CSI Medblogs: Dissecting the Cadaver: Yushchenko's Official Medical Record

In today's edition, the Libertarian Newsletter, AntiWar.com,  published the complete account of my evaluation of the official medical report from Viktor Yushchenko's medical admission to the Rudolfinerhaus clinic on September 10th, 2004. The report is analyzed and positioned within the context of Yushchenko's story. For CodeBlueBlog's previous articles about the Yushchenko incident go here and here;  here, here, and here -- as well as other intervening posts.

Today's news brings word of Viktor Yushchenko's victory in the Ukraine. As I mentioned in the Antiwar.com story, let's hope we don't witness another pitiful and disgraceful public deterioration, as we saw with Boris Yeltsin, from what most likely is Viktor's biggest health problem, alcoholism.

Comments

[Pythagoras C]

VY's RASH EXTREMELY UNLIKELY TO BE CHLORACNE
A major problem with the "dioxin poisoning" theory is that the rash looks much more like an erythematous rash partially covered by make-up, rather than chloracne. I challenge dermatologists, toxicologists or anyone else to present medical evidence to the contrary (excepting, of course, the case under discussion).
Chloracne takes its greenish color from cystic lesions filled with dead keratinocytes and material from secondary bacterial infections (abscesses). Therefore chloracne lesions look really rough and their appearance changes only slowly. To my knowledge, there are not many pictures freely available in the internet, but a good example is: http://dermnetnz.org/acne/chloracne.html . If you have full text medline access, see also http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12850300 for a good picture and a thorough theoretical discussion.

In sharp contrast to chloracne as described in the medical literature, the greenish color on VY's face is not present in the form of solitary or confluent cystic lesions but as a smooth layer of green/blue on top of an otherwise erythematous rash.

Many photos of VY's face can be found at:
http://cnn.netscape.cnn.com/ns/news/photosearch.jsp?cap=Yushchenko

A picture from Nov. 19, for example, shows a roughened face with mostly normal color with some hints of erythema and only faint hints of green at malar areas:
http://cnn.netscape.cnn.com/ns/news/bigpic.jsp?photoid=20041210MOSB115.jpg&this=7&searchpage=photosearch.jsp&cap=Yushchenko&w=ap+or+reuters&max=8&first=24&fs=
(Note: if some individual pictures are not displayed, they can be retrieved by typing "Yushchenko", "[month]" and "[date]" at the search field of the page).

A very informative, close-up picture from Dec. 10 shows erythematous cheeks and nose tip (classic for alcohol-induced rash but not described in association with chloracne) with a smooth bluish layer at malar areas and nasal sides (strongly suggestive of make-up):
http://cnn.netscape.cnn.com/ns/news/bigpic.jsp?photoid=20041211VIE133D.jpg&this=1&searchpage=photosearch.jsp&cap=Yushchenko&w=ap+or+reuters&max=8&first=56&fs=

On Dec. 12, cheeks look similar to Dec. 10 (erythematous with smooth blue-greenish patches), but the nose tip now looks greenish instead of red (different lighting or more make-up?):
http://cnn.netscape.cnn.com/ns/news/bigpic.jsp?cap=Yushchenko&photoid=20041212VIE132.jpg&searchpage=photosearch.jsp&first=40

LITTLE REASON TO TRUST A SINGLE "BLOOD DIOXIN LEVEL" TEST
In the absence of a rash compatible with chloracne as described in the medical literature, nothing in VY's clinical picture suggested poisoning by dioxin or by any other maliciously administered substance. In fact, as CBB has brilliantly analysed, the whole clinical picture was entirely compatible with sequellae of alcohol abuse. Therefore, the only piece of evidence suggesting TCDD poisoning is, as far as publicly known, a series of tests performed on a single blood sample drawn and handled under conditions easily amenable to manipulation. If it is easy to find TCDD to poison someone, it is even easier to find a smaller sample to "poison" a blood sample.

REPEAT TESTS NECESSARY TO PROVE / DISPROVE DIOXIN POISONING
All that is needed is PROCEDURALLY TRANSPARENT repeat blood tests for TCDD levels. The mechanisms and expertise for medically impeccable body fluid acquisition, handling and testing are already in place for monitoring performance-enhancing drug use by athletes. They can be used for this case as well.
Total TCDD body burden and blood levels take years to decrease to "normal", and even the most effective attempts have not led to reductions of toxin half-life below the range of a year (see, for example: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12107649 ). Therefore, if procedurally reliable tests within the next year showed TCDD in the "normal" range, the "poisoning" theory would collapse.
The Ukrainian investigators must be aware of their obligation to verify with repeat tests that VY was indeed poisoned by TCDD before scratching their heads to find out who poisoned him and how. Intelligent investigative journalists and other writers should keep the issue alive.

[Julie]

So why, I asked myself was CodeBlue blogger so exercised about VY? Why the insistence that VY's illness had to be due to alcohol? Why the drive to make VY into the oafish cause of his own troubles? Then I went to the site described by CodeBlue as "libertarian.", Antiwar.com.
Libertarian my foot. Ron Paul, Congressman from Texas, is a Libertarian. This site is leftist, anti-freedom, Noam Chomskyite propaganda. So here's why Code Blue wants so badly to diminish VY: The Orange Revolution in Ukraine is a stunning blow to the leftist socialist mindset. Ukraine demonstrates the Bush principle that people everywhere strive towards the freedom that is humanity's gift from God. Naturally leftists detest this idea. They believe that most people are too stupid to run their own lives freely; they need the guidance of an elite (including, of course, intellectual physicians) to run things. As for God; what a ridiculous notion. Why, the people in the U.S. are so stupid that they go to church and many willingly enlist in the Army to fight for...of all things...freedom. So Antiwar.com keeps a running tally of the military dead under the guise of "sorrow" while in reality they hope that this attempt to instill democracy in the heart of the Middle East turns into a catastophe for America. The gloating is impossible to disguise. They are not worried about a "quagmire" at all; they want a quagmire even when it doesn't exist.
When I first raised the issue of dioxin, CodeBlue responded with a degree of hostility and condescension that was way out of proportion to the suggestion. I believe I know why.

[CodeBlueBlogMD]

Your accusations are amazing tangential branches of invective, and your erratic conclusions about war, God and political beliefs bloom dead on the end of them.

Careful readers of my posts clerarly understand where I stand in politics and morals.

I know very little about politics in the Ukraine now and I knew nothing about those politics when I read the first reports about Yushchenko and his obvious problem.

Unlike you, I take my conclusions from the data offered.

[Pythagoras C]

Oh, Julie, you got it all figured out! Rep. Ron Paul is indeed, as you correctly assert, a Libertarian. But you may also be interested to know that he is a regular contributor to antiwar.com and that he is in agreement with positions taken by that site on most major domestic and international issues (see, for example, his antiwar.com article: "Quit Meddling in the Middle East"; http://antiwar.com/paul/?articleid=3987 ). Notably, in the case of the Ukraine, he harshly criticizes the open support that both wings of the Washington establishment (i.e. both the Bushies and their Sorosian opponents) have offered to Yushchenko. Read his informative antiwar.com article: "US hypocrisy on Ukraine" ( http://antiwar.com/paul/?articleid=4135 ), which is in agreement to the position of most American paleoconservative and libertarian honest patriots.

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