June 18, 2018
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Medical sleuths discuss the forensics of death

By Manuel Roig-Franzia, The Washington Post

BALTIMORE — Death never dies here.

It just keeps getting more interesting, more beguiling. More, well, alive. Alive in every cringe-worthy detail, in every clue about its causes, in every shard of evidence waiting to be spliced to another shard … and another shard until a picture starts to form, an image assembled from nuggets of information collected decades or centuries ago.

Death, at least for the doctors and history buffs who gather each year at the University of Maryland School of Medicine, is the coolest of puzzles, leading them to the coolest of theories. Could Abraham Lincoln have been saved? (Yes.) Was George Custer as much a victim of a personality disorder as the Indians he was fighting? (You betcha.) What turned Florence Nightingale into a recluse? (She might have been bipolar.)

They’ve been at it for 18 years, poring over autopsy records, consulting historical texts and lobbing questions at nationally recognized experts who fly in for an annual conference hosted by the school’s Medical Alumni Association that has turned into a melange of old gore, old guts and old glories. Death may scare you, but to Philip Mackowiak, the professor who dreamed up the conference, mulling human expiration — no matter how ancient — can be “a tremendous amount of fun.” These folks were House way before House was “House,” but unlike the riddle-solving television doctor, their preoccupation is with the dead rather than the living.

Mackowiak presides over his realm of medical intrigue in a grand, old, semi-circular lecture hall where the air is musty, as if you’d just entered an ancient wine cellar or, more appropriately, a crypt. Light trickles into Davidge Hall through the panes of windows that spread out in the shape of spider webs, windows that Alfred Hitchcock would have loved. Sturdy metal kilns are set into the back wall of the 200-year-old hall. They were used for chemical experiments, a conference organizer assures me, not for the cadavers that were once examined in the “anatomical hall” on the upper floor.

Mackowiak has a bucket list of historical figures whose deaths interest him. He’d love to dig into the medical history of Spanish painter Francisco de Goya: “According to his biography, he was deaf as a stump,” Mackowiak confides. Or maybe Buddha or Confederate Gen. Stonewall Jackson.

But the subject in question on this day, it turns out, was a headbanger. Heavy metal may have played a role in his death. Parts of his brain had the texture of this: rock.

The dead dude, sadly, couldn’t be with them today. He’s kept under glass in Red Square. But the vital data about his waxing, then waning vitality was there in the old lecture hall for all to see.

Vladimir Lenin, the long-gone Bolshevik revolutionary and Soviet leader, was born with short, weak legs and a giant head, these medical-history detectives learned. As a child, he had a habit of banging his head on the floor when he was upset, making his mother think that he might be developmentally disabled, according to the historical data.

An assassin’s only lead bullet resided near his right clavicle, introducing the notion of a heavy metal. But it was his brain that was really messed up. His cerebral blood vessels “were rock hard,” Harry Vinters, a respected UCLA professor of pathology and laboratory medicine, said during his, ahem, deadly serious presentation.

But why? Why would a man who in 1924 died just three months shy of his 54th birthday have such unusually hardened cerebral blood vessels?

During his presentation and later in small clutches of attendees, Vinters went through his checklist of risk factors for stone-hard cerebral blood vessels. Diabetes? “No.” Smoker? A big, “No.” Not only did Lenin not smoke, but he was apparently super fussy about other people not smoking around him.

Stress? Getting warmer. Stress might have played a role, Vinters theorizes. Family history? Ah, now we’re on to something. Lenin’s dad croaked at age 54 after a series of strokes. Lenin also had strokes. In the audience of about 200, pens raced across notebooks and the backs of programs. Wheels were turning. Theories were forming.

Some have posited that Lenin was a victim of syphilis. Vinters doesn’t buy it. There’s no evidence to that effect, the professor said after his presentation as attendees descended on him with their best guesses.

But it may have been possible that his doctors thought he had syphilis, a condition often treated with arsenic in those days, he said. Which got everyone around to a theory that has nothing to do with the medical evidence, and everything to do with good old-fashioned historical dot-connecting. They were helped along by a Russian writer, Lev Lurie, who speculated that Lenin, even though his health was in precipitous decline because of the strokes, might have been finished off by a poisoning ordered by Joseph Stalin.

After the conference speeches, during the noshing and theory-sharing portion of the day, Dahlia Hirsch, a retired surgeon, rolled up all the evidence into a hero sandwich of a conclusion: It was the family history and the stress and the lead bullet and the arsenic! It made a lot of sense from a medical perspective, but Doris Cowl, a Towson University math instructor, pined for an answer that added up to a sexier historical yarn. “Poisoning is more interesting,” she offered.

In the parking area, the valets wondered what all the fuss was about. One of the participants told them about the subject of the conference, but their minds went to a homophone: Lennon, the rocker, not Lenin, the guy with rock-hard blood vessels. Once they were set straight, one of them exclaimed, “Oh, the Russian guy!”

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