Effect Measure

The anthrax story just gets weirder and weirder. More than weird, some of it reeks. A circumstantial public case first via media leaks and now via a press conference by the Justice Department is being built against Bruce Ivins, the Army scientist who reportedly committed suicide as federal prosecutors were closing in on him. Reporter Larissa Alexandrovna (at-Largely) has raised a number of significant questions about some of the sources, especially the supposed therapist Jean Duley who is the one who has accused Ivins of stalking her and alleging he was a homicidal maniac who had already tried to kill people. You can read about Duley and make your own judgments. Ivins’s friends and colleagues have also questioned the media portrayal, saying they don’t recognize him in these descriptions. I’m not an investigative journalist, so I don’t have any new facts to add, but I am a doctor and I have some real questions about some of the facts that we know about. One in particular raises red flags for me:

Ivins’s death is being investigated as an apparent suicide from a drug overdose, said Lieutenant Shawn Martyak of the Frederick Police Department’s criminal investigation division. Based on laboratory test results of blood taken from the body, the state medical examiner “determined that an autopsy wouldn’t be necessary” to determine the cause of death, Martyak said.

The Los Angeles Times, which first reported the story, said Ivins took an overdose of prescription Tylenol with codeine. (Bloomberg, Aug. 1)

I read this with disbelief. The chief suspect in one of the most notorious crimes in US history dies an unexpected death for non-natural causes and there’s no autopsy? In most states the Chief Medical Examiner has the authority to release the body to the family and isn’t required to do an autopsy but this seems like a very strange decision and I am sure I am not the only one to notice it. Two days later some ambiguity crept into the response of the medical examiner:

With Ivins dead, the Justice Department is expected to decide within days whether to close what had been one of its most high-profile unsolved cases, according to the Associated Press.


Maryland’s chief medical examiner, Dr. David Fowler, confirmed Saturday that the cause of Ivins’ death was found to be an overdose of acetaminophen, the active drug in Tylenol; and that it was ruled a suicide based on information from police and doctors, according to the AP.

Kimberly Thomas, a forensic examiner with the Maryland Office of the Chief Medical Examiner, would not comment Saturday on results from Ivins’ autopsy or confirm Dr. Fowler’s statement.

Despite the widespread publicity following Ivins’ death, Keeney and Basford Funeral Home said Saturday that the family had made no changes to funeral arrangements announced Friday in his obituary. A memorial service is scheduled for 10 a.m. Saturday at St. John the Evangelist Roman Catholic Church in Frederick, followed by a reception at the church parish hall. (Frederick [Maryland] Post News)

The implication here is that an autopsy was done, but it can also be read that one wasn’t (typically a medical examiner’s office never says anything about autopsies; they are considered personal medical records). Since everything else was leaked, including information that the cause was an overdose of acetomminophen, presumably on the basis of a tox screen according to the medical examiner himself, why not just say an autopsy was done and was consistent with an acetominophen overdose? But was there, in fact, a tox screen done at all or was this on the basis of an empty bottle near the body? For most scientists, acetominophen (the active ingredient in Tylenol) would seem an unlikely suicide weapon for a male. Statistically it is often used by women but rarely by men. Of course he could have used it. But did Ivins have guns in his house or have access to them? Did they even check? Guns are the weapon of choice for male suicides. Was anything else looked for in the tox screen if one was done? You only get what you look for. Were specialized screens done looking for unusual agents?

More to the point, what else might an autopsy have revealed besides an immediate cause of death? It could have revealed whether Ivins had a terminal disease, a frequent motive for suicide. It could have revealed that he died of other causes and the tylenol was not the main cause (e.g., cyanide or an exotic toxin like ricin). Were there pathological findings that were indicative of other causes of death? If multiple agents were involved, which one was the most likely cause of death? Who knows? So far, we sure don’t and apparently neither does the FBI.

There’s no investigation of Ivins’s death here, no exclusion of other causes, not attempt to rule out other forensic possibilities. All this kind of shoddy work does is open the door wide to speculation, skepticism and all sorts of conspiracy theories.

If, in fact, no autopsy was done on Ivins, the whole thing doesn’t just smell bad. It reeks


  1. #1 iRobot
    August 7, 2008

    Its smells bad because it is bad. Both W and Cheney have made statements that they wanted to do something like the anthrax attacks. Use american resources dressed up as somebody else to attack american interests or draw fire from the country in question to start a war. See navy seals dressed as Iranians and a U2 plane with UN colors. If they are talking in public about doing this sort of operation, how can you reject out of hand that they would actually do it through some secret channel? Get anthrax from an american lab, send it to only Democrats and the SCLM, blame it on someone they already hate, a scientist, he commits “suicide” and presto you have your ends met and you are clean.

  2. #2 Mark P
    August 7, 2008

    You don’t have to dream up paranoid fantasies about the government to think this case reeks. Ivins might or might not have been guilty, but you certainly can’t count on the FBI or anyone else in the government to help you decide. The FBI in particular is bad about smearing people they are convinced are guilty, and they also have a reasonably bad record at making the decision about who’s guilty, especially in high-profile cases. But isn’t it convenient that they won’t actually have to prove he did it?

  3. #3 _Arthur
    August 7, 2008

    Hey, Dr. Ivins was a biochemist working at a bioweapons lab; why should he take -expletive- Tylenol ?

    He could have taken cyanide, he could have sniffed pure anthrax, he could have killed himself with the most exotic vectors !

    Come to think of it; maybe it is a good thing they had revoked his lab access…

  4. #4 PalMD
    August 7, 2008

    Tylenol with codeine overdose…hmmm…

    OK, if you took a lotlotlot of codeine, it could kill you.

    APAP obviously can kill, but you usually become terribly ill first and are hospitalized for a few days before you die.

  5. #5 Edmund
    August 7, 2008

    Tylenol with codeine comes in 4 strengths in the US: 300 mg acetaminophen combined with either 8, 15, 30, or 60 mg of codeine per dose.

    I have read that the LD50 for codeine is 800 mg in an average person (with very little or no tolerance).

    A single dose of acetaminophen over 10 grams has a reasonable chance of causing toxicity in adults, eventually leading to liver failure within the next several days.

    So if you do the arithmetic, for the highest two strengths of Tylenol with codeine (known as Tylenol #3 and Tylenol #4 — and I think #3 is the most common out of all 4), it’s clearly possible that an overdose could lead to lethal levels of codeine in the bloodstream before lethal levels of acetaminophen would be reached.

    Again, it’s important to remember that acetaminophen overdose doesn’t lead to instant death. It leads to a drawn out death due to liver failure, lasting several days. On the other hand, codeine overdose would not have this protracted effect, as far as I can tell.

  6. #6 M. Randolph Kruger
    August 7, 2008

    In the military we used to say that there is a turd in the punchbowl. The last thing I want is yet another investigation of an investigation. The FBI is investigating a military facility and they are sometimes allowed to do so. IRobot is way out there with a conspiracy theory about GWB and Cheney and Robot, he’s gone in January. You and many others will watch that happen, otherwise you’ll have people like me lining up to make sure it happens for sure.

    OTOH-We got this little Ivins thing and Revere is and has been poking holes in the Swiss cheese in this case. An autopsy is REQUIRED in every state where there is the slightest implication of a felony as they so voluminously have said the guy was involved in. There is NO WAY he could have acted alone if this goes beyond a suicide and they have without a doubt asserted that to make him go away. For family’s sake and trust?

    My best but its really the worst guess is that this mother probably got some stuff out the door with or without help having been coerced by money, sex, power used some of it and then sold the rest on the black market. The latter is a maybe. He might have been told it was to capture someone. Then they got their sacrificial goat if it goes south, and may have.

    The stuff all has markers in it to indentify it by countries so that they CAN determine who made it. Terrorists wont mark theirs and thats likely how it got tracked back. Did he have a problem with lefties? Well obviously if he mailed it thats the case and while I disliked immensely all of the lefties that were attacked, I am not going to go out and kill them for their views. Gotta have balance in this world.

    See what happens in a Congress when one party is in control…. only what they want. We got that going on right now.

    In the above it makes sense that the guy was likely stuck on the 3rd floor in his mental elevator, but was that the case. He started feeling the pressure and sought out help. Who is the shrink? Has anyone checked the links to that one? Nutcases can be manipulated. Check to see if this shrink had prescription writing privileges, directly or indirectly.

    I want to know what else was in his blood stream and whether it was checked for other things that might make you psychotic. You get that from an autopsy and a lot of people crank themselves in advance of a suicide. Codeine? Gimme a break. Cap himself with a weapon, turn on the gas in the lab and go for a smoke, trash bag over the head with a tank of nitrous (I recommend this one for fun and a lack of pain)…All sorts of ways to do it and he picks the old standby…Tylenol w/codeine. Dread killer that stuff.

    Motive-The good doctor stood to make a lot of money if anthrax was released into the environment via infections, vaccines, etc. Did he get caught, did he almost get caught after a total bug inventory was done. Did it get out the door and sold on the open market and we get into a going and coming anthrax/anthrax vaccine go around? Did he do it for a misguided and misdirected attempt at what he thought was for national security.

    What if something ELSE got out and that could be some hairy assed something or other that we dont know about…..What if H5N1 is a sexed up variant of some other type A flu bug and it got out? Now there is something that really flips my skirt that if there is skulduggery going on would be a matter of national security. It also goes to motives on all sides of this or something like it.

    It would also mean that the US was engaged in illegal bio warfare (growing new bugs) activities and THAT is a matter that goes to the President and Cabinet level. Defense in this case is offense and labs do it all the time and then create countermeasures to what they think an opponent would do. That would be a micro program that no one would say anything about. But if the doctor was actually involved in the manufacture and sale of weapons grade bugs it would explain the lack of real information that is underway. Disinformation. It would also mean that he went off the reservation with a couple more Indians. If it were a black operation he might have been given the option to scuse me, “bug out.” If this goes really quiet, really fast then it might be the case. Control of the media by explaining everything away. 7 years of investigation…? Think about it. If he was involved in the sale, distribution etc for 7 then why didnt they tag him?

    The only answer was of course to run the tracks and trails to the network of who were the buyers. That explains 7 years.

    You get all sorts of answers from an autopsy. Its STANDARD in any suicide investigation in every state. About that turd in the punchbowl…. its starting to float and stink at a high level. Whether it leads back to national security I dont know. Excuse me but when does the “CHIEF MEDICAL EXAMINER” issue a statement on a supposed suicide?

    Its newsworthy, but not if something far more sinister is going on. This is is suddenly compartmentalized.

    Time for an independent prosecutor to take a look at it from a state level. If one starts to open an investigation and its quashed you’ll know something big time is going on. I guarantee you someone is obstructing justice but they can if the national security act is invoked. It just might be in the interests of national security, but well it would be obstruction now wouldnt it? Fine line. The only way it cant be obstruction is if the AG is involved and if there is something else that is far more important out there. One or more federal judges would have to be involved as well so they could execute warrants and seal indictments.

    It aint over I think and may come up with a really interesting spider-web of wrong doing. .

  7. #7 Path Forward
    August 7, 2008

    Comments on three issues:

    1. Jean Duley, the low-level drug and alcohol counsellor:

    Duley sounds like an absolutely typical “low level” group drug/alcoholism counselor. Many, if not most, drug and alcoholism treatment programs employ recovering “users” who have a modest level of training. They are often very useful parts of the treatment team for substance abusers.

    It sounds like Duley just started her career as a D&A counselor, and she was still accumulating required “hours under supervision.” Such counselors are very often recovering alcoholics / drug users — and recovering users do often “slip”, and then have to climb back to sobriety.

    I do not see anything at all unusual in her personal / criminal history background, vis a vis being an alcoholism counselor.

    What is unclear re: the counselor-client relationship is: when did Duley first have any contact with law enforcement officials about Ivins? Was it after his alleged July 9 outburst in group, or earlier?

    If earlier, then it sounds like a betrayal of client trust. If after the alleged July 9 outburst, it sounds perfectly appropriate: if her report is true, he did sound like he presented a “danger to self or others,” and she would have been required to try to warn potential victims, and try to get him committed.

    After that, it would be up to a judge or the hospital to decide when to “uncommit” him, regardless of whether he was voluntarily or involuntarily committed. It wouldn’t have been up to Duley once he was hospitalized.

    Duley’s July 24 petition for a “peace order,” more commonly called a “restraining order,” is more problematic for us outsiders to interpret. I speculate that she genuinely felt at personal risk due to his scheduled release from the hospital, and was terrified. But it is hard to know how much that was due to her own communications with Ivins, versus what she heard from the FBI.

    2. The leaks in recent cases — Plame, Hatfill, Ivins:

    The leaks have been repulsive and disgusting behavior by government officials. I fully support the media for reporting the leaks. But I would love to see the leakers fired, and charged with the most serious applicable charges for malfeasance. (I have no idea what those charges would be called).

    3. On knowing the anthrax attacks were an inside job:

    Regardless of whether the culprit was Ivins or someone else, I am sick at heart to know that one or more of our own U.S. government bioterrorism workers is responsible for the murderous anthrax attacks on our country.

  8. #8 caia
    August 7, 2008

    Not to mention, an editorial by a former weapons inspector in that liberal rage the Wall Street Journal stated the following:

    The spores could not have been produced at the U.S. Army Medical Research Institute of Infectious Diseases, where Ivins worked, without many other people being aware of it. Furthermore, the equipment to make such a product does not exist at the institute….

    The multiple disciplines and technologies required to make the anthrax in this case do not exist at Army’s Medical Research Institute of Infectious Diseases.

    They’re just lying. I don’t know why. I don’t have an elaborate backstory or conspiracy theory constructed. Maybe they’ve run out of leads and just decided to pin it on a guy who can’t sue them. But they’re lying.

  9. #9 caia
    August 7, 2008

    * liberal rag.

  10. #10 Grace RN
    August 7, 2008

    I think you’re being polite by saying it reeks. What an atrocious load of horse turds has been dumped on the American population, most of whom swallow whatever MSM puts out.

    The worst results of the lousy public education system in the US? Moronic citizens who wouldn’t know crap if it fell on them. Tylenol OD-please, save me. If so,best bet would be he’d be on a liver transplant list now.

    Former weaponized bioweapon PhD who’s off his rocker and no one higher up the food chain noticed until now-no coworker noticed/reported this?

    Am I the only one who thinks GW and DC need to indicted for (pick the crime, lots of them fit here) and held without bail, without access to a lawyer for 5 years then tried at Gimo?

    What happened to my America?

    ; <

  11. #11 The Doctor
    August 7, 2008

    The Irvin case is a very interesting lone assassin story. Sound familiar, 1960’s redux?

    That the perpetrator was a U.S. interest was pretty clear from the beginning. The motive of the attack(ers) is really the key to his, her or their identity. IMO the anthrax attacks were motivated by the concern that the U.S. was highly vulnerable to bioweapons and it was designed to be a wakeup call for the need to become better prepared for this occurrence.

  12. #12 Karl
    August 7, 2008

    I point you all to the movie “Wag the Dog” based on the book “American Hero” by Larry Beinhart.
    I also invite you to read about the CIA’s “Family Jewels” on Wikipedia.
    “…Investigative journalist Seymour Hersh revealed some of the contents of the “Family Jewels” in a front-page New York Times article in December 1974, in which he reported that:
    (among other things)
    The Central Intelligence Agency violated its charter for 25 years until revelations of illegal wiretapping, domestic surveillance, assassination plots,…”

  13. #13 Captaain Joe
    August 7, 2008

    Jean Duley’s Amazon Wish list. Looks like a real kook.

  14. #14 pft
    August 7, 2008

    Obviously 9/11 and Anthrax were done by the same people. This dudes just a patsy to declare the case is solved and prevent any further investigations which could expose the conspiracy behind 9/11.

    We have seen this so often, JFK, RFK, MLK, TWA 800, 9/11. The offical version always reeks, and conspiracy theories are shut down in the same fashion debate on AGW is.

  15. #15 slovenia
    August 8, 2008

    Extensive coverage can be found at http://www.crooksandliars.com

  16. #16 Jonathon Singleton
    August 11, 2008

    zay?flama ürünleri, “Tylenol OD — please, save me. If so, best bet would be he’d be on a liver transplant list now.”

    M. Randolph Kruger, “By being here [EM Blog], we are all “persons of interest.” Hell, I bet a bunch of us are already on their ‘shit list'”

    Zay and Randy, ta tres muchley for the honest to God laugh as my Yahoo! account access has — for no good X-File reason — been limited whilst I was merrily in the middle of copying out (for research purposes) a Recombinomics article. Gee, it’s a bit hard to study when others slow the research student down — where’s the bloody Tylenol:*)

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