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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♫}

  • AHHHH save last bullet for yourself. There probably won't be any supportive treatment if this "rare" thing became NOT rare!

  • Not really sure the woman in chernobyl lost her child due to being near her husband. The show may have made it look like that but i think her just being where she was (and on the bridge of death, called so since apparently they all died) and many other times she could have been exposed.

  • A movie with an accurate depiction of ARS is "When The Wind Blows" Here are some scenes from it, although not the scenes with ARS

  • the thing about Chernobyl is they didn't know how to treat ars effectively during that time period, I think its accurate to how they dealt with it back in the day. I mean they tried to treat the burns with milk ffs.

  • I've noticed a lot YouTube science communicators pushing back (albeit gently) against the horror that HBO's Chernobyl presented because it makes nuclear energy….unpalatable and many of them are of the opinion that, if you look at it statistically, nuclear is safe – or at least much safer than many of our current options. The problem with this is that the horrors are so grotesque our natural instinct is to say, "bad thing is bad", overriding objective reasoning. I for one think this is fine. Accidents are inevitable. Anyone who argues otherwise does so in bad faith. We can do with out plutonium based nuclear power. "But no", the science communicator community says, "ma statistics!" and they begin spinning their wheels trying to soften the image. Accidents are rare, its clean etc. This is the first time I've seen soviet information management products used to this end. Not you're best day, guys.

  • So (hopefully someone can comment on this and help me out) if you had a 3 inch cube of Uranium, how dangerous would that be to your health and how much radiation would it release?

  • I can appreciate media taking liberties with how things work, like radiation giving superpowers because most of the time no one is exposed or anywhere near that amount of radiation, and by the time they get older they should know that that's not how it works. But I think there should be a lot more care taken to depict illnesses accurately, even if it might be a bit boring to some people. There's a lot of people who get medical information from TV and movies, and they might need that information one day. Not only that, the people who have/had those illnesses deserve to be shown properly. I can only speak for myself as a disabled person with chronic illnesses, but it can be so annoying to see incorrect or straight up lies about things that I have when you could easily find someone with that condition or a doctor and depict it properly.

  • I don't know but this episode feels like it's directly against Chernobyl. Spoiler: on one episode, Legasov explained the EXACT same thing they said about the latency period. In his own words, Legasov said "the victim appears to be recovering, healthy even" so no, it didn't really go off from reality that much

    Also, that show was a dramatization not a documentary. They were portraying what people knew about radiation during that time

  • Why do the Russians have to bury the first responders from Chernobyl, and the maintenance crew who welded the leaking cooling system on the Widowmaker in lead coffins if they were not emitting harmful levels of radiation?

  • Mutations can have positive effects. But they're completely random, and when you randomly change a part of an extremely complex machine it usually just breaks. Radiation-induced mutations are pretty much always bad because they occur on per-cell basis, even if you got few cells that got better, it's offset by having billions of cells that got worse.

  • It's estimated that some workers were exposed to extreme radiation for 5 hours and so would've received a dose of 1000 Gy. Perhaps at this level the destruction of cells would only take minutes. Also disappointed that sci show didn't consider the inhalation and exhalation of particles trapped in one's lungs.

  • Wouldn't hugging a recently hospitalized loved one who hasn't been properly decontaminated make you sick, as they're still covered in dangerously radioactive stuff?

  • What TV or movie were you watching that had people getting radiation from other people? I think you misunderstood Watchmen.

  • Yeah, the biggest factor of radiation 'poisoning' commonly portrayed incorrectly in media is definitely time scales. It's often a slower process to get the effects, mostly due to your own body's rate of breaking down. It's not like pure ionizing radiation is a pressure wave that lifts you off your feet or an intense heat that blisters your skin – those are the other effects of a thermonuclear explosion, and their intensities vary by distance, overlapping only in the ultra-deadly area where basically nothing survives, buildings included.

  • It realy bothers me that so many people think the Chernobyl show is 100% accurate especially since nuclear is one of the most reasonable power sources we can make in the 21st century

  • So, you’re saying that the people in the wind’s path from Chernobyl, and had statistically significant higher percentage of cancers were NOT related to exposure to radiation? Seriously?

    Come on SciShow, you are capable of doing better work. This was a missed opportunity. For shame

  • Ok but how come we always use lead to reflect radiation instead of another metal like steel or aluminum

  • I've heard a few people say Tony Stark actually died a pretty realistic death from the MCU proposed amount of radiation he got using the infinite gauntlet, although to kill him that fast just about everyone else should have been on their death bed soon after.

  • Have you heard of the man whose skin sloughed off after being in the middle of a nuclear disaster? The doctors kept him alive in the hospital for 80 days. It's as gross as it sounds.

  • I've gotten blisters from radiation damage before, but it's from the sun. Usually my blisters are the result of slapping the bass…

  • If you can hug someone with ARS how come when a relative had radioactive therapy to remove her thyroid (it was too messed up for surgery) she needed different trash cans & wash the clothes separately & couldn’t touch anyone for days?

  • We all know the dangers of radiation, but with the right precautions, you CAN prevent accidental death or even eewww ghoulification. If you do need to head into the heat, be smart give yourself a nice boost of Rad-X first. Remember, only you can prevent human flesh virus.

    9:30 did you have to use the picture of the memorial with bird poop on it? Seems to be a bit disrespectful

  • I have to make a criticism about the contagiousness of nuclear radiation. Yes ionizing forms of radiation (alpha, beta, gamma) will not remain with you while you leave the source of radiation. However, neutron radiation, which is most common in nuclear reactors and is what generates the nuclear fission reaction, will make other items radioactive. The neutron gets absorbed (typically by the hydrogen in water which your body is mostly made of) and makes your fluids and by extension you radioactive.

    For instance, Vasily Ignatenko, the firefighter portrayed in chernobyl, was heavily irradiated by the still fissioning reactor core while trying to put out the reactor fire which gave him a decent dose of neutron radiation. As a result, his body and many of the other bodies of the firefighters and workers at the plant were highly radioactive even after removing their clothes and washing. This is why the Soviets spent a decent chunk of money on a state funeral with lead-lined coffins filled with concrete.

  • I had radiation therapy for six weeks. When the beam was on, it felt like getting a sunburn inside my body, not on the surface. On a daily basis it was kind of like having the flu for six weeks without the headaches. I don't know what my dose was. It was spread over a fairly large area of my torso, with higher concentration on a lymph node below my lung.

  • Of course "Hollywood gets it wrong" they're in the business of telling compelling, visually interesting stories that reflect people's desires and fears, not being science educators. Do not look to movies for accurate science or perfect documentary history any more than you would ancient Greek myths.

  • And if the exposure was more than 50 grays, the patient could move really quickly…
    Me: Wait, I thought you said no super powers
    …through all the earlier stages to reach the manifest illness stage.
    Me: Oh

  • Wellllllllll, Chernobyl also took place in the Soviet Union, which would lie about a lot of things….. especially about how bad the situation actually i.e. how many people got radiation sickness

  • I have an issue with that catch all statement that a person who has been exposed to ionizing radiation cannot be radioactive after basically washing themself. If the radiation absorbed was of the alpha or beta variety, then their skin probably does stop it from getting out. But gamma? You need several inches of lead to stop those suckers. So if the patient was exposed to and then now contains gamma emitters? They would be radioactive still.

  • the effects of radiation decrease by half by the square of the distance from the radioactive material. And i totally can't remember where I learned that.

  • While ARS is quite rare, and it's true you need to receive an astromomical amount of ionizing radiation, very close to the scene of the event (like a nuclear meltdown) and very shortly after the start of the event, radiation induced cancer, on the other hand, is widespread. It takes years, and not all types of cancer are fatal, but it is much more common.

    In the Chernobyl incident, there were less than 50 deaths from ARS in the first couple of months, but the number of deaths from cancer directly related to the incident is projected to be in the tens of thousands in the first 10 years after the incident. There were also thousands of miscarriages reported and minor birth defects reported in the first few years following the event.

  • Thanks. Great vid. Watched because I have a movie written about working in the radiation zones after the WW3. 
    Called 'Radiation Harvesters'
    I wanted to see if what I wrote works in scientific context. Thank you Justine and the SciShow Team for this vid. 
    If it makes you feel better I got it pretty close…

  • Maybe instead of trying to "debunk" a show, just explain how each person would have died in a scientifically correct way. It would be constructive criticism instead of seeming like an attack, but I guess that would take more work and research.

  • Can we just call this what it is "How Chernobyl got some things wrong". I was impressed with many aspects of that series for getting details correct, but I also literally screamed at the TV when firefighters standing near the graphite suddenly had burns through their gloves within minutes. But then later they get things right again when the firefighters appear to be fine in the hospital, but it's just the latent stage. Radiation sickness is not so much a fire that burns you instantly, so much as it's a breakdown of the bodies ability to perform several of the processes it needs to do in order to stay healthy, and the accumulative damage from so many cells dying or being unable to function, can eventually kill you days or weeks later.

  • I watched the most heartbreaking documentary about Chernobyl (in Russian) where people who had to work after the explosion have a meeting: the majority of them are incapable of work and while the country promised them great rewards for their sacrifice, most of them can barely survive. Plus, of course, they have countless medical problems. Really shocking to hear the story firsthand…

  • So you wouldn't develop symptoms of ARS by sitting beside someone who is for days or weeks, but what about months? Years? Decades? What then? How long is too long for bed side sitting?

  • A slight correction, mutations from radiation are typically detrimental, but they "can" be beneficial. There are some plant varieties that are the result of mutagenic breeding, essentially using ionizing radiation to force mutations and hope to find a good one. So, there IS a chance at a good mutation if exposed to ionizing radiation, but the risks are so great that it's not a good idea, for humans at least.

  • Also, it's 100% shady that you're taking for granted the story that "no one got ARS, no confirmed cases", when you know damn well that other international health watchdog organizations have established that the sickness and body count estimates were far, far higher than the official USSR Party line you parroted.

    WHAT HAPPENED TO THIS CHANNEL? This video is straight up *insulting*. I'm sorry if it sounds like im attacking you personally, this is a message of utter disappointment geared to your whole staff. Hire someone to do a little research the next time.

  • Not that I disagree with most of the video, but when it comes to talking about cities close to Chernobyl, other nuclear power plant disasters, as well as populations living close to nuclear bomb testing sites, there has been a whole lot of documentaries and researches showing people several generations later still displaying signs of abnormal birth defects, cancer, a whole host of health problems and whatnot. I don't think the video is implying those aren't real, but perhaps some will interpret it like that when said "there were no confirmed cases in residents of the closest town".

    I think it isn't classified as ARS, but it's important to make the distinction that while citizens of close cities to Chernobyl and other places might not have been diagnosed with ARS (which is still extremely questionable given how much was hidden by the government back at the time, so confirmed cases for the time might as well be because no one actually tested anyone there in the first place), this does not mean they didn't suffer, and probably are still suffering, a whole host of health problems because of the accident and radiation. ARS is not the only health problem that arises from a nuclear accident.

  • Lastly, hey everybody I recommend you listen to the Chernobyl podcast, where the host interviews Craig Mazin about the show. They go into exquisite detail outlining the painstaking effort Mazin and crew took to show ACCURATE events wherever possible. I'm talking about details most people won't know or care about it (but he felt and I concur that it was a hugely important to stick to real events). He is eager to point out any part whereby some concessions had to be made to keep the show compelling and flow better. Discrepancies like
    Ulana serving as an amalgamation of several scientists involved in the aftermath and containment efforts. These are not MISTAKES. They are carefully selected slices of time where changed needed to be made because it's a tv show.

    So much of the dialogue may even sound kind of outlandish…. Which is why they kept it in the show – word for word from what was actually said 33 years ago. The design of every room, the condition the patients were in, the outfits, everything was a deliberate choice.
    Seriously, it's a labour of love, respect for those who lived and died due to the disaster, and scientific accuracy, all wrapped into a well shot, well cast, fantastically performed show. Right now probably my second favourite show off all time. So it gets under my skin when someone dismisses their hard work and especially dismisses the realism depicted. You guys need someone to do extensive research before you release anymore embarrassing episodes like this one. Cheers.

  • Chemotherapeutic treatment is very harmful, sometimes kills you before the cancerous cells due to destroying your immune system.

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