This is part 2. Part 1 can be found
here.
It seems it's my "luck", whether good or bad, to find these kinds of stories - a brief investigation into what seems to be a minor divergence between published reports leads to an endless chasm of speculation.
What sparked my investigation was a tip from a reader of my blog (see Part 1) whom I cannot identify but has worked for intelligence agencies in the region and has given me accurate information in the past (on other topics).
That being said, I've spent the last five hours investigating this case and I've come across some new information.
From a December 4
IHT article I learned several things:
- Yushchenko first went to Rudolfinerhaus on September 10, just 5 days after eating dinner with two top USB (Ukrainian KGB) agents at the top USB man's country house
- When he got to Rudolfinerhaus, Yushchenko was "conscious but groggy", had to be brought in via wheelchair (could not walk) and complained of enormous abdominal pain
- Blood tests were "abnormal" (including elevated liver and pancreatic enzymes) put didn't point to any known diagnosis
- Liver and pancreas were both swollen although no "clear reason" could be established
- Skin was covered with "odd-looking lesions" and his entire abdominal tract, "from top to bottom", was "dotted" with ulcers (bleeding perforations)
- 8 days later, the doctors not having reached a diagnosis, Yushchenko checked himself out against their advice (AMA)
- Two weeks later Yushchenko returns to Rudolfinerhaus, this time with a new complaint - "excruciating" back pain
- Rudolfinerhaus doctors administer Yushchenko so much morphine that he almost needed to be hooked up to a ventilator
- Zimpfer, the director of Rudolfinerhaus (and former anesthesiologist), threads a catheter (tube) into his back to deliver morphine so Yushchenko can return to campaigning
- Zimpfer then decides on his own (after much "soul searching") to leave Rudolfinerhaus and travels with Yushchenko in Ukraine
- Believing Yushchenko was poisoned, Rudolfinerhaus doctors consulted with "biological and chemical weapons experts"
- Rudolfinerhaus doctors did not even test for dioxins at first because Yushchenko's skin was not that bad plus Yushchenko refused to submit to a biopsy
Although doctors at Rudolfinerhaus had not even identified what was sickening Yushchenko after his first visit, Yushchenko made public speeches in Ukraine saying he had definitely been poisoned.
Last Saturday Zimpfer stated that he had "no doubt" that Yushchenko had ingested dioxin (rather than absorbed it via respiration or through the skin). Zimpfer in fact categorically stated:
"We can state that there has been an oral intake. "It would be quite easy to administer this amount in a soup that contains cream, and I am saying cream because of the issue of fat solubility."
Rudolfinerhaus doctors also said that they suspect a "third party" administered the poison in September. Zimpfer also said an intentionally poisonous dose would be "only a couple of milligrams".
According to CNN, Zimpfer said Yushchenko has "tremendous levels of dioxins", so much so that it's "beyond the scale".
Yushchenko's American-Ukrainian wife said she had tasted something either metallic or like "medicine" on his lips after that September 5th dinner and averred that he never consumed medicine. She told the Associates Press last weekend that she "knew from the very beginning" that he had been poisoned.
Oddly though, Yushchenko "mostly drank liquids" at the September 5th dinner (CNN says "drank various liquids"), although it's unknown whether that includes soup.
The Washington Post lists another incident of dioxin poisoning with severe skin problems following shortly thereafter , an explosion in a chemical plant in Italy. The victims in that case however contracted the dioxins through respiration - not orally.
They also quote a "dioxin expert" at the University of Texas who says if Yushchenko was deliberately given dioxin, it was done by someone who "was very clever and very knowledgeable". Another scientist stated dioxins could be administered to cause "long-term illness".
The WaPo also states the dioxin levels in Yushchenko's case was confirmed by an unnamed hospital in Amsterdam while CNN says the tests were done in unnamed "labs within Europe and across the Atlantic Ocean".
The Guardian meanwhile reports that an unidentified "senior official" in the Yushchenko camp is blaming a KGB bioweapon called "T-2" or "yellow rain" and that the (American) CIA had been consulted concerning the substance. "Yellow Rain" was the Russian equivalent of "Agent Orange" (which does contain high levels of dioxins), a chemical defoliant. A major source of dioxins in the general environment is commercial herbicides. High doses of "Yellow Rain" however cause heavy bleeding from nose and gums, blindness, tremors and other neurological symptoms.
So that sums up the reported symptoms and findings. But what about the diagnosis?
Dioxin "poisoning" has always been either a result of long-term exposure to environmental hazards or fluke exposures. Only one reported case of potentially deliberate dioxin poisoning occurred in 1997 in Vienna, when two employees of a textile factory inexplicably developed chloracne all over their body. A dioxins expert, Olaf Paepke, determined they had dioxin levels "thousands of times" higher than normal but the police never concluded just how the employees had been poisoned.
I've done extensive reading on this report of dioxins. There are only two known cases where people consumed high levels of dioxins orally - in 1968 in Japan and in 1979 in Taiwan 1,900 and 2,000 people respectively ate rice cooked in dioxin-contaminated oil. In both cases the people consumed "massive" doses but the symptoms (including liver and lung damage) did not last very long. The primary deleterious effect was on fetal development amongst women pregnant at the time - many of the babies born had chloracne as well as neurological deficits such as problems in speech development.
As for the symptom of chloracne:
Chloracne is the most common symptom and the hallmark effect that follows high dose exposure to dioxin. A serious skin disorder that begins with an acne-like appearance two to four weeks after exposure, it progresses to pus-filled boils, pimples that may be colored more darkly than the rest of the face, blackheads, and cysts that sometimes persist for years (Reggiani, 1980). Chloracne may disappear after exposure to dioxin ceases, or it may remain for more than 10 years (Suskind, 1984), or even for an average of 26 years, after exposure (Moses, 1984). In Seveso, Italy, most (88%) of the reported chloracne cases were children (Bertazzi, 1998). Those who had chloracne also had frequent gastrointestinal symptoms and eye irritation, and abnormal levels of the liver enzymes GGT (gamma-glutamyltranspeptidase), AAT (alanine aminotransferase), and ALA-U (urinary aminolevulinic acid) (Bertazzi, 1994). These enzymes are indicators of liver damage (see discussion below), and also result from high dose exposures. In addition to chloracne, people exposed to dioxin at Seveso had several transient skin effects including conjunctivitis, sebaceous cysts and inflammation (Reggiani, 1980; Bertazzi, 1994). Inflammation of the eye lids or blepharitis (squamous metaplasia of meibomian glands) was also reported.
Yushchenko's symptoms, including the inability to walk, developed just five days after his alleged poisoning. The only rapid onset cases of skin lesions and chloracne occurred in people whose skin and lungs were subject to massive single doses of dioxins, not through oral consumption. The Seveso, Italy incident concerned an explosion at a chemical plant and therefore exposure was through the skin and lungs, however Yushchenko did have one irritated/inflamed eye and signs of liver damage.
A list of the primary symptoms of dioxins in humans (remember, most of the cases are from accumulated exposure):
Cancer - lung, stomach, soft tissue, liver
Skin disorders - chloracne, hyperpigmentation, hirsutism
Male reproductive toxicity - reduced sperm count, testicular atrophy, abnormal testis structure, reduced size of genital organs, lower male hormone levels, feminization of hormonal, and behavioral responses
Female reproductive toxicity - hormonal changes, decreased fertility, inability to maintain pregnancy, ovarian dysfunction, endometriosis
On unborn fetus - birth defects, alterations in reproductive system, decreased sperm count, altered mating behavior, structural abnormalities in female genitalia, reduced fertility, delayed puberty, neurological problems, developmental problems
Hormonal Changes including alterations in sex, thyroid, digestive and other hormones)
Immune suppression and increased susceptibility to infectious diseases
Metabolic changes including altered glucose response, decreased insulin levels, altered fat metabolism, weight loss, wasting syndrome, fetal death
Neurological damage to the central and peripheral nervous systems including impaired neurological development and subsequent cognitive deficits
Damage to liver, thymus, spleen, and bone marrow
Damage to heart leading to arrhythmias
Diabetes
Lung Problems
Yushchenko's symptoms again were: partial facial paralysis, severe back pain, abdominal pain, skin lesions/chloracne. His doctors discovered he had an abnormally wide array of gastrointestinal ulcers, elevated pancreatic and liver enzymes and that both of these organs were inflamed.
Again, I'm not a doctor but it seems that his symptoms to not match the clinical literature - not for one-time single doses and not for long-term exposure. With such a limited number of documented cases of orally-administered high levels of dioxins, how can Yushchenko's doctors be so sure about their diagnosis? Especially two doctors who have no expertise in this field?
As for Yushchenko's mysterious doctors, I found this book by Nikolai Karpan, again dealing with cryosurgery - a field totally unrelated to ANY of Yushchenko's symptoms. I also found Korpan had filed for a patent (PDF) in Austria for a cryosurgery technique.
As for Michael Zimpfer, it looks like he was working for a different hospital as recently as July of this year. I've found listings for him at two other separate hospitals as well so it seems that, like his colleage Korpan, he's bounced around a lot.
As for the Rudolfinerhaus clinic itself, it is a private hospital which deals mainly with wealthy clients who come for elective surgery or treatments. It is NOT an emergency hospital (of which several other fine facilities exist in Vienna) and seems a very odd choice for a man who cannot walk and is clearly quite ill. In fact in the linked article above, the former president of Austria (Thomas Klestil) was treated at the AKH Hospital in Vienna for multiple organ failure and a heart attack.
According to its own website, Rudolfinerhaus specializes in: obstetrics, same day surgeries (aka "outpatient" surgeries), a sleep disorder clinic, diagnostic tests, physiotherapy and long-term nursing services. Oh and a dental facility as well.
I'm afraid all my research has just led to more questions - however despite all of Yushchenko (and his supporters) "trying" to downplay the poisoning angle, it has become a huge political event now before the all-important re-run of the run-off elections on December 26.
A look at Google showed over 2,200 separate newspapers worldwide covered a variant of the story that Yushchenko had been poisoned.
Pax