Antiwar.com
Yushchenko's Disease: A Tale of Two Poisons
by Thomas Boyle, M.D.
After weeks of rampant speculation and political intrigue of the highest order, the mystery of Viktor Yushchenko's rapid and startling facial disfigurement was settled with a simple blood test and reported with bold finality: The Ukrainian presidential candidate was poisoned with dioxin. Not just routinely poisoned. No, it was a silver-medal performance, scoring a blood dioxin level 6,000-times higher than normal ? the second-highest level ever recorded. The case was immediately closed in dramatic fashion. Major media collectively breathed a sigh of relief that rippled across the Internet: Their unfounded and rash medical assumptions of poisoning were confirmed, and they were off the hook. After all, just because you jump to conclusions doesn't mean you can't land on solid ground.
With Yushchenko's medical mystery cleared up and off the table, the Ukraine ? and the world ? could go on with the new elections, elections that almost certainly will crown the righteous and harmed opposition party candidate.
Except Yushchenko could not have been admitted to the Rudolfinerhaus Clinic in Vienna for dioxin poisoning. And the medical records obtained from that clinic do not indicate that diagnosis. In fact, Viktor Yushchenko's problem is likely much more severe than record blood levels of dioxin. His problems are in all probability so severe and of such import for him and his party that he and the Rudolfinerhaus medical claque chanced a daring and bold gambit in order to hide the truth and simultaneously implicate his opponent. The truth is, Viktor Yushchenko may well be the victim of two poisonings, the more severe of which his physicians have yet to reveal.
How We Got to Here
Viktor Yushchenko claims he was poisoned during a Sept. 5 dinner with the head of the Ukrainian Security Service, Ihor Smeshko, and his deputy, Volodymyr Satsyuk. Yushchenko claims to have developed symptoms almost immediately, and during the next day, Sept. 6, he suffered severe abdominal and back pain. Yushchenko first sought treatment at Vienna's private Rudolfinerhaus clinic five days later, on Sept. 10. He went home in mid-September to resume campaigning, but he came back to the hospital later that month for more treatment and was released in early October ? although still unwell ? to continue his pursuit of the Ukrainian presidency. Yushchenko is certain that the poisoning took place at the dinner on Sept. 5, saying:
"That was the only place where no one from my team was present and no precautions were taken concerning the food. It was a project of political murder, prepared by the authorities."
Speculation was rampant in the media and on the Internet as to how Yushchenko's face became disfigured. The overwhelming opinion was a groundless assumption that, given the unusual appearance of the skin disease and the political circumstances surrounding an ideologically charged election, Yushchenko surely must have been poisoned, as he claimed. At the same time, the Ukrainian election was declared invalid and a second round of voting was scheduled.
At first, Yushchenko resisted further tests that would easily determine whether or not he was actually poisoned. However, certain blogs, including CodeBlueBlog, turned up chronological and medical inconsistencies in the story, and the undercurrents created by these voices forced Yushchenko to pursue a definitive diagnosis as a second election loomed.
During the obviously contrived and farcical weekend of Dec. 10, Yushchenko returned to the Rudolfinerhaus clinic, where his doctors drew blood and sent it off to Amsterdam for a "new" test that had not been previously available. Yushchenko was thereafter rapidly (within 12 hours) diagnosed with dioxin poisoning ? a diagnosis that had previously stumped Yushchenko's physicians for months.
Poison Number One: Dioxin
Because dioxin does its damage by binding to cell material on a molecular level, the effects of its actions are delayed. It takes weeks to months to years to manifest dioxin poisoning. Chloracne ? the skin condition Yushchenko is said to have ? develops months to years after exposure. In the only two known analogous dioxin poisoning cases, the patients involved had no clinical symptoms besides upset stomach for six to eight months after the presumed exposure. Even then, they sought medical help only because of the development of acne.
Yushchenko, on the other hand, developed dramatic and severe symptoms almost immediately after his meal with the secret service on Sept. 6. After four days, the persistent, severe pain and generalized malaise forced Yushchenko to have himself admitted to the Rudolfinerhaus clinic in Vienna. There is no scientific or medical explanation that can account for this chronology of symptoms on the basis of dioxin poisoning.
Poison Number Two: Alcohol
There is another poison, however, that accounts for the timing, severity, and character of Yushchenko's symptoms as they relate to the dinner on Sept. 6: alcohol.
The New York Times reported that on the night of Sept. 5, 2004, Yushchenko and the Secret Service agents "drank beer and ate boiled crayfish from a common bowl, as well as a salad made of tomatoes, cucumbers, and corn. Later, they selected vodka and meats, and then cognacs for a last drink."
It was the next day, after drinking beer, vodka, and cognac at dinner, that Yushchenko developed the symptoms that drove him to Rudolfinerhaus four days later. The doctors at that Vienna clinic surely knew immediately what we can also deduce now: Yushchenko's symptoms indicate pancreatitis (inflammation of the pancreas), and the cause was binge drinking on the night of Sept. 5.
Pancreatitis is caused 65-80 percent of the time by either alcohol or gallstones. Yushchenko did not have gallstones. Pancreatitis ? which can be caused by chronic alcohol consumption or by one night of heavy drinking ?causes severe stomach and back pain and can occur shortly after the alcohol ingestion.
Newly discovered documents, including Yushchenko's official medical records, obtained from the Rudolfinerhaus clinic show conclusively that Yushchenko had pancreatitis. The Viennese doctors themselves flatly state that there is pancreatitis, and the laboratory and diagnostic test results shown are all consistent with that diagnosis. In addition, the test results show that Yushchenko also has an enlarged liver. This indicates that his drinking pattern is probably chronic and, because of that, he is on the road to developing severe liver disease. Here is the CT scan report from Rudolfinerhaus:
"Pancreas intermittently massive without clearly-defined edges, peripancreatitis."
And the ultrasound report states:
"Gallbladder without concretion [meaning: no gall stones].
"Diffusive enlargement of the liver [hepatomegaly]."
The ultrasound report states that the pancreas is normal, but this is a known and common error in abdominal ultrasound. This test is not sensitive for evaluation of the pancreas because of the pancreas' position in the abdomen. A CT scan is like a photograph of the abdomen, so it is much more accurate in evaluating this organ.
Despite claims that such imbibing is "typical" for an important meal in the Ukraine, such behavior represents an abnormal drinking pattern:
"The U.S. government defines moderation as no more than one drink per day for women and no more than two drinks per day for men."
Liver enlargement (hepatomegaly) is a frequent finding in alcoholics and can be a precursor to cirrhosis (an often fatal, end-stage liver disease). As stated previously, pancreatitis is a frequent complication of alcohol over-indulgence (acute or chronic), and "massive" enlargement of this organ, associated with blurred edges, is diagnostic (the medical term for conclusive) for pancreatitis.
...
This report was designed purposely to deceive the world by putting them on
the trail of poisoning while deflecting attention from the obvious
diagnosis: alcoholism. This is the type of report one would expect from a
fawning celebrity halfway house, not a significant or major medical center.
Poisoned? Not!
>From the beginning, I have said it seems ridiculous to imagine that anyone
with any amount of sophistication or purpose would have dosed Yushchenko
with poison. Especially dioxin, which has never been used to poison anyone!
Detractors of this theory write variously that I don't understand how
backward, stupid, and incompetent these spies are and life in the Ukraine
is. I can't buy that. And neither can most other reputable sources and
experts. As stated by Dr. Andrea Sella of University College, London: "If
you really want to kill someone, you use cyanide or ricin or strychnine."
And The New York Times said:
"Murder by poison has largely been relegated to the history pages,
principally because science has overtaken the great advantage that the
poisoner of old had over his pursuers: the ability to hide his work beneath
the normal calamities that afflict human life."
Similar comments are common throughout the Internet and the media.
Finally, there is the theory that Yushchenko was poisoned not to kill him
but only to disfigure him. This is a dubious proposition, because a moment's
reflection would lead to the conclusion that the disfigurement could (and
did) have the opposite effect. Also, chloracne cannot be predicted as a
definite complication of dioxin poisoning, and its exact manifestation ?
given the rarity of its occurrence ? also could not be predicted.
What are we left with?
1. Yushchenko may have been exposed to a large amount of dioxin (barring
outright fraudulent manipulation of the blood drawn in Vienna and sent to
Amsterdam). However, dioxin poisoning was not why he was admitted to
Rudolfinerhaus on Sept. 10, 2004.
2. The chronology of the proposed exposure to dioxin, the manifestation of
symptoms, and the appearance of chloracne do not fit the chronology of the
claims made by Yushchenko and the Rudolfinerhaus clinic.
3. Yushchenko drank too much alcohol the night of Sept. 5 2004, and he
likely drinks too much frequently.
4. Test results released from Rudolfinerhaus show conclusively that
Yushchenko had pancreatitis and an enlarged liver, both of which are common
sequelae of alcoholism.
5. Rudolfinerhaus tried to cover these findings with inaccurate press
releases and a grossly and purposely misleading clinical report
"conclusion."
6. If Yushchenko keeps drinking, it is not unlikely that his liver and
pancreatic disease will progress and he will be left with chronic
pancreatitis (which can lead to diabetes and insulin dependence) and/or
cirrhosis (which can lead to death by numerous pathways).
What we are left with is a story by Dickens or Hugo, and a tale for the
ages.
Scheming politicians, nefarious spies, and bearded Viennese doctors weave in
and out of a gloriously contrived plot set in a tottering former Soviet
state. Titans struggle for the political helm as a rigged election falls
apart, replaced by a second round of voting. Towering at the podium, the
monstrously disfigured Yushchenko declares that he has been poisoned ? an
act completely at home in the Byzantine plot structure and apocalyptic
themes of the story.
No writer worth his ink would deflate the balloon of this grand epic. The
denouement calls for a soaring finish, not a tawdry crash. So the elections
went off with the successful subterfuge that was crafted in Rudolfinerhaus
and sold to a media that wanted to go along with the Dickensian tale.
But as Boris Yeltsin showed the world with his disgraceful public decline 10
years ago, alcoholism is not a disease that will be ignored. The occurrence
of pancreatitis and hepatomegaly in Viktor Yushchenko spells out an ending
that will not be disguised by fairy tales, just as it cannot be covered up
by acne or a new election.
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