I belong to this quirky group of docs that gets together once a month --- we have a few adult beverages followed by two of us giving a talk. The talks have to be 10 minutes long, with no notes or visual aids (I said it was quirky). My turn comes around every two years or so --- I have posted some of the talks I have given a while back here and here. The last few weeks were light on blogging because my turn was up again, so time not spent working was frequently spent trying to put together a talk that would be entertaining and pass along something that the docs in the room had never heard. This rather long post is that talk -- I did edit it a bit to get to around 10 minutes, but this is the whole enchilada. And I know that there may be a few incorrect dates or factual errors, but I was trying to "tell a story."
On the night of September 5th, 2004, Ukranian presidential candidate Victor Yushchenko sat down for a relaxing dinner. He was fully at ease, dining with the chairman of Ukraine’s security services, Igor Smeshko, at the home of Smeshko’s head deputy, and so had released his usual security detail. The purpose of the meeting was to try to persuade Smeshko to restrain his underlings from interfering in the rather contentious election that was underway. Unfortunately for Mr. Yuschenkko, his dinner companion had already chosen to become a particularly active supporter of Yushchenko’s opponent, the sitting Prime Minister Victor Yanukovich.
Within hours of the dinner meeting, he was violently ill, with abdominal pain, nausea, and 
profuse vomiting. The following day, his face and trunk erupted with a forest of painful skin lesions. By the time he had been flown to Vienna for medical care four days later, he was desperately sick, barely able to walk, with biochemical evidence of hepatitis and pancreatitis. There was little doubt that Mr. Yushchenko had been poisoned, and the painful skin eruptions known as chloracne provided an important clue as to the agent that was used. Chloracne is almost exclusively seen as a result of heavy dioxin exposure.
Colorless, odorless, and tasteless, Tetrachlorodibenzo-p-dioxin had not previously been seen as a possible method of assassination or intimidation by poisoning. In this instance, however, it had been bound to alpha-fetoprotein. This created a highly soluble and toxic little bio-bomblet, carrying a much more immediate and devastating impact. In effect, the addition of a simple delivery system allowed the dioxin ingested by Mr. Yushchenko to nearly take his life.
Somewhere, someone was ringing a bell. Sending a message.
On the evening of November 1st, 2006, ex-KGB agent Alexander Litvinenko dined with a pair men at a sushi bar in the heart of London. Litvinenko was living in political asylum in England, fearful of his life after publicly clashing with Russian authorities. He met with these gentlemen because they offered information for an expose on the murder of a Russian journalist Mr. Litvinenko was working on.
When he fell ill later that night, he had enough prior experience as a KGB officer to know that his severe abdominal pains and nausea were not due to a bad batch of raw fish. His hospitalization and rapid deterioration over the next two weeks provided anyone with a newspaper or an internet connection with a crash course in radiation poisoning. Color-less, odorless, and tasteless, the dose of Polonium-210 ingested by Mr. Litvinenko in a cup of tea has been estimated at greater than 100 times the lethal dose.
Somewhere, someone was ringing a bell. Loudly. But whose hand was on the bell rope?
To answer that question, we need to travel eastwards a few thousand miles, and back-wards several decades.
In 1888, an imposing Baroque building was erected in central Moscow as the headquarters of the All Russia Insurance Company. After the Bolsheviks took control of the country, this massive structure became the headquarters of a different kind of insurer --- the kind that ensures the absolute subjugation of a populace. The Lubyanka housed not only the Russian secret police, called the Cheka since before the revolution, but also the infamous Lubyanka prison. For decades, Muscovites dared not even utter the name of Cheka’s headquarters, calling it instead after a nearby toy store, “Detsky Mir.”
But just one block away from Lubyanka square sits a nondescript, squat square building that generated no concern even to the ever apprehensive citizens of Moscow. This building housed Laboratory Number One, where Vladimir Lenin established the Office of Poisons in 1921, a short four years after establishing total control over the Soviet Union. But the “cabinet,” as it was then 
known, was relatively inactive, as the head of the Cheka preferred more “traditional” methods of eliminating “enemies of the people.” It was only with the active involvement of Josef Stalin and Lavrentiy Beria, the head of the Cheka after 1938, that the lab’s productivity blossomed as part of the First Chief Directorate of the secret police. The First Chief Directorate was responsible for foreign intelligence and special operations --- basically, everything associated with spies, assassinations, double agents, and the like. They were also responsible for assassinations within the Soviet Union. The poison laboratory would be given a half-dozen names over the next 40 years, but to those few that knew of its existence it was simply the “Kamera,” which is Russian for “chamber.”
The secret police certainly had no compunction about using a billy club, a piano wire around the neck, or a bullet in the back of the head to achieve their results; one does what one can with the tools at hand, after all. But some situations called for an approach that would be seen as less obvious, except to those being assassinated and their associates. Poisoning gives just such an effect, leaving a very cold corpse that gives off the hint of assassins who can reach anyone, at any time. In short, sending a signal. Ringing a bell that certain people are sure to hear.
But the Cheka at the time had very little to work with, and complaints about ineffective poisons from Cheka officers prompted Beria to jump start research in the Kamera. He wasted no time in finding a man with just the right combination of intelligence and amorality, tapping the head of the secret labs in the Bach Institute of Biochemistry in Moscow to take over poison research for the Cheka. For now, let’s simply call him by the nickname given to him by Stalin: Doctor Death.
A physician, Doctor Death was a professor of pathophysiology, but he was an unsavory character even by the standards of the secret police. Eager to please his patrons, Doctor Death took to this new task like Rosie O’Donnell with a bad case of PMS tearing into a box of chocolates. But his initial efforts fell a bit short of the high expectations of Beria and Stalin. Called on the carpet, he apologized, stating that it was difficult to predict the effect of poisons that had only been tested upon animals. Beria would have none of these excuses, asking “Who’s stopping you from experimenting on humans?”
Now, remember that Beria was most certainly aware of the rather artless murder of Rasputin a year before the revolution, who was poisoned, beaten, shot, and finally thrown into a river before he died. Or perhaps it was the lack of murderous elegance demonstrated by First Directorate agents in the assassination of Leon Trotsky, who failed to die for two days after being impaled with an ice axe to the head, that provided additional urgency for Stalin, Beria, and their pet biochemist to develop a simpler and less obvious method of state sponsored murder.
Regardless of the reason, Doctor Death was happy to comply, and he was rather success-ful. In fact, Stalin himself awarded him with a PhD for the thesis entitled “Biological Activity of the Products of Interaction of Mustard Gas with Human Skin Tissues.” Given the subject matter, it is no surprise that this award was kept highly classified.
In the long run, the ultimate goal of Doctor Death and his colleagues in the Kamera was the development of poisons which could be used without arousing suspicion in the victim, and which could not be easily traced. In other words, colorless, odorless, tasteless agents with rapid and devastating results. While death was the goal, an autopsy result of “heart failure” was seen as the optimal outcome.
Doctor Death certainly did not lack for research subjects, as the cellars of the Lubyanka were continuously refreshed with an influx of newly condemned enemies of the state. Almost all of these victims had been convicted on Statute 58: engaging in anti-Soviet propaganda, or in other words, thought crimes. He nicknamed his subjects “ptichki,” or little birds, and he had a preference for foreigners, including at least one known American named Cy Oggins.
The prisoners were brought in groups to the small lab, tricked into thinking they were getting medical treatment. Isolated in separate dingy cells, they were given poison and then observed through small windows. Sometimes, poisons that had worked with cruel efficiency on animals would fail to kill a prisoner. If they didn’t die, a bullet to the back of the head would suffice, but occasionally the victims were nursed back to health for another go with this deadly version of Russian roulette.
There were no survivors.
Over the next few years, Doctor Death experimented with a variety of agents, including digitalis, colchicine, cyanide, thallium, ricin, and curare. Delivery systems were devised for each agent, such as a ricin pellet in a sharp-tipped umbrella, poison cyanide sprayed from a rolled up newspaper, a poison-carrying bullet, or a powder surreptitiously slipped into a cup of tea. Each fresh victim was carted off for autopsy at the Lubyanka, looking for any obvious trace of poisoning, with all involved hoping for a result of "heart failure.".
Now, keep in mind the time frame here. Doctor Death was active in the Kamera from 1938 through at least 1945, and probably for a few years after that. The end of World War II was quickly followed by the Nuremberg trials, which made the Soviet hierarchy a bit nervous about the Kamera being discovered. Beria decreed that no further experiments on humans would be officially permitted, as “crimes against humanity” would most certainly include the research activities of Doctor Death and the rest of the Kamera crew.
Whether human experimentation continued after that is up for speculation, but what is not is that Kamera continued its existence for many decades longer, changing names about as frequently as Elizabeth Taylor changed husbands. Regardless of its official name at any given time, Kamera's poisonous biological and chemical agents were constantly refined over the years. Highly specialized poisons were crafted cause death or incapacity, and one thing in their design was constant, making the victim's death or illness appear natural, or at least produce symptoms that would baffle doctors and forensic investigators. In the long run, the Kamera became singularly specialized in transforming known poisons into original and untraceable forms. And they were highly successful.
So, in the post-Soviet world, who is ringing the bells now? Who is sending these kinds of messages today? The past few years have seen a dramatic increase in the number of politicians and journalists being murdered in Russia itself, and the non-Russian cases of Yushchenko and Litvinenko certainly have many pointing fingers at Moscow. Why would that be? Well, it is instructive to look at the current occupants of the upper echelons of the Kremlin. Russian governmental structure has changed in the past fifteen years, but there is still a Soviet style “top-down” approach in place. It is estimated that 80% of top Russian government officials are former or active KGB officers. And the man at the top, Prime Minister and former president Vladimir Putin, cut his teeth in the KGB as an officer in the First Chief Directorate --- the very same part of the Cheka responsible for running the Kamera.
In the end, though, there is no denying the role played by Doctor Death, or ultimately, by Beria and Stalin as well, who famously stated that "The death of one man is a tragedy, the death of millions is a statistic." While those men may not have had an active hand in ringing these bells, their bony carcasses are certainly still clinging to the ropes.
What became of Doctor Death and his patrons? Stalin died in 1953 after a night of heavy drinking with his Politburo cronies. The official cause of death was an intracranial hemorrhage, but the presence of Beria that evening has always led to speculation that Stalin was poisoned. Adding fuel to that speculation is the fact that Beria himself later claimed to have had a hand in Stalin’s death, and that he quickly moved to try to position himself as Stalin’s successor. But Beria’s poker hand was a few cards short of a full house, and he was arrested within a few months, with a bullet to the head being his reward for his service to the party.
With the fall of Beria, a raft of his Lubyanka cronies were arrested, interrogated and tortured with their own methods. A large contingent called the Berievtsy, or the Beria men, were shipped off to the Vladimir prison. Eager to save his own skin from mustard gas, Doctor Death testified against Beria, using his own notes as evidence. But he was not spared arrest, and was sentenced to 10 years in the Vladimir. In a classic example of Soviet era judicial double speak, he was imprisoned not for murder, but for “illegally storing strong-acting chemicals outside the workplace.”
Not content with such a light sentence, Doctor Death peppered officials with letters, pleading with them that he had been a good scientist in service of the Communist Party. Eventually given early release in 1961, he was sent to internal exile in the Caucasus region, heading up a chemical institute in Dagestan. But he was Jewish, and has commonly been referred to as “Stalin’s Jewish Mengele” in Russia since his existence became more publicized. And this Jewish Mengele, who somehow escaped Stalin’s own periodic bloody purges of Soviet Jews, was to spend his remaining years exiled in a backwater Soviet republic on the Caspian coast that was more than 90% Muslim.
The story of Doctor Death would have ended there, never to see the light of day, if it were not for the Soviet bureaucracy’s obsession for detailed record keeping. Researchers dedicated to uncovering and documenting the Soviet regime’s crimes against its citizens were able to bring Doctor Death back to life, so to speak, and in doing so have given us the rather ironic story of his death.
Doctor Grigory Mairainovsky, also known as Doctor Death, pining away in a dirty port city on the Caspian Sea, made a final, fatal miscalculation. He wrote a letter appealing directly to the new master of the Kremlin, Nikita Kruschev, for official rehabilitation. In his letter, he reminded Kruschev that they had once met. Not one for subtlety, Mairanosvsky eagerly asked Kruschev to remember that they had shared a conversation on a train in the Ukraine, just before the assassination of a troublesome Archbishop; gee, what a happy coincidence! I helped kill meddlesome Russians too!
Mairanovsky received no “official” response to his letter. But this little “remember me” note may have struck a nerve in the Kremlin, as soon thereafter Mairanovsky died. The official cause of death? “Heart failure.”
I first heard of Grigory Mairanovsky in a book entitled The Lost Spy: An American in Stalin's Secret Service. Eventually, I cobbled together a bit more information from a variety of other sources to try to put a coherent story together.
A sticky wicket has been picked up.
That's a pretty honest look in the mirror. What did they see? Overall, their trauma center mortality rates were excellent, and were significantly better than the mean rates of the National Trauma Data Bank for patients with all levels of injury. However, despite such good numbers,
Wait a minute. That means.....yes! Experience makes a difference! Us old guys do have something to offer after all. Of course, common sense would tell us this any way, but it is nice to be "validated" every once in a while.
