstances YES it would be painfull.
    Please note this is explained in the brief mention of the tecnique of “WaterBoarding”
    This system of Interegation is a very mild version of TLV and that is why the process has been “Apparently Officially banned as an interrogation method”
    the efect of appearing to drown and then being brought round again many times is traumatic, painfull and mentally damaging.

    Therefore I do Suggest that if you are going to review something you dont just read the book once but read it several times then just to make sure READ IT AGAIN, as you read a bit closer you may begin to understand the authors Mindset and see the book for what it is, Fiction based on available Researched Facts but augmented with the writers imagination. Because “THAT IS WHAT MAKES A BEST SELLING BOOK AND AUTHOR”
    So I say to you Messrs Pope and Shaffer DO YOUR DUE DILLIGENCE ALSO before you attack a singular item in a book

  • Mar 16th 201212:03
    by ryan r

    @ Ellen, ‘The Lost Symbol’ was great… Waterboarding, yikes!

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