Amber Zone - Assassination by Anaphylactic Shock Nugget

Last Updated 14 October 2003.

------------------------------
1999 #1783

Date: Fri, 21 Jan 2000 01:50:00 +1100
From: David Healey
Subject: Re: Ethically-challenged organ traders

On 19/1/99, Leonard said:
>But regen is *by definition* making *your* body regow the missing
>parts. Transplants are sticking somebody else's tissues into your body,
>and trying to *fool* your body into not rejecting these "alien" tissues.

Fair enough. I hadna thought about that part. I 'spose doing the regen thing is probably the way the 3I does it, rather than a roaring trade in 'donated' organs. How do you see them doing trauma cases tho' ? Like, we need a heart, now. Not in three weeks (or whatever it'll take to grow), now. Would they just stick 'em in Low Berth until one could be grown, or flash-freeze 'em or something?

>If transplants were common among the rich, then a favored assassination
>technique would be slipping them something that revived their body's
>immune response to the transplanted organs. Done properly, death could
>occur in *minutes* due to massive anaphylactic shock (extreme allergic
>reaction to the foreign tissue). That's not a bad idea. One the players are sure to miss. Mind if I pinch it ? ( Side-note to Andrew : not that this is going to happen in our campaign).

Dave

------------------------------
#1786

Date: Fri, 21 Jan 2000 08:39:30 +1100
From: Robert O'Connor
Subject: Re : Organlegging (and tips for budding Burkes and Hares)

Jason Barnabas wrote :-
> Then, by some miracle (ala any number
> of telemovies and schlock), they miraculously recover and spring up. Isn't
> there some disease/condition that slow down the metabolism to a near-death
> rate?
>
> Someone suffering from a sever case of hypothermia (sp?) might be mistaken
> for dead.

The causes of hypothermia is one of those middling lists inflicted on medical undergraduates (hypothyroidism, hypoadrenalism, overwhelming sepsis, post anaesthetic/cardio-pulmonary bypass, etc.). Some intoxications could lead to one looking like a fresh corpse, also ('Zombies' were carefully prepared with a hypnosedative mixture).

That's why we TL 8 medics currently have the maxim that 'you aren't dead until you are warm and dead.'

As medical tech advances, the criteria will be pushed further and further back. Ultimately, only overwhelming brain damage will prevent someone being restored to their pre-morbid state.

Leonard Erickson wrote :-
> If transplants were common among the rich, then a favored assassination
> technique would be slipping them something that revived their body's
> immune response to the transplanted organs. Done properly, death could
> occur in *minutes* due to massive anaphylactic shock (extreme allergic
> reaction to the foreign tissue).

The pharmacodynamics of today's immunosuppressants would give you a couple of days to escape the scene of the crime before (hyper)acute rejection syndrome kicked in.

True anaphylaxis (Gell and Coombs type 1, relying on elaboration of high levels of immunoglobulins E and G) would require a customised agent - and presensitisation to some antigen, as does any 'allergic' reaction.

[Useless] info-chunk #1 - the other types of immune hypersensitivity under this classification are :-
2. antibody mediated cell cytotoxicity e.g. haemolytic anaemia of the newborn (maternal antibodies vs. Rh factors on foetal blood cells);
3. immune complex deposition e.g. 'serum sickness' where the recipient of pooled horse antibodies (e.g. snake antivenom) generates an antibody response to the foreign protein ; and
4. delayed type hypersensitivity e.g. T-cell and macrophage response to purified protein deriviative 48-72hrs after inoculation - the Mantoux test for tuberculosis.

Given likely developments in pharmacology and pharmacogenetics over the next century (~TTL 9-10), such exotic toxins would be possible, but difficult to synthesise. I would not allow my genetic sequence to be held in a easily accessible database in this sort of environment.

Useless info chunk #2 :-
The simplest way to kill a human, if you have intravenous access, is with 1cc/kilo body weight of air. Some days will be required for the air bubbles to be lost in the gas evolving in decomposing tissue.

A better method, if you only have half an hour up your sleeve, is to administer a mixture of insulin, potassium salts and adrenaline (epinephrine for those living under the U.S. Pharmacopoeia). Dr. Kevorkian (and your local vet, for that matter) used/uses a mixture of barbiturate, potassium and adrenaline for euthanasia.

Barbiturates can be detected with standard 'drug screens'. The other stuff can't.

If one can't get at a vein, suffocate your victim. A large Ziploc(TM) bag over the head is very effective. Ten minutes should suffice. Using a plastic bag leaves none of the usual stigmata of asphyxiation (congested neck veins and face, little skin haemorrhages, etc.)

Robert O'Connor
Medico, Gamer
-------------------
100+ digests in the last week! Good grief...

------------------------------
#1790

Date: Fri, 21 Jan 2000 01:58:44 PST
From: Leonard Erickson
Subject: Re: Ethically-challenged organ traders

In mail you write:
> On 19/1/99, Leonard said:
>>But regen is *by definition* making *your* body regow the missing
>>parts. Transplants are sticking somebody else's tissues into your body,
>>and trying to *fool* your body into not rejecting these "alien" tissues.
>
> Fair enough. I hadna thought about that part. I 'spose doing the regen
> thing is probably the way the 3I does it, rather than a roaring trade in
> 'donated' organs. How do you see them doing trauma cases tho' ? Like, we
> need a heart, now. Not in three weeks (or whatever it'll take to grow),
> now. Would they just stick 'em in Low Berth until one could be grown, or
> flash-freeze 'em or something ?

Low berth is possible, except that what hospitals use is much higher maintenance (and totally unsuited for shipboard use) and doesn't have the 10% chance of death (maybe 1%?).

Though it'd be just as easy to hook them up to the TL-12 (-15, whatever) equivalent of a heart lung machine. That's what we do *now* for some cases.

By then, the artifical heart ought to be small enough and "gentle"[1] enough, that you can return to limited activity the next *day*.

>>If transplants were common among the rich, then a favored assassination
>>technique would be slipping them something that revived their body's
>>immune response to the transplanted organs. Done properly, death could
>>occur in *minutes* due to massive anaphylactic shock (extreme allergic
>>reaction to the foreign tissue).
>
> That's not a bad idea. One the players are sure to miss. Mind if I pinch
> it ? (Side-note to Andrew : not that this is going to happen in our
> campaign).

Go ahead. Do note that even *higher* doses, or doses of *different* chemicals can have similar effects on normal people. The "trick" here is that this wouldn't *hurt* "normal" people, so unless his security folks were medically trained (and* had thought of it) any "food sniffer" gizmos won't be set to catch it!

Another nasty just occured to me. Assume that "regen" is accomplished as "easily" as in the Lensman stories (basicly, once you know how you "zap" the pituitary with the right sort of radiation). So a cunning enemy might manage to "zap" the rich guy just before a trip by jump.

So, depending on how regen works, his body could be trying to grow a replacement for the transplanted organ(s). Or the transplanted organ(s) could be trying to regrow a body. Or both!

In any of the above cases, sheer *crowding* is going to cause problems within a few days (assuming regen is "faster" than normal growth). And the ship's sick bay may not be equippped to deal with the problem. :-)

[1] current heart replacements mangle *way* too high a percentage of the blood cells passing through. Mainly in the valves.

In mail you write:
> Leonard Erickson wrote :-
>> If transplants were common among the rich, then a favored assassination
>> technique would be slipping them something that revived their body's
>> immune response to the transplanted organs. Done properly, death could
>> occur in *minutes* due to massive anaphylactic shock (extreme allergic
>> reaction to the foreign tissue).
>
> The pharmacodynamics of today's immunosuppressants would give you a
> couple of days to escape the scene of the crime before (hyper)acute
> rejection syndrome kicked in.

I'm assuming that they'll have found a way to "retrain" the immune system to treat the transplant as "self" rather than requiring a lifetime regimen of immunosuppresant drugs.

Thus, the victim has an *active*, healthy immune system. Which "suddenly" discovers that large mass of "foreign" tissue.

> True anaphylaxis (Gell and Coombs type 1, relying on elaboration of high
> levels of immunoglobulins E and G) would require a customised agent -
> and presensitisation to some antigen, as does any 'allergic' reaction.

[snip]

My thought is perhaps something tailored to look harmless until it enocounters the transplanted tissue, at which point it bonds with the surface antigens, resulting in *new* antigens which are very much "non-self".

> Given likely developments in pharmacology and pharmacogenetics over the
> next century (~TTL 9-10), such exotic toxins would be possible, but
> difficult to synthesise. I would not allow my genetic sequence to be
> held in a easily accessible database in this sort of environment.

Alas, all you need is a tissue sample and even some kinds of *blood* sample will work. If the person has been in for a transplant, all you need to do is intercept the old organ between the path lab and the "incinerator".

And I agree about the developments. Things like being able to tailor an organism or a virus to a *specific* genetic code. So only the target and any twins/clones will be affected. Or, as a better cover, everybody else gets a "bad cold". He dies of "the flu". Pity.

> Useless info chunk #2 :-
> The simplest way to kill a human, if you have intravenous access, is
> with 1cc/kilo body weight of air. Some days will be required for the air
> bubbles to be lost in the gas evolving in decomposing tissue.
>
> A better method, if you only have half an hour up your sleeve, is to
> administer a mixture of insulin, potassium salts and adrenaline
> (epinephrine for those living under the U.S. Pharmacopoeia). Dr.
> Kevorkian (and your local vet, for that matter) used/uses a mixture of
> barbiturate, potassium and adrenaline for euthanasia.
>
> Barbiturates can be detected with standard 'drug screens'. The other
> stuff can't.

If you are in the "right place", get him "mis-typed" before an emergency transfusion. This may require swapping labels on a pair of blood samples, which may (depending on the types involved) kill another patient in the ER. A pro will regret this "necessity".

If I recall correctly, if he's O-, then the mistake may not even hurt the other patient.

Of course, odds are the ER staff can save him anyway...

> If one can't get at a vein, suffocate your victim. A large Ziploc(TM)
> bag over the head is very effective. Ten minutes should suffice. Using a
> plastic bag leaves none of the usual stigmata of asphyxiation (congested
> neck veins and face, little skin haemorrhages, etc.)

Or just spray a bit of nerve gas into the respirator...

Leonard Erickson (aka Shadow)
shadow@krypton.rain.com <--preferred
leonard@qiclab.scn.rain.com <--last resort


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