Pulp Fiction : Adrenalin shot straight to the heart

To refresh your memory, hit man Vincent (John Travolta) has the job of squiring his boss's wife, Mia (Uma Thurman), around town. While he's in the bathroom, she discovers his stash of what she thinks is cocaine and promptly snorts some. Bad idea--it's actually high-octane heroin. Vincent returns to find her comatose and frantically drives her to the home of his dealer Lance (Eric Stoltz), who hands Vincent a railroad-spike-sized syringe. The following classic dialogue ensues over the supine Mia:

Lance: OK, you're giving her an injection of adrenaline straight to her heart. But she's got breastplates. You've gotta pierce through that. So what you gotta do is, you gotta bring the needle down in a stabbing motion. [Makes multiple stabbing motions]

Vincent: I gotta stab her three times?

Lance: No, you don't gotta fucking stab her three times! You gotta stab her once, but it's gotta be hard enough to get through her breastplate into her heart, all right? And then once you do that, you press down on the plunger.

Vincent: OK, then what happens?

Lance: I'm curious about that myself.

Vincent does as instructed. Mia immediately sits bolt upright, eyes wide open and apparently fully recovered.

OK, this isn't a 100 percent accurate depiction of what would actually occur. But here's the thing: doctors honest to God do on (rare) occasion jab a big hypodermic of epinephrine, aka adrenaline, directly into the heart of someone who's gone into cardiac arrest, a technique called intracardiac injection (ICI). If the patient is lucky she revives quickly--epinephrine is the fight-or-flight hormone that blasts through your system in moments of extremity. So there's a grain of truth to the scene. But only a grain. Among the problematic details: (1) The heart isn't beneath the "breastplate" (presumably Lance means the breastbone, or sternum--the heart is to the left of this), and in any case only a fool would try to force a needle through bone--you'd go between the ribs. (2) A cardiac arrest victim getting ICI doesn't instantly jerk up like the alarm clock just went off--the heart might restart right away, but it would take a while to regain consciousness. (3) Mia's problem probably isn't cardiac arrest anyway--the immediate consequence of heroin overdose is severe respiratory depression. As long as her heart keeps beating, ICI is pointless. If Mia needs an injection of something, a plain old intravenous shot will work just fine, since her blood is still circulating. (4) Epinephrine wouldn't sober up someone who was OD'ing. To neutralize heroin you'd administer a drug such as Narcan (naloxone), which blocks the opiate receptors in the brain and can bring a junkie back to earth in a matter of minutes.