Thorns

This article includes mentions to topics related to self harm and intrusive thoughts

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Thorns es una condición causada en raros casos por el uso de medicinas creadas con la planta Niño de Espinas. La peligrosidad del tratamiento puede ser mayor si la medicina no fue manufacturada correctamente, pero se calcula que una de cada 100 personas tratadas con esta planta mostrará síntomas.

Sintomas

"En sus ojos vi fuego. Hasta hacía pocos días, parecían estar congelándose lentamente"
-Esposa y víctima de un hombre intoxicado con Niño de Espinas

Las personas afectadas sienten oleadas de calor y sueño, acompañadas por sudoración. Su temperatura no sube. En la gran mayoría de los casos, las personas reportan alucinaciones auditivas, especialmente el sonido de voces diciendo cosas al azar, y música. A esto se le conoce como "La etapa de desgaste" En los casos graves, especialmente si la persona cede velozmente al sueño y se duerme, se presenta una serie de reacciones que le dan a esta etapa el nombre de "Etapa de la posesión": Poca reacción a estímulos externos, mirada perdida y la necesidad de actuar en forma violenta y agresiva (En contra de los deseos activos del paciente, que suele tratar de resistirse). Esto puede escalar en ataques violentos de parte del paciente, que ha llegado en casos a que personas afectadas maten a otros. En las etapas tardías de la intoxicación, generalmente cuando el resto de los síntomas comienzan a desaparecer, el paciente siente dolor intenso en sus ojos, que se ven secos y apagados. A esta última etapa se le llama "Etapa de purga"

Tratamiento

No se conoce una cura inmediata para esta intoxicación, pero los síntomas se pueden tratar para reducir el plazo o las consecuencias. Usualmente, tratar el calor y el sueño con baños y consumo de agua fría ayuda a evitar que la persona se duerma, lo cual reduce bastante las posibilidades de que la persona entre en la etapa de posesión. Si esto no funciona y la persona se vuelve agresiva, el apoyo emocional puede ayudar a la persona a resistirse a los impulsos de agresividad, pero en general la única forma de prevenir consecuencias graves es la contención de la persona, mediante el encierro o atándole/encadenándole en forma segura. Para prevenir secuelas psicológicas, se recomienda que la persona sea apartada de sus seres queridos en esta etapa, para evitar que recuerden el deseo de herirlos. No se encontró aún una forma de apaciguar la última etapa.

Prognosis

Dentro de lo horrible de esta condición, el punto positivo es que suele resolverse por si sola, y no tener efectos a largo plazo. La etapa de desgaste suele durar entre uno y seis días, siendo más largo usualmente en los casos que no evolucionan a la fase siguiente. Aquellos que llegan a la etapa de la posesión pueden permanecer por semanas con ataques de agresividad y falta de reacción, pero en la mayoría de los casos esta fase se resuelve entre 5 a 8 días, incluso menos. La etapa de purga ocurre en forma invariable, usualmente comenzando de uno a cuatro días antes de que el resto de los síntomas desaparezca. Este dolor en los ojos puede durar semanas luego de que el resto de los síntomas desaparezca.

Secuelas

Una vez que los ojos de la persona dejan de arder al final de la etapa de purga, la condición se resuelve por sí sola, y la persona no suele seguir teniendo síntomas relacionados directamente a la intoxicación. Sin embargo, es común que la persona se lastime a sí misma durante la etapa de posesión si son contenidos, incluso ocasionando huesos rotos o desgarros al tratar de librarse de las ataduras. Quizá las secuelas más comunes son las psicológicas: Algunas personas sufren de amnesia, y se cree que esto ocurre como método de defensa. Se dice que estos casos son los más afortunados, ya que las personas que pasaron por la fase de posesión y pueden recordarlo suelen quedar atormentados por los pensamientos que tuvieron durante esa etapa, y reportan haber estado en una lucha constate con el deseo de herir a todo el que vieran, incluso sus seres queridos.

The year 3002 E.Alz hit the Stunveldti and the Ruhk people hard and tragically with an epidemic of an otherwise rare blackout, a wasting disease usually described as an inner cold that weakens the body to the point of failure.

Fortunately, the epidemic was put to a stop when it was discovered that the leaves of a plant known as the thorn child could be turned into a concoction that cured blackout quickly and reliably.
The cure, however, came with an unlucky drawback: A small percentage of patients, seemingly at random, would develop an entirely new condition known as thorns. High at first, the percentage of people intoxicated by the plant was reduced by refining the concoction, and ended up at around 1% of consumers on a properly prepared mix, and much higher if steps were skipped or improperly followed.

Symptoms

"In his eyes, I saw fire. Just a few days ago, they seemed to be freezing slowly"

— Wife and victim of a man intoxicated with thorn child potion

A course of thorns disease consists of three stages, the middle of which may be skipped by those lucky enough.
The symptoms start with hot flashes and sleepiness, accompanied by intense sweating, without any signs of increased body temperature.
Most patients report auditory hallucinations, including music and snippets of disconnected conversations. This is known as the Weariness stage.
Serious cases, which may be anticipated by the person quickly conceding to the urge to sleep in the previous step, are presented as a state that gave it the name of Posession stage.
The person will show little reaction to external stimuli accompanied by lost focus and intense violent thoughts leading to an urge to act aggressively against their will.
Unproperly managed, this can escalate into violent attacks that could turn into the patient hurting or killing others.
Recovered patients report to have been in a constant fight against their thoughts and the unstoppable urge to hurt anyone they saw, and being unable to control their actions despite being fully conscious.
The late stage of the intoxication sees the rest of the symptoms fade as the patient feels intense pain in their eyes, which look dry and dulled. This last period is known as Purge stage.

Treatment

There is no medication known to treat and cure a thorns' intoxication. However, proper management of the symptoms is vital to reduce their duration and consequences.
Treating the hot flashes and sleepiness with cold water baths and drinking helps the person resist the urge to sleep, therefore reducing the chances of evolving into the possession stage.
If the possession stage cannot be prevented and the person becomes aggressive, emotional support may help the person resist their aggressive impulses. However, in most cases, the only way to prevent serious consequences, including severe mental trauma for the patient derived from the horrible intrusive thoughts, is to securely lock up the person in a contained facility, away from family members and, critically, unable to keep eye contact with loved ones.
In places where the blackout wasting disease became endemic, "Thorn Cells" were developed as specialized facilities to keep the "possessed" people in and minimize the risk to themselves and others.
No treatment has been found to alleviate the symptoms of the last stage.

Prognosis

Despite all the suffering caused by this condition, thorns resolves on its own, without leaving long-term physical sequela. The weariness stage lasts between 1 and 6 days, usually lasting longer for milder cases that don't get the more serious symptoms.
Those unlucky to pass to the possession stage may have flares of aggression and lack of reaction for up to several weeks, but in most cases, it resolves in between 5 to 8 days.
The purge stage invariably comes after, starting between 1 and 4 days before the rest of the symptoms disappear.
Eye pain usually lasts several weeks to a month after the rest of the symptoms fade.

Sequela

Once the persons' eyes stop hurting, the condition is considered to be resolved and the patient doesn't usually have any additional symptoms directly related to the active disease.
However, indirect sequela from the disease are common:
It is common for a person that has been restrained during the possession stage to hurt themselves in an attempt to free themselves, up to the point of broken bones or torn muscles.
More frequent are the psychological sequela. Some people suffer from amnesia after the events, which is believed to be a defence mechanism from the person's body to avoid further trauma. Those are usually considered to be among the fortunate cases, as people that went through the "possession" ordeal without the appropriate support and are able to remember it usually end up tormented by the memories of the intensely violent thoughts they had towards anyone including their loved ones.
Plenty of sufferers took their own lives in the years after their disease, a number that decreased drastically after the Thorn Cells and other mechanisms to prevent the patient from seeing or hearing others were developed.

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A Ruhk woman afflicted by thorns

Type

Chemical Compound

Origin

Natural

Cycle

Short-term

Rarity

Rare

Affected Species

• Societarians

Special thanks to Kisater's amazing roleplaying story for bringing the inspiration for this condition and allowing me to give a place to Varric in this world. You are awesome!