How Movies and TV Get Radiation Sickness Wrong


{♫Intro♫} Radiation sickness might sound like something out of a post-apocalyptic horror film. And it often is. It’s been portrayed in movies and television for more than 50 years. And those portrayals vary a lot. I mean, the fate-worse-than-death described in 1959’s On the Beach is very different than the ‘based on a true story’ version depicted in the 2019 miniseries Chernobyl. But if there’s one thing pretty much all these portrayals have in common, it’s that they get radiation sickness wrong— at least somewhat. Like, people don’t just start oozing blood out of their legs, and you can’t get the illness from hugging a hospitalized loved one. To start off, technically, radiation sickness is called Acute Radiation Syndrome or ARS. And it’s not one thing, but rather, a bunch of different syndromes that result from being exposed to large doses of ionizing radiation. That’s the kind of radiation that carries enough energy to knock electrons off of atoms. And it’s a problem for your cells, because all that energy can break chemical bonds and therefore mess with essential molecules like DNA. Your cells have ways of fixing broken molecules, of course, especially breaks to DNA. But they aren’t perfect, so ionizing radiation often leads to mutations. And let’s be clear: cells don’t become better from these mutations. The more radiation-induced mutations a cell has, the more likely it is that it will die or become cancerous. So although radiation can change your DNA, it isn’t going to turn you into a walking, roaring, city destroyer a la Godzilla, or give you superpowers. I’d hope that radiation myth was pretty obvious, but not all of them are so easy to spot. For example, let’s say a person walks into the exact wrong room and is exposed to a lot of radiation. And by a lot, I mean enough that this person gets more than 0.7 grays of radiation exposure from spending five minutes in that room. A gray is a measure of how much energy is absorbed by an object or person per kilogram of weight. And though it might not sound like much, 0.7 grays is a lot. For comparison, when you get a chest x-ray, you absorb about 0.0001 grays, and a full-on CT scan exposes you to just 0.01 grays. So, yeah, 0.7 grays is a lot of radiation, and this person has just been exposed to it. What happens next? Based on Hollywood, you might think their skin will instantly blister or they’ll start bleeding from everywhere. But that’s not how radiation sickness works. They might have no symptoms for a while. Depending on the exposure, it could take minutes to hours before they enter what’s called the prodromal stage of ARS. At this point, they might feel nauseous or
vomit, or have a fever, headache, or diarrhea. Symptoms like these can happen on and off for a few days. And we’re not entirely sure why that happens. The best explanation we have is that radiation somehow activates cells in the gastrointestinal tract to release the neurotransmitter serotonin, and that triggers the brain’s vomit center. A similar thing can happen when people get chemotherapy. What’s weird about ARS, though, is that after this period of queasiness, people often feel a lot better. This is what’s known as the latent stage. And as the name implies, during this phase, it might not seem like there’s a lot going on. A person who’s been exposed can feel generally healthy… but they’re not. Oddly enough, this is the stage where cells are actually dying. You see, the cells that die from radiation generally don’t die right away. DNA damage mostly becomes a problem when cells go to divide and realize they can’, because the DNA has breaks in it or the coding sequence is wrong. So the length of the latent period partially depends on where the radiation damage occurred and how often the affected cells divide. That’s why, when symptoms start to show up, they often appear in places like the intestines, bone marrow, or skin, because those tissues contain cells that divide the most often. Of course, how long the latent period lasts
also depends how strong the dose of radiation was. Higher doses over a shorter period of time mean more damage, faster. Now, the latent period might sound similar to the incubation period of other illnesses where a person doesn’t show symptoms, but they can transmit the disease to someone else. But, unlike TV shows would have you think, people with ARS aren’t dangerously radioactive. Their radiation sickness isn’t contagious. You could, say, sit by the bedside of your dying partner for days or even weeks, and you wouldn’t develop ARS yourself. Now, it is possible for a person to be emitting dangerous amounts of radiation right after they’ve left the exposure site, because radioactive material can stick to their skin and clothes. But once those clothes are removed and their skin is thoroughly washed, the danger is gone— even if there’s still radioactive material inside them. If they inhaled or swallowed bits of ash, for example, they might have stuff emitting ionizing radiation inside their body. But, even though any radioactive material inside them will continue to give off radiation until it fully decays, that radiation is lost
so quickly to nearby cells that the person doesn’t pose a danger to others. Basically, it’s just hurting them. So, technically, you could go ahead and hug
a loved one who’s been hospitalized with ARS. But it might not be a good idea to do that—for
their sake. You see, the radiation may have killed off
a lot of the stem cells in bone marrow that make white blood cells. And those white blood cells are the immune
system’s army, so without them, the immune system is weakened and the person is vulnerable
to infection. Plus, damage done to other tissues — like
connective tissue and blood vessels — can eventually cut off the bone marrow’s blood
supply. And without blood, the bone marrow keeps dying
even after the radiation threat has passed. Eventually, the body can’t compensate for
the cell damage anymore. And that that point, the person enters the
manifest illness stage. This stage lasts anywhere from a few hours
to several months, and looks different depending on the kinds of tissues that were damaged. Some forms of radiation syndrome show up in
the skin, which can get dry, red, or itchy, or in severe cases can start to blister. Basically, it’s the same idea as a sunburn—though,
potentially, a lot worse. Other forms, triggered by smaller doses of
radiation, mostly affect the bone marrow, resulting in internal bleeding, a drop in
white blood cells, and anemia. But if a person is exposed to more than 10
grays of radiation, advanced phases can also have gastrointestinal effects, like severe
diarrhea, vomiting, or becoming unable to absorb the nutrients in food. And if the exposure was more than 50 grays,
the patient could move really quickly through all the earlier stages to reach the manifest
illness stage in a matter of hours. And in cases like these, damage occurs to
the central nervous and cardiovascular systems, resulting in convulsions or comas. And… there isn’t really any chance of
survival. But, the good news is, in most of those lower-dose
scenarios, a person can recover—especially if they receive prompt treatment. Though, there is no silver bullet. Hollywood seems to think all you have to do
to survive a nearby nuclear disaster is pop some iodine tablets. Don’t get me wrong, iodine tablets are great. And it’s true these pills are recommended
as soon radiation exposure is suspected. But they’re not a cure-all. In fact, they don’t so much treat ARS as
prevent the person from absorbing too much radiation in their thyroid—that walnut-sized,
H-shaped organ in your neck. See, the thyroid’s job is to take iodine
and use it to make thyroid hormones, which help regulate your metabolism, among other
things. Most of the time, that’s totally fine. But if you’ve been in a fallout zone, you
might have radioactive forms of iodine in your body—like iodine 131, which is one
of the radioactive elements made in a nuclear reactor. And if a bunch of that gets into your thyroid,
it can cause a lot of DNA damage and even lead to thyroid cancer. Iodine pills contain potassium iodide, a stable
form of iodine. The hope is that your thyroid absorbs it instead
of the radioactive stuff. And for that reason, they do help—but they
only really protect the thyroid, because it’s the body part that sucks up most of the iodine
in your body. And they don’t help your body deal with
any other radioactive elements. Plus, they don’t actually do anything to
the radioactive material. And if a person has radioactive stuff inside
them—what doctors call internal contamination—getting rid of it will help minimize the total damage
done, so that’s an important part of treating ARS patients. Radioactive elements do eventually stop emitting
radiation on their own, of course. Radioactive iodine, for example, has a half
life of about eight days—so even if it’s still in a person’s body, after 8 days,
it’s lost half of its radioactivity. But it takes almost two months for it to lose
99% of its radioactivity, and other radioactive elements have much longer half-lives. And remember, they’re emitting cell-damaging
radiation that whole time. So it’s not ideal to just wait things out. That’s why, to speed things along, doctors
might give a patient substances like radiogardase or DTPA, which bind to radioactive metals
to stop them from entering cells and block them from emitting radiation. Once bound, they’ll leave the body in urine
or feces. Even then, though, the whole process of totally
removing radioactive material from a person’s body can take several weeks or even years. And it doesn’t treat the damage already
done. [SIY-toh-kihn]
Actual treatments for ARS might include transfusions to replace the blood cells that were damaged
or destroyed by radiation, and cytokine therapy to stimulate the bone marrow to make more
white blood cells. Many patients are also given antivirals and
antifungals to prevent infections while their immune systems are weakened. And hopefully, with enough medical support,
the person will reach the final stage: recovery, where things pretty much go back to normal. So yeah, radiation sickness can be really
bad, but even without iodine tablets, people can recover. That’s different from a lot of what you
see in movies or TV shows, where basically anyone exposed to radiation dies—even if
they only left the bunker for a minute, or were miles away on a bridge watching the fallout. In fact, actual cases of ARS are really rare. And that’s in part because the events that
lead up to them, like nuclear bomb blasts or reactor meltdowns, are thankfully rare. But it’s also because you have to be pretty
close to the action to get ARS. For example, as awful as the Chernobyl accident
was, cases of ARS were limited to people who worked in the plant or who went on-scene as
emergency responders, and most of them actually didn’t get ARS. There were no confirmed cases in the residents
of the closest town. Of course, the rareness of ARS is part of
why we didn’t really know a lot about radiation sickness or how to treat it when some of the
most inaccurate movies or shows were filmed. So they really may have thought that people
with ARS were emitting tons of radiation, for example, though we now know better. And even today, myths from the past can persist
because we don’t really see ARS cases in our everyday lives. Also, some things are just a whole lot less
entertaining if they’re portrayed accurately. Like, we wouldn’t have superhero movies
if we let reality get in the way of a good origin story. So maybe we can forgive our favorite filmmakers
for not getting all the details 100 percent right. Maybe. Of course, science fiction doesn’t always
get things wrong. And if you liked learning about the scientific
realities behind these TV tropes, you might like our episode on 5 Sci-Fi Futures We Actually
Should Worry About. {♫Outro♫}

100 thoughts on “How Movies and TV Get Radiation Sickness Wrong”

  1. Aaargh. Don't use grays for the medical impact of ionizing radiation. Use sieverts. Each type of exposure has differing effects depending on where and what type of radiation. Alpha particles have about 5% of the effect that beta, gamma, and x-rays have.
    see: https://www.nrc.gov/reading-rm/doc-collections/cfr/part020/part020-1004.html

  2. I thought that radiation attacks the soft tissue that’s easily accessible and that’s what causes the nausea and vomiting?

  3. "People with ARS are not radioactive. "
    Then what happened with mrs Ignatenko's baby? Did she lied or what? Maybe she get confused?

  4. Makes me think of "Fat Man and Little Boy" and what happened to Michael Merriman (a pastiche of real-life scientists Louis Slotin and Harry Daghlian).

  5. So, getting too close to "The Giant Behemoth" won't immediately burn you to death? I don't care. It's still a very underrated '50s sci-fi classic.

  6. has anyone even been exposed to 50 grays? I was researching Hisashi Ouchi just a week ago and he was exposed to 16-25 grays. 8 being classified as guaranteed death. Useful visualisation: https://xkcd.com/radiation/
    btw. that infamous horrible picture of Hisashi Ouchi is not him, is just a classic case of people repeating something until it becomes fact.

  7. Based on this it seems that Fear the Walking Dead has gotten it mostly right. So a show about a zombie apocalypse has covered radiation exposure more realistically than most other shows and movies?

  8. "no documented cases in the closest town" Soviey union wasn't exactly known for caring for their citizens and transparency

  9. The video implies that some of the treatments, in addition to binding the radioactive material so it can't enter cells, can prevent it from decaying. Since radioactive decay is a nuclear process and binding would be a chemical process I wouldn't expect the chemical process to affect the rate of decay. Was that a misstatement/mistake or is there something to that? I might imagine bond configurations affecting decay probability, but it seems like a stretch, so to speak.

  10. You’re right now in 2019 we have a much better understanding of how radiation works so the doctors and people in 1986 that were being portrayed should know too…

  11. One cell that refuses to die and now mutating like crazy becouse a random colission in its nucleus, if only there was a way to control the comosomes to our will

  12. Michael, get a neck massage on your left side and train your left wing (latissinus dorsi). It's gonna make wonders for your overall neck health. 😉

  13. And then there's 'Another Life' with the guy "discovering" that Gama Rays can kill this pathogen so those infected open the hatch to expose themself with it….

  14. Now I feel like I haven’t seen any movies or TV, because I don’t think I’ve ever heard of most of these misconceptions 😄🤷‍♀️. (Except for superpowers 😁.)

  15. When I was a kid, I already knew that exposure to nuclear blasts and waste did not make a person into a super hero.

    IF that was EVER true, then considering Japan's TWO nuclear bombings would mean there'd be hundreds of THOUSANDS of Japanese people with superpowers.

    C'mon, seriously- if you believed that you'd have to be mentally challenged / a kid toooo into superhero movies and kept unaware of real science.

  16. Oooh, right, there were no CONFIRMED cases of radiation sickness in the soviet union which is notorious for reporting on its own messes. That sure is a relief.

  17. I had a civil defense manual from the 1970's and it had an accurate description of radiation sickness. So no real excuse.

  18. This one touched a soft spot with me try reading tge book sidalko and the thousand paper crains its about a yung girl dying from radiation poisoning post ww2

  19. Lots of ppl died of Radiation sickness after working as a Reserve Army Soldier To put back radioactive Ash and Rock back inside the plant, the Russian government did completly fail but one Scandinavian Scientist thoght 4 days after Incident, it was one of thei Reactor leaving contamination.

    PPL work 5 min in Areas where it was Dangerous to work 1 min with good safty equipent, those poor ppl could have actually some throw themselfes into the plant too, there where Cases of ppl dieing of Radiation sicknessbecause Contaminated Person was not perfectly washed, or had verry high dose of Radiation, and by vopmiting sweating Urine and more othe ppl which cared for the sick, died sometimes after the first one.

  20. when my little sister was getting treated for thyroid issues, i couldn't even be in the same room as her until her radiotherapy treatment was done.

  21. I get that you’re trying to say Chernobyl was incorrect when the doctors wouldn’t let the woman sit with her husband, but maybe that was what the doctors actually said? They might have been incorrect, but it doesn’t mean the series was inaccurate.

  22. There's a sci-fi caveat to most of the radiation-born origin stories for superheroes. Long story short; early in the existence of humans, aliens stuck an 'X gene' into them, and that can activate when someone is exposed to stress like radiation, it CAN activate that gene, and then you get the Hulk.

  23. REAL documentary on Chernobyl aftermath – https://youtu.be/O2YNLv_uGTo
    it's Old (from the 90s) – BUT the info is eye opening! shows what the government did immediately following the incident …… (The girl at about 30:00 min mark broke my heart)
    https://youtu.be/O2YNLv_uGTo

  24. The idea that people exposed to radiation emit radiation comes from misunderstanding results from the early atomic tests.
    Some included live animals who were tested afterward. They were radioactive because many had irradiated sand literally blasted into their skin. Though the reason why was explained fairly soon after the test, the idea of being exposed equaled emitting caught on.

  25. There is no chemical substance (like the radiogardase you mention) that can prevent a radioactive isotope from emitting radiation. It's a stochastic nuclear process. At best it could chelate common radioisotopes and help your body eliminate them before they decay.

  26. You mean how the entertainment industry doesn't care about doing their research about anything that deals with STEM, History, ect. Because we want to scare people

    Its 2019, get it right….

  27. I like how the radiation sickness turned Captain Kirk and the landing party gray and wrinkly in a matter of hours, and the synthetic adrenaline treatment changed them instantly back.

  28. and this, by the way, is why cigarettes cause cancer, heart attacks, and periodontal disease – tobacco contains polonium. not strictly equivalent, and much slower-acting, of course, but still.

  29. I'm a bit puzzled as to why nothing was mentioned about the knowledge on ARS and the long term effects of radiation exposure gained by studying the victims of Nagasaki or Hiroshima?

  30. If a person takes a strong Gamma source into their body, it can affect others.
    This video glosses over the risk to make people feel better

  31. Hmmm … If ARS is left untreated, will it then become an ARSE-sickness (maybe even a pain in the butt?)? ^^

  32. Downplaying the catastrophic rate of cancer caused by radiation exposure. Standard boffins that justify swaths of uninhabitable land and ruined lives with numbers and a dispassionate attitude towards the sanctity of life. Tell it to the victims.

  33. What causes radiation to stick to a person though rather than just go through like it goes through everything?

  34. Dude, you're off by an order of magnitude. Hemopoetic is roughly 1 Gy acute. People don't start puking until 2-2.5 Gy whole body; LD50/30, is 4.5 Gy. That's 50% lethal @ 30 days.

  35. To be fair, Chernobyl does get it mostly right. The only people who really took the hit were the workers attempting to fix the problem at the reactor site. The people who did die or become ill from the town were largely first responders, nurses and doctors who came into direct contact with patients in irradiated clothing. Most of the effects came in the form of cancer which is damage you don't realize until months or years after exposure. In some cases it was people's unborn children who were the unfortunate hosts of much of their intake of radiation.

  36. So, instead of turning me into Spiderman, being bitten by a radioactive spider is more likely to turn me into lymphoma man.

  37. If your having a CT scan and get a hot shot of radiation in the vein, stay away from pregnant women/kids & flush two times after passing urine.

  38. My wife just farted under the quilt, what are my chances of survival? Think I’m going through the vomiting stage 🤢

  39. 9:44 "No confirmed cases in the residents of the closest town…" From a cold war era event that has never happened before in the history of humanity on a nation that held safety as secrecy punishable by imprisonment in a gulag in Siberia…
    Oh and they claimed the death toll was 37?

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  41. You should have seen our dog dying of Radiation Sickness 3y after Chernobyl and ca. 1000km away from it. Mutated rabbits and chickens, etc. Sorry to say, but you seem to miss a lot of knowledge. This is especially petty for such a highly so far regarded by me channel like yours.

  42. And here I thought constant radiation exposure only leading to minor statistical drawbacks until the really advanced stages in the Fallout games was inaccurate!
    (Granted, your character should stop what they're doing start puking every few in-game hours… But even so, pop-culture told me that significant radiation exposure was way more debilitating.)

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