CodeBlueBlog: CSI MEDBLOGS: Name Your Poison: What Happened to Viktor Yushchenko--A CodeBlueBlog Follow-Up

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« CSI MEDBLOGS: THE POISONING OF VIKTOR YUSHCHENKO | Main | CodeBlueBlog Nominated in "2004 Weblog Awards" »

CSI MEDBLOGS: Name Your Poison: What Happened to Viktor Yushchenko--A CodeBlueBlog Follow-Up

In my last post I discussed the buzz around the internet and in the media regarding the possibility that Viktor Yushchenko was poisoned, as a rationale for his freakish facial transformation form HUMAN to REPTILIAN. What follows is a summary of that post, encapsulating the ideas; and a supporting argument that is less medical, and more common sense.

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CSI MEDBLOGS STAT SUMMARY OF YUSHCHENKO'S CONDITION

THE NUTSHELL:

An adult male from a nation and a culture where alcoholism has been described as "rampant"

Has a long dinner with other like-minded, ethnically and geographically-related males

Next day develops acute an acute abdominal problem (diagnosed as pancreatitis) that most often is secondary to HEAVY ALCOHOL exposure (known in most sectors as binge drinking)

Disappears for SIX WEEKS to a CLINIC (I don't know of clinics for the poisoned or clinics for the victims of pancreatitis)

Now with bumpy, swollen face which is half-paralyzed

THE NUT:

Alcoholism is the underlying disease; the acute event was triggered by some heavy Stoli-lifting the night of his dinner

Rosacea is the underlying skin disease -- it is common and can cause all the features V.Y. has, and it is frequently set-off by alcohol

Bells Palsy is the viral complication that caused his facial hemi-paralysis

____________________________________________________________________________

The Rationale For Poisoning...Or Not

One question for those who favor poisoning as the rationale behind Viktor Yushchenko's facial changes:

If you were a secret agent or assassin and you wanted to poison a world political figure, would you invite him to dinner and then give him a rare and dramatic poison? Or even a plain, run-of-the-mill poison? Something that would immediately point every heat-seeking-missile on the Internet and in the media-drenched globe at your conjugal meal??

The Napoleonic Complex

There's a reason the public is fascinated with murder by poisoning. Some famous figures, including Socrates, Napoleon and Castro are associated with tales of poisoning. And there have been significant mass murders perpetrated with poison including thee suicides at Jonestown in the late '70's.

There is a shock and a macabre glamor, of sorts, to this mechanism of murder; however, for professional killers, or for those who are looking to get a job done efficiently and with little chance of detection, poisoning is not a mechanism of choice. In fact, nowadays, it is strictly the domain of amateurs, terrorists, psychopaths, and the frontal lobes of fiction writers.

Let's face it. Poisoning went out with...well, poisoning. With modern detection methods and the level of diagnostic acumen that can be leveled at a sick person -- especially one of note -- it is criminal negligence to attempt a murder by poisoning; and, certainly, no secret service or spy agency worth its salt is going to be poisoning major political figures that it really wants DEAD.

No Poison For Tony Soprano

If I were a secret agent or assassin, and I wanted to kill a famous political figure with whom I was dining, I would wait until the dinner was over and have a hold-up man shoot him outside. Or arrange a piano to fall on him as he walked out the door; or have Paulie Walnuts chase him into the woods and pump him full of lead (Paulie's choice, actually)...but the LAST thing I would do is blast him, feed him, irradiate him, or shower him with some poison, thereby incriminating myself and putting the whole world on my trail.

But if you FORCED me to poison him -- I mean, gave me no choice, as in poison this guy or die -- I would POISON him! You know -- with a good poison! One that would KILL him, not turn him into a carbuncular Mr. Potato Head!

So, yes, poisoning is a statement of drama-- one that rouses anger in a visceral way, unlike more mundane assassination protocols, and because of its effect, the poisoning card is quick to be played by figures who are struggling in the geopolitical arena...but, from the standpoint of a member in good standing of the secret agent, assassin, or Soprano organizations, there are better, more efficient, less obvious, and more secure ways to get the job done...for sure.

Posted by Doctor CBB on December 02, 2004 at 11:47 AM | Permalink

Comments

I will accept you argument that victor was not poisoned. Simply because of the exact reasons you stated "posoning went out with...poisoning". I like your thinking, although, maybe that's what makes this sort of murder so great, no one would believe it. But let's get past my paranoia- no poisoning.
But Rosacia? what? not with that kind of look. First, rosacea most commonly affects only parts of the face, namely, nose and cheecks most commonly. I conceded that roseacea can affect other parts but it is much less common.
Second, Rosacia does not look like this. This is more on the side of "freaky". Roseacea is usually erythema with telengiectasisas, and sometimes, subaceous gland growth. Does victor have subacious glands all over his face? unlikely.

I don't know what he has. I am not sure we can trust the pictures, much like you. But this should be interesting.

Posted by: madhousemadman | December 03, 2004 at 11:52 AM

What if the intent were not to kill the man but to make him less appealing as a politician? A beating or an accident could cause an increase in sympathy, while poisoning could be dismissed as the results of excess drinking, or some other self inclicted injury.

Posted by: Jorge | December 07, 2004 at 01:08 PM

Well...slipping him a fistful of Dioxin seems a long way to go to make the guy less telegenic. Besides, there's no guarentee that one will develop "chloracne" after Dioxin exposure, and, it SHOULD have killed him...I don't think that's the answer; besides, if that were their objective, it didn't work, right?

Posted by: CodeBlueBlogMD | December 08, 2004 at 03:33 AM

Your attribution of these symptoms to alchohol poisoning is laughable. Severe back pain that required an epidural?

A month earlier, his car was run off the road by a truck.

You forget that Moscow engineered a "famine" 2 generations earlier that killed 10 million other Yushchenko minded Ukrainians. duranty called it "malnutrition" which is more accurate than your diagnosis.

Finally, your remark about a nation of alchoholics is rascist and untrue - per capita consumption of alchohol during the US revolution was far greater.

And the substance was visibly absent from the Ukrainian revolt as widely reported.
The Kremlin suggests bad sushi - try that, its more plausible.

Posted by: bmp | December 09, 2004 at 09:46 PM

If Yushchenko had a drinking problem it would be common knowledge. His condition worsened in a matter of a few days. Maybe the symptoms parallel something that would befall an alcoholic, but that doesn't mean it was caused by drinking.

Posted by: big_soaniel | December 10, 2004 at 03:32 PM

bmp:

Pancreatitis (which V.Y. is documented to have had at Rudolfinerhaus clinic)is almost always caused by binge drinking. One of the MAJOR ways that pancreatitis presents is with SEVERE BACK PAIN (you can look that up in Harrison's textbook of medicine, if you have so little faith in my knowledge).

I defy you to point out ANYWHERE I said "a nation of alcoholics." Are you reading MY blog?

I'm sorry that the MOST LIKELY medical scenario is one that is upsetting to you. I have no political bent in this case and it does not affect my analysis in the least.

Thank you for reading. I work very hard at thinking about these cases, doing research, and presenting the facts in the order that is most logical to my mind and training.

Posted by: CodeBlueBlogMD | December 10, 2004 at 05:57 PM

big soaniel

Problem drinkers often hide their addiction. That's a fact. Many quite famous people have had serious drinking problems that were NOT common knowledge.

Besides -- and I don't want to scare anyone -- even ONE bout of BINGE drinking can cause pancreatitis. So, it can happen overnight if you drink enough.

My contention is that POISONING sounds cool and mysterious, but makes no sense from any medical vantage point. Believe me, if I COULKD put it together by poisoning I WOULD. I have NO motivation to say it ISN'T poisoning except that it makes no sense to me medically (and in praqcticality).

I created my scenario of drinking -->pancreatitis --> rosacea FROM THE FACTS. I did not start with alcoholism and work BACKWARDS to his symptoms -- that's what people are doing with the POISONING rationale --and that is a fundamental error of logic and thinking.

Posted by: CodeBlueBlogMD | December 10, 2004 at 06:02 PM

BlueBlogBlog, Brilliant deduction! I am not a medical student, but have learned a lot.

Posted by: Mae Ann Minicucci | December 11, 2004 at 09:53 AM

Hey, what happened to my comments re: dioxin? And chloracne? And has anybody checked Druge today? BTW, I didn't hypothesize poison because it's cool or mysterious; I applied Occam's Razor.

Posted by: Julie | December 11, 2004 at 07:30 PM

Oops, sorry, that's Drudge, not Druge. I hope I spelled Occam correctly!

Posted by: Julie | December 11, 2004 at 07:32 PM

As a board certified toxicologist, it pains me to see the media continuing to expose the public to misinformation about dioxin, just because they are too lazy to find real dioxin experts to interview. Instead, reporters go back again and again to the same cohort of NYU physicians. The following are a few simple facts about dioxin that everyone should know:

1) True, dioxin may be "one of the most toxic substances known," i.e., on a weight basis. But, is present at such miniscule levels in the general environment that (notwithstanding certain regulatory policy assumptions to the contrary) it poses no plausible public health hazard of any kind, including cancer. One millionth of a gram per kilogram body weight (1 μg/kg) can slowly kill a guinea pig or, administered chronically (i.e., every day), give cancer to a rat. But, the levels to which human beings are exposed in the general environment (less than one trillionth of a gram per kilogram body weight or 1 picogram/kg/day) are a million times smaller, still. (In addition, the weight of evidence suggests that humans are much less sensitive to the effects of dioxin than are most laboratory animals, anyway.) Think Superman and Kryptonite. High intrinsic toxicity plus extreme rarity equals virtually nonexistent risk... unless, of course, Lex Luthor or Boris Badenov know where they can pick up a vial of the pure stuff for "research" purposes.

2) As a corollary to #1 above, dioxin is NOT a knowledgable assassin's tool; there has NEVER been a fatal case of acute dioxin poisoning...anywhere... ever. Exposed children at Seveso, Italy in 1976 with blood dioxin levels as high as 56,000 ppt exhibited only one lasting effect...chloracne. In 1999, a secretary in Vienna was apparently intentionally poisoned by someone with access to concentrated laboratory grade dioxin. She (instead of that little girl at Seveso) now holds the all-time world's record for the highest blood dioxin concentration (144,000 ppt) and she too suffered only one long-term effect...chloracne. Ugly 'em up...maybe...IF the dose is high enough - and a mere "1000 times normal levels" would not be anywhere near high enough for an adult male - but KILL them...never.

3) Superficially, the pictures of Yushchenko's skin condition certainly do resemble chloracne, in which case intentional dioxin poisoning by a lab tecnician or a government agent would not be out of the question. However, the only way to be sure is to have a sample of the man's blood analyzed for dioxin at one of the relatively rare facilities capable of such analyses. Apparently that has been done. CBC news reported that "The Austrian doctor's initial examination showed the dioxin was 1,000 times above [unspecified] normal levels." However, the same story indicated that, now, after only 2-3 months, "his dioxin levels have returned to normal." No way. Either it was NOT dioxin poisoning after all, or the reporters are doing a really lousey job of reporting the facts. The biological half-life of dioxin in human blood is several YEARS.

4) Dioxin is highly hydrophobic and lipophillic. In other words, it is NOT water soluble and an effective dose could NOT be delivered in someone's drink. Rather, it would have to be mixed in with a fatty food stuff such as mayonaise or butter.

All questions will be resolved (in my mind, at least) when the actual dioxin levels in Yushchenko's blood or other specified tissue are reported quantitatively (e.g., in parts per trillion) by a reputable technical source. I have yet to find those figures anywhere on the internet. If anyone else has seen them, I would appreciate it if they would share them (and the source)with me.

Comments & queries are welcome. But, I would prefer they came from people who genuinely want additional info about dioxin that has been purged of all politically motivated speculation. I get more than enough static at work from bureaucrats and environmental activists whose devotion to keeping the perceived hazard alive makes them hostile to scientific facts.

Posted by: ToxDoc | December 12, 2004 at 02:43 AM

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Posted by: qwer | November 16, 2006 at 03:29 PM

"Victor Yushchenko was poisoned with TCDD in late December of 2004. There was a high concentration of it in his blood which was more than 50,000 times that of the general population. The medical team identified TCDD and its metabolites. For three years they monitored levels using different chemical techniques. They analyzed samples of blood, fatty tissue, feces, skin, urine, and sweat.

They found that during the three years, 60 percent of the TCDD that was eliminated was in its original form and had not been metabolized."
Sometimes an attack is just an attack.

Posted by: Ree Gee | March 01, 2010 at 12:22 PM

I've used AutoCad professionally, and IMHO it's a bit steep in price for less than very high vumole work. Also, even if your drawings are done in Autocad, the company building your desk will often want drawings done in "industry standard" formats so their workers can understand you drawing with the minimum number of phone calls for explanations, etc. I'd recommend that you take a beginners' course in Autocad at a community college in your area. That way you'll pick up the core basics of CAD (and drafting standards in general) quickly, you can get any questions answered from a real live person, and you'll be able to get pointers on other lower cost drafting software from the instructor. -Autocad (and CAD programs in general) are a whole lot better than the old manual "pencil and paper" "drawing board" methods (been there, etc.), as a time saver, especially for very detailed or large (buildings, cars) projects. But even with CAD, you still have to be able to convey the required information to the shop making your stuff which is why I still recommend taking the course from a real person who should have a handle on real-world requirements for drawings.

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Posted by: Jannery | June 18, 2012 at 09:21 PM

I'm making a CD full of dfereifnt kinds of media pictures, video, documents, etc. and I'd like to make design a site that would run locally from the CD. My question is, is there a way to make the home page of this site, which again, would be located on the CD, automatically popup when the CD is inserted?Just like installation dialogs popup when you insert software CDs?

Posted by: Jegan | June 19, 2012 at 07:27 AM

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