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The year is 2006. Bush Jr. is in the White House; NASA launches its New Horizons spacecraft on a nearly decade-long journey to Pluto; the Nintendo Wii arrives on store shelves; we’re still a year away from the first iPhone and the smartphone revolution; and Google buys YouTube. It’s there that you see a trailer for a movie called Crank (streaming now on Peacock).

The wild action flick stars Jason Statham as L.A. hitman Chev Chelios, a man living on borrowed time. Over the previous six years, Statham turned in performances in Snatch (a spiritual successor to Guy Ritchie’s first film, Lock, Stock and Two Smoking Barrels), The One, The Transporter and its sequel, and The Italian Job. He was the action star du jour and it was time to do something weird about it.

Jason Statham Cranks Up the Madness in Crank

Chelios wakes up in his apartment feeling all wiggly, frantic, and scared; a DVD with a handwritten message (and not a friendly one) reveals the stakes. As revenge for killing mob boss Don Kim, Chelios has been dosed in his sleep with what his killer describes as a high-tech, sci-fi, synthetic poison. He’s got about an hour to live.

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The poison, Chelios learns, works by blocking the receptors in the adrenal glands, cutting off the flow of hormones and stopping his heart. He notices pretty quickly that every time he relaxes even a little bit, his heart slows and his senses dull. Chelios is hit with waves of confusion and pain as his heart struggles to keep beating. You can see what kind of mayhem this causes in the NSFW clip below.

Crank is inarguably built on a toxic bedrock of shock humor, impropriety, and blood. It’s a time capsule of what appealed to teenagers and twenty-somethings in the early aughts and there are elements that don’t hold up under contemporary scrutiny. Still, there’s something about the visual styling that might still sweep you up. It borrows some of the aesthetic and tone of caper flick Domino (starring Keira Knightly as bounty hunter Domino Harvey) which released a year prior, to deliver a first-person portrayal of Chelios’ fights against a slow-motion death. It’s those visual choices which elevate Crank from a bottom of the barrel action romp to something at least a few steps up the side of the barrel. As an added bonus, a rewatch will earn you a brief cameo from It’s Always Sunny in Philadelphia’s Glenn Howerton, as a doctor taken hostage, as well as an even briefer appearance by Linkin Park’s Chester Bennington.

After a call to the mob’s medical consultant, Doc Miles (Dwight Yoakam), Chelios learns that his only chance of survival, temporary as it might be, is to keep the adrenaline pumping. If he calms down, he dies. A quick stop at a corner store nets him a garbage bag filled with energy drinks, energy shots, energy pills… basically every form of stimulant you can buy over the counter. And he gets a bonus burst of adrenaline by robbing the joint. According to the good doctor, the body produces ephedrine as part of the stress response, and that’s the only thing preventing his heart from seizing. Start a fight, put your hand in a waffle iron, take down California’s organized crime syndicates, and call me in the morning.

Finding an Antidote to Crank’s Mysterious Poison

We don’t get many specifics about the compound flowing through Chelios’ veins. We know it inhibits the adrenal glands and stops your heart, and we know L.A. criminals call it the “Beijing Cocktail,” referring to its apparent origins in China. Otherwise, we’re left to wonder what’s going on, so let’s wonder.

Adrenal insufficiency is a real disorder which impacts real people and is commonly caused by chronic glucocorticoid treatment. If left unchecked, it can lead to an acute adrenal crisis, which mirrors the on-screen experience of Chelios in many ways. The adrenal glands become inhibited, leading to a drop in the production of cortisol, a hormone produced and released by the adrenal glands alongside other corticosteroids. Just like Doc Miles says, cortisol is released as part of the stress response. However, if you think you might be suffering from adrenal insufficiency or an adrenal crisis, professional medical treatment is a better bet than shocking yourself with heart paddles or leading the local police on a high-speed chase.

Symptoms of adrenal insufficiency include lightheadedness, headache, dizziness, profound weakness, abdominal pain, nausea, vomiting, confusion, coma, loss of consciousness, and death via overwhelming shock. The most common causes are an overuse of the drugs ketoconazole and aminoglutethimide.

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Ketoconazole is commonly used to treat athlete’s foot and other fungal infections. The risk of significant side effects during topical use is low, but when taken orally it inhibits hormone production in the adrenal glands. It’s used medically to treat Cushing’s, seizures, and various cancers and has to be managed to avoid adrenal insufficiency. Aminoglutethimide has similar medical applications but is commonly used recreationally by athletes to prevent muscle loss. The official use of aminoglutethimide has largely fallen out of favor precisely because of the side effects. About 10% of users experience severe side effects including circulatory collapse.

Fortunately, the treatment is readily available, fairly simple, and doesn’t require a madcap adventure across Los Angeles. All you need is a cortisol injection either in a medical setting or at home. Patients at risk of adrenal crisis are often prescribed emergency injectors and taught how to use them. If Doc Miles was any sort of good doctor, he would have known that. Of course, that wouldn’t have made for a very exciting movie.

Get your heart pumping with Crank, streaming now on Peacock!